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#94127 - 12/04/11 05:09 AM Paradoxical Laser Hair Stimulation
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Re-posted as a sticky from the 'Be careful' thread.



Paradoxical Laser Hair Stimulation

The use of lasers to remove hair has become very popular in recent years. However, there are sometimes strange phenomena that occur when lasers are used to remove unwanted hair. On rare occasions, instead of removing hair, laser treatments can actually promote hair growth. This phenomena, known as hypertrichosisis, is paradoxical effect of laser epilation. The new hair growth is actually created in part by the effect of the laser although this effect and how it occurs is not yet completely understood. Scientists are now searching for a better understanding of the mechanism behind this paradoxical effect of laser induced hypertrichosis so as to prevent it in future cases.

In order to better understand this phenomenon, scientists set up an experiment using an alexandrite laser to remove the unwanted hair of 489 patients. The patients had all been customers at a single laser hair removal clinic at the University of British Columbia Dermatology Division in Canada, and were treated by trained nurses and supervised by board certified dermatologists. Out of these 489 patients, only 3 cases of laser induced hypertrichosis were identified, but these cases were enough to offer further information on this rare phenomenon.

The three patients who had experienced an increased amount of hair growth instead of a decrease became the focus of further study. Paradoxical hypertrichosis had been seen before in other cases, but it had not been so carefully watched. Scientists first identified the hypertrichosis in each of the three patients by noting an increase in hair density, hair color or hair coarseness after laser application. Once this definition was established, they began to examine each individual case more closely.

One of the patients who experienced this increase was a 39 year old Mediterranean woman with black hair. At first, when the laser was applied to an area with unwanted hair, the hair growth decreased just as it was supposed to. However, the continued applications of the laser resulted in increasingly stubborn hair that would simply not respond to the treatment. Eventually, the woman reported a gradual increase in hair density around that area rather than a decrease.

A second patient who experienced an increased quality of hair growth was a 30 year old white man with black hair on both his arms and his back. The man had wished to have some of this hair removed from his back, but the treatment was not successful. During the first three sessions, he experienced a positive result where the unwanted hair began to slowly disappear. However, further treatments began to require higher and higher intensities of laser light in order to be successful. After six visits to the clinic, the man began to notice an increase in hair growth rather than a decrease. This was only noticed at the specific locations where he had been receiving the treatments. Even with a further increase of laser intensity, there was no success and the man abandoned the treatment entirely.

The third patient who experienced laser induced hypertrichosis was a 21 year old Chinese man with black hair. Besides the common factor of black hair, which existed in all three of these patients, there was a similar skin type amongst them known as Fitzpatrick "Skin Type IV". Skin type IV indicates a darker level of skin that rarely burns with sunlight exposure (as opposed to skin type I, which is very white skin that easily burns when exposed to sunlight). Out of six different skin types in the Fitzpatrick skin type classification; this skin type IV was the only type of skin that was known to have been adversely affected by laser hair removal treatment in any of the 489 patients. Hair color and skin type may have obviously contributed to the hypertrichosis because, just like the other two patients, this third Chinese man began to notice an increased growth after 11 days of the laser epilation.

The results of the testing were compiled and analyzed so that the most obvious cause of the hypertrichosis was determined to be a result of the laser epilation itself. This was evident from the fact that the increased hair growth only occurred in the areas that were treated by the laser but, more specifically, scientists have determined that the problem may be a result of the wrong intensity of laser light rather than just the laser light itself. These ideas are being tested further and it is the hope of scientists that a solution to this rare adverse hair growth occurrence can be corrected in type IV patients.

Paradoxical hypertrichosis after laser epilation references

Alajlan A, Shapiro J, Rivers JK, MacDonald N, Wiggin J, Lui H. Paradoxical hypertrichosis after laser epilation. J Am Acad Dermatol. 2005 Jul;53(1):85-8. PMID: 15965427
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#94128 - 12/04/11 07:00 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
C O'Connell Offline
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Registered: 05/17/09
Posts: 729
Loc: Sydney,Australia
It doesn't appear to occur as often, as it would seem to us electrologists. Personally I have noticed its' occurance in several fair skinned individuals. Perhaps operator skill is a factor too.
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Christine O' Connell, D.R.E., F.I.E. ,M.B.I.A.E. (UK)
http://www.clinicalelectrolysis.com.au

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#94129 - 12/04/11 07:39 AM Re: Paradoxical Laser Hair Stimulation [Re: C O'Connell]
Brenton Offline
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Registered: 06/09/11
Posts: 717
Loc: San Diego
I'm wondering why they also used the alexandrite on someone whose a skin type IV, which seems to run counter to the advice about using a YAG for that skin type

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#94130 - 12/04/11 11:09 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
depilacionelectr
Unregistered


http://tdx.cat/bitstream/handle/10803/2195/GMA_TESIS.pdf?sequence=1

One of the conclusions of this study about effect of IPL (in the face of 52 women), funded partially by the University of Barcelona:

Figure 35. The appearance of fine terminal hair in untreated areas adjacent to treated area was observed in five patients carrying the syndrome polycystic ovarian disease. The diagram explains how the light scattered from the treated area would have a subtherapeutic effect, that would trigger the follicles of the adjacent untreated area, causing terminal hair.

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#94135 - 12/04/11 02:49 PM Re: Paradoxical Laser Hair Stimulation [Re: C O'Connell]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: C O'Connell
It doesn't appear to occur as often, as it would seem to us electrologists. Personally I have noticed its' occurance in several fair skinned individuals. Perhaps operator skill is a factor too.


When they report three out of one hundred had laser hair stimulation, that makes me curious. That is why a national / internatonal data bank would be helpful. I seem to see more and more clients with this frustrating side effect and it personally deflates me to hear their stories. With that said, I am a fan of laser reduction for certain body areas. It does a fabulous job to whack out a lot of hair. If laser reduction was not an option, I would be booked until December 2012. That would be overwhelming indeed, something I do not want.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#94217 - 12/06/11 03:47 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
jonhyvb Offline
Contributor

Registered: 02/23/11
Posts: 45
Great post I must say. It really worries me that all of this PLHS is not studied enough and that this problem seems to be overlooked or not even accounted or known in most laser clinics throughout the world. Mostly in my country.

It also worries me that this tends to happen in darker skins more often...

Also the patient number two intrigues me. The story of him having three treatments and all seemed to go well and then it got worse. It really bothers me and worries me about possible future treatments I could make.

A SUGGESTION: As I've seen the "post success stories", I think it would be great to have a place to gather STORIES AND INFORMATION of cases of paradoxical laser hair stimulation.

-photos
-areas treated
-treatments
-type of skin
-coarseness of the hair
-WHATEVER PEOPLE ARE CONFORTABLE SHARING.

I think it would be very good for the forum as it would make more clear what/who can and shouldn't be treated with laser.

I know it may seem a bad idea for some because it can make people worried, etc... but I think telling about these things is the way to go. Also, I only make this suggestion to laser/ipl treatments because as far as I know they're the only ones that can trigger MORE hair growth, I'm not talking about scars or treatments that simply don't work. Some people search for these treatments because their hair makes them really uncomfortable/depressed, to make their problem worse is as bad as telling someone who suffers from an eating disorder that they're fat.

Just a suggestion, thank you all. I'm glad I've found you.

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#94226 - 12/06/11 09:48 PM Re: Paradoxical Laser Hair Stimulation [Re: jonhyvb]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
That is a wonderful suggestion. Thanks! I have no idea if this is a rare occurrence or not for a woman's face and neck and male upper backs, upper arms and shoulders.

I will run your idea by Andrea and James and see what we can do.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#97414 - 04/02/12 04:26 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Meemz514 Offline
Contributor

Registered: 03/29/12
Posts: 15
What can one do to reverse the effect of paradoxical laser hair stimulation?

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#97415 - 04/02/12 04:45 PM Re: Paradoxical Laser Hair Stimulation [Re: Meemz514]
stoppit&tidyup Offline
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Registered: 05/04/08
Posts: 1799
Loc: London, UK
It cannot be 'reversed'. You must either live with this new hair or have it permanently removed with electrolysis.
_________________________
31/F/UK
Laser for reduction on Underarms, Bikini, Full Legs & 3/4 Arms. Skin type IV
Electrolysis - Further details in: My sister's electrolysis diary
[27hrs of Blend, April 2008-Dec 2010 in UK, for coarse hair on lower sideburns, coarse chin hair, completed upper lip, shaped eyebrows]
[Sept 2011 to date, once yearly sessions with Josefa. Completed reduction of facial/neck fuzz in approx 27 hrs TTT]

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#97420 - 04/02/12 07:57 PM Re: Paradoxical Laser Hair Stimulation [Re: stoppit&tidyup]
Meemz514 Offline
Contributor

Registered: 03/29/12
Posts: 15
How about if you do laser and apply Vaniqa? Would that help?

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#97421 - 04/02/12 08:00 PM Re: Paradoxical Laser Hair Stimulation [Re: Meemz514]
Meemz514 Offline
Contributor

Registered: 03/29/12
Posts: 15
Stopit&tidyup Do you know any good Electrologists in London?

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#97427 - 04/02/12 10:52 PM Re: Paradoxical Laser Hair Stimulation [Re: Meemz514]
beate_r Offline

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Registered: 07/25/05
Posts: 853
Loc: Hattersheim, Germany
Originally Posted By: Meemz514
How about if you do laser and apply Vaniqa? Would that help?


One of my clients suffers from induced hair growth caused by vaniqua.

Anyway: vaniqa reduces hair growth only during the time it is applied regularly. "Reduces" does often just mean that the hair is growing slower.
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Beate Ritzert

Elektroepilation Dr. Beate Ritzert
http://epi.ritzert.net/en/

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#97428 - 04/02/12 11:00 PM Re: Paradoxical Laser Hair Stimulation [Re: beate_r]
Meemz514 Offline
Contributor

Registered: 03/29/12
Posts: 15
Beate r. Thanks for the information! My dermatologist told me that it can't make matters worse. I was a bit suspicious. Thanks for setting that straight.

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#97430 - 04/02/12 11:06 PM Re: Paradoxical Laser Hair Stimulation [Re: beate_r]
stoppit&tidyup Offline
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Registered: 05/04/08
Posts: 1799
Loc: London, UK
Meemz,

My electrologist in London was Sharon at Parkside Beauty Centre.

http://www.hairtell.com/forum/ubbthreads.php/topics/97043/Mark831.html#Post97043
_________________________
31/F/UK
Laser for reduction on Underarms, Bikini, Full Legs & 3/4 Arms. Skin type IV
Electrolysis - Further details in: My sister's electrolysis diary
[27hrs of Blend, April 2008-Dec 2010 in UK, for coarse hair on lower sideburns, coarse chin hair, completed upper lip, shaped eyebrows]
[Sept 2011 to date, once yearly sessions with Josefa. Completed reduction of facial/neck fuzz in approx 27 hrs TTT]

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#97433 - 04/03/12 02:27 AM Re: Paradoxical Laser Hair Stimulation [Re: beate_r]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: beate_r


One of my clients suffers from induced hair growth caused by vaniqua.


Wowee! This is the first time I heard this! Is this your client's personal conclusion? This should be reported. I believe there is a form on the FDA website to do this? Or, maybe the prescribing physician should be told? I am really curious about this one. I can't find anything on the internet so far about this, Beate. It is not a life threatening side effect, but if you think this should be reported, here is some information:

Report Problems to the Food and Drug Administration
 You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#98273 - 04/30/12 07:44 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
mhawkes Offline

Major Contributor

Registered: 01/23/11
Posts: 183
Loc: oban scotland uk
I don't think PLHS is that rare, as an electrologist having returned to Scotland just over a year ago, and now working mainly on Celtic skin types I have already encounter this kind of promoted hair growth. I have had 5 clients so far with this problem. Laser/ipl not sure which, seems to cause this problem on the neck and sideburn area, typical hair growth that I have seen from PLHS is fine long and dark. Will be interesting to see if the scientists can come up with any answers?
_________________________
mairi hawkes D.R.E. Apilus Platinum. Trained and worked in Uk and Australia
Member of the British Institute and Association of Electrolysis since 1993
Fully licensed by Argyll and Bute Council UK.
www.aeclinic.co.uk

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#98274 - 04/30/12 01:34 PM Re: Paradoxical Laser Hair Stimulation [Re: mhawkes]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
I see this enough times where I would not label it as rare. I also see fabulous results with LASER, which makes my job easier. Clients need to be INFORMED of the possibility that this may or may not happen and then be willing to invest more time, money and effort in electrolysis to clean up the extra hair.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#98275 - 04/30/12 03:23 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
mhawkes Offline

Major Contributor

Registered: 01/23/11
Posts: 183
Loc: oban scotland uk
Many clients have had successful laser treatments. Though many are also spending too many years having treatments without making progress. I agree Dee the public have to be better informed, thank goodness for websites like this.
_________________________
mairi hawkes D.R.E. Apilus Platinum. Trained and worked in Uk and Australia
Member of the British Institute and Association of Electrolysis since 1993
Fully licensed by Argyll and Bute Council UK.
www.aeclinic.co.uk

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#99053 - 05/30/12 03:34 PM Re: Paradoxical Laser Hair Stimulation [Re: mhawkes]
carljung Offline
Contributor

Registered: 03/09/12
Posts: 12
Can more laser get rid of paradoxical laser hair stimulation or is the new hair untreatable?

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#99055 - 05/30/12 03:41 PM Re: Paradoxical Laser Hair Stimulation [Re: carljung]
stoppit&tidyup Offline
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Registered: 05/04/08
Posts: 1799
Loc: London, UK
Laser places will tell you 'yes'.

I have not come across anyone who has experienced this and then found further laser improves the situation. And I know a number of people who carried on for a year or more after already going through a course of treatments which lead to laser induced growth.
_________________________
31/F/UK
Laser for reduction on Underarms, Bikini, Full Legs & 3/4 Arms. Skin type IV
Electrolysis - Further details in: My sister's electrolysis diary
[27hrs of Blend, April 2008-Dec 2010 in UK, for coarse hair on lower sideburns, coarse chin hair, completed upper lip, shaped eyebrows]
[Sept 2011 to date, once yearly sessions with Josefa. Completed reduction of facial/neck fuzz in approx 27 hrs TTT]

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#99058 - 05/30/12 04:03 PM Re: Paradoxical Laser Hair Stimulation [Re: stoppit&tidyup]
beate_r Offline

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Registered: 07/25/05
Posts: 853
Loc: Hattersheim, Germany
Well, laser people also believe in their method.

A quick research in MEDLINE shows several abstracts reaching back ovfer about 10 years. The content can be summarized as:

- no idea what's going on
- extremly rare condition
- can be cured by further treatmens
- no proof of the latter, not even attempts to explore that

Reminds me to "Vogel Strauß" - hide its head in the sand.

I also saw some victims of that, some of them with massive additional growth (possibly the underlying hormonal issues play their role?).
_________________________
Beate Ritzert

Elektroepilation Dr. Beate Ritzert
http://epi.ritzert.net/en/

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#99061 - 05/30/12 05:30 PM Re: Paradoxical Laser Hair Stimulation [Re: beate_r]
carljung Offline
Contributor

Registered: 03/09/12
Posts: 12
It seems like more laser would fix it since the hair is dark and "terminal", but who really knows what's going on? Haha.

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#102962 - 12/03/12 01:09 AM Re: Paradoxical Laser Hair Stimulation [Re: stoppit&tidyup]
Crest Offline
Member

Registered: 11/27/12
Posts: 2
My son is experiencing this paradoxical hair stimulation after having laser hair removal on his back shoulders; Unfortunately now has more hair than before. Will electrolysis cover a large area such as back and shoulders? How long would it typically take? Any recommendations for someone in BayArea (Between SF and San Jose)?

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#102963 - 12/03/12 01:12 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Crest Offline
Member

Registered: 11/27/12
Posts: 2
I personally had successful laser treatments for underarms and bikini area but my son has had increased hair growth on back and upper shoulder. After the PA at the dermatologist office (same person who did my laser treatment) said he is experiencing this paradoxical hair growth issue, she even checked with various "experts" and tried various settings on the laser, to no avail.
Is electrolysis his only other option? How long for a large area (now VERY hairy) such as back? Will he experience better results?

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#102967 - 12/03/12 03:38 AM Re: Paradoxical Laser Hair Stimulation [Re: Crest]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Crest, yes, electrolysis can help, but not every electrologist may enjoy doing large areas, so that limits his options. It takes quite a bit of effort and time to do a large back area and it is costly, but it does work as long as the electrologist punches those hairs. I tell my clients that they really have to want this and they have to stay on an ambitious schedule.

Submitting a picture would be great.

I never seem to get those men with back hair that only take 12 hours to clear. My guys take anywhere from 40 hr. - 125 hours just to clear. However, after that first, full clearance, it's all down hill.

Specifically, I like to use Synchro thermolysis with a large probe. That's my favorite, but I can make any modality work.

Yes, electrolysis is the only choice for your son now that laser has changed the hair structure and stimulated more hair to grow.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#102992 - 12/03/12 05:00 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
LAgirl Offline

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Registered: 12/22/04
Posts: 9994
Loc: New York, NY
Please post on the electrolysis forum with photos. If the hair is not COARSE AND DENSE, then electrolysis is the only permanent option, no matter how long it takes. An average electrologist removes 5-10 hairs per minute. You need a clearance of all present hair once a month or so for about 12-18 months. So you can estimate timing that way.

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#103894 - 01/07/13 06:30 AM Re: Paradoxical Laser Hair Stimulation [Re: Crest]
odi Offline
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Registered: 05/08/09
Posts: 380
Originally Posted By: Crest
My son is experiencing this paradoxical hair stimulation after having laser hair removal on his back shoulders; Unfortunately now has more hair than before. Will electrolysis cover a large area such as back and shoulders? How long would it typically take? Any recommendations for someone in BayArea (Between SF and San Jose)?



You didn't mention how old your son is.

Guys continue to develop hair in that area until the late 20's so if he had some hair and was treated and ended up with more hair, it doesn't necessarily mean that the laser stimulated more hair, it could also mean that not all the hair grew before he started the treatment.
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Laser Hair Removal Toronto (my own clinic)

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#104367 - 01/31/13 07:03 AM Re: Paradoxical Laser Hair Stimulation [Re: odi]
prettysure Offline
Major Contributor

Registered: 09/29/05
Posts: 57
Loc: nyc
i can add here, i got a diode test (well, it was supposed to be a treatment, but i got outta there) for my chin with someone who had no idea what they were doing. (i want to say a few years ago or more). She did place it under the jaw, so at least she knew to be inconspicuous, right next to the jaw bone. I could feel it really just feeling way too hot and not right (oh yeah, something like a laser being burned into my skin!), she did at most 10(?) zaps of the laser when i thanked her and left, and i'm not sure how much later(a handful of months maybe i think when i noticed) i got coarse straight hairs growing right at the top of my neck where it meets the jaw, i have never had them before, can't remember how many, 10? 15? Started as a couple then i actually had to spend time plucking them, so no idea how many in the end, but not too many. I am olive medium brown, this was a few years ago. (i got rid of them with electrolysis recently).
_________________________
38 y/o female. Fitzpatrick III-IV

95%+ hair reduction on legs from nd:Yag laser done years ago
75%+ hair reduction on axilla with nd:Yag laser done years ago (the rest being finished with flash electrolysis)
100% permanent hair removal on bikini line with electrolysis over 15 years ago
100% removal of hair on chin with flash electrolysis (well, almost done, maybe 2 fifteen minute sessions left for the small amount of dormant hairs.
0% permanent removal on brazilian after 5 sessions of Yag (and 3 IPL). no idea why. Will try again in 2013.

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#105807 - 03/30/13 06:19 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Michk Offline
Contributor

Registered: 03/23/13
Posts: 25
I'm a new member and wrote a post the other day regarding electrolysis scars. But, I am also curious about laser stimulation as I believe it happened to me. I did LHR prior to electrolysis on my lip and chin. I had some dark, course hairs but not enough to cover the whole area. I know the first couple of treatments was done on a lower setting bc the nurse was afraid of hyperpigmentation( I was just getting over melasma from my 3 pregnancies). She did turn it up after once she knew my skin was ok. After going for about 10 months( 6 wks apart) she said electrolysis would be best to take care if the rest. At this time, I noticed that my peach fuzz type hairs seemed longer all over my face and some with more color? I have no idea if this was a post pregnancy/ hormonal thing or due to laser or bc I had never examined my face so closely?) Does anyone know if the new hairs are usually course, or just more in quantity? I feel like my lip did not get fuzzier, but my cheeks, jawline, chin and under chin did. I'm also 38 so I know woman do get fuzzier w/ age. I really wish I knew about laser stimulation prior to getting laser..... I need to figure out a way to stop beating myself up about it!!!

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#106696 - 05/10/13 02:32 AM Re: Paradoxical Laser Hair Stimulation [Re: Michk]
CRC Biomedical Offline

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Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
There is no scientific basis for the claim that laser hair removal lasers stimulate new hair growth. This is completely contradictory to science, in fact. What may be happening, as some have mentioned, is a natural coincidence of the failure of a laser to remove hair, and naturally occurring new hair growth.

Laser hair removal is designed to destroy the hair follicle through targeted heating of the melanin in hair. The energy delivered is not literally hot- the wavelength of the laser is attracted to the melanin and heats it up. So if there is heat- there is a destructive reaction. There is never a constructive reaction from lasers.
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The industry leaders in third party laser sales, service, and warranties!
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CRC Biomedical Services

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#106699 - 05/10/13 04:33 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
How many years have you personally performed laser reduction?

There have been a serious pattern of consumer post over the years here on Hairtell and the cosmetic enhancements forums of people observing laser hair stimulation. There is at least one scientific paper copied and pasted on this forum noting this fact. As a practicing electrologist, I see many ex-laser clients for clean ups and there have been more than enough that swear they have more hair than when they started their laser treatments.

If you are profiting from the sale of lasers, then I can see why you would make the statements you made. On the other hand, we all like to learn from experts like yourself.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106700 - 05/10/13 05:51 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
mhawkes Offline

Major Contributor

Registered: 01/23/11
Posts: 183
Loc: oban scotland uk
CRC, the type of hair I see in clients with PLHS is all too similar to be anything but this, tends to happen on the neck and sideburns area and is dark, long and thin.
I would get referrals from the laser clinics when I worked in Sydney as this was not a rare occurrence. Plus on the consultation forms that I have seen from several clinics this is one of the wavers they have sign against- that there could be promoted growth.
By the way I regularly recommend laser for some of my clients so I'm definitely not anti, electrolysis and laser can compliment each other very well.
_________________________
mairi hawkes D.R.E. Apilus Platinum. Trained and worked in Uk and Australia
Member of the British Institute and Association of Electrolysis since 1993
Fully licensed by Argyll and Bute Council UK.
www.aeclinic.co.uk

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#106706 - 05/10/13 01:34 PM Re: Paradoxical Laser Hair Stimulation [Re: mhawkes]
Michael Bono Offline

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Registered: 01/11/11
Posts: 3051
Loc: Santa Barbara, CA USA
“There is no scientific basis for the claim that laser hair removal lasers stimulate new hair growth.”

Adding my two-cents here. I would say “indeed,” and that’s why it’s called “paradoxical hair stimulation,” since this mechanism is not yet known.

A better statement: “At this time, there is no know scientific basis for the many reports and observations of lasers stimulating new hair growth.”

I could offer a few suppositions, but even more interesting is reduced hair growth from laser with virtually no thermal reaction.

We all assume that the mechanism of laser’s success is thermal (and it probably is). However, several clinics use laser at extremely low settings, multiple treatments and are “paradoxically” reducing hair growth on black men’s beards. (Reference: Skip Mahler, Instantron).

I have seen more than 30 or so men who have had laser and the normal ratio of anagen/telogen hair was “reversed.” After many laser treatments: one (or two) anagen to 99 telogen! (Yes, I counted.) “Prolonged telogen” is also talked about in the literature. How can “thermal damage” alone do that? “Paradoxical?”

The true scientific mind never stops looking for the truth and never rests with “established theory.”

Since the 1930s, we have been told that dental X-rays were completely safe. As late as 2000 we were still told this. A little research on the internet will open your eyes on this one … at least to see that the controversy is NOT over. Yes, still “pro and con” after all these decades!

http://www.economist.com/node/21552538
http://titusdentistry.com/2012/04/x-rays/

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#106748 - 05/12/13 02:10 AM Re: Paradoxical Laser Hair Stimulation [Re: Michael Bono]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
I think you are using not very well researched information. Let's start where you ended:

"Since the 1930s, we have been told that dental X-rays were completely safe. As late as 2000 we were still told this."

This is not true at all. Anna Bertha Roentgen died in 1919 of radiation sarcoma. She was the first person to receive an x-ray, and the first person to die from ionizing radiation poisoning due to x-ray use. Her husband, Wilhelm Roentgen, the inventor of the x-ray, regularly used lead shields to protect himself from x-rays. To this day every x-ray machine is manufactured to store the treatment parameters used on every patient so as to log radiation exposure, and meet other regulatory requirements per 21 CFR 1020.30-33 and other regulations intended to protect patients from exposure to ionizing radiation. The Center for Devices and Radiological Health at the FDA is the department charged with governing x-rays and their use. If you have been told dental x-rays are safe, you may simply misunderstand the definition of "safe".

""The true scientific mind never stops looking for the truth and never rests with “established theory.”
- That's a manipulative statement intended to level an accusation against my assessment based on known evidence. It is not actually a rebuttal.

"We all assume that the mechanism of laser’s success is thermal (and it probably is)'

"We" is quite a few individuals. Not all laser treatments work by the thermal energy produced by lasers. Some treatments work due to the destructive impact the laser light has on a particular chromophore. But whether we are discussing thermal energy, or kinetic- these are the only proven mechanisms of laser. All others are results of these two.

"A better statement"
- A statement is only "better" if it actually enhances the message of what the person is trying to get across. In this case, your choice of words is better for you because you have chosen to speculate about a notion that has no evidence worth speculation. My choice of words is based on my knowledge of how lasers work, and how they do not.
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
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CRC Biomedical Services

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#106749 - 05/12/13 03:13 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
CRC, I'm interested to know if you actually perform LHR on people or do you sell and service lasers only. I asked that a couple of posts ago.

Are you seeing patients and performing laser reduction on a weekly basis? Roughly, how many treatments do you perform a week?
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106750 - 05/12/13 04:03 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Michael Bono Offline

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Registered: 01/11/11
Posts: 3051
Loc: Santa Barbara, CA USA
Well, you certainly know everything.

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#106751 - 05/12/13 04:10 AM Re: Paradoxical Laser Hair Stimulation [Re: Michael Bono]
Michael Bono Offline

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Registered: 01/11/11
Posts: 3051
Loc: Santa Barbara, CA USA
Only one comment (I will not get into a pissing contest with you).

When I said "told x-rays were safe," I meant the dentists told us they were safe ... they still do!

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#106757 - 05/12/13 12:47 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
beate_r Offline

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Registered: 07/25/05
Posts: 853
Loc: Hattersheim, Germany
Originally Posted By: CRC Biomedical
There is no scientific basis for the claim that laser hair removal lasers stimulate new hair growth. This is completely contradictory to science, in fact.


That is plain wrong.

I did a research in medline a while ago and found articles documenting that photoepilation may well stimulate hair growth - for unknown reasons - since more than ten years ago.

Bein an electrologist i have seen several of the victims, and i know the same from many of my collegues.

As a vendor and manufacturer You should be honest about the risks and possible side efects of Your machines. In the same way we as electrologists (some with a background as scientists) to as well.

(But that seems to be a problem in the LHR industry - the extreme unawareness of the limitations and even risks of their method, increasing the number of inadequate results)
_________________________
Beate Ritzert

Elektroepilation Dr. Beate Ritzert
http://epi.ritzert.net/en/

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#106759 - 05/12/13 02:07 PM Re: Paradoxical Laser Hair Stimulation [Re: beate_r]
Brenton Offline
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Registered: 06/09/11
Posts: 717
Loc: San Diego
I'm going to throw these out here:

http://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2009.01433.x/abstract

http://skin.gcnpublishing.com/fileadmin/content_pdf/archive_pdf/vol38iss6/70445_main.pdf

http://www.ncbi.nlm.nih.gov/pubmed/15965427

I'm not going to argue on one side or the other, but I wanted to add that just because we observe something, that's not enough to say there is a scientific basis for why it happens (I'm running on about 5 hours of sleep right now so I may want to reword this later.) For example, why is it fine hairs on the face/shoulders are much more likely to have induced growth than on the legs? Why is it that if I laser an area and the hair becomes much finer and weaker, why does lasering it again not seem to result in induced growth?

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#106761 - 05/12/13 02:32 PM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
Michael Bono Offline

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Registered: 01/11/11
Posts: 3051
Loc: Santa Barbara, CA USA
SEHR gut gesagt, Beate!

Back at CRC again …

In your original statement you seem to be saying that since there is no “scientific basis” for “paradoxical hair stimulation,” these observations are worthless, mistaken and should therefore be dismissed.

Then you say: “… In this case, your choice of words is better for you because you have chosen to speculate about a notion that has NO EVIDENCE WORTHY OF SPECULATION.”

Question: So, when did you become the anointed arbiter of “truth?” Hasn’t the Inquisition been over for, well, a few decades anyway? Is Stalin still in power? I mean, aren’t we allowed to ASK questions based on our observations?

I have learned, over the years, to listen to people’s observations, and even their suppositions. Real scientists question everything, including their own “sacred ideas.” All of us, EVERYONE, has a RIGHT to ask questions, even if the questions seem “stupid” or UNWORTHY to you “Mein Herr CRC.”

Finally, here’s a question for you that, since you are THE laser expert, I have wanted answered for years! (Try answering this as a BIOLOGIST and not a physicist!).

(Background: I have been doing electrolysis for 38 years and have observed many hundreds — probably thousands — of patients: I know what NORMAL hair growth looks like!)

Question: How does laser “induce” an entire field of body hair to completely REVERSE the normal hair growth cycle that then results in more than 97% of the hairs now being in telogen stage? Please answer this, thanks. (Thermal, Kinetic, Martian invasion?)

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#106769 - 05/13/13 02:26 AM Re: Paradoxical Laser Hair Stimulation [Re: Michael Bono]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: Michael Bono
...........................

Question: How does laser “induce” an entire field of body hair to completely REVERSE the normal hair growth cycle that then results in more than 97% of the hairs now being in telogen stage? Please answer this, thanks. (Thermal, Kinetic, Martian invasion?)


A light bulb went off in my head a couple weeks ago. I have been so puzzled by a young woman who had laser hair reduction on her bikini line and underarms. The reduction had been great, probably 90%, but over the course of three years now, I am still removing sporadic hairs! The hair structures are not small. I would say they are medium to coarse to very coarse.. When treated, they slide out with no traction whatsoever. Like clockwork, every 6 weeks, she's back for another clearing. This is not the same hair. My best guess is, either new hair is sprouting or laser caused some hairs to go dormant and the are waking up bit by bit.

I know how to permanently disable hair follicles. I do not feel that I am ever going to reach the bottom of the barrel for this case. We are both frustrated. I do think it has something to do with her previous laser treatments. Good thing she is a very patient person.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106783 - 05/13/13 04:40 PM Re: Paradoxical Laser Hair Stimulation [Re: Michael Bono]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
" you seem to be saying that since there is no “scientific basis” for “paradoxical hair stimulation,” these observations are worthless, mistaken and should therefore be dismissed."
- That is not quite a rational rebuttal. As a consumer, if something does not have a scientific basis, it is that notion, or product, which should be dismissed.

"So, when did you become the anointed arbiter of “truth?”"
- Adult and professional conversation requires no arbiter of truth other than truth itself. Simply asking when I became the arbiter of truth doesn't actually challenge my statements- only facts do.

"aren’t we allowed to ASK questions based on our observations?"
- Of course you are "allowed" to ask questions. Am I not "allowed" to answer questions factually?

"Real scientists question everything"
- First of all, I've never claimed to be a scientist. Second, scientists operate by the scientific method. When they question their own notions, it is due to new evidence, not anecdotal speculation.

"How does laser “induce” an entire field of body hair to completely REVERSE the normal hair growth cycle that then results in more than 97% of the hairs now being in telogen stage?"

- While I believe your question is cynical in nature, and not truly inquisitive, I will answer nonetheless.

First, it is common sense that photothermolysis is the primary function of the laser in laser hair removal. The monochromatic light is attracted to specific chromophores, and this attraction is converted into heat energy, damaging any chromophores attracting the laser light.

When performing hair removal, you must be aware of this, as well as the natural cycle of hair growth, but more specifically, the cycle of hair growth per body part.

25% of the average chest and back hair is anagen at any given time, while 75% is telogen vs. 85% anagen in the scalp (not necessarily an area you want to treat for hair removal- just using an example) and 15% telogen. The duration of telogen in the scalp is 3 months on average, and 9 months on the chest and back.

At least two responses occur to hair removal treatment:
1- Sublethal injury to the bulge with induction of long term or permanent regression to a vellus hair (miniaturization).
2- Sufficient energy is delivered to the bulb and bulge to completely and selectively destroy the follicle.

There are various limitations- in most cases, telogen follicles will be shocked, and recur as anagen follicles; not every anagen hair will be affected; treatment parameters, technique, appropriate wavelength, adequacy of coverage- a myriad of factors may affect the efficacy of treatment.

Typically, after the first treatment, both anagen and telogen hairs are shed; the longer duration of telogen in the treated area, the longer the interval before visible hair appears; a greater percentage of follicles enter anagen synchronously, etc.

After the second treatment, follicles will enter anagen before visible hair shafts appear. You can either treat at an interval equal to half the telogen phase, or treat when visible hair makes a reappearance.

"Paradoxical hair growth" is best understood as sublethal thermal stimulation and resultant hyperemia. This can be prevented by double passing, or appropriate peripheral cooling. It's not so much "paradoxical" as it is poorly understood.

While laser hair removal is not regarded as "permanent," the length of hairlessness in large areas has been known to extend, in many cases, upwards of 11 years- the standard for consideration as "permanence," after 5-10 treatments.
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106793 - 05/13/13 08:23 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
Michael Bono Offline

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Registered: 01/11/11
Posts: 3051
Loc: Santa Barbara, CA USA
I’m certainly not cynical, but “your tone” from your first comment was (and is) haughty and condescending; we have all reacted to this (private emails). It’s probably just a personality trait. But no problem really. (I’ve taken “classes” from Anderson and Goldman and both fellows were kind, sincere and interested in my "silly" comments … and were never condescending.)

I’m pretty sure that you got your hair growth “statistics” from a textbook. In reality, the amount of hairs on a young person’s body (such as the back) is more like 70% anagen (young male). I have seen all the various textbook charts and some are close to reality and others are way off.

As a “worker in the trenches” some of the results from laser have been wonderful … but also very odd and inexplicable. Time will sort this all out.

Indeed, I understand TOTAL thermal destruction of a hair follicle but (as you say):

“1-Sublethal injury to the bulge [causes] with (sic) induction of long term or permanent regression to a vellus hair (miniaturization).” (I changed your sentence, because it didn’t make any sense the way you wrote it. Actually, it wasn’t a sentence.)

Anyway, how do you suppose that this “regression” takes place? How do germ cells in the bulge, having been “sublethally” injured, create a progressively smaller hair … or, for that matter, a major shift in hair growth cycles. THAT’S MY QUESTION!

Just being picky, but your first statement makes no sense. You are actually agreeing with me. You DID dismiss “paradoxical hair stimulation” (as well as the observer herself) because it had no “scientific basis.” But I do agree with your second sentence.

Anyway, it really doesn’t matter since the MARKETPLACE is going to decide what it wants. Over the years, I have read countless “scientific papers” (from “famous” reputable physicians) that endorsed all types of truly stupid devices and techniques (frauds?). If you’re in “the business” you know how this works.

In the end, clients are only interested in what WORKS for them and could “care less” about you and me “ranting” at each other. (It is sort of fun, however! Well, maybe not “fun” … )


Edited by Michael Bono (05/13/13 08:50 PM)

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#106800 - 05/13/13 10:20 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: dfahey
How many years have you personally performed laser reduction?

There have been a serious pattern of consumer post over the years here on Hairtell and the cosmetic enhancements forums of people observing laser hair stimulation. There is at least one scientific paper copied and pasted on this forum noting this fact. As a practicing electrologist, I see many ex-laser clients for clean ups and there have been more than enough that swear they have more hair than when they started their laser treatments.

If you are profiting from the sale of lasers, then I can see why you would make the statements you made. On the other hand, we all like to learn from experts like yourself.


CRC, did you see this post? It would be so helpful if you would respond to this.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106801 - 05/13/13 10:41 PM Re: Paradoxical Laser Hair Stimulation [Re: Michael Bono]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
"I’m certainly not cynical, but “your tone” from your first comment was (and is) haughty and condescending"
- Mr. Bono, while I appreciate your taking the time to respond, understand that I am not A- your employee, B- your child, or C- in any way your inferior. As such, it is not your place to tell me how you perceive my factual premises to be haughty and condescending. If my responses are inaccurate, then please point out their inaccuracies. Your personal assessments are both unnecessary and completely irrelevant.

"we have all reacted to this (private emails)"
- I'm glad to hear a couple of you have joined hands and exchanged emails concerning a topic placed right in public view on the internet, and by someone who has neither a need to hide behind a computer, nor the reason to. My statements are out in the open, and I am fully responsible for every word I say.

"I’m pretty sure that you got your hair growth “statistics” from a textbook"
- Again, Mr. Bono, I'm sure in your education as a school teacher, and in your experience educating other human beings you, at some point, learned there are logical fallacies in arguments. If my information is incorrect- then please state so, and how so. If it is correct- the source is irrelevant, is it not?

"In reality, the amount of hairs on a young person’s body (such as the back) is more like 70% anagen (young male)."
- And this just proves you didn't take time to read my statements. The length of anagen and telogen would make a young male's back a similar percentage anagen some times as it is telogen at other times. A young male's back hair doesn't continuously grow of it's own accord, now does it? And if the typical male's back is 70% anagen all the time, wouldn't that imply most young males have hairy backs??? Or are you merely singling out a particular group in the overall scale of my statistical analysis of human backs in general so as to attempt to make a point?

"I have seen all the various textbook charts and some are close to reality and others are way off."
- And as a historian, you would know this is why we call this data statistical analysis. You would also know that anecdotal evidence may account for a reduction in statistics with regard to an overall total, but don't account for truth beyond the statistical analysis to begin with. So if I say, for example, the average back is 75% telogen for 9 months, and you say "the amount of hairs on a young person's body, such as the back, is more like 70% anagen in a young male," my statistics would agree with your suggestion at least 3 months out of the year. Of course, your information is incorrect, and your point is moot... but we will let others decide for themselves, shall we not?

"results from laser have been wonderful … but also very odd and inexplicable."
- There are very few results from lasers that can be considered "very odd and inexplicable"- especially from the point of view of an esthetician vs. that of a dermatologist. They may be odd and inexplicable to you, but not to everyone... such as the flight of a bumble bee is a miracle to some, yet a bumble bee flies completely within the confines of physical law.

"Sublethal injury to the bulge with induction of long term or permanent regression to a vellus hair (miniaturization)"

- Let me break down my statement for you so you understand it. I will try to use 8th grade English as much as possible.

My statement was made as follows-

"At least two responses occur to hair removal treatment:
1- Sublethal injury to the bulge with induction of long term or permanent regression to vellus hair (miniaturization)"

Let me break it down for you... At least two responses (to laser) occur to hair removal treatment...

This means that at least two responses occur during laser hair removal. The hair is doing the responding. It is responding to the laser energy.

The first possible response is sublethal injury to the bulge (this means only part of the follicle is damaged). This induces long term, or permanent regression of the hair to vellus (fine) hair. This is called miniaturization.

The second possible response is, when sufficient energy is delivered to the bulb and bulge (the whole of the follicle), the follicle is completely destroyed.

I didn't originally write them as complete sentences, rather bullets... but thanks for your attempt at correcting my grammar. I see your desire to challenge me is not limited to your self perceived offenses against your profession as an esthetician.

" How do germ cells in the bulge, having been “sublethally” injured, create a progressively smaller hair … or, for that matter, a major shift in hair growth cycles. THAT’S MY QUESTION!"
- I don't believe this is a very honest question... but I will answer it as best I can. It is commonly known that Telogen Effluvium, or "thinning hair" is a natural process caused by stress, DHT, and other known and unknown causes. In any case, the hair enters either extended or permanent periods of telogen. I believe I did explain the treatment cycles of hair removal, and that one of the effects is, well, Telogen Effluvium. In this case, damage to the follicle causes shock and regression to anagen, and after every treatment, anagen is less aggressive, while telogen becomes extended over time. This is a DESIRED effect of laser hair removal, and I guess I truly don't understand your confusion. Are you asking for a common sense answer, or are you looking for a scientific answer down to the cellular level? What, exactly, is the point of your question???

"Just being picky, but your first statement makes no sense"
- You mean you don't understand my first statement. It makes perfect sense.

"You are actually agreeing with me"
- I'm not agreeing with you at all.

"You DID dismiss “paradoxical hair stimulation” (as well as the observer herself) because it had no “scientific basis.”"
- I did... and I haven't retracted that dismissal.

"the MARKETPLACE is going to decide what it wants"
- We ARE the market place.

"Over the years, I have read countless “scientific papers” (from “famous” reputable physicians) that endorsed all types of truly stupid devices and techniques"
- So how should this reflect on me? My reputation is solid throughout the industry. My statements are out in the open, and within their context stand on their own as completely rational, and justified by both science and statistical analysis. I've never endorsed a stupid technique, idea, or device. I am well known for challenging even the most common notions, and for concisely and accurately making my point. Your experience does not reflect on me at all, and this is a double logical fallacy- ad-hominem+ tu qoque.

"If you’re in “the business” you know how this works."
- I am in the business of healthcare. I am a Certified Biomedical Equipment Technician, and a Certified Laser Repair Technician. My reputation as a consumer advocate, my reputation for regulatory compliance, and the service and products my company renders and sells stand on their own within the industry.

"In the end, clients are only interested in what WORKS for them and could “care less” about you and me “ranting” at each other."
- Consumers care about the truth. They care about reliability, efficacy, cost effectiveness, and most of all- safety. That is all I am concerned about, and by engaging you in this conversation my only goal has been to expose the truth while correcting misconceptions. I don't "rant"...
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106803 - 05/13/13 11:46 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio

DUDE! ( or DUDESS?)

Why am I being ignored ?!


Originally Posted By: dfahey
CRC, I'm interested to know if you actually perform LHR on people or do you sell and service lasers only. I asked that a couple of posts ago.

Are you seeing patients and performing laser reduction on a weekly basis? Roughly, how many treatments do you perform a week?
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106805 - 05/14/13 12:51 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
beate_r Offline

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Registered: 07/25/05
Posts: 853
Loc: Hattersheim, Germany
Dee, maybe it is similar to paradoxiacal hypertrichosis - he does only recognise what he wants to recognise ?

(But strange enough, that an effect which is documented in the scientific literature for more than a decade is being neglected as such...)
_________________________
Beate Ritzert

Elektroepilation Dr. Beate Ritzert
http://epi.ritzert.net/en/

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#106806 - 05/14/13 01:17 AM Re: Paradoxical Laser Hair Stimulation [Re: beate_r]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Dee,

First of all, my name is Mickey.

I did not ignore your post- I merely did not assume it was meant for me, and did not read it. I only saw there had been a response to one of my comments from the person I originally addressed.

With that said:
"How many years have you personally performed laser reduction"
- None.

"people observing laser hair stimulation."
- As I have already noted, "paradoxical hair stimulation" is not paradoxical- it is a natural process of hair removal resulting from poor treatment parameters resulting in sublethal stimulation to vellus and telogen hair. This usually occurs around the periphery of treated areas in darker skin types. This isn't "paradoxical hair growth"- it is part of the normal cycle of hair removal. If vellus hair, which is more difficult to remove (not impossible, as some have stated) with laser, is sublethally stimulated, it may become anagen, and grow thicker. This makes it easier to remove during the next treatment.

"There is at least one scientific paper copied and pasted on this forum noting this fact."
- I would like to see this paper, but does this paper note the fact, or does it document the fact scientifically through study of what is perceived as an unexplainable phenomenon?

"there have been more than enough that swear they have more hair than when they started their laser treatments."
- As a Biomedical Engineer, I often get called in to repair equipment in which I am considered an expert. Oftentimes the practitioner will contradict what I have noted as the fault, and will give me their 30 years of experience worth of explanation as to why they are right, and how I am wrong. If consumers were experts, they wouldn't require them.

"If you are profiting from the sale of lasers, then I can see why you would make the statements you made."
- I do profit from the sale of lasers. I also profit from reporting laser manufacturers for violations of the law. I also profit from assisting attorneys in defending their physician/medspa/esthetician clients from lawsuites. I also profit from serving as a consultant with medspas, physicians, hospitals, clinics, magazines, regulatory bodies, standards organizations, and more.

Do you profit from electrolysis? Ridiculous question... of course you do. I wouldn't use that fact in a rebuttal as it means nothing if what you're saying is true. I don't govern my statements with my ego- I govern them with reason. If you have reasonable information that would make me retract my statements, I will do so willingly. There is no need to beat your chest, and sound the drums of war as if someone came to walk all over your territory. I am not "invading" Hairtell. I am attempting to enhance it. If you do not appreciate my input, I'm sure there's a way you can ignore my future posts.
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106807 - 05/14/13 01:45 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Let me answer this first:


Originally Posted By: CRC Biomedical
Dee,

"There is at least one scientific paper copied and pasted on this forum noting this fact."
- I would like to see this paper, but does this paper note the fact, or does it document the fact scientifically through study of what is perceived as an unexplainable phenomenon?
.


Paradoxical Laser Hair Stimulation

The use of lasers to remove hair has become very popular in recent years. However, there are sometimes strange phenomena that occur when lasers are used to remove unwanted hair. On rare occasions, instead of removing hair, laser treatments can actually promote hair growth. This phenomena, known as hypertrichosisis, is paradoxical effect of laser epilation. The new hair growth is actually created in part by the effect of the laser although this effect and how it occurs is not yet completely understood. Scientists are now searching for a better understanding of the mechanism behind this paradoxical effect of laser induced hypertrichosis so as to prevent it in future cases.

In order to better understand this phenomenon, scientists set up an experiment using an alexandrite laser to remove the unwanted hair of 489 patients. The patients had all been customers at a single laser hair removal clinic at the University of British Columbia Dermatology Division in Canada, and were treated by trained nurses and supervised by board certified dermatologists. Out of these 489 patients, only 3 cases of laser induced hypertrichosis were identified, but these cases were enough to offer further information on this rare phenomenon.

The three patients who had experienced an increased amount of hair growth instead of a decrease became the focus of further study. Paradoxical hypertrichosis had been seen before in other cases, but it had not been so carefully watched. Scientists first identified the hypertrichosis in each of the three patients by noting an increase in hair density, hair color or hair coarseness after laser application. Once this definition was established, they began to examine each individual case more closely.

One of the patients who experienced this increase was a 39 year old Mediterranean woman with black hair. At first, when the laser was applied to an area with unwanted hair, the hair growth decreased just as it was supposed to. However, the continued applications of the laser resulted in increasingly stubborn hair that would simply not respond to the treatment. Eventually, the woman reported a gradual increase in hair density around that area rather than a decrease.

A second patient who experienced an increased quality of hair growth was a 30 year old white man with black hair on both his arms and his back. The man had wished to have some of this hair removed from his back, but the treatment was not successful. During the first three sessions, he experienced a positive result where the unwanted hair began to slowly disappear. However, further treatments began to require higher and higher intensities of laser light in order to be successful. After six visits to the clinic, the man began to notice an increase in hair growth rather than a decrease. This was only noticed at the specific locations where he had been receiving the treatments. Even with a further increase of laser intensity, there was no success and the man abandoned the treatment entirely.

The third patient who experienced laser induced hypertrichosis was a 21 year old Chinese man with black hair. Besides the common factor of black hair, which existed in all three of these patients, there was a similar skin type amongst them known as Fitzpatrick "Skin Type IV". Skin type IV indicates a darker level of skin that rarely burns with sunlight exposure (as opposed to skin type I, which is very white skin that easily burns when exposed to sunlight). Out of six different skin types in the Fitzpatrick skin type classification; this skin type IV was the only type of skin that was known to have been adversely affected by laser hair removal treatment in any of the 489 patients. Hair color and skin type may have obviously contributed to the hypertrichosis because, just like the other two patients, this third Chinese man began to notice an increased growth after 11 days of the laser epilation.

The results of the testing were compiled and analyzed so that the most obvious cause of the hypertrichosis was determined to be a result of the laser epilation itself. This was evident from the fact that the increased hair growth only occurred in the areas that were treated by the laser but, more specifically, scientists have determined that the problem may be a result of the wrong intensity of laser light rather than just the laser light itself. These ideas are being tested further and it is the hope of scientists that a solution to this rare adverse hair growth occurrence can be corrected in type IV patients.

Paradoxical hypertrichosis after laser epilation references

Alajlan A, Shapiro J, Rivers JK, MacDonald N, Wiggin J, Lui H. Paradoxical hypertrichosis after laser epilation. J Am Acad Dermatol. 2005 Jul;53(1):85-8. PMID: 15965

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From PubMed:

http://www.ncbi.nlm.nih.gov/pubmed/17716243

Copied and pasted the link:

Display Settings:AbstractSend to:
J Cosmet Dermatol. 2006 Dec;5(4):274-6.
Paradoxical effects of hair removal systems: a review.
Lolis MS, Marmur ES.
Source
Department of Dermatology, Mount Sinai School of Medicine, New York, NY 10029, USA. margarita.lolis@mssm.edu
Abstract
Although a variety of lasers have proven to be clinically effective for long-term hair removal, the use of these lasers has also been associated with undesirable side effects, such as hyper- and hypopigmentation, crusting, erythema, and edema. One notable side effect that seems to be underreported in the literature is the growth of fine dark hair in untreated areas close to the treated ones. This contradictory hypertrichosis is known as the paradoxical effect. In this paper, we review the published reports of the paradoxical effect and offer some possible explanations for this effect. The paradoxical effect has been documented most commonly after the use of induced pulse light and alexandrite lasers. One possible explanation is the activation of dormant hair follicles by suboptimal fluences. Another mechanism may be the synchronization of hair growth cycles by direct light stimulation.
PMID: 17716243 [PubMed - indexed for MEDLINE]
Publication Types, MeSH Terms



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Edited by dfahey (05/14/13 02:07 AM)
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#106809 - 05/14/13 02:01 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

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Here are some consumer observations over the years. The list is much longer than this, by no means is this list complete:

http://www.hairtell.com/forum/ubbthreads....html#Post94327

Cosmetic enhancements forums document consumer complaints as well.


Edited by dfahey (05/14/13 02:03 AM)
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#106811 - 05/14/13 02:14 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
fenix Offline
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Originally Posted By: CRC Biomedical

While laser hair removal is not regarded as "permanent," the length of hairlessness in large areas has been known to extend, in many cases, upwards of 11 years- the standard for consideration as "permanence," after 5-10 treatments.
Mickey, can you clarify your statement? So the people that complete laser hair reduction will only have "permanent" results that will last about 11 years and after that they should expect to see hair regrow to the same hair density and pattern before laser treatments?

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#106813 - 05/14/13 02:17 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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Dee,

While I appreciate your posting of this study, I cannot accept the results of the study as scientific for various reasons. I know you will not like those reasons, so I'll just leave it at that.

As for consumer observations, have you considered the perfectly viable explanation I have offered, which is also a speculation considered in the "study"... which wasn't actually a study (you can't perform a scientific study with only three individuals).

How do we know, for example, the paradoxical hypertrichosis wasn't caused by some other factor? Did they compare patients with natural paradoxical hypertrichosis with those that had undergone laser hair removal? What are the treatment parameters used for those who experienced paradoxical hypertrichosis vs. those who did not? What size hand piece was used? What was the overall average power of the laser system used? Have these parameters, spot sizes, and laser systems been compared with others?

The answers seem pretty clear to me. There is a common sense natural cycle of hair that laser seeks to interrupt. There are portions of the cycle that cause decreased, miniaturized hair, and there are portions of the cycle with thicker, darker hair. Laser acts like a defibrillator- if the heart is experiencing atrial or ventricular fibrillation, the current will shock the heart and cause it to resume normal rhythm. If the heart is not pumping at all- a shock may cause either atrial or ventricular fibrillation, or cause it to go back into a normal rhythm. If the hear is experiencing normal rhythm, the defib may cause fibrillation, or stopping of the heart.

The only statement I find compelling is where the new hair growth on one patient was not responsive to further treatment. I would request the treatment parameters, spot size, laser system, and a pre-treatment power output test before taking ANY of this information too seriously.
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#106814 - 05/14/13 02:21 AM Re: Paradoxical Laser Hair Stimulation [Re: fenix]
CRC Biomedical Offline

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"Mickey, can you clarify your statement? So the people that complete laser hair reduction will only have "permanent" results that will last about 11 years and after that they should expect to see hair regrow to the same hair density and pattern before laser treatments?"

LOL! No. That's not what I meant. 11 years is the legal threshold for "permanent hair removal" using any system available. Though lasers have been documented to produce "permanent" laser hair removal per this 11 year criteria, none have been approved as such because of the inability, or difficulty of laser to remove vellus hair (which electrolysis does not miss).
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#106815 - 05/14/13 02:25 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
fenix Offline
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OK thanks for clarification. smile

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#106818 - 05/14/13 03:06 AM Re: Paradoxical Laser Hair Stimulation [Re: fenix]
dfahey Offline

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Let me clarify something - the FDA CLEARS laser for hair reduction , not hair removal.

Okay, Mickey, you said you have no experience actually performing laser hair reduction. I assume you read through the thread where consumers have reported laser hair stimulation. That is just the tip of the iceberg of negative concerns. All accounts have not been recorded there. Keeping that in mind, you also have electrologists like me and Mike reporting our observations . I know I am being honest and Im sure Mike is, too.We also report laser successes. I refer my clients to a laser specialists, when appropriate.

I'm sure you do your job well, but you have no contact with consumers to even know what what is actually occurring , good or not so good. All your education and training to fix lasers can't replace real world happenings with consumers.



Edited by dfahey (05/14/13 03:18 AM)
Edit Reason: Added thoughts
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#106819 - 05/14/13 03:16 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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Originally Posted By: dfahey
Let me clarify something - the FDA CLEARS laser for hair reduction , not hair removal.


That is exactly as I have stated.

Originally Posted By: dfahey
you have no contact with consumers to even know what we see and hear, good or not so good.


You are absolutely incorrect. I not only have contact with consumers, I have contact with scientists- some at manufacturer locations, some at the FDA, some are just Biomedical Engineers with a PhD who have dedicated themselves to scientific studies- physicians, estheticians, nurses, pediatricians, plastic surgeons, dermatologists, etc., including patients- the end consumer.

I not only contribute to Hairtell (which I just started doing so... and am on the verge of regretting), but I contribute to many other sites speaking of not only laser hair removal and cosmetology, but medical devices in general. You may not know who I am, and you may not respect my expertise (just yet), but if you're willing to consider the facts we shouldn't have any issues.

Again- it is not my intent to look for arguments, or to get into a urinating contest with individuals who are so enamored with their own speculations that they would be offended by a suggestion in opposition. It is my intent to contribute to this website as best I can, and if I am proven to be incorrect about something, I can be the most graceful in accepting new knowledge as I am not diminished in humanity by learning a little something every day.

With that said- anecdotal speculation does not adequately refute scientific data. There is a scientific explanation for what may seem paradoxical to some. It has not been proven as the cause of all instances of new hair growth after laser treatments, but obviously- the problem is not reported enough, followed up enough on, or treated with enough concern for there to be a rational rebuttal to the scientific default speculation I have presented.
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#106820 - 05/14/13 03:18 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

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BTW - please read my last post again. I edited a few things.

You said removal not reduction


Edited by dfahey (05/14/13 03:19 AM)
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#106821 - 05/14/13 03:22 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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Dee, please read my original statement: While laser hair removal is not regarded as "permanent," the length of hairlessness in large areas has been known to extend, in many cases, upwards of 11 years- the standard for consideration as "permanence," after 5-10 treatments.
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#106822 - 05/14/13 03:26 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

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The exact terminology is laser hair reduction. I saw you state laser hair removal twice. Just a correction again for preciseness, as I'm sure you can respect.

What is your contact with consumers entail if you are not actually performing laser hair reduction. I only ask because I'm not sure how much you can possibly hear about their disappointments and observations about laser hair stimulation. Would you mind clarifying that? I am having trouble figuring out how a repair person hears from the the LHR consumer.


We appreciate your presence here.
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#106823 - 05/14/13 03:28 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Brenton Offline
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Originally Posted By: CRC Biomedical
anecdotal speculation does not adequately refute scientific data.


As a scientist myself, I would like to lend my full support to this statement.

Dee, as you may recall, you and I had a debate about whether or not someone reporting an increase in growth of about 10-15 hairs counted as induced growth. I said no and you felt yes it did. Again, I'm not picking sides here, but as you can tell Dee, we did have several cases of people claiming induced growth when there were doubts about it. Unfortunately, in the science world, that consumer report thing has next to no validity.

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#106824 - 05/14/13 03:30 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
dfahey Offline

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Please show me that discussion. I don't remember the 10-15 hair "argument".
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#106825 - 05/14/13 03:35 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
dfahey Offline

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Originally Posted By: Brenton
...Unfortunately, in the science world, that consumer report thing has next to no validity.


How does the list of side effects reported for a drug come about then?
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#106826 - 05/14/13 03:39 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Brenton Offline
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Correction -- we were debating about whether or not the person who reported hair growth 10 years after her laser treatment was suffering from induced growth. I was mixed up with something else.

As for drugs side effects, consumers can report, but then after the reporting happens, the drugs are extensively retested. People don't just submit a report and the FDA looks at it and says "Ok, someone said they had this effect so therefore it must be true"

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#106827 - 05/14/13 03:41 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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Originally Posted By: dfahey
The exact terminology is laser hair reduction. I saw you state laser hair removal twice. Just a correction again for preciseness, as I'm sure you can respect.


Dee, again- re-read my statement. I said lasers PERFORM permanent laser hair removal per a stated criteria. I said the FDA does NOT approve lasers for permanent hair removal for a very specific reason.

Originally Posted By: dfahey
What is your contact with consumers entail if you are not actually performing laser hair reduction.


Most of my contact with consumers occurs at medspas and schools when conversing with regular customers. I also do marketing for medspas, and am involved with acquiring new customers, and stimulating new customer bases. As a servicer and dealer I do partner with medspas. I have reference sites where I field demo units, and some of my customers hold inventory for me while I work on getting it sold. Most of what I do when I am not selling or repairing lasers is contacting my customers, and asking questions about consumer feedback. I often hear feedback like what I'm reading on this page- but when I give my advice, it is taken, and I rarely hear the same complaint twice- unless it is about a machine I originally suspected wouldn't deliver as promised.

Apart from real world feedback, I compile feedback through various sources- some equipment specific. I am probably on the MAUDE database more than any technician I know, but if you look at when I joined Hairtell, you would also realize I peruse many consumer forums (well I shouldn't say many... there aren't many). I am up to date on the last incident reported to the FDA for most lasers and light based devices, as well as warning letters, and recalls (I am responsible for some of them).

I get more feedback from more consumers on more laser types than you could possibly get from your own customers because, well, it is people like you who feed me information on a daily basis... and I have far more than one customer.

And believe me- if no big deal has been made about this issue, I will. I am going to contact every major manufacturer for their statistics on paradoxical hair growth, as well as feedback from all of my customers. I will say, however, that there is a clear trend among those who are making the claims vs. those who are not. Mr. Bono, for example, is cited in an article citing a study that has nothing to do with the claims he makes in the article.

Are you around laser hair removal more than I am, as you think you are???
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#106828 - 05/14/13 03:44 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
CRC Biomedical Offline

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Originally Posted By: Brenton
As for drugs side effects, consumers can report, but then after the reporting happens, the drugs are extensively retested. People don't just submit a report and the FDA looks at it and says "Ok, someone said they had this effect so therefore it must be true"


FDA logs every single report regardless of conclusion in the MAUDE database. Every practitioner who injures a patient with a medical device, or administering a drug is supposed to self report via form 3500A for mandatory reporting. These reports may not translate as drug side effects, but they are logged nonetheless.

Of course, not very many people do this... I am probably the number sumbitter of FDA forms 3500 (voluntary reporting) for all equipment combined.


Edited by CRC Biomedical (05/14/13 04:01 AM)
Edit Reason: changed wording of statement
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#106829 - 05/14/13 03:46 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
dfahey Offline

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Consumers are encouraged to report side effects of drugs and medical devices to the FDA.

For the eyelash (glaucoma drug) Latisse, it looks like this:

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please click here for full LATISSE® Prescribing Information.


When consumers of laser hair reduction report a negative side effect, the FDA or the physician in charge should be told and these observations should be kept in a data base. Instead, consumers have come here and complained. I have attempted to group those complaints on one thread for scientists, lawyers and such, to consider and for other consumers to peruse before they decide to get lased on certain areas. Researching-type adults can decide for themselves what they want to do after considering the information presented by others. I'm just a by stander trying to organize information.


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#106830 - 05/14/13 03:52 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
Brenton Offline
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Yes Dee, I know they are encouraged to report the effects. What I'm saying is that just because people have reported something to occur, it doesn't make it a scientific reality. I applaud you for grouping this together, but I'm letting you know as a friend that in the science world, simple reports like that hold little to no value. It's a good way for scientists to say "We should take a look into this effect and see if it's real" but it's not safe or valid to say "Induced growth is a real thing" without testing it further. With the reports on here, it definitely warrants a look at in the science world, but the reports here aren't enough to generate any conclusions. That's just how science is


Edited by Brenton (05/14/13 03:53 AM)

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#106831 - 05/14/13 03:52 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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Originally Posted By: dfahey
When consumers of laser hair reduction report a negative side effect, the FDA or the physician in charge should be told and these observations should be kept in a data base. Instead, consumers have come here and complained. I have attempted to group those complaints on one thread for scientists to consider nd for other consumers to peruse before they decide to get lased on certain areas.


Dee, you are absolutely right about reporting... however, complaining about new hair growth isn't a valid complaint unless the consumer completes the hair removal process with a specific laser type and model based on that manufacturer's specifications.

You can't, for example, start with a Cutera Xeo for your back, then go get Lightsheer done, and finish it off with a Palomar Starlux 500 and claim that any one is defective- they all deliver different energies at different wavelengths in different spot sizes!

If you show me a person who had hair removal performed on them in at least 6 intervals with the appropriate treatment parameters on a reliable, efficient laser system- then those complaints begin to look more valid. THAT is how FDA reporting works. If you don't report treatment parameters, model, spot size, etc.- you are only complaining, not reporting.
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#106832 - 05/14/13 03:53 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
CRC Biomedical Offline

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Originally Posted By: Brenton
I applaud you for grouping this together, but I'm letting you know as a friend that in the science world, simple reports like that hold little to no value.


This is ALL I've been trying to say frown
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#106833 - 05/14/13 04:02 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
CRC Biomedical Offline

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BTW Dee, can you please link that forum? Also, have you reported any of these incidents to the FDA? Just curious...
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#106834 - 05/14/13 04:04 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

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I am beginning to understand you better, CRV. Thank you for your careful explanations.

I am not a laser specialist. I do electrolysis only. I do refer clients to two or three laser specialists that I like if they are a good candidates for successful laser hair reduction. I am so grateful that LHR exists as I am so busy treating hair structures and colors that laser can't see or I am finishing the job for total hair removal that requires the preciseness that only electrolysis can accomplish. I get feedback on a monthly basis from clients that are disenchanted with their laser experience or are satisfied, but not totally pleased with the amount of hair that is left. I hear less about laser hair stimulation, but will say it is not as rare as the PubMed article says it is.

Thank you Mickey for your patience.


Edited by dfahey (05/14/13 04:07 AM)
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#106835 - 05/14/13 04:04 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
Brenton Offline
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Originally Posted By: CRC Biomedical
Originally Posted By: Brenton
I applaud you for grouping this together, but I'm letting you know as a friend that in the science world, simple reports like that hold little to no value.


This is ALL I've been trying to say frown


VERY few, if any other posters here, have science backgrounds it seems. As of the current posters on here, I think you and I may be the only ones with physical science backgrounds, so I understand what you're saying with regards to how things work in the science world

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#106836 - 05/14/13 04:05 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

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Didn't mean to call you CRV. I drive a CRV. Must have been thinking of my car. Sorry CRC.
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Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
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British Institute & Association of Electrolysis

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#106837 - 05/14/13 04:07 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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smile No offense taken! It's not my name wink And I know it was a typo! I actually thought "probably drives a CRV" wink
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President and Senior Technician
CRC Biomedical Services

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#106838 - 05/14/13 04:14 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: CRC Biomedical
BTW Dee, can you please link that forum? Also, have you reported any of these incidents to the FDA? Just curious...


No, since I didn't perform the treatments, I didn't report them. I did encourage the consumer to go back to the laser spa and give them feedback though. They would know the laser model, spot size, joules used, etc. Some have gone back to their laser specialists to complain and were told this has never happened to anybody else. So, now if falls back on consumer hair sites like this. We are like a bitching post for disenchanted laser clients.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106839 - 05/14/13 04:15 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: CRC Biomedical
smile No offense taken! It's not my name wink And I know it was a typo! I actually thought "probably drives a CRV" wink


Ha! grin! It's a real chick car. Good mileage and peppy!
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106840 - 05/14/13 04:17 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Do you mean www.cosmeticenhancementsforum.com ?

I haven't been hanging out there for awhile (too busy removing the rest of the finer, lighter hairs that laser can't see).
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106841 - 05/14/13 04:21 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
You said you were compiling all those complaints in one thread. I want to see those complaints. This issue is going to bug the heck out of me. Sorry, but I get a little OCD with things like this :-/
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106842 - 05/14/13 04:26 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
Brenton Offline
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Registered: 06/09/11
Posts: 717
Loc: San Diego

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#106843 - 05/14/13 04:27 AM Re: Paradoxical Laser Hair Stimulation [Re: Brenton]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: Brenton
Yes Dee, I know they are encouraged to report the effects. What I'm saying is that just because people have reported something to occur, it doesn't make it a scientific reality. I applaud you for grouping this together, but I'm letting you know as a friend that in the science world, simple reports like that hold little to no value. It's a good way for scientists to say "We should take a look into this effect and see if it's real" but it's not safe or valid to say "Induced growth is a real thing" without testing it further. With the reports on here, it definitely warrants a look at in the science world, but the reports here aren't enough to generate any conclusions. That's just how science is


Dear Brenton,

The medical scientists used the term laser hair stimulation first. I use the words they use. I don't diagnose the problem. I listen to the words that medical scientists use and listen to the words and description that consumers of laser use. I observe hair structures all day long and into the late evenings on most days and wonder what I am observing . I'm not dumb, I know how the scientific process works. I do think there is something going on. Hopefully, the genius's like you can bring it altogether in a conclusive type way.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106844 - 05/14/13 04:33 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
I posted that link earlier, but thank you sweet Brenton for doing that again.

Mickey, please offer your feedback on how that can be improved? When someone posts about having more hair than when they started LHR, I try to copy and paste on that thread. Very crude, I know, but many times, the consumer can't report parameters, something I know you would like as a scientist.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106845 - 05/14/13 04:44 AM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Thanks Dee. I'll review some of these tomorrow, and I'll get some feedback from estheticians, doctors, and scientists I chat with regularly. Just by quickly browsing the forum, a slight trend did stand out to me... though I wouldn't have expected the GentleLase to be an issue- not the Mini anyhow. It has an 18mm spot size. Granted, nobody claimed to have had that spot size used, but 18mm is the only spot size for any laser hair removal (this, or larger) that provides 100% depth penetration of energy to the follicle bulb. A 10mm hand piece, for instance, which is the most commonly used spot size for the most common hair removal laser (the Cutera Vantage/Excel/Xeo line of lasers) does not provide 10mm of coverage at follicle depth. Low energies on smaller spot sizes will cause sublethal injury to the follicles. Sublethal injury to vellus hair may explain why it would go anagen.
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106846 - 05/14/13 05:00 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Great information!

Let me know how or if we can be useful and more accurate in obtaining consumer information about laser hair reduction.

We have very few laser specialists and experts that post here on a regular basis, so we do the best we can to comfort the hairy when they come here with their concerns about laser reduction.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106871 - 05/14/13 06:55 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
mhawkes Offline

Major Contributor

Registered: 01/23/11
Posts: 183
Loc: oban scotland uk
Glad to see CRC is going to contact the providers of laser to get some feedback about PLHS. As prior to going to Australia in 1998 I hadn't seen this type of hair growth before, as laser became more affordable so too being presented with this type of growth pattern.
Majority of clients are not going to complain they will quietly try and find something else that they hope will work. Most are incredibly embarrassed the last thing they want to do is draw extra attention to their unwanted hair.
Also I've never met a Dr or dermatologist that actually performs hair removal usual someone else is employed to do this.
It would be fantastic to get clearer guidelines with laser, and I know the same can be said for electrolysis that's why this forum is so good to let the public know what results should be expected.
_________________________
mairi hawkes D.R.E. Apilus Platinum. Trained and worked in Uk and Australia
Member of the British Institute and Association of Electrolysis since 1993
Fully licensed by Argyll and Bute Council UK.
www.aeclinic.co.uk

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#106872 - 05/14/13 09:06 PM Re: Paradoxical Laser Hair Stimulation [Re: mhawkes]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
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 wink
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106886 - 05/15/13 02:26 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
Lkjhgf Offline
Member

Registered: 05/11/13
Posts: 9
I got laser on my back and shoulders. They were very light hairs. I did 7 sessions and all I got was longer darker hair. Throughout the laser process only patches were growing back and I thought it was working and a few months after I stopped it all grew back. Laser ruined it for me

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#106892 - 05/15/13 07:35 AM Re: Paradoxical Laser Hair Stimulation [Re: Lkjhgf]
electrolysislady Offline

Major Contributor

Registered: 10/19/12
Posts: 131
Loc: London, Ontario, Canada
CRC

Thank you for your informative posts.

There have been numerous posts on this forum indicating people are not getting good results with the Soprano XL, I have been using this machine since 2009 and have had very good results. I suspect that these individuals are being under treated. The manufacturer recommends 5 to 8 kJ of accumulative energy for a 100 cm square area in the SHR mode


Do you have any experience with the Soprano XL? If so, what are your thoughts?
_________________________
Carmella Hammond, CPHI(C), Certified Electrologist, CPE, Laser Technician
electrolysislady@hotmail.com
Visit North London Electrolysis and Laser website



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#106897 - 05/15/13 12:02 PM Re: Paradoxical Laser Hair Stimulation [Re: electrolysislady]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
We have a LASER SUCCUSS STORY THREAD here on Hairtell.

It would be so helpful Carmella if you would direct your successful cases to that thread to tell their story. We want to hear good news and the more detail there is the better for hair consumers.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106906 - 05/15/13 03:16 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Carmella,

I guess we should move that question to another thread wink
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106908 - 05/15/13 03:49 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Mickey,

I just added your four points to the REPORT LASER HAIR STIMULATION thread.

It looks like this now:
____________________________________





For ease, You can copy and paste the information below so as to give complete information:

Gender:

Age:

Date you started treatment:

Hair color:

Color of Skin (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):

Hair Structure:

Area(s) treated:

Name of LASER or IPL (Make, and model of laser, date of manufacture, and software revision- this will give a more clear indication of the particular system's capabilities.):

Treatment settings (Complete treatment parameters including Energy/cm2, pulse width, repetition rate, cooling method, spot size, and number of passes (if more than one).

Skin reaction:

Shedding?

Did you report increased hair growth to your laser specialist?

Before and After pictures?

***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.




Other comments - no detail is too small:


_____________________________________________

THANK YOU for your valuable input, Mickey.

I asked a consumer, who private messaged me last night, to post his message on the open forum . It is listed above, but I will paste it here for ease of reading.
______________________________
"#106886 - Yesterday at 09:26 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
Lkjhgf
Member

Registered: Fri May 10 2013
Posts: 6
I got laser on my back and shoulders. They were very light hairs. I did 7 sessions and all I got was longer darker hair. Throughout the laser process only patches were growing back and I thought it was working and a few months after I stopped it all grew back. Laser ruined it for me "

_____________________________

Mickey, to help you understand where we are coming from:

These are the kind of posts and pm's we experience here on Hairtell FREQUENTLY. These consumer-driven pleas, along with articles from the medical community, frame the words 'laser induced hair stimulation'. This is not electrologist-driven because we are territorial. We are not worried about competition. We are already over-worked if we are among the ones that are skilled. We sell our time and believe me, there are more hairy people than there is time to sell.

On the AEA Facebook site (the site closed to the public - an electrologist blog only) a survey was taken asking how many hours we work per week. Conclusion: more than is humanly healthy. I don't have my website up and I spend very little to advertise because my referral base is large. I am not unique.

If you think there is a fear of competition happening here, your are sorely mistaken! Both modalities compliment each other and serve the hairy very well. A lot of us do both modalities. I bristled when you stated that electrologists are fearful of laser because of COMPETITION. Please take this as an earnest, polite correction on that point. We have PLENTY of work.

We all want to understand the consumer-driven comments about ending up with more hair than when they started laser. Are there better words to describe this very real phenomenon? What should replace 'laser induced hair stimulation' ?

Thanks,

Dee


Edited by dfahey (05/15/13 04:03 PM)
Edit Reason: Added and corrected typo
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106910 - 05/15/13 04:04 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
LAgirl, you may want to add some or all of Mickey's four points to your Laser FAQ's page. Mickey, have you perused LA's FAQ's yet?
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106913 - 05/15/13 04:18 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Dee,

I don't accept the term "paradoxical" hair growth, or laser induced hair stimulation because it makes it sound mysterious.

The laser is doing it's job. It is shocking non-anagen hairs into anagen, and vellus hairs are becoming terminal. This is normal, though not always desirable. It IS, however, VERY important that the patient follow up with a trained PHYSICIAN if they experience new growth. Preferably a dermatologist.

I have left messages for Dr. Shapiro, and Dr. Rivers (co-authors in the paradoxical hair growth "study") and they should be calling me back. Hopefully we can get some information from them after 8 years more experience after their study.

As for the gentleman who messaged you, his statements make clear WHY this is not being treated properly.

First of all, he says he started with very light hairs on his back and shoulders. How light? Were they too light to treat to begin with???

Let's assume they were treatable. What laser was used? I would use nothing less than an 18mm 755nm laser for "light" hair on the back and shoulders- REGARDLESS of skin type (for very dark skin I would use a laser that gets more than 300ms pulse width, but very light hair rarely translates to very dark skin).

And how far apart were the intervals? He says he did 7 sessions? How old is he???

There is a rule of thumb with follow up treatments... well, two.

1- Treat again at half the telogen cycle. So if the telogen cycle of back and shoulder hair is 6-9 months, treatments (after the first) should be spaced out at least 3 to 4.5 months apart.

2- Treat when visible hair makes its reappearance.

With either rule, 7 sessions on the back and shoulders would span at minimum 18 months, and as much as 4.5 years.

The biggest problem with using the second rule of thumb is ejection. Telogen hair will be naturally ejected within days of laser hair removal (or you can pluck it out as I do). Anagen hair should eject some time after that as it is deeper down the shaft. In any case, not all "new hair growth" is actually new hair, and if treatment is delivered... say, one month after the first treatment (on the back) you may be treating hair that appears to be growing, but is still being ejected while the true hair is beneath it pushing it out.
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106917 - 05/15/13 04:35 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

Top 10 Contributor

Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
I am beginning to understand you better. You see, it is very important that you are here teaching us (patiently so) because WE want to guide people in an unbiased approach. We are on the frontline, seeing clients who come complaining about their half-baked laser experience. I want to emphasize that we also hear and observe the excellent laser results as well.

We can better calm and educate the disenchanted laser client if we understand some very basic principles of laser hair reduction.

This is a consumer-driven website and the integrity of this site must be truth-based and unbiased as we support, guide, comfort and teach the distraught, depressed hairy client. That is why I hang out here - for free. If it were anything but truthful and unbiased, I would be gone, "quick! like a bunny!".

Thank you again for adding your expertise. We can never be too balanced or transparent (unlike the US government) . Just threw that in to stir up some people.
_________________________
Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106918 - 05/15/13 04:38 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
stoppit&tidyup Offline
Top 10 Contributor

Registered: 05/04/08
Posts: 1799
Loc: London, UK
Mickey,

I think you will find that from a consumer's perspective, vellus hairs (or any fine hair for that matter) becoming thicker or darker is undesirable.

I joined HairTell as a consumer and at the time was attending consultations at Laser clinics to make an informed decision. I decided not to undergo LHR for my fine, downy (but black) facial hair because of the risk of these hairs becoming thicker. This defeated the purpose of permanent hair removal treatments for me.

I instead decided to proceed in areas where I had coarse hair only.

One thing I don't quite understand - not all fine hair is vellus. What do you say only fine vellus hair can be 'stimulated'? What if a fine terminal hair receives sublethal damage in the follicle?

I know you refuse 'hearsay' but my cousin has experienced LHR to cause her previously fine lower arm hair to become thicker and darker. For me, this is a first hand account, though for you it is 'third party'. How has this happened? I am willing to see if she will discuss her experience with you. As a medical professional, I'm sure she will be able to get all the required details from her clinic - she has said they have been very 'good' about what has happened and are trying to resolve it. They may even be interested in your help and advice.
_________________________
31/F/UK
Laser for reduction on Underarms, Bikini, Full Legs & 3/4 Arms. Skin type IV
Electrolysis - Further details in: My sister's electrolysis diary
[27hrs of Blend, April 2008-Dec 2010 in UK, for coarse hair on lower sideburns, coarse chin hair, completed upper lip, shaped eyebrows]
[Sept 2011 to date, once yearly sessions with Josefa. Completed reduction of facial/neck fuzz in approx 27 hrs TTT]

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#106919 - 05/15/13 04:46 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Dee, I appreciate your patience with me smile

And I am always open to correction! Beate_r pointed out some contradictions in my arguments others had missed, and I believe that correction finally got my point across to some wink

I would still like to have a definitive answer on this question of thicker hair growth after laser hair removal. I am already seeing a trend not only in skin and hair type- but laser type as well. Alexandrite is not only poorly understood by many practitioners- most Alexandrite lasers are not adequately powered to begin with, and for some strange reason they are being used at unusually low treatment settings :-/

I hope you all don't mind emoticons... I have been accused of using them more than 95% of the population. I don't like my "tone" to be misunderstood, so if something sounds emotionally ambiguous, I put a smile next to it smile
_________________________
The industry leaders in third party laser sales, service, and warranties!
Mickey A. Couvertier, CBET, CLRT
President and Senior Technician
CRC Biomedical Services

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#106920 - 05/15/13 05:00 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
beate_r Offline

Top 10 Contributor

Registered: 07/25/05
Posts: 853
Loc: Hattersheim, Germany
Originally Posted By: CRC Biomedical
..., and for some strange reason they are being used at unusually low treatment settings


Not only these.
_________________________
Beate Ritzert

Elektroepilation Dr. Beate Ritzert
http://epi.ritzert.net/en/

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#106922 - 05/15/13 05:12 PM Re: Paradoxical Laser Hair Stimulation [Re: stoppit&tidyup]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Originally Posted By: stoppit&tidyup
I think you will find that from a consumer's perspective, vellus hairs (or any fine hair for that matter) becoming thicker or darker is undesirable.


Yes, in your case- on the face, very undesirable. BUT this is a sign of deficiency in treatment- not 'normal' treatment. Also, some vellus hair may need to become thicker before laser hair removal can be performed. I haven't read any comments from consumers regarding correction of new growth, but the main study which documents it was written by doctors who now say it can be treated.

Originally Posted By: stoppit&tidyup
One thing I don't quite understand - not all fine hair is vellus. What do you say only fine vellus hair can be 'stimulated'? What if a fine terminal hair receives sublethal damage in the follicle?


It has only been proven that fine terminal hair can receive lethal damage, or sublethal damage and miniaturization. If it is terminal, it will become fine until it no longer reacts to treatment, or it will eventually receive a lethal treatment. Fine terminal hair- especially dark hair- should react to laser hair removal given the proper settings. But think about it- if it is "stimulated," and grows back thicker- why wouldn't it react to laser THEN? (not that I agree with the notion of terminal hair growing back thicker after hair removal... unless the person was experiencing some form of telogen efflevium, and the deficient treatment amounts to Low Level Light Therapy, inducing a natural growth cycle.

Originally Posted By: stoppit&tidyup
How has this happened?


The two known mechanisms of laser hair removal are sublethal injury to the bulge, or lethal injury to the bulge and bulb. Laser shocks telogen hair into anagen by sublethal injury to the bulge. Laser removes anagen hair by lethal injury to the bulge and bulb. Laser may shock vellus hair into becoming terminal, but other factors are more likely. Laser may shock hair in extended telogen, or telogen efflevium back into anagen.

The most likely cause, and I know this is the one most people will disagree with, is synchronicity- after the first treatment, most of the hairs treated will be in anagen synchronously while, for example in the arm, hairs are usually 20% anagen to 80% telogen. About 95% will be anagen synchronously after the first treatment.

There are tons of other conditions which cause hypertrichosis, and hirsutism. This is why I recommend seeing a dermatologist if this occurs.

Originally Posted By: stoppit&tidyup
They may even be interested in your help and advice.


I would be more than willing to give it. Hopefully the problem is not an underpowered laser :-/

Though not many people complain about that- how do you think I make MY money? smile Underpowered, poorly serviced, broken down lasers...
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#106923 - 05/15/13 05:21 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Emoticons are great. mad

Low settings are a problem. We have said many times (LAGirl more than anyone here) that a large spot size and aggressive settings are better. Not aggressive in the sense to burn someone though, but delivering as much energy as the skin can take. We like alexandrites like GentleLase and Yags like GentleYag's. Other types are mentioned, but I don't remember them right now. IPL's are viewed as long term waxing around here and we usually steer people toward "real lasers".

If any of that information is unfair, it was not done with any selfish or competitive motive. This is why I have been asking laser specialists for the last year or so if they could help answer some questions or correct any information here on the forum. We have been doing the best we can, but we don't have the caliber of laser specialists like we do electrologists on this forum
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Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
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#106924 - 05/15/13 05:30 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

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Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
No no no... I agree completely.

18mm spot sizes are the only ones which deliver 100% energy at 100% area of coverage at the target depth of the deepest follicles.

For clarity- I am not being biased. I chose this company after doing much research: I am a distributor and service partner for Light Age, Inc.

With that said, the only lasers with 18mm spot sizes are:

Candela GentleLase (755nm)
Candela GentleMax (755nm/1064nm)
Candela GentleYag (1064nm)
Light Age EpiCare Duo (755nm/1064nm)
Light Age EpiCare Yag (1064nm)
Light Age EpiCare LPX (755nm)
Light Age EpiCare LP (755nm)

Next in line would be the Cynosure Apogee/Acclaim/Elite series which have a 15mm max spot size at both wavelengths, but that only covers 69% of the total area covered by an 18mm spot size.

I never recommend IPLs. It's like offering someone cheap mezcal when they ordered premium blue agave tequila wink Yea, it'll get you drunk... but is it worth it?
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#106925 - 05/15/13 05:45 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
dfahey Offline

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Registered: 10/27/03
Posts: 9438
Loc: Columbus, Ohio
Originally Posted By: CRC Biomedical
Dee,

.........

I have left messages for Dr. Shapiro, and Dr. Rivers (co-authors in the paradoxical hair growth "study") and they should be calling me back. Hopefully we can get some information from them after 8 years more experience after their study............



This is very exciting! I am anxious to hear what they say. Can you ask them to make a statement here?
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Dee Fahey, R.N., C.T.
Licensed by the State Medical Board of Ohio for Nursing license and Cosmetic Therapy/Electrolysis license
_____________________
ELECTROLYSIS FAQ'S:

British Institute & Association of Electrolysis

http://www.electrolysis.co.uk/?page_id=16

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#106926 - 05/15/13 06:01 PM Re: Paradoxical Laser Hair Stimulation [Re: dfahey]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
I will ask! Shapiro has a Dermatology department at University of British Columbia to run, and Rivers is a working practitioner with a pretty successful laser practice wink So I don't know how available they are.
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#106930 - 05/15/13 06:33 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
fenix Offline
Top 10 Contributor

Registered: 03/17/12
Posts: 380
Originally Posted By: CRC Biomedical
No no no... I agree completely.

18mm spot sizes are the only ones which deliver 100% energy at 100% area of coverage at the target depth of the deepest follicles.

For clarity- I am not being biased. I chose this company after doing much research: I am a distributor and service partner for Light Age, Inc.

With that said, the only lasers with 18mm spot sizes are:

Candela GentleLase (755nm)
Candela GentleMax (755nm/1064nm)
Candela GentleYag (1064nm)
Light Age EpiCare Duo (755nm/1064nm)
Light Age EpiCare Yag (1064nm)
Light Age EpiCare LPX (755nm)
Light Age EpiCare LP (755nm)

Next in line would be the Cynosure Apogee/Acclaim/Elite series which have a 15mm max spot size at both wavelengths, but that only covers 69% of the total area covered by an 18mm spot size.
You forgot to mention Cynosure Elite MPX that has an 18mm spot size. That model has been out for a few years now.

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#106931 - 05/15/13 06:49 PM Re: Paradoxical Laser Hair Stimulation [Re: fenix]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
Yes yes... sorry... Also forgot the Elite+ which is not a multiplex system, but also has an 18mm spot size.
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Mickey A. Couvertier, CBET, CLRT
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#106951 - 05/16/13 08:37 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
CRC Biomedical Offline

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Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
So I spoke with Dr. Rivers of the Vancouver Dermatology & Laser Skin Care Clinic, one of the authors of a "study" that was used to start this thread, and has been repeatedly cited throughout.

A few things he pointed out to me- it doesn't seem anybody who is commenting on the paper has actually read it. He suggested I purchase the paper, and I have. I will read it and follow up with my findings tomorrow.

He also pointed out that this was not a study, and should not be cited as scientific- the doctors had received complaints from patients, and decided to retroactively review the procedures that had been performed on them. He called it a "chart review." The doctors did not take part in the treatments, and the documentation was done by the practitioners themselves as part of their regular work. This leaves great room for error, for example, in logging of treatment parameters, though he said much of that is available in the paper.

I asked the following questions:

ME: In my experience, and with my knowledge of the physics of lasers, and the mechanisms at work during laser hair removal, I find the term "paradoxical" to imply an unknown- is laser stimulation of hair "paradoxical," or is it part of the normal function of laser on hair?

DR: We used the term paradoxical because the device itself is supposed to remove hair, not stimulate new hair growth.

ME: Do you think laser is stimulating new hair growth through an unknown mechanism of laser?

DR: Laser seems to stimulate new hair growth in patients with darker skin, and at lower fluences. The information from this article is being used to develop LLLT (low level light therapy) devices that stimulate hair growth.

ME: That's a little confusing. Are you saying LLLT uses an unknown mechanism to stimulate hair growth?

DR: No. I'm saying laser hair removal lasers are supposed to remove hair, not stimulate it.

ME: It is my understanding that there are two desired mechanisms in laser hair removal- lethal injury to the follicle in anagen hair, and sublethal damage to the follicle in telogen hair. Can any of these mechanisms be the cause of the new hair growth?

DR: The laser seems to stimulate the epidermis around the hairs.

ME: Hyperemia is a natural occurrence in all laser treatments though, right?

DR: Subdermal heating will almost always cause increased blood flow to the area.

ME: Ok. So is it safe to say that if subdermal heating is normal, there could be some other mechanism of laser causing the new hair growth... like sublethal damage to dormant telogen hair, or shock to vellus hair?

DR: I believe that is not only possible, but probable.

ME: Ok. So if sublethal injury to the follicle is an expected mechanism of laser, and all other options are speculation...

DR: I would say sublethal injury is the primary cause of stimulation.

ME: Should we call it paradoxical? Is the laser not doing what it's supposed to do?

DR: It's paradoxical because the machine is supposed to remove hair.

ME: Fair enough. Do you believe this new hair growth is treatable?

DR: Yes. I really think it's best of you purchase the paper. There are many questions you have asked, and will ask that are answered in the paper. It's not a study- it's a review of our past treatments, and we had this review published. Also, this was almost a decade ago. I can't remember all the details, but the paper answers more questions than a summary can tell you.

ME: Dr. I appreciate your time, and patience with me.

I told him about the site, and about the request for the authors to participate on the site. He sounded interested at first, but expressed he doesn't have time. Maybe one of these days he'll show up and answer questions for himself wink
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Mickey A. Couvertier, CBET, CLRT
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CRC Biomedical Services

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#106953 - 05/16/13 10:23 AM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
stoppit&tidyup Offline
Top 10 Contributor

Registered: 05/04/08
Posts: 1799
Loc: London, UK
I have read the paper in full and the paragraphs I posted in the L.I.T thread were copied/pasted from it. I have offered to email it to people in the past.
http://www.hairtell.com/forum/ubbthreads.php/topics/106880/stoppit_tidyup.html#Post106880
The authors make some attempt to explain what may be going on. It's the only useful part if you ask me. Most of these papers suggest further Laser to resolve the stimulated hair. Some posters of this forum have tried but it was not successful.

Offline, I've been following the Laser treatments of many people and the few that I have experienced this and continued with Laser to resolve, were unsuccessful in doing so. Generally they purchased package treatments and had great results on the parts of the body we know respond very well to Laser. Maybe there are a great many shortcomings with the treatments they were having in regards to the stimulated areas but the fact remains that is has happened and has not yet been resolved. I know first hand how difficult it is to find a good Laser clinic where you leave the consultation having had a test patch where the settings were good enough to start with. Unfortunately, this is the reality that consumers are facing.
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31/F/UK
Laser for reduction on Underarms, Bikini, Full Legs & 3/4 Arms. Skin type IV
Electrolysis - Further details in: My sister's electrolysis diary
[27hrs of Blend, April 2008-Dec 2010 in UK, for coarse hair on lower sideburns, coarse chin hair, completed upper lip, shaped eyebrows]
[Sept 2011 to date, once yearly sessions with Josefa. Completed reduction of facial/neck fuzz in approx 27 hrs TTT]

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#106959 - 05/16/13 01:10 PM Re: Paradoxical Laser Hair Stimulation [Re: CRC Biomedical]
depilacionelectr
Unregistered


The conclusion I draw after reading the answers of Dr. is that the paradoxical effect is a risk that the customer who chooses laser treatments should consider.

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#106963 - 05/16/13 03:45 PM Re: Paradoxical Laser Hair Stimulation [Re: ]
CRC Biomedical Offline

Major Contributor

Registered: 08/15/11
Posts: 68
Loc: Washington, DC Metro Area
So after reading the paper, I have to say I'm very disappointed with the wording of their findings. Knowing these were dermatologists writing the findings makes me think they really didn't take this paper seriously, and weren't really interested in resolving their patient's issues. Considering these were patients that had undergone 13 treatments each, and they waiting at least a year after the last patient complaint to do anything about it is just ridiculous. Here are my own observations after reading the treatment parameters, history, and viewing pictures:

The laser used was the very first laser approved for permanent hair reduction. I know this laser very well, as I am a service partner and distributor for the manufacturer of the laser, Light Age, Inc. Of course I'm talking about the Sharplan Epitouch 5100- the grandfather of nearly every hair removal laser since. My own personal knowledge of suggested treatment parameters are largely dictated by the work of Dr. Heller, the patent holder for this laser, and the CEO of Light Age, Inc. This laser was first introduced into the market in 1993.

Case 1: June 1999-June 2003
39yo F, Type IV, Mediterranean
Facial hair- thin, light to dark brown, 1.5 inches average length (from photos, not stated in the study)
First treatment: 7mm, 23J/cm2/30ms (time between pulses not noted)
Final treatment: 7mm, 37J/cm2 (pulse width/time between pulses not noted)
The doctors noted that tests were done for hyperandrogenism. They didn't do tests for hirsutism, and didn't take into account any other factors which may have caused hair growth. First of all, upon examining the pictures, I don't agree there is "longer, thicker, darker" hair growth. What I did note is that there was barely any hair visible in the original picture- she may have shaved in preparation for her first treatment- this is not noted. However, the "new hair growth" looks natural, and treatable.

I can't say these are vellus hairs that have gone terminal- they appear to be miniaturized terminal hairs both before, and after. While this is the only case I find compelling in the least bit, I do have some issues with the treatment.

First of all, facial hair lies at anywhere between 10 degrees, and 45 degrees. This, in and of itself, makes treatment difficult. A very experienced technician or dermatologist should make the recommendation as to whether laser hair removal is an option to begin with.

Second, the combination of spot size, energy, and pulse width are unheard of to me for skin type IV with an Alexandrite laser. Dr. Rivers, and the paper itself, refer to these settings as "low fluence." I disagree. This is unusually high for a skin type IV with 755nm... but I'm not a clinical expert.

With that said, skin type IV should be treated with a 1064nm laser, and that treatment could have been delivered far more aggressively. The max setting on the Epitouch is 40J, but the pulse width is not long enough for skin type IV. I am skin type V, and the minimum setting on a Yag laser for efficient hair removal on my body is 25/25, and the standard is 35/35 with a minimum 10mm spot size. Spot size does affect depth of treatment, and pulse width affects melanin absorbtion of the laser. Because 755nm has less absorbtion into melanin in the hair, and more absorbtion into melanin in the skin than 1064nm, much longer pulse widths should be used when treating darker skin types to get the same effect. So if 25/25 is effective in Yag at 10mm, 23/30 at 7mm with 755nm is not at all enough time for melaning abosorbtion (though the energy is a little high for skin type IV).

Of course, I could be all wrong :-/
....................
Case 2 and 3 pissed me off, and I won't even explain much other than the following:

Case #2- The pre-treatment pictures show some back hair with almost no acne. The post-treatment pictures show more back hair (not significantly more, not thicker, not darker, not longer) and significant acne. This is obviously a case of androgenic hypertrichosis. The paper does not note the new acne, and ignores this was a 30 year old male. 13 treatments over a period of 2 years on the back is ridiculously excessive. Telogen in the back is 9 months. 6 treatments should take a minimum of 18 months.

Case #3- This was a 21 year old male who experienced androgenic alopecia in other areas after starting treatment on his face. First of all, he's 21. Second, the guy clearly has significant acne in the post-treatment picture, and NONE in the pre-treatment picture. Now get this- he was taking 1mg of Finasteride per day for 2 months prior to his complaint of... NEW ANDROGENIC HAIR GROWTH. He was taking Finasteride to treat androgenic alopecia!!! While this is noted in the paper, it is dismissed as the cause because Finasteride has been used to treat androgenic hypertrichosis in women. WHAT??? Finasteride is a growth stimulator- like Minoxidil.

In any case, I don't buy the last two cases. This is ridiculous. The first case is questionable, and barely compelling. The fact that these people ignored clear signs of androgenic stimulation is horrible considering the paper is cited 68 times in other articles and papers.

I am more convinced after reading this "study" that "paradoxical" hair growth is a normal function of lasers being used by amateurs.
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Mickey A. Couvertier, CBET, CLRT
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#109480 - 10/01/13 11:20 AM Re: Paradoxical Laser Hair Stimulation [Re: Meemz514]
Streglo Offline
Member

Registered: 09/28/13
Posts: 4
I am a 31 year old female of Irish decent. I decided to undergo laser hair removal when I was 25 years old- I had all my treatments with Laser Clinics Australia.

I had a few sessions on my face and arms for pigment removal (I think the Candela GentleLASE laser was used). A few months after the treatments course hair appeared all in all areas that had been treated (including my forehead).

I had about 5 treatments with the YAG and 20 with Candela GentleLASE lasers. This treatment made the hair even worse but as I only had the YAG periodically I can't say which was the main source of stimulation. For these sessions which aimed to reduce the paradoxical growth the settings were high.

I had about 10 sessions of Candela GentleLASE on my full legs: the treatment has been partly effective for my lower legs but from above my knew to my bikini line I have thick dark hair that I never had.

I have spend thousands of dollars on my face and arms with electrolysis which has been effective and still ongoing (with probably years to go)but I can't afford to do the same for my legs and given the number of hairs located in this area electrolysis would not see practical of such a large area.

I know that my legs were treated with a range of settings- starting from low to very high for about 5 sessions. As I had regular treatments I can't speculate as to when the prominent hair growth commenced.

I don't want to just bleach, shave, or wax.

I would be extremely if anyone has any ideas on what kind of machine or settings may be effective in removing or reducing my course dark paradoxical hair growth.

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