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

2. Hair Removal
Electrolysis
Creams
Laser

6. 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

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

8. 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

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

10. Relative Absorption of Laser Light & Competing Chromophores
1064nm

11. 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

12. 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

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

14. Richards-Merhag

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

16. 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

17. Contraindications Pregnancy Recent sun exposure Sun tan
Suspicious lesions

18. 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

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

20. 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

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

22. 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