Questions! Please help (with reference to Lightsheer and LHR on Indian male)


#1

Just some questions really.

I’m thinking of using either the Lightsheer diode or the nd: YAG Coolglide to reduce my hair on my forearms and get rid of as much hair on my upper arms, shoulders and back as possible. I understand this is quite a large area and thus ask, firstly, whether to get the back and shoulders area treated first (as that’s what I want removing/reducing the most) and then have treatments on my arms later. Or to try and do it in one session and run with it for however long it takes (I’m looking at 18-24 months).

My second question has to do with the correlation between the amount of fluence used and the effectivness of hair reduction/removal. I was reading a study-- http://www.aesthetic.lumenis.com/pdf/safety_efficacy.pdf–based on the Lightsheer that suggested that the melanin in a hair follicle absorbs 3-4 times more engery at 800 nm (the wavelength used in the Lightsheer) than at 1064 nm (the wavelength used in the Coolglide and other nd: YAG lasers). Thus as a consequence lower fluences can be used, reducing discomfort, without affecting the result (that’s my deduction!).

Does this claim carry substance? I was reading RJC2001’s posts with great interest about using fluence numbers and - generally - the higher the better. But if the Lightsheer is more effective with regard to absorbtion than perhaps a more “accommodating” fluence level can be used (say 25-30 as opposed to 40-45).

Am I so far so good in this suggestion?

In addition, the clinical paper suggested that a pulse width of 100ms would improve the results provided in the paper for people with skin type V.

I understand that everyone is different but am I fair to assume that the usage of a fluence level of how about 30 with a pulse width of 100ms using the Lightsheer would be a good combination.

:smile:

Thanks for sticking with it! Just a few more Qs…

:smile:

Ok, so if the Lightsheer is more effective at absorbing melanin then a lower fluence can be used.

This website – http://youre-looking-great.com/lightsheer_paper.htm – copies a clinical paper and ignoring its commercial attributes suggests that the Lightsheer should be used in the following way:

skin type IV - Fluence - 20-30 J/cm2, pulse width: 30ms
skin type V - Fluence - 15-25 J/cm2, pulse width: 30ms

Is this accurate? And if it is true about the Lightsheer’s effectivness, then are these values that would do significant damage (after several treatments obviously)?

Now with regards to the Coolglide…if it’s safter for darker skin (which I’ve learnt it is–in comparison to the Lightsheer)–then can higher fluences be used? 30-45 perhaps? It would be less comfortable than the Lightsheer but it would certainly be more effectie, no? And as the nd: YAG laser is safer on darker skin, a higher fluence can be used and it would be more effective per treatment than the Lightsheer?

Is this deduction correct?

thanks in advance for your help!

:grin:

[ December 03, 2003, 01:58 PM: Message edited by: Zambo ]


#2

It’s unusual to respond to your own posts before everyone else but - what the heck!

Ok, did some further research, which threw up the following on the Coolglide:

http://www.altusmedical.com/us/documents/cg3month.pdf

It more-or-less confirms what was suggested in my inital post–that the melanin absorbs more with the diode laser than the nd YAG one. However, advantages are noted in this paper, to quote:

“The advantages of less melanin absorption include reduced epidermal heating and damage, the ability to treat a wider range of patients (dark as well as light), and the ability to use higher fluences. Additional advantages of the longer wavelength are reduced scatter and deeper penetration of the light so that more energy is delivered to the target. While the decreased melanin absorption of longer wavelengths is an advantage in terms of epidermal heating and damge, it also means that the melalin in the desired target has less absorption. This decreased absorption at the target is overcome by the use of higher fluences and by taking advantage of the reduced attenuation and scatter of the laser light as it passes through the epidermis.”

Mmmm…! So is the Lightsheer the better bet as melanin is more receptive to it or is the Coolglide which allows higher fluences? If I’m either a skin type IV or V (I rule out III on the grounds that I’m not that light and VI as I’m not that dark!)–then which would suit me better? Financially, the Boston Clinic in London offers a good deal with the coolglide whilst the lightsheer is generally more expensive in usage. But perhaps more significant issues should come to hand–better effectivness, saftey most importantly.

Can anyone assist? (!)


#3

Hello Zambo

Ok let me have a go at answering your questions.

If money is not a major hinderance I would have all the areas you want treated done at the same time in an effort to achieve your goals of hair reduction in the quickest time, however that said by just focusing on a smaller area (say shoulder) you can evaluate the effectiveness of the treatments without spending the cash for the larger area.

It is very hard to determine how your skin will respond to the different laser sytems. I would try and schedule a consult with both of the places and have them perform a test patch on you at effective treatment fluences. The 100ms pulse delay is there to give the cooling tip more time to chill the surface of your skin such that the risks of adverse skin reactions will be reduced from using the higher treatment fluences.
I have been treated at both 30ms and 100ms pulse spacings and I have type 2 skin. They used the 100ms pulses on me mostly at the beginging treatents due to the high hair densities.
Only near then end of my treatments did they get into the 40 J/cm range of power density and that was near the limit of my skins ability to survive the treament with only mild redness. I would suspect anything under 20 J/cm to be near useless at permenantly removing the hair. I have seen people of Jamaican decent being treated with the lightsheer and they have shown good progress but they do seem to require a few more treatments then those of use with lighter skin.

Chris


#4

Hey

thanks for the reply!

If I wanted to get all areas noted treated at the same time (or over a course of two consecutive sessions) then I would have to go for the Coolglide as I can manage arms, back, shoulders for £300. Whilst with the Lightsheer operators I have looked at, it would be £240-£280 just for the back and shoulders!!!

Seems like a pretty good deal, eh?

I suppose you are right though with regard to test patches and seeing which one I react to the best. I was reading clinical studies that put the Lyra nd: YAG laser against the Lightsheer diode and on particular patients they would respond much better to one than the other.

But if it’s safer to use higher fluences with the nd: YAG does that mean it’s a better laser to go for, for skin types IV/most probably V??


#5

The fluence (power density) may be higher with the Yag (1024nm?)laser for a given skin type but the dark pigmnent found in most dark hairs, absorbs the Diode laser wavelength (800nm) energy more efficiently so it is hard to know which one is the best. Truly a trial and error approach would be best given just how expensive laser hair removal can get.

Chris