Skin type III-IV, laser wooooo

Okie, so I had a consultation about 2 years ago with a clinic in baltimore… they used 18 mm 24 jcw, 10ms on a test patch on legs… I’m skin type iii/iv… wasn’t able to start laser due to financial issues at the time/scheduling issues…

anyways now i’m ready to begin my laser journey.

I went to an esthetic institute in vienna, va that had good reviews online. i only got my legs done(they had a special, so I could test the place out). A teacher does all all the laser work, students don’t work on the more invasive procesures… anyways, stupidly I didn’t look up the settings I should have used online andthey used the settings… 18 mm spot size, 14 joules, and delay of 20(not sure what that even means) on the gentle yag. Obviously way too low of settings. Laser didn’t take that well and I was back in 2 weeks for a “touch up” meanings full legs again but same settings except she used 16 joules this time. I asked her if she could test higher settings, because I thought my last clinic I did a consult for did use higher settings(found the settings the other office used after the session) and she said she had a protocol to follow and she would raise it each time. GAH, I know it’s not going to work since everyone recommends at least 22, plus she still missed a bunch of spots on the touch up! That’s what I get for not researching before hand so done with that. At least the session wasn’t too expensive…

I found another place online that has good reviews has different machines including the gentle yag… what questions should i make sure to ask this time and what settings would you recommend(i know it’s hard to say, but some general ideas for minimum settings and what not). seems like i should ask for 15 or 18 mm spot size. At least 24 joules… and not sure about the pulse width.Any ideas?

I found another place that had great reviews, they use a cynosure elite(not sure about settings for that one)
Any ideas for settings for that one for skin type iv…

I’m going to wait probably a month and a half before i get my legs redone or would it not matter if i went sooner(i doubt the settings she used on me are going to work at all)

I think in 2 weeks I’m going to have one of the places do a consult on my bikini(didn’t get that area done)

My goal is to eventually have legs, buttocks, bikini, stomach(thining the middle thick hairs before electro) underarms, 3/4 arms, and feet.

You need at least 30J on a YAG laser. As skin type 4, you might not be able to take 30J on 18mm. So I’d suggest you use 12mm or 15mm. You can easily go upto 40-45 on 12mm and 30J on 15mm. I’d go for 12mm.

Pulse width should be 20ms or LESS. Finer the hair, shorter the pulse width should be. For coarse leg hair, 20ms works fine for most people for the first three treatments.

Thanks for the response mumbaigirl!

That’s crazy she only did 14 joules the first time and she’s a teacher! No wonder most of these clinics suck at giving treatments if they don’t even have decent teachers…

I’m going to be more on my game when I look at these other clinics…

How many joules do you think a skin type 4 should do at 12mm or did you mean i should use 40-45 on 12 mm…

At least 30. You can upto 45 on 12mm if you’re a true skin type 4.

I’d start at 35-40.

That’s good to know that you can go that much higher in joules with a lower spot size. Why do people use a higher one, is it less likely to miss spots or to save time?

Both. That and because a larger spot size penetrates deeper. My dermatologist also told me that the other reason is how your skin reacts (45J going against the skin is brutal, whereas 20J on a larger spotsize penetrates deeper as well as is easier on the skin.)

I am not happy with people posting " THEORETICAL " settings without paying close attention to detail. Not all YAG lasers are created equal. Depending on spot size,
22 Joules on one YAG can equate to 35 Joules on another YAG laser, yet you may need to use 60 Joules on an OLDER YAG to get the same results. PLEASE, be careful.
The settings described above CAN CAUSE PIGMENTATION issues, if not administered properly.

Romeo, i know settings are approximate but on hte safe side my tech considered me a iv, might be iii are there any setting recommends you have?

forgot to mention it’s a candela gentle yag…

You might want to go through sslhr’s posts

" Now as to the GentleYag. Max on a 18 mm is 30 joules, but this is a function of the machine power and pretty low. We never use an 18 mm spot on a yag, except perhaps for a man’s beard due to density. Max with the 15 mm spot is 44 joules. I personally believe that 20 joules on a YAG is almost worthless. We actually have treated people with multiple treatments at 20 joules on a yag in an effort to promote collagen build up and have seen no hair removal effect. And the same goes for 24 joules. "

The post above from SSLHR ( A very respected Member in the laser hair removal field ) clearly specifies that they did not use an 18 mm spot size for hair removal on body parts on the YAG side.

18 mm at 30 Joules YAG on legs ( upper legs in particular ) would create complications on skin types III and above. Also, the post is from 2006, at the time when the Gentleyag had a 3 mm fixed pulse width.

I am just trying to caution potential laser clients from taking these suggestions to their clinics and trying to enforce them.

Taking your precious time to explain this is very valuable information for the consumer.


I think there is some misunderstanding here…

I never suggested her to use 30J on 18mm spot. I just said one needs at least 30J on a YAG laser IRRESPECTIVE OF THE SPOT SIZE. Since someone who is skin type 4 can’t take 30J on a 18mm spot size, she should use a smaller spot size- 12mm or 15mm. This is in line with what sslhr used to say.

From what I know, a longer pulse width is safer as compared to shorter pulse widths.

Yes, if someone is going below 3ms, then they need to lower the joules but I don’t think Candela’s GentleYag goes below 3ms(Please correct me if I’m wrong). Nevertheless, I suggested around 20 ms depending on the thickness of the hair to be treated.

Mumbaigirl, you are a great addition to this Forum. I just want to caution users of this Forum to be careful with settings, as they can create complications. Each laser has a different BEAM PROFILE, therefore one should use caution when comparing lasers on same wavelength.

I have another consultation at a laser place in northern va, any questions do y’all feel would be important for me to ask?

Take a look at the Laser FAQ’s on the laser forum if you haven’t already. It will prepare you well.

I did a while back, but forgot about it. thanx for the reminder dfahey. =]

The laser consultation went awfuly. I had such high hopes for her, she uses a great machine(gentlemax) and had a lot of great reviews. I decided I was going to have a mini session of just underarms to test the waters. She said she would even use alexandrite on one underarm and the yag on the other to see which one reacts better(awesome). But, then I find out what settings she’s using… 18mm spot size and only 9 joules on the alexandrite side and only 18 joules on the yag side… I told her I thought the settings were low as the doctors clinic I had a consult with before used 27 joules on yag. She said that all machines are different but I told her I didn’t think it should be that different on yag settings on a candela yag and a candela gentle max(yag settings), since they were both candela machines. But, she kept going on about it being two different machines… She said if she used anywhere near that many joules on a yag that it would burn me, and rudely she said that she has 9 years of experience and she’d be out of business if she went by what everyone said… I asked her if she could at least try and she wouldn’t budge… Moving on from there

at least my electro consults today went brilliantly!

Ok on the YAG side, what were the other settings? pulse width? spot size? Can you call her and also ask for the exact name of the machine?

I suggest you PM Romeo with all the information and see what he has to say.

Also, I don’t think she’d mind using 30+ Joules on 12mm spot size. Ask her on the phone?

All the best!

She used the candela gentlemax. She used 18mm spot size, but I don’t think she would budge on settings, like lowering the spot size. She pretty much acts like her way is the best since she’s been doing it for 9 years and said that “if she listened to clients all the time she’d be out of business.”

When I called her when I left the consult literally a few minutes later about coming back in for maybe just higher test patches she snapped back saying it would shed in 3 weeks with the settings she used…