Hair Stimulation Following Laser and Intense Pulsed Light

The increased terminal hair growth occurred mostly in areas in which fine hair or both fine and coarse hair was present prior to initiation of treatment.

Laser based technology has provided a permanent hair reduction for many people. However, for a very small percentage there can be counterintuitive hair growth.

Increased terminal hair growth has been seen with near infrared and infrared technology.

It is important to be aware of this possibility when providing Laser Hair removal services.
 

Hair Stimulation Following Laser and Intense Pulsed Light
Photo-Epilation: Review of 543 Cases and Ways to Manage It

Andrea Willey, MD,Jaioae Torrontegui, RN, Jose Azpiazu, MD, and Nerea Landa, MD

Article - Author: Thomas G Greidanus, MD, Chair, Department of Emergency Medicine, Parkview Medical Center
Coauthor(s): Beth Honl, MD, Dermatology Associates, PC; Private Practice
 

Laser based infrared technology may be used to perform a Laser Vein treatment to hemangiomas. Treating hemangiomas is an advanced vascular treatment and should only be attempted if the treatment provider understands the anatomy and physiology of the lesion and has performed a complete assessment.

Management Strategies for Infantile Hemangiomas
 

Hemangiomas are benign tumors in which growth of capillary blood vessels occurs through angiogenesis.2 They rarely occur in utero, but instead appear as bluish or red marks within the first 2 weeks of infancy. Following this initial stage, they show rapid growth lasting for up to 12 months, the proliferation phase. In the next phase, the involuting phase, they slowly regress until an average of 5 to 7 years, after which hemangiomas remain unchanged.3 Traditional management of hemangiomas therefore, has been to wait until involution occurs spontaneously. However, complications such as bleeding, infection, ulceration, obstruction of orifices or psychosocial distress may be cues for intervention.

Maya Barsky, BS, and Robert Buka, MD, JD

Performing Test Spots serve several different purposes and are an important part of a skin care treatment plan. Infrared technology used in laser-tissue interactions produces thermal effects on the tissue.

The primary reason for performing a test spot is to observe epidermal response and to determine safe treatment parameters when treating tissue because of absorption by the chromophore. Immediate epidermal damage presents as a blanching or graying of the skin (common with the Nd:YAG). Epidermal damage may take up to 72 hours to be visibly evident especially when treating melanin. A burn from an IPL may take 48-72 hours to appear.  It is very important to perform a test spot when treating pigmented lesions.

A test spot may be beneficial for skin types IV-VI to evaluate risk for developing post inflammatory hyperpigmentation. However, this test spot must be evaluated 4-8 weeks post procedure as it takes this amount of time for the PIH to develop. Laser based technology on skin types IV-VI may increase the risk of pigmentatary changes.

Port Wine Stains require test spots as the parameters will vary widely due to the different types and involvement of these vascular malformations. Starting parameters for vascular treatments are usually lower then an average vascular treatment. A cluster of veins is a better target then a single leg vein so there is a higher risk of a burn.

There are advertisements on the internet offering "Free Test Spots" prior to Laser hair removal in order to determine if the treatment "will work before the client pays for the treatments". This perhaps could be beneficial to help determine proper parameters; however, the time period for evaluating the test spot for efficacy may be 4 to 12 weeks or longer depending on the growth cycle.

Test spots are considered an "Industry Standard of Care" and therefore have Medical/Legal implications. The elements of a malpractice suit are the "Breach of a duty that causes harm".

Informed Consent should be obtained for Test Spots and should include any potential complications that can occur from performing a test spot. It is better for the practitioner see the patient back to observe the test spot rather then allowing to patient to report on the results. This allows the practitioner to learn what the end result is and eliminates uncertainty if there is a complication.

Since laser light has a specific wavelength dependent on the laser active medium that emits light, protective filters that match the wavelength and power of the specific source of laser radiation are needed.

Many factors contribute to the development of telangiectatic facial veins and leg veins. Age, heredity, pathological conditions, occupations that require long periods of standing and pregnancy can all contribute to development venous disease. A successfull vascular treatment is dependent upon comprehensive history including presenting complaint, active symptoms, history of vascular disease, and general health and occupation history. Varicose vein treatment may require a combination of Laser based technology and sclerotherapy to adequately address the client's needs. Any successful vascular treatment is dependent on the treatment provider being able to successfully locate facial veins, legs veins and any reticular feeder veins that are often associated with the superficial telangiectasias.

There are several tools that can aid the visualization of the superficial venous system:

Syris V600 headlamp uses cross polarization technology allows the user
to see approximately 1mm below the skin's surface. 

The new Venoscope^® II transilluminator utilizes an array of high intensity LED lights to transilluminate the patient’s subcutaneous tissue thereby highlighting the veins which absorb the light rather that reflecting it.

About the author:
Dr. Kevin Smith is a dermatologist in Niagara Falls, Ontario with a particular interest in protecting the skin and in correcting skin problems resulting from aging, rosacea and sun damage. He is an expert in the use of Botox®, fillers, lasers and intense pulsed light to maintain and enhance the appearance of the skin, and have lectured on those subjects across North America, and in Europe, Asia and Mexico. Read more at www.smithlaser.com