Unwanted hair can be removed from all parts of the body, including legs, chin, upper lip, bikini line, underarm, back and chest.
The initial consultation is one of the most crucial aspects of any cosmetic procedure. A clear idea of each individual client’s expectations are assessed and a comprehensive educational consultation follows explaining what is realistically achievable. Occasionally photographs are used to illustrate achievable results. An abridged explanation of how the treatment works is then explained in an easy to understand format. There are a number of questions that you may like to ask yourself / be asked at this stage:
- What do you expect the procedure to accomplish?
- In which way do you think the procedure will help you?
- Can you show the Practitioner what it is that bothers you?
- When do you expect the results to show?
- Do you know anyone who has undertaken the procedure?
- Have you seen this procedure advertised in magazines or newspaper articles?
The education process of the treatment ensures that the client is fully informed about how the treatment works and any possible side-effects. A comparison with other procedures is useful as this helps to alleviate any fears held by Clients.
It is of paramount importance that the individual client understands the procedure, achievable results, side effects and therefore may like to ask themselves the following questions
- Have you understood the information presented to you with regards to the treatment?
- Have you only absorbed certain parts of the information presented?
- Do you over-identify with a specific look?
- Are your concerns about minor blemishes reasonable?
- Are you prepared to undertake the treatments as a continuing maintenance program?
There are certain conditions which may exclude an individual from treatment.
- History of keloids (scarring)
- Oral acne medication in the last six months (Accutane)
- Photosensitivity in the last six months
- Medication for which sunlight is a contraindication (See Drug Information)
- Kaposi’s Sarcoma (malignant lesions)
- Tanned Skin
- Malignant or suspicious tissues
- History of poor wound healing
- Tattoo over treatment area
The initial stage of the hair removal process is to undertake the health history consultation and hair consultation. This will ensure that there are no underlying medical conditions which may exclude you from treatment.
The Practitioner must be shown the site where treatment is to be carried out. Any pre-existing scars, moles or pigmentary inconsistencies will be documented before testing or treating.
Good clinical photographs are taken, using a camera with a macro facility, in the same position and same lighting to ensure parity at the review stage of the treatment. The clinical photographs are kept with the client’s record and are taken to ensure that:
- Clinic has a record of any existing scars or pigmentary changes
- Clients have a visual record of the density of hair prior to treatment
As clients see themselves every day there is a tendency to forget how dense the hair growth was initially, thus the photographs provide the opportunity to review a visual record of the area side by side at the end of the course of treatments.
The client should now understand the hair growth cycles and that realistically only hairs that are in the early growth (Anagen) stage can be successfully treated. The patient’s expectations should not be set too high and be reasonable. This is a key element to a successful treatment!
A review date must be set within the treatment regime to allow the clinic to meet with the client and review the results to ascertain how the treatment is progressing. At this stage any remedial action can be undertaken and amendments to the protocol can be made.
All clinics complete small test patches, which must always be carried out on the intended final treatment area.
Test patches are always to be carried out on darker skinned Clients (Type 3 and above) since there is a possibility of hypo/hyper pigmentation (a change in the colouring of the treated area), or in cases where there is any doubt about the efficacy of the treatment.
The treatment area should be free from cosmetic make-up with the hairs slightly protruding above the skin. Cooled gel is then applied to the area in order to provide the required optical coupling and to also maintain a ‘cool’ sensation on the skin being treated.
Using a sterilised applicator a firm contact pressure is maintained between the glass coupling block and the treatment area. The contact pressure should be such that if the applicator were removed the skin underneath would appear paler than the surrounding skin, thus indicating that the blood had been forced out from the area under the glass.
Temporarily restricting the blood flow to the treatment area has two beneficial effects. Firstly, since blood would have the tendency to scatter the light we can reduce this effect and ensure that the maximum energy reaches the hair shaft, and secondly reducing the flow of blood will desensitise the nerves in the treatment area, thereby reducing any Client discomfort during treatment.
After firing the first treatment pulse the area treated is left for a short period and then checked for reddening, at this point the operator ensures that the Client is comfortable with the procedure and little or no discomfort is present.
Ideally, a small amount of reddening should be seen, particularly around the hair shaft (Perifollicular Erythema) as this indicates successful treatment. If reddening is not evident then the energy setting can be raised. Once reddening is evident and provided the Client is feeling no discomfort, treatment can continue at this setting.
Treatment is conducted with each pulse overlapping the previous by about 1mm; for large areas a red (or white), water soluble marker (no other colour since they will absorb the light energy and heat up the skin) can be used to mark out sections.
Number of Treatment Sessions Required
Generally, between five to eight treatment sessions are required, although it depends upon the area being treated. The aim of each treatment is to reduce the hair density successively to a level that is satisfactory to the Client. If the density of the hair growth has been reduced so much that the hairs are sporadic then electrolysis may be a more suitable treatment to address these remaining hairs.
The number of treatment sessions may increase when treating darker skin or lighter hairs since the percentage of hair removed during each treatment will be reduced in these instances.
Period between Successive Treatments
Due to the cyclical nature of hair growth, a number of treatments are required in order to ensure that treatment covers the early growth stage of all follicles. It is only during this stage, with the hair present, that the follicles can be successfully treated.
It is recommended that each treatment be performed once when the next phase of hair has grown through, this time period varies depending on the area of the body and on the individual. For example, the hair on the upper lip has a growth cycle of approximately 6 weeks, whereas the growth cycle for leg hair is about 24 weeks, so to catch the stages (catagen, telogen) as they come into the "anagen" stage 2 more treatments will need to be scheduled between these weeks. Since growth cycles can vary significantly between individuals, a good indication of the period between successive treatments can be obtained from the Clients themselves. When the Client considers that they have a full re-growth of hair then it is most probably time for the next treatment.
Note: At the start of each subsequent treatment the same safety steps that are recommended for the first treatment are completed. To ensure that subsequent treatments produce favourable results, the Client must inform the Operator if any pigmentary changes have occurred. If so then these are assessed individually, but generally an increase in the amount of melanin in the skin would indicate that a lower energy should be used.
Immediately following the treatment session, or at regular intervals in the case of treatment of large areas, soothing gel is applied to the treated area. Recommended gels include Witch Hazel, Tea Tree or Aloe Vera. These gels have the effect of cooling the area and generally include antiseptic properties to protect the damaged follicle against opportunistic infections.
The client is advised to refrain from using cosmetic make-up, perfumed soaps and similar products for about 24 hours following treatment. Also, exposure to the sun should be avoided for about one month unless a high factor sun block is used as a precaution against exacerbating any pigmentary changes which may not be immediately evident.
If the area is overtreated and small blisters, or crusting, is evident the client should take greater care and must not pick at these, as this may increase the risk of superficial scarring. Preparations which have good antiseptic properties should be used.
What to Expect Following Treatment
The immediate after effect is that the treated area should become slightly red, particularly around the hair (Perifollicular Erythema). Typically, this redness will disappear in a matter of a few hours at most (and often in just a few minutes) with the skin then returning to its normal colour. The Client is advised that the hair will still be in place in the follicle since the treatment, unlike laser, is not a vaporising process.
During the 1 to 3 weeks or so, the hair will appear to continue growing, albeit more slowly than before. What actually is happening is that the hair is no longer supported by the follicle but is being pushed out by the growth of the epidermis which is still in close contact with the hair shaft. If left alone, the treated hairs will fall out naturally.
If the Client does not want to allow the hairs to fall out naturally, then they can be removed manually (e.g. by tweezing or waxing) after about 4 to 7 days. Prior to this time the hair is acting as an effective barrier to infection of the inflamed follicle, and so they should not be removed.