GentleYAG

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GentleYAG
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GentleYAG 1064nm
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Laser Hair Removal
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Laser Hair Removal

• 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.

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Permanent Hair Reduction
The FDA allows us this definition long-term
stable reduction in the number of hairs
re-growing after a treatment regime
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How Effective is it?

• Studies have shown up to 80 reduction in hair
  after a series of treatments
• The 1064nm wavelength 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

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

• What are the 3 cycles of hair growth?
• Anagen Hair is actively growing
• Catagen Hair is dormant
• Telagen Hair is falling out

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Hair Biology

Anagen
Telogen
Catagen
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How Many Treatments?

• 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

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Time to Retreat?

• 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.

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Hair Growth Information
Body Area Anagen Hair Telogen Hair Telogen Duration Follicles Density / cm² Depth of follicle
Axillae 30 70 3 months 65 3.5-4.5 mm
Brow and Ears 10-15 85-90 3 months 50 2-2.5 mm
Beard 70 30 10 weeks 500 2-4 mm
Upper Lip 65 35 6 weeks 500 1-2.5 mm
Scalp 80-90 13 3-4 months 350 3-5 mm
Trunk 10-20 80-90 4 months 70 2-4.5 mm
Pubic Area 20-30 70 3 months 70 3.5-4.5 mm
Arms 20 80 18 weeks 80 2-4.5 mm
Legs Thighs 20 80 6 months 60 2.5-4 mm
Breast 30 70 3 months 65 3-4.5 mm
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Bottom Line

• 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.

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Pre-Treatment Instruction

• 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

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Pre-Treatment Instruction

• 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

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Clinical Endpoints

• 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

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Post-Treatment Instruction

• After
• Cool compresses can be used to reduce patient
  discomfort swelling
• Aloe vera
• Topical Cortisone cream
• Sun block of 30 SPF

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Treatment Technique

• 3 Things to ALWAYS remember while treating
• FLUSH The distance gauge should be flat and in
  contact with the skins surface
• PERPENDICULAR The hand piece should be 90 to
  the skins surface
• OVERLAP Pulses should be overlapped at 20-30.
  Think of the Olympic Rings

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Complications

• 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

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Vascular Lesions Linear Telangiectasia

• 1064nm Wavelength

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GentleYAG does what?

• 1064nm
• Facial Vessels
• Leg Veins

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Leg Telangectasia or Spider Veins

• Sclerotherapy is the GOLD STANDARD for the
  treatment of leg veins
• The 1064nm wavelength can clean up what
  Sclerotherapy does not
• Veins lt 3mm in size are treatable

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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 only be treated with the
  1064nm wavelength

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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

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Clinical Endpoints 1064nm

• Facial Vessels
• ONLY the 1.5mm spot size should be used on the
  face
• Vessels should disappear and erythema the end
  result
• Leg Veins
• Vessels should disappear
• Wheal Flare or Cat Scratch appearance after
  about 5minutes

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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

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Wrinkle Reduction Skin Tightening
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How does it work?

• 1064nm
• Bulk deposition of heat can cause both collagen
  contraction collagen stimulation

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3 Techniques for Skin Tightening

• New Taylor
• 18mm, 50ms, 18 J/cm² with the DCD turned off 3
  Passes
• Keys
• 10mm, 50ms, 20 J/cm², DCD off, Double Pulse/3
  Passes
• Painting
• 8-10mm, .25-.5ms, 12 J/cm², DCD off, 7-10 Hz
• All deliver bulk heating into the dermal layer of
  skin

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Clinical Endpoint?

• The use of an Infra-Red Thermometer allows us to
  achieve a surface temp of 40-44 C
• This translates to an approximate dermal temp of
  65 C
• This is the temperature that can cause collagen
  contracture

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Thank You