After performing electrolysis on myself on the front and top of my shoulders with excellent results and then seeing three different professional electrologists for treatment on the back of my shoulders with no results (and $3500), I am going to try laser.

I am a guy with type-2 skin and dark, course hair on my back. I found a clinic close by that uses a Candela Alexandrite and had a consultation yesterday. I was hoping the nurse would try a few different settings so when I go in for my first appointment, I would not have to worry about areas treated at the wrong settings. This is a large area and will cost about $500-$600 so I would like to know the settings are correct. She only tried one or two settings and I think the settings were much too low at about 10 jules.

Of course no one can know the correct settings for me without seeing and possibly working on me, but is 10 jules a good starting point? There was almost no redness. Also, would it be unreasonable to request a second consultation for another test spot to try to nail down the settings? And finally, she said that she would "treat around each hair several times." Does this seem right? Or should each hair be treated once or twice?

Any guidance would be greatly appreciated! Thanks!

We need to know the spot size used. It makes a huge difference. However, even at the largest spot size of 18mm, 10 joules is very low and won't produce any permanent results.

On GentleLASE, on 18mm 20 joules is max. You should try to get as close to that as your skin can handle. Generally, anything under 14-16 joules on 18mm probably won't be permanent. With type II skin, you shouldn't have any problems going high. $500-600 just for the back (and sounds like it may not be full back?) is also definitely on the high end of things. It sounds like you may want to check out more clinics. In general, we recommend at least 4-5 to compare things.

Where are you located? How dense is your hair?

The price is for back and back of shoulders. There is not a lot of hair on my shoulders and the middle of my back, so I am hoping the price will be lower. The $500 - $600 range was quoted from their standard price sheet. There are two clinics near me and the prices at this one are lower, but for San Francisco, this seems fairly normal based on the 2 other clinics I spoke to.

For men and for the areas I want treated, does the larger spot size and shorter pulse work best? And if so, would 18mm and 16 - 18 joules be a good starting point for settings?

Thank you very much for the quick reply and info!

First, dont choose a clinic based on the price. Choose one that has success with male clients. The back region is probably the most difficult to clear. Many factors are working against you and the practitioner.

How old are you? Your age and background may make getting a full clearance difficult. Do you have male pattern baldness?

The first 2-3 sessions your going to want to use an 18mm spot size and 20j or as close to 20j as possible. This is going to hurt, you need to use a numbing agent. EMLA is an Rx or Lidocaine 5% can be purchased over the counter.

Make sure to discuss the induced growth phenomenon with your practitioner. If they have no idea what induced growth is you may want to consult with another clinic. It is rare, but most commonly happens on the back.

I am 42 and have male pattern baldness.

I mainly chose this clinic based on my visit, and partly on location. I felt comfortable with the people working there, the office itself and the nurse who will be treating me. Price was not really a factor.

The nurse said she has treated the same areas on a lot of guys with success. I thought about asking for a reference(s), but even if she's only treated 2 guys successfully, I am sure those would be the two names they would give me so I dismissed that idea.

I did not discuss the induced growth phenomenon. Can anything be done before the treatments begin to minimize the possibility that this will occur? What should I look for once the treatments begin? New hair? Existing hair that is darker?

And regarding the spot size (lagirl's question in her first post), I forgot to ask during the consultation. I called the nurse and she should get back to me within a day or two.

One other piece of info... I had one treatment on the back of my shoulders 8 weeks ago at different clinic. I asked that Alexandrite laser be used, but somehow she ended up using IPL. I did not pay for the treatment and will not be going back there, but the hair in the treated area is much shorter, lighter and less dense. There is a significant difference. It seems like for one treatment 8 weeks ago, the hair should be more like it was prior to the IPL treatment. I had this area treated 8 or 10 times by an electrologist about a year ago, but with little or no change in the density or coarseness. Could the follicles have been damaged enough that one IPL treatment could make a difference?

One of my good friends lives in SF (and I used to) and she went through a pretty rigorous process to find a clinic she's happy with with my help. She's been done with treatments for at least a year now I believe and she has had great results. She finally picked Aura Skin Spa in SF and got treated with GentleLASE at high settings. She really liked the experienced nurse there (sorry I don't know her name). It's someone who went on maternity leave for a while in the past 2 years.

What you should be striving for is high joules, low pulse, and large spot size. The largest spot size on GentleLASE is 18mm, highest joules on that spot size is 20J. Pulse is stable at 3ms on the machine and is not adjustable, so you don't need to worry about it, it's already as low as it gets.

To avoid induced growth, make sure you're only treating dark dense coarse hair. Don't have them touch any areas with finer, more sparse, etc hair, especially on the shoulders.

When you say you had the area treated by electrologist 8-10 times, do you mean you got clearance on the entire area where you want the hair removed 8-10 times? If not, it's really hard to tell whether it worked with so few treatments. However, what you describe now after the IPL treatment could be a results of those electrolysis treatments, i.e. most of the remaining hair is in a certain phase of growth, that you may have hit when you got the treatment. This area has longer hair growth cycles though. So give it another 4 weeks at least before you truly judge if anything changed. Also, the treated hair should have shed.

Also, do understand that even at high settings, laser can kill the coarse hair, but you'll still need electrolysis for any remaining finer hair. Bay Area has lots of electrologists. I'm sure you can find a good one if you do decide to go that route afterwards. This site has lots of info on how to find a good one on the electrolysis section of this forum.

Thanks pdeco1 and lagirl.

Thanks also for the tip re: Aura Skin Spa. I had discounted this place because they seem to focus on other procedures, but I will make an appointment and let you know how it goes. I will also try to post some pictures so you can have an idea of what the hair looks like and the areas I want treated.

Honestly, I'm not sure if there was shedding. I looked for it, but it's difficult to see the area (nape of my neck and back of my shoulders). The hair didn't reappear until about 6 weeks after the treatment. There could have been shedding, but it wasn't obvious. It was not like the hair grew a half inch and then fell out. The ones that have come back, now 8 weeks later, are fewer than before and they are smaller and less dense, but don't feel like they are going to fall out (after gentle pulling).

As for the electrolysis, yes the area was cleared 8 - 10 times. I guess I was going so frequently (2 sessions per week for 1.5 - 2 hours per session over 4 1/2 months), I didn't realize the treatments were ineffective until the electrologist went on vacation for a month. At the end of the 4th week, my shoulders looked like I had never seen an electrologist.

The areas on the front of shoulders that I treated myself over 3 years ago are completely clear so I know it can work for me. Hopefully laser will too and I can find an electrologist who can clear the remaining fine hairs.

Thanks again and if you can remember the nurses name, please let me know!

Actually, you may be misjudging electrolysis. 4.5 months is around the time when your hair gets synchronized and you're seeing a bunch of hair in the same phase at the same time. Electrolysis takes at least 9-12 months to completely go through all the hair cycles and kill hair in each one. So you were probably doing well and just stopped less than half way in. When you do it again, make sure to keep this in mind. You have to commit for at least a year, with both laser and electrolysis. Expect around 8 treatments with laser spaced 8-12 weeks apart for this area.

I emailed my friend about the names of the nurses at Aura. I'll let you know when she responds. There is also a long list of various clinics in SF with names of machines and a bunch of other information about each one. She created a spreadsheet and I pasted all the info in one long post on the forum here. If you run a search, you should be able to find it. It'll probably save you some time calling around various clinics

Also, don't discount places that don't focus exclusively on hair removal. It's most important that the person treating you has experience, especially on their specific machine. And that person can be working at a spa somewhere. Calling and asking questions clears this up.

Here's what my friend said:

"Nita is the one who had a baby. She might still be there part time. Hannah is good...I think thats who's there now and there might be a 2nd person also. All the nurses they hire, even though they are new to Aura, they are not new. They always hire them with experience from other places. So they can call Aura and ask how many years experience the nurse has, but most likely she came from another place where she worked 3+ years."

She also mentioned that they basically use the same settings they established were good for your skin in the beginning unless you want something different. So you can have them do some test spots when you go in.

Thank you so much. I will keep you updated on my progress.

SG