Dr. Alireza Vaez Shooshtari Hair Removal laser Dr. Alireza Vaez Shooshtari Dermatologist

Hair Removal Electrolysis Creams Laser

Laser Hair Reduction Epidermis: 40 - 150 microns E & D: 180 >/= 550 microns 1.Papilla: neurovascular tuft 2. Bulge: at Erector Pili 3.Matrix cells:>= 2 mm Anagen> Catogen> Telogen

Selective Photothermolysis Target Isolation Can we target over other similar targets? (Can we seek melanin in hair over skin?) Selective Photothermolysis

What is the Target ? Eumelanin: brown or black hair Best absorption of light Pheomelanin: red or blond hair Poor absorption Gray hair: pigment-free White hair No absorption

Hair Removal Lasers Nd:YAG 1064 nm Flashlamp 575/ 515-1200 nm Diode 800/810 nm Alexandrite 755 nm Ruby 694 nm

Relative Absorption of Laser Light & Competing Chromophores 1064nm

Features Wavelength:. nm Power:. watts Fluence:. power/cm2 Spotsize: Features Wavelength: nm Power: watts Fluence: power/cm2 Spotsize: mm Overlap: % Pulsetime: ms Pulse interval: ms or freq

Keys for success Wavelength: >690 nm (>wavelength=depth) (shorter -> competing chromophores) Spot size: at least 5 millimeters Pulse time: 18 or > milliseconds Pulse interval of 35 or > milliseconds

When do you treat? During Anagen cycle Not during telogen Cycle time determined by Richard-Merhag chart

Richards-Merhag

Fitzpatrick Types OK: Fitzparick IV/VI: Nd-YAG non-confluent scanner >15 ms Continuous cooling

Consultation Patient history( mense, PCO, other sign) Any previous hair methods Expectations Treatment explanation 3-6 session, 1-2 month apart 20-30% reduction per session 70-80% long term reduction Photographs & Consent

Contraindications Pregnancy Recent sun exposure Sun tan Suspicious lesions

Before Treatment Shave 1-3 days before treatment (stubble) Avoid other methods for 30 days SPF 15+ for 4-6 weeks Avoid tanning creams Hydroquinone if necessary

What is the endpoint ? Small contact spark/flash Smell of burnt hair Perifollicular edema Sensation of light sunburn One in three hairs extrude

After treatment Redness: 4-6 hours after treatment Hair appears to grow for several days Hair falls out: day 10-14 Hair reappears, next phase: >3-6 weeks Treat again: >= 6 weeks later

Complications of Laser Hair Removal Blistering Hypopigmentation Hyperpigmentation Scarring Koebner phenomenon in psoriasis , vitiligo Temporary or permanent leukotrichia

Complication (cont.) Found conversion of fine vellus hair to dark, coarse terminal hair or induction of growth of long fine hair from repetitive low fluence