hair removal laser hair removal laser dr. alireza vaez shooshtari dermatologist

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

Post on 13-Dec-2015

216 views

Category:

Documents

3 download

Embed Size (px)

TRANSCRIPT

  • Slide 1

Hair Removal laser Hair Removal laser Dr. Alireza Vaez Shooshtari Dermatologist Slide 2 Hair Removal Hair Removal Electrolysis Electrolysis Creams Creams Laser Laser Slide 3 Slide 4 Slide 5 Slide 6 Laser Hair Reduction Epidermis: 40 - 150 microns Dermis: 140 - 400 microns E & D: 180 >/= 550 microns 1.Papilla: neurovascular tuft 2. Bulge: at Erector Pili 3.Matrix cells:>= 2 mm Anagen> Catogen> Telogen Slide 7 Target Isolation Can we target over other similar targets? Can we target over other similar targets? (Can we seek melanin in hair over skin?) (Can we seek melanin in hair over skin?) Selective Photothermolysis Slide 8 What is the Target ? What is the Target ? Eumelanin: brown or black hair Eumelanin: brown or black hair Best absorption of light Best absorption of light Pheomelanin: red or blond hair Pheomelanin: red or blond hair Poor absorption Poor absorption Gray hair: pigment-free Gray hair: pigment-free White hair No absorption Slide 9 Hair Removal Lasers Hair Removal Lasers Nd:YAG1064 nm Nd:YAG1064 nm Flashlamp575/ 515-1200nm Flashlamp575/ 515-1200nm Diode800/810nm Diode800/810nm Alexandrite755nm Alexandrite755nm Ruby694nm Ruby694nm Slide 10 Relative Absorption of Laser Light & Competing Chromophores 1064nm Slide 11 Features Wavelength: nm Power: watts Fluence:power/cm2 Spotsize: mm Overlap: % Pulsetime: ms Pulse interval: ms or freq Features Wavelength: nm Power: watts Fluence:power/cm2 Spotsize: mm Overlap: % Pulsetime: ms Pulse interval: ms or freq Slide 12 Keys for success Keys for success Wavelength: >690 nm (>wavelength=depth)Wavelength: >690 nm (>wavelength=depth) (shorter -> competing chromophores) (shorter -> competing chromophores) Spot size: at least 5 millimetersSpot size: at least 5 millimeters Pulse time: 18 or > millisecondsPulse time: 18 or > milliseconds Pulse interval of 35 or > millisecondsPulse interval of 35 or > milliseconds Slide 13 When do you treat? During Anagen cycle During Anagen cycle Not during telogen Not during telogen Cycle time determined by Cycle time determined by Richard-Merhag chart Richard-Merhag chart Slide 14 Richards-Merhag Slide 15 Fitzpatrick Types OK: Fitzparick IV/VI:Nd-YAG non-confluent scanner >15 ms Continuous cooling Slide 16 Consultation Patient history( mense, PCO, other sign) Patient history( mense, PCO, other sign) Any previous hair methods Any previous hair methods Expectations Expectations Treatment explanation Treatment explanation 3-6 session, 1-2 month apart 20-30% reduction per session 70-80% long term reduction Photographs & Consent Photographs & Consent Slide 17 Contraindications Contraindications Pregnancy Pregnancy Recent sun exposure Recent sun exposure Sun tan Sun tan Suspicious lesions Suspicious lesions Slide 18 Before Treatment Shave 1-3 days before treatment (stubble) Shave 1-3 days before treatment (stubble) Avoid other methods for 30 days Avoid other methods for 30 days SPF 15+ for 4-6 weeks SPF 15+ for 4-6 weeks Avoid tanning creams Avoid tanning creams Hydroquinone if necessary Hydroquinone if necessary Slide 19 What is the endpoint ? Small contact spark/flash Small contact spark/flash Smell of burnt hair Smell of burnt hair Perifollicular edema Perifollicular edema Sensation of light sunburn Sensation of light sunburn One in three hairs extrude One in three hairs extrude Slide 20 After treatment Redness: 4-6 hours after treatment Redness: 4-6 hours after treatment Hair appears to grow for several days Hair appears to grow for several days Hair falls out: day 10-14 Hair falls out: day 10-14 Hair reappears, next phase: >3-6 weeks Hair reappears, next phase: >3-6 weeks Treat again: >= 6 weeks later Treat again: >= 6 weeks later Slide 21 Complications of Laser Hair Removal Blistering Blistering Hypopigmentation Hypopigmentation Hyperpigmentation Hyperpigmentation Scarring Scarring Koebner phenomenon in psoriasis, vitiligo Koebner phenomenon in psoriasis, vitiligo Temporary or permanent leukotrichia Temporary or permanent leukotrichia Slide 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 Found conversion of fine vellus hair to dark, coarse terminal hair or induction of growth of long fine hair from repetitive low fluence