I posted that link earlier, but thank you sweet Brenton for doing that again.
Mickey, please offer your feedback on how that can be improved? When someone posts about having more hair than when they started LHR, I try to copy and paste on that thread. Very crude, I know, but many times, the consumer can’t report parameters, something I know you would like as a scientist.
Thanks Dee. I’ll review some of these tomorrow, and I’ll get some feedback from estheticians, doctors, and scientists I chat with regularly. Just by quickly browsing the forum, a slight trend did stand out to me… though I wouldn’t have expected the GentleLase to be an issue- not the Mini anyhow. It has an 18mm spot size. Granted, nobody claimed to have had that spot size used, but 18mm is the only spot size for any laser hair removal (this, or larger) that provides 100% depth penetration of energy to the follicle bulb. A 10mm hand piece, for instance, which is the most commonly used spot size for the most common hair removal laser (the Cutera Vantage/Excel/Xeo line of lasers) does not provide 10mm of coverage at follicle depth. Low energies on smaller spot sizes will cause sublethal injury to the follicles. Sublethal injury to vellus hair may explain why it would go anagen.
Great information!
Let me know how or if we can be useful and more accurate in obtaining consumer information about laser hair reduction.
We have very few laser specialists and experts that post here on a regular basis, so we do the best we can to comfort the hairy when they come here with their concerns about laser reduction.
Glad to see CRC is going to contact the providers of laser to get some feedback about PLHS. As prior to going to Australia in 1998 I hadn’t seen this type of hair growth before, as laser became more affordable so too being presented with this type of growth pattern.
Majority of clients are not going to complain they will quietly try and find something else that they hope will work. Most are incredibly embarrassed the last thing they want to do is draw extra attention to their unwanted hair.
Also I’ve never met a Dr or dermatologist that actually performs hair removal usual someone else is employed to do this.
It would be fantastic to get clearer guidelines with laser, and I know the same can be said for electrolysis that’s why this forum is so good to let the public know what results should be expected.
Dee, and others- the most important things, you probably already know, but I will add a few caveats that I hope are available… in any case, this is information I will be gathering from my own customers and other sources… I would recommend consumers keep track of the following as well:
1- Skin type can be relative, so pictures are much better. It would be much better, and more scientific if we had clear photos of the area being treated before, and the same area after. Close up would be nice- so as to be able to clearly see the hair color and thickness.
2- Complete treatment parameters including Energy/cm2, pulse width, repetition rate, cooling method, spot size, and number of passes (if more than one).
3- HIGHLY DESIRABLE- Proof of accurate energy output from laser/IPL source- company name, technician name, and date of service within the last 6 months are of the utmost importance. Any medspa who uses third party service should be able to get this info from the company if they do not already have it themselves.
4- Make, and model of laser, date of manufacture, and software revision- this will give a more clear indication of the particular system’s capabilities.
After reading a few posts I have a few suspicions. One is a problem I encounter nearly every day with my customers. Whenever I walk in, most of the time there are people in the waiting room. Usually a certain type of customer is attracted to a particular medspa- I usually see similar skin types at specific medspas. I’m sure most of you will recognize this observation as not “racial” in nature, rather it has a lot to do with equipment, and the experience of the practitioners themselves as well as their marketing, and word of mouth.
In any case, I usually see darker skin types at locations with Yag lasers only, for example. I see lighter skin types in rural areas. I see mixed skin types in sunny locations like Florida, or Southern California, etc. In any case, I gauge who should be more of an expert on what skin type, and I ask questions.
One trend that I see among technicians of all backgrounds, and with customers of all skin types is unusually low treatment parameters. For example, if I go to one of my customers, who has a predominantly Eastern Asian, Latin American, and African American customer base, and I ask her- “For skin type 5, what would you set your Cutera Xeo to?” and she’ll say “Oh I use 35/35. That works about 90% of the time.”
I know from personal experience that 35/35 is reliable, efficient, and relatively painless (for it’s efficacy) for skin type 5 (though I’m probably more between 4-5). In fact, I’ve gone 25/25, and though it is painful- it is the most efficient setting I’ve found for my skin type using an Nd:Yag laser with a 10mm spot size.
Most other customers will give me numbers like 20/35… 15/25, etc. THEN they tell me they have problems with darker skin types not achieving good results, or experiencing too much pain!
Now, when I say “painful” please keep in mind that when I play with lasers I use no protection. That is, the only cooling I use when testing a device on myself is any built in cooling mechanism. If it doesn’t have one, I don’t use any. So if 25/25 is bearable with little to no cooling, it should be more than efficient with appropriate cooling.
But I digress… the point I’m trying to make is that I have seen a trend of unusually low settings. I know what the settings SHOULD be because I, as many of you have pointed out, am not an esthetician- so all I have to go by is manufacturer literature, clinical nurses, scientists, etc. I always recommend these settings to my customers, and ask them not to deviate from them as they take on the liability of experimentation rather than leaving the liability with the manufacturer whom designed the machine to work a certain way.
I believe if we try to keep track of this information we may be able to have our own scientific assessment. I know it seems tedious, but it’s probably well worth it. I don’t support laser hair removal because I make money selling lasers or repairing them- I support laser hair removal because it is a technology I feel has been misunderstood by practitioners, manufacturers, consumers, the government, service companies, and licensing bodies alike. My background is running and servicing medical equipment management plans in large hospitals. I have been responsible for angio/cath labs that cost upwards of $2 million, and tens of thousands per repair. I’ve helped administer multi-million dollar contracts involving the purchase of new equipment, and part of my path to those responsibilities has entailed learning how to assess problem issues, document them, and correct them based on statistical data. I hope you all understand where I’m coming from 
I got laser on my back and shoulders. They were very light hairs. I did 7 sessions and all I got was longer darker hair. Throughout the laser process only patches were growing back and I thought it was working and a few months after I stopped it all grew back. Laser ruined it for me
CRC
Thank you for your informative posts.
There have been numerous posts on this forum indicating people are not getting good results with the Soprano XL, I have been using this machine since 2009 and have had very good results. I suspect that these individuals are being under treated. The manufacturer recommends 5 to 8 kJ of accumulative energy for a 100 cm square area in the SHR mode
Do you have any experience with the Soprano XL? If so, what are your thoughts?
We have a LASER SUCCUSS STORY THREAD here on Hairtell.
It would be so helpful Carmella if you would direct your successful cases to that thread to tell their story. We want to hear good news and the more detail there is the better for hair consumers.
Carmella,
I guess we should move that question to another thread
Mickey,
I just added your four points to the REPORT LASER HAIR STIMULATION thread.
It looks like this now:
[color:#000099]
For ease, You can copy and paste the information below so as to give complete information:
Gender:
Age:
Date you started treatment:
Hair color:
Color of Skin (Skin type can be relative, so pictures are much better. It would be much better, and more scientific if we had clear photos of the area being treated before, and the same area after. Close up would be nice- so as to be able to clearly see the hair color and thickness):
Hair Structure:
Area(s) treated:
Name of LASER or IPL (Make, and model of laser, date of manufacture, and software revision- this will give a more clear indication of the particular system’s capabilities.):
Treatment settings (Complete treatment parameters including Energy/cm2, pulse width, repetition rate, cooling method, spot size, and number of passes (if more than one).
Skin reaction:
Shedding?
Did you report increased hair growth to your laser specialist?
Before and After pictures?
HIGHLY DESIRABLE*****
Proof of accurate energy output from laser/IPL source- company name, technician name, and date of service within the last 6 months are of the utmost importance. Any medspa who uses third party service should be able to get this info from the company if they do not already have it themselves.
Other comments - no detail is too small: [/color]
THANK YOU for your valuable input, Mickey.
I asked a consumer, who private messaged me last night, to post his message on the open forum . It is listed above, but I will paste it here for ease of reading.
"#106886 - Yesterday at 09:26 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
Lkjhgf
Member
Registered: Fri May 10 2013
Posts: 6
I got laser on my back and shoulders. They were very light hairs. I did 7 sessions and all I got was longer darker hair. Throughout the laser process only patches were growing back and I thought it was working and a few months after I stopped it all grew back. Laser ruined it for me "
Mickey, to help you understand where we are coming from:
These are the kind of posts and pm’s we experience here on Hairtell FREQUENTLY. These consumer-driven pleas, along with articles from the medical community, frame the words ‘laser induced hair stimulation’. This is not electrologist-driven because we are territorial. We are not worried about competition. We are already over-worked if we are among the ones that are skilled. We sell our time and believe me, there are more hairy people than there is time to sell.
On the AEA Facebook site (the site closed to the public - an electrologist blog only) a survey was taken asking how many hours we work per week. Conclusion: more than is humanly healthy. I don’t have my website up and I spend very little to advertise because my referral base is large. I am not unique.
If you think there is a fear of competition happening here, your are sorely mistaken! Both modalities compliment each other and serve the hairy very well. A lot of us do both modalities. I bristled when you stated that electrologists are fearful of laser because of COMPETITION. Please take this as an earnest, polite correction on that point. We have PLENTY of work.
We all want to understand the consumer-driven comments about ending up with more hair than when they started laser. Are there better words to describe this very real phenomenon? What should replace ‘laser induced hair stimulation’ ?
Thanks,
Dee
LAgirl, you may want to add some or all of Mickey’s four points to your Laser FAQ’s page. Mickey, have you perused LA’s FAQ’s yet?
Dee,
I don’t accept the term “paradoxical” hair growth, or laser induced hair stimulation because it makes it sound mysterious.
The laser is doing it’s job. It is shocking non-anagen hairs into anagen, and vellus hairs are becoming terminal. This is normal, though not always desirable. It IS, however, VERY important that the patient follow up with a trained PHYSICIAN if they experience new growth. Preferably a dermatologist.
I have left messages for Dr. Shapiro, and Dr. Rivers (co-authors in the paradoxical hair growth “study”) and they should be calling me back. Hopefully we can get some information from them after 8 years more experience after their study.
As for the gentleman who messaged you, his statements make clear WHY this is not being treated properly.
First of all, he says he started with very light hairs on his back and shoulders. How light? Were they too light to treat to begin with???
Let’s assume they were treatable. What laser was used? I would use nothing less than an 18mm 755nm laser for “light” hair on the back and shoulders- REGARDLESS of skin type (for very dark skin I would use a laser that gets more than 300ms pulse width, but very light hair rarely translates to very dark skin).
And how far apart were the intervals? He says he did 7 sessions? How old is he???
There is a rule of thumb with follow up treatments… well, two.
1- Treat again at half the telogen cycle. So if the telogen cycle of back and shoulder hair is 6-9 months, treatments (after the first) should be spaced out at least 3 to 4.5 months apart.
2- Treat when visible hair makes its reappearance.
With either rule, 7 sessions on the back and shoulders would span at minimum 18 months, and as much as 4.5 years.
The biggest problem with using the second rule of thumb is ejection. Telogen hair will be naturally ejected within days of laser hair removal (or you can pluck it out as I do). Anagen hair should eject some time after that as it is deeper down the shaft. In any case, not all “new hair growth” is actually new hair, and if treatment is delivered… say, one month after the first treatment (on the back) you may be treating hair that appears to be growing, but is still being ejected while the true hair is beneath it pushing it out.
I am beginning to understand you better. You see, it is very important that you are here teaching us (patiently so) because WE want to guide people in an unbiased approach. We are on the frontline, seeing clients who come complaining about their half-baked laser experience. I want to emphasize that we also hear and observe the excellent laser results as well.
We can better calm and educate the disenchanted laser client if we understand some very basic principles of laser hair reduction.
This is a consumer-driven website and the integrity of this site must be truth-based and unbiased as we support, guide, comfort and teach the distraught, depressed hairy client. That is why I hang out here - for free. If it were anything but truthful and unbiased, I would be gone, “quick! like a bunny!”.
Thank you again for adding your expertise. We can never be too balanced or transparent (unlike the US government) . Just threw that in to stir up some people.
Mickey,
I think you will find that from a consumer’s perspective, vellus hairs (or any fine hair for that matter) becoming thicker or darker is undesirable.
I joined HairTell as a consumer and at the time was attending consultations at Laser clinics to make an informed decision. I decided not to undergo LHR for my fine, downy (but black) facial hair because of the risk of these hairs becoming thicker. This defeated the purpose of permanent hair removal treatments for me.
I instead decided to proceed in areas where I had coarse hair only.
One thing I don’t quite understand - not all fine hair is vellus. What do you say only fine vellus hair can be ‘stimulated’? What if a fine terminal hair receives sublethal damage in the follicle?
I know you refuse ‘hearsay’ but my cousin has experienced LHR to cause her previously fine lower arm hair to become thicker and darker. For me, this is a first hand account, though for you it is ‘third party’. How has this happened? I am willing to see if she will discuss her experience with you. As a medical professional, I’m sure she will be able to get all the required details from her clinic - she has said they have been very ‘good’ about what has happened and are trying to resolve it. They may even be interested in your help and advice.
Dee, I appreciate your patience with me 
And I am always open to correction! Beate_r pointed out some contradictions in my arguments others had missed, and I believe that correction finally got my point across to some
I would still like to have a definitive answer on this question of thicker hair growth after laser hair removal. I am already seeing a trend not only in skin and hair type- but laser type as well. Alexandrite is not only poorly understood by many practitioners- most Alexandrite lasers are not adequately powered to begin with, and for some strange reason they are being used at unusually low treatment settings :-/
I hope you all don’t mind emoticons… I have been accused of using them more than 95% of the population. I don’t like my “tone” to be misunderstood, so if something sounds emotionally ambiguous, I put a smile next to it
Not only these.
Yes, in your case- on the face, very undesirable. BUT this is a sign of deficiency in treatment- not ‘normal’ treatment. Also, some vellus hair may need to become thicker before laser hair removal can be performed. I haven’t read any comments from consumers regarding correction of new growth, but the main study which documents it was written by doctors who now say it can be treated.
It has only been proven that fine terminal hair can receive lethal damage, or sublethal damage and miniaturization. If it is terminal, it will become fine until it no longer reacts to treatment, or it will eventually receive a lethal treatment. Fine terminal hair- especially dark hair- should react to laser hair removal given the proper settings. But think about it- if it is “stimulated,” and grows back thicker- why wouldn’t it react to laser THEN? (not that I agree with the notion of terminal hair growing back thicker after hair removal… unless the person was experiencing some form of telogen efflevium, and the deficient treatment amounts to Low Level Light Therapy, inducing a natural growth cycle.
The two known mechanisms of laser hair removal are sublethal injury to the bulge, or lethal injury to the bulge and bulb. Laser shocks telogen hair into anagen by sublethal injury to the bulge. Laser removes anagen hair by lethal injury to the bulge and bulb. Laser may shock vellus hair into becoming terminal, but other factors are more likely. Laser may shock hair in extended telogen, or telogen efflevium back into anagen.
The most likely cause, and I know this is the one most people will disagree with, is synchronicity- after the first treatment, most of the hairs treated will be in anagen synchronously while, for example in the arm, hairs are usually 20% anagen to 80% telogen. About 95% will be anagen synchronously after the first treatment.
There are tons of other conditions which cause hypertrichosis, and hirsutism. This is why I recommend seeing a dermatologist if this occurs.
I would be more than willing to give it. Hopefully the problem is not an underpowered laser :-/
Though not many people complain about that- how do you think I make MY money? Underpowered, poorly serviced, broken down lasers…
Emoticons are great. :mad:
Low settings are a problem. We have said many times (LAGirl more than anyone here) that a large spot size and aggressive settings are better. Not aggressive in the sense to burn someone though, but delivering as much energy as the skin can take. We like alexandrites like GentleLase and Yags like GentleYag’s. Other types are mentioned, but I don’t remember them right now. IPL’s are viewed as long term waxing around here and we usually steer people toward “real lasers”.
If any of that information is unfair, it was not done with any selfish or competitive motive. This is why I have been asking laser specialists for the last year or so if they could help answer some questions or correct any information here on the forum. We have been doing the best we can, but we don’t have the caliber of laser specialists like we do electrologists on this forum
No no no… I agree completely.
18mm spot sizes are the only ones which deliver 100% energy at 100% area of coverage at the target depth of the deepest follicles.
For clarity- I am not being biased. I chose this company after doing much research: I am a distributor and service partner for Light Age, Inc.
With that said, the only lasers with 18mm spot sizes are:
Candela GentleLase (755nm)
Candela GentleMax (755nm/1064nm)
Candela GentleYag (1064nm)
Light Age EpiCare Duo (755nm/1064nm)
Light Age EpiCare Yag (1064nm)
Light Age EpiCare LPX (755nm)
Light Age EpiCare LP (755nm)
Next in line would be the Cynosure Apogee/Acclaim/Elite series which have a 15mm max spot size at both wavelengths, but that only covers 69% of the total area covered by an 18mm spot size.
I never recommend IPLs. It’s like offering someone cheap mezcal when they ordered premium blue agave tequila Yea, it’ll get you drunk… but is it worth it?
This is very exciting! I am anxious to hear what they say. Can you ask them to make a statement here?