Dee, and others- the most important things, you probably already know, but I will add a few caveats that I hope are available... in any case, this is information I will be gathering from my own customers and other sources... I would recommend consumers keep track of the following as well:
1- Skin type can be relative, so pictures are much better. It would be much better, and more scientific if we had clear photos of the area being treated before, and the same area after. Close up would be nice- so as to be able to clearly see the hair color and thickness.
2- Complete treatment parameters including Energy/cm2, pulse width, repetition rate, cooling method, spot size, and number of passes (if more than one).
3- HIGHLY DESIRABLE- Proof of accurate energy output from laser/IPL source- company name, technician name, and date of service within the last 6 months are of the utmost importance. Any medspa who uses third party service should be able to get this info from the company if they do not already have it themselves.
4- Make, and model of laser, date of manufacture, and software revision- this will give a more clear indication of the particular system's capabilities.
After reading a few posts I have a few suspicions. One is a problem I encounter nearly every day with my customers. Whenever I walk in, most of the time there are people in the waiting room. Usually a certain type of customer is attracted to a particular medspa- I usually see similar skin types at specific medspas. I'm sure most of you will recognize this observation as not "racial" in nature, rather it has a lot to do with equipment, and the experience of the practitioners themselves as well as their marketing, and word of mouth.
In any case, I usually see darker skin types at locations with Yag lasers only, for example. I see lighter skin types in rural areas. I see mixed skin types in sunny locations like Florida, or Southern California, etc. In any case, I gauge who should be more of an expert on what skin type, and I ask questions.
One trend that I see among technicians of all backgrounds, and with customers of all skin types is unusually low treatment parameters. For example, if I go to one of my customers, who has a predominantly Eastern Asian, Latin American, and African American customer base, and I ask her- "For skin type 5, what would you set your Cutera Xeo to?" and she'll say "Oh I use 35/35. That works about 90% of the time."
I know from personal experience that 35/35 is reliable, efficient, and relatively painless (for it's efficacy) for skin type 5 (though I'm probably more between 4-5). In fact, I've gone 25/25, and though it is painful- it is the most efficient setting I've found for my skin type using an Nd:Yag laser with a 10mm spot size.
Most other customers will give me numbers like 20/35... 15/25, etc. THEN they tell me they have problems with darker skin types not achieving good results, or experiencing too much pain!
Now, when I say "painful" please keep in mind that when I play with lasers I use no protection. That is, the only cooling I use when testing a device on myself is any built in cooling mechanism. If it doesn't have one, I don't use any. So if 25/25 is bearable with little to no cooling, it should be more than efficient with appropriate cooling.
But I digress... the point I'm trying to make is that I have seen a trend of unusually low settings. I know what the settings SHOULD be because I, as many of you have pointed out, am not an esthetician- so all I have to go by is manufacturer literature, clinical nurses, scientists, etc. I always recommend these settings to my customers, and ask them not to deviate from them as they take on the liability of experimentation rather than leaving the liability with the manufacturer whom designed the machine to work a certain way.
I believe if we try to keep track of this information we may be able to have our own scientific assessment. I know it seems tedious, but it's probably well worth it. I don't support laser hair removal because I make money selling lasers or repairing them- I support laser hair removal because it is a technology I feel has been misunderstood by practitioners, manufacturers, consumers, the government, service companies, and licensing bodies alike. My background is running and servicing medical equipment management plans in large hospitals. I have been responsible for angio/cath labs that cost upwards of $2 million, and tens of thousands per repair. I've helped administer multi-million dollar contracts involving the purchase of new equipment, and part of my path to those responsibilities has entailed learning how to assess problem issues, document them, and correct them based on statistical data. I hope you all understand where I'm coming from