Laser ProtocolLaser Hair Removal

Choosing the Ideal Candidate

� Skin type I-II can be treated on the Alexandrite

� Skin type I-VI can be treated on the ND:YAG

Determine Skin Type

© Simplicity Laser, LLC 2013

Fitzpatrick Skin Type Assessment

Client Name: _________________________ Date: ____________________ First: Answer the questions below

CIRCLE ONE ANSWER IN EACH LINE/ROW 0 1 2 3 4

FAMI

LY

DISP

OSIT

ION What is the color of your eyes? Light Blue,

gray, green Blue, gray or

green Blue Dark Brown Brown Black

What is the natural color of your hair? Sandy red Blond Chestnut

brown, dark blond

Dark brown Black

What is the color of your skin in non-exposed areas? Reddish Very pale Pale with beige tint Light brown Dark Brown

Do you have freckles in the non-exposed areas? Many Several Few Incidental None

REAC

TION

TO

SUN

EXPO

SURE

What happens when you stay in the sun too long?

Painful, blistering, redness,

peel

Burns followed by

peeling

Burns sometimes followed by

peeling

Rare burns Never had a burn

To what degree do you turn brown? Hardly at all Light color tan

Reasonable tan

Tan very easy

Turn dark brown

Do you turn brown within several hours after sun exposure?

Hardly or not at all. Seldom Sometimes Often Always

How does your face react to the sun? Very sensitive Sensitive Normal Very

resistant Never had a

problem

TANN

ING

HABI

TS When did you last expose your body to the sun or

sun bed? More than 3 months ago

2-3 months ago

1-2 months ago

Less than one month

Less than 2 weeks ago

Did you expose the area you want treated to the sun? Never Hardly ever Sometimes Often Always

Second: Add your total points ____ Third: What other ethnic considerations do you have? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Fourth: Circle your corresponding Fitzpatrick Skin Type

Type I (0-7) Type II (8-16) Type III (17-25) Type IV (25-30) Type V-VI (30+)

The client will fill out the Fitzpatrick SkinAssesment to the best of their knowledge

You will then evaluate their answers and ask the following qualifying questions:

What is your ethnic background? What are your sun exposure habits?

You will then add any notation if there are changes and put it in their medical chart

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New Client Intake Form

� You must review the client medical history for any contradictions such as medications, allergies, history of cancer, illness etc.

� Ensure the client intake form has been signed and all questions have been answered.

� Reviewing every client’s intake form, new or existing to ensure they are elgible for treatment.

� If the client states any changes with their medical history it must be noted in their client intake form.

� If the client has stated they have a tattoo make sure it is documented on the body diagram.

� This form goes in the last page on the right hand side.Canidates that are not elligible for treatments:

- Have been diagnosed with epliepsy, cancer, and HIV - Have used Accutane within the last 6 months - Are currently pregnant

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Informed Consent to Treat

� On all subsequent treatments, ask client for any changes in sun exposure, medications, allergies, menstrual cycle, adverse reactions, illness or pregnancy.

� Client must sign and date the informed consent to be treated before each treatment

*If client is a minor, parent or guardian must sign before each treatment.

� You will then document any notes necessary and initial.

� 0M�JSPLU[�OHZ�OHK�HU`[OPUN�JVUÅPJ[PUN�^P[O�[OL�questions on the consent to treat form, document it in the notes section.

� This document goes on the left side of their medical chart.

Inventory Use

� Always wear gloves for each treatment.

� Always wear a medical mask during every treatment; use one mask per shift.

� Always use white cloth tape over tattoo’s.

� Ensure proper cleaning of equipment and gauges with Steriplex between every appointment.

� Paper drapes are necessary for covering private areas.

� Baby wipes must be used to remove any topical products on the skin.

� Alcohol prep pads must be used for removing make-up or oily topical products.

� White pencils should be wiped with alcohol and re-sharpened between each appointment (please sharpen over garbage and dispose of shavings).

� Disposable panties are available upon client request.

� Apply restorative gel post treatment on all clients.

� Refer to Inventory usage form for further inventory purposes.

Evaluate Areas� When scanning over areas to be treated, look for abnormal

lesions. If you identify to an abnormal lesion, refer them to their medical provider for written clearance.

If an abnormal lesion has been identified, they are not elligible fortreatment on that area until they recieve written permission fromtheir medical provider and approved by Simplicity’s Disctrict Manager.

� What are the signs of an abnormal lesion:

� A - Asymmetrical� Normal moles are symmetrical. Cancerous lesions are

non-uniform.� B - Border.

� Normal Moles have a smooth border. Cancerous lesions have a jagged border.

� C - Color� Normal moles have consistent color. Cancerous lesions

have varying shades.� D - Diameter

� Normal moles are smaller than a pencil eraser. Cancerous lesions are normally bigger than 6mm.

�

Evaluate Areas...continued

� Do not treat over active rashes, wounds or bruising.� If the client does have an active rash in the treatment

area do not treat and inform client to reschedule treatmentonce it is healed.

� For wounds and bruising in the treatment area, mark the area off with white pencil and treat around the affected area.

Tattoo’s

• Evaluating the treatment area for any tattoo’s.

• If the client does have a tattoo in the area being treated, you must tape over the tattoo with white cloth tape.

• You must stay 1 inch away from the edge of the medical tape when lasering.

• To ensure you stay 1 inch away, draw out 1 inch from the medical tape with white pencil.

• DO NOT LASER OVER THE LINE OR THE TAPE.

Tattoo’s... continued

� Tattoo ink is placed in the Dermis just on the border of the Epidermis.

When the laser light is absorbed the heatdisperses under the tattoo ink which causes the ink to heat. The ink may lift out of theepidermis then shed. The heat may alsocause blistering.

It takes 6 to 9 months for the skin to heal before the client can have the tattoo redone.

Due to the severity of this incident, any technician who hits a tattoo with laser light will be suspended, effective immediatelyfollowing the incident.

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Removing Products

� Make sure the area being treated has been cleared of lotions, make-up, deodorant, perfumes, body oils and perspiration.

� Ensure the area being treated has been wiped down with a baby wipe or an alcohol pad before treating.

� When treating the face you must clean with an alcohol wipe, cleaning the entire face and neck in a sweeping motion.Do not forgot to wipe along the hairline and down the front of the neck. The alcohol pad must wipe clean before treatment.

� If the area “sparks” at anytime, STOP immediately and re-wipe the entire treatment area and let dry before starting again.

� If self tanner is used, it must be 7 days or more prior to treatment and the alcohol pad must wipe clean for the client to recieve treatment.

Shaving

• Client must be clean shaven in areas to be treated.

• If client has a few stray hairs we can use a razor to shave the minimal hairs.

• If the area is not shaved they need to be rescheduled.

• Communicate with each client to shave 12-24 hours prior with a clean razor to minimize irritation and possible infection.

Eye Protection

• You and your client MUST wear eye protection at all times during laser treatment.

• For Facial treatments near the glabella, sideburns and eyes, the client must wear metal eye shields.

• NEVER point the laser at the clients eyes.

• NEVER laser inside the ocular orbit or on the eyelid area (i.e. Any soft tissue areas near the eye.).

Mapping

� For larger areas such as legs, back, arms, chest, and abdomen, mark a grid on the skin to ensure thorough coverage of the treated area.

� Only use white eyeliner to mark the grid (i.e. no marker, pens, or highlighters).

� This step is mandatory to ensure consistency of treatment for our clients.

Setting Parameters

� Always refer to your General Parameter Guidelines.

� If the client has had previous treatments it is imperative to review their previous treatment settings and verify reduction with the client.

� If the previous treatment parameters were incorrect, inform your Clinic Manager, District Manager and treat within correct treatment parameters.

.� Double check the settings prior to pulsing the laser.

When going from the Nd: YAG to the Alexandrite laser, you must start at the Alexandrite treatment 1 parameter.

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Treatment Procedures

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Treatment Procedures...continued

� As you proceed with treatment you are looking for the following clinical end points:

1. Even redness across the treated area.2.(�ZSPNO[�W\MÄULZZ�[V�[OL�ZRPU�3. “Pock” like bumps across the skin, especially in areas of

darker, thicker hair.

� STOP treatment and re-evaluate settings, clean equipment and check for topical products on the skin if any of the following are present:

1. Solid red circles.2. Deep red circles that appear within 30-60 seconds after

your laser pulse.3. Slash or half moon shape marks.4. Uneven redness on the skin.5. Extreme client discomfort.

STOP!

PROCEED

Client Comfort

• Use ice during the treatment to increase client comfort, remembering to not leave ice on the area to be treated for longer than 5 seconds.

• Touching the client triggers a response that helps distract and reduce discomfort.

• Offer the client numbing cream for future appointment so we minimize their discomfort.

Treatment Record

� Always write client’s full name.

� Make sure to write in every box and initial every box. Do UV[�KYH^�SPULZ��OHYZO�THYRZ�VY�SHYNL�PUP[PHSZ�[V�ÄSS�T\S[PWSe boxes.

� Always list the date with the year included (i.e. mm/dd/yy.).

� Always ask NAMES questions and document the letter that is necessary in the NAMES column.

� Use SOAP notes when documenting in the notes (See client charting.).

© Simplicity Laser 2012

Laser Services Treatment Record Client Name: _Jane Doe___________________________ Skin Type: ______2_____ First Tx Date: ___12/10/13________ Medical Supervisor Signature:_________________________________________Date__12/10/13_______________

N.A.M.E.S Wavelengths N: Any New medications, illnesses, or allergies since you last treatment? A: Did you have any Adverse reactions from your last treatment? M: Are you on your Menstrual cycle or hormonal medications? E: Since your last treatment did you Experience a) reduction in hair growth or b) desired results

from laser S: When were in the Sun or tanning last?

Alexandrite ND:YAG Diode IPL

Date

NA

ME

S

La

ser

Ma

nf

La

ser

Mo

de

l

Wa

vele

ng

th

TX #

TX Area

SptSize

Flu

en

ce

MS

DCD/ Zimmer

Clinical End Point

(Redness & Swelling

Observed)

Treatment Notes

Sta

ff S

ig.

12/6/13 E Cand G.Pro 1064 1 Face/

Neck 18 15 30 / 4 / 0 1 2 3 4 5 K.A

12/6/13 E Cand G.Pro 1064 1 U/A 18 15 30

/ 5 / 0 1 2 3 4 5 K.A

12/6/13 E Cand G.Pro 1064 1 Braz 18 15 30

/ 5 / 0 1 2 3 4 5 K.A

Post Treatment

� Apply Restorative Gel immediately following treatment.

� Review Post Care instructions and hand them a copy of Simplicity’s Pre & Post Care document.

� Schedule client for their next treatment.