GentleLASE

2. GentleLASE

3. GentleLASE – 755nm

4. How does it work? Targets the pigment in the hair follicle. Heat is absorbed and destroys the cells lining the hair follicle specifically around the bulb, bulge, and vascular supply. Laser Hair Removal

5. Permanent Hair Reduction The FDA allows us this definition: “long-term stable reduction in the number of hairs re-growing after a treatment regime”

6. Studies have shown up to 80% reduction in hair after a series of treatments The GentleLASE will NOT treat white, blonde, or gray hairs! Some reds hairs will not achieve desired efficacy. Patients should be informed of all possible outcomes prior to treatment How Effective is it?

7. Hair Anatomy Epidermis Sebaceous Gland Follicle Bulge Vascular Supply (Matrix) Bulb **Bulb/bulge are critical structures responsible for hair re-growth

8. What are the 3 cycles of hair growth? Anagen: Hair is actively growing Catagen: Hair is dormant Telagen: Hair is falling out Cycles of Hair Growth

9. Hair Biology Anagen Catagen Telogen

10. Different areas have different percentages of hair in the Anagen phase. Face, Axilla, Bikini have approximately 20-35% Trunk and Extremities have approximately 10-20% How Many Treatments?

11. As a rule: Face/Axilla/Bikini: 4-6 weeks Trunk: 8-10 weeks Arms & Legs: 10-12 weeks Or within 7 days of when regrowth is observed. Time to Retreat?

12. Hair Growth Information

13. For best results, multiple treatments will be needed. For most areas 4-6 treatments are necessary to achieve desired hair clearance. One may need more or less than 6 treatments depending on hair type, previous methods of hair removal, and skin color. Results may vary from patient to patient and to various degrees of efficacy. Bottom Line

14. Before Shave hair 24-48 hours prior to treatment If the patient has a history of cold sores/fever blisters, an anti-viral can be prescribed If there is concern over pigmentary changes, a prophylactic bleaching cream can be used weeks prior to treatment Pre-Treatment Instruction

15. NO Plucking – 6 weeks prior or after NO Waxing – 6 weeks prior or after NO Tweezing – 6 weeks prior or after Patients should only shave Pre-Treatment Instruction

16. PFEs Perifollicular erythema: The treatment area should appear red Perifollicular edema: There should be swelling around each hair follicle Some patients will experience a hive like response Lighter hairs may not respond as significantly Clinical Endpoints

17. After Cool compresses can be used to reduce patient discomfort & swelling Aloe vera Topical Cortisone cream Sun block of 30+ SPF Post-Treatment Instruction

18. 3 Things to ALWAYS remember while treating: FLUSH: The distance gauge should be flat and in contact with the skin’s surface PERPENDICULAR: The hand piece should be 90° to the skin’s surface OVERLAP: Pulses should be overlapped at 20-30%. Think of the Olympic Rings Treatment Technique

19. There are risks and complications that can occur from laser treatment. Use of conservative DCD settings are important. Complications are rare! Heat rash Bruising Scarring Infection Hyper-pigmentation Hypo-pigmentation Swelling Welting Complications

20. Pigmented Lesions

21. A pigmented lesion is caused by an abnormal production of melanin which makes it visible on the skins surface Pigmented Lesions

22. The following benign pigmented lesions can be treated with the 755nm wavelength: Mottled or hyperpigmentation Lentigines Ephelides (freckles) Epidermal melasma Café’ au lait Pigmented Lesions

23. Lentigines: Are small, tan to medium brown lesions that are located on the skins surface Usually caused by excessive sun exposure Need to be differentiated from the potential skin cancers. (i.e., have it checked off by a physician) Pigmented Lesions

24. Lentigines

25. Ephelides: Also known as freckles Commonly seen on fairer skinned patients Pigmented Lesions

26. Ephelides

27. Café’ au lait: Are typically light tan to pale brown patches that are seen at birth or soon after. Pigmented Lesions

28. Café’ Au Lait

29. Remember that this will treat Epidermal pigmentation issues. NOT LIKELY TO RESPOND Nevi of Oto or Ito Melanocytic Nevi Should only be treated by dermatologist Blue Nevi Pigmented Lesions

30. Method of Treatment: Treat only on Skin Types I-III (and Asian skin) No DCD is used. May require multiple treatments (2 – 3 TX) For treatment of smaller lesions a small spot size should be used. Pigmented Lesions

31. Some factors that could possibly trigger a recurrence of pigmented lesions are: Hormonal imbalance Pregnancy Medications Menopause Sun Exposure Pigmented Lesions

32. Potential Side Effects: Discomfort Bruising Swelling Scabs Hyper-pigmentation Hypo-pigmentation Infection Scarring Lesion Recurrence Side effects are quite rare! Pigmented Lesions

33. Clinical Endpoint You may hear a “Snap” while treating. The darker the lesion, the louder the “Snap” It is not uncommon to see a “Frosting” of the lesion Single Pulse Only! Pigmented Lesions

34. Clinical Endpoint: The lesion will darken within 5 - 10 minutes after treatment and may remain so until the lesions forms a micro-crust. Use of an ointment is recommended. Aquaphor, bacitracin or even vaseline can be used to keep area moist until the crust falls off. The skin underneath will be pink. There is a gradual return to normal skin color over time. Pigmented Lesions

35. Avoidance of direct and indirect sun exposure for at least 2 weeks before & after the laser treatment is advisable. Sunblock of at least SPF 30+ on the treated area daily. Sun exposure may contribute to hyperpigmentation in treated area. Pigmented Lesions

36. Vascular Lesions & Linear Telangiectasia 755nm Wavelength

37. Vascular Lesions Facial Vessels Leg Veins Hemangiomas Resistant PWS GentleLASE Does What? 37

38. Leg Telangectasia or Spider Veins Sclerotherapy is the GOLD STANDARD for the treatment of leg veins The 755nm wavelength can clean up what Sclerotherapy does not Veins < 2mm in size are treatable

39. Special Considerations Vitamin E, Aspirin, Ibuprofen, Fish Oils or other Blood thinners may increase the likelihood of bruising. Avoid for several days if possible, if not, practitioners should perform test spots When treating lower extremities diabetic patients should have clearance from their primary physicians Darker Skin Types should not be treated with the 755nm wavelength

40. Pre-Treatment Squeaky clean skin! No tanned skin! No Topical anesthetics Topical Alpha-hydroxy Can be used for 1-2 weeks prior to treatment Measure vessel size

41. Clinical Endpoints – 755nm Facial Vessels & Leg Veins Structure will vaso-spasm or darken Peri-vascular erythema is normal Hemangiomas Transient purpura Resistant PWS Transient gray color that evolves into deep purpura 41

42. Post treatment Apply pressure to treated area after a few pulses Cool Compresses Topical Cortisone Cream Encourage sun block 30+ SPF Avoid activities that cause vasodilatation or increase blood pressure for 3-5 days

43. Wrinkle Reduction

44. 755nm Thermal Injury stimulates the body’s response to create collagen How does it work? 44

45. Use of 755nm Treatment of skin types I-IV Requires a series of treatments performed once a month Technique is similar to LHR Clinical endpoints are slight edema & erythema 45

46. Thank You