SKINSTAR LASER HAIR REMOVAL

How do Cutera CoolGlide® laser and ProWave™ 770 hair removal work?

The Cutera CoolGlide® laser and the ProWave™ 770 are noninvasive light therapy systems which have been custom designed to eliminate undesired hair from all parts of the body. The Cutera CoolGlide® laser and the ProWave™ 770 generate pulses of intense, concentrated light which are directed through small, cooled hand pieces which are gently applied to the treatment site.

This energy passes through the skin to the hair follicle, where the energy is absorbed by pigment in the hair and hair follicle, causing selective damage to the hair root while protecting delicate pores and structures of the skin. The energy is pulsed, or "turned on", for only a fraction of a second. The duration of the pulses is carefully determined so that energy will be absorbed by the hair follicle without transferring excessive heat to the surrounding skin.

Some of the hair which was in the treated follicles is wiped off immediately after treatment, and the rest is shed over the next 2-3 weeks. The hair roots which have been destroyed are reabsorbed by the body. If you have ingrown hairs, they will be reabsorbed by the body and the appearance of the skin will improve greatly over the next few months.

Unlike "hair-by-hair" treatments such as electrolysis, the CoolGlide® and in particular the ProWave™ 770 use wide beams which treats many hairs at once. Because the Cutera CoolGlide® laser and the ProWave™ 770 can treat dozens of hairs with each pulse, it is possible to treat larger areas -- for example the back, shoulders, arms, legs and face. The Cutera CoolGlide® laser can be used just about anywhere on the body, and usually requires no anesthesia. Even sensitive areas such as the nipples, upper lip and bikini line can be treated easily and with minimal discomfort.

The ProWave™ 770 is customized for the treatment of large untanned areas like the back and legs.

The unique design of these systems allows us to customize treatment, according to your hair and skin color, hair texture, and location on the body.

How do Cutera CoolGlide® laser and ProWave™ 770 differ from older technologies?

Other laser and intense pulsed light systems include:

• Older intense pulsed light (IPL) systems were flash lamps producing a spectrum of light energy rather than laser light. Those intense pulsed light systems were limited by their short wavelength and so tended to stun rather than kill hair follicles, so that there is often an unacceptable amount of hair regrowth, even after many "intense pulsed light" treatments.
  
  The ProWave™ and the CoolGlide feature programmable LONG wavelength pulses which can be customized to your skin color, in order to give the maximum possible safe and effective hair removal treatment, killing as many hair follicles as possible with each treatment.
• Older laser systems:
• First generation Ruby laser: 694 nanometer (Epilaser™, Epitouch™, Chromos™)
• Second generation Alexandrite laser: 755 nanometer (Epitouch ALEX™, Photogenica LIPR™, GentleLASE™)
• Third generation Diode laser: 800-810 nanometer (LightSheer™, Apex™)

These relatively short wavelength lasers can produce good results in some circumstances, but because they produce light which has a shorter wavelength, their laser energy both scatters more in the skin, and is mostly absorbed in the top few millimeters of the skin, above many of the hair roots. This means that sometimes not enough energy reaches the hair roots, where it is needed. These short wavelength, lower power systems are effective in some cases, but in other cases may only stun rather than destroy many of the hair roots and therefore sometimes cause temporary rather than permanent hair reduction. Short wavelength lasers can be difficult or impossible to safely use on people with dark, tanned or black skin. Our fourth Generation Cutera CoolGlide® laser uses the longest available, deeper penetrating 1064 nanometer wavelength. Cutera CoolGlide® reaches even the deepest hair roots, which can be 4-6 mm below the skin surface in some cases.

The long 1064 nanometer wavelength of the Cutera CoolGlide® makes it possible to safely and effectively treat all people -- even those with tanned, very dark or black skin. Like all lasers, the CoolGlide® works more efficiently on light colored skin -- so to minimize the number of treatments you need, try not to have a fresh suntan when you come in for treatment.

CoolGlide® also allows the operator to adjust the duration of the pulse of laser energy to best suit the thickness of the hair shafts on different parts of your body. Some older laser systems lack this degree of fine control.

The gold plated ClearView™ cooling head on the CoolGlide® laser provides an extra margin of safety and comfort, allows the operator a clear view of the area to be treated, and does not require pressure on your skin.

What areas of the body can be treated?

ALL parts of the body CAN be treated (and ARE treated) with the Cutera CoolGlide® hair removing laser. In women, the most common areas for treatment are upper lip, chin, bikini line, arms and legs, and underarms. In men, the most common areas for treatment are shoulders and back, and the beard area. While it is technically possible to treat even the eyelashes and eyebrows, we do not treat those areas at the present time. The top of the eyebrows can be treated when the forehead is treated. The ProWave™ 770 is customized for the treatment of large untanned areas like the legs and back

What are the benefits of CoolGlide® laser and ProWave™ 770 hair removal compared to alternative treatments?

The primary benefits of CoolGlide® laser and ProWave™ 770 hair removal include:

• Larger areas may be treated with less discomfort than with electrolysis, waxing or tweezing.
• The CoolGlide® and ProWave™ combine speed, comfort and long lasting results.
• The CoolGlide® works on any area of the body where a hair-free appearance is desired. The ProWave™ is mainly used on large areas like the back and legs.
• The CoolGlide® and ProWave™ are safe for use on pregnant women -- who respond well because their hair is often thicker and darker during pregnancy.

Shaving, waxing and depilatory creams remove the hair but leave the hair follicles intact, so the hair re-grows within one to four weeks in most cases. CoolGlide® laser and ProWave™ 770 hair removal offers you a long-term reduction in both the amount of hair, and also in many cases a reduction in thickness and color of hair shafts which do grow back.

Hair removal methods like plucking, waxing or sugaring which cause irritation may actually stimulate hair growth. This happens because one way the body defends itself against having hair pulled out is to produce thicker, stronger hairs which are harder to pull out next time. Another advantage of CoolGlide® laser and ProWave™ 770 treatment is that your skin can be kept nice and smooth between treatments by shaving -- you will never again have to grow your hair out long enough to be waxed or sugared. Occasional waxing can be useful to temporarily get rid of white hairs and fine peach fuzz hairs after you have completed a course of Cutera CoolGlide® laser or ProWave™ 770 treatment.

Cutera CoolGlide® laser and ProWave™ 770 hair removal offer long lasting results, and even if hair does eventually grow back it is usually finer in texture and lighter in color than the original hair, and much less of a cosmetic problem.

What are the advantages over electrolysis?

It has been said that:
"Removing hair by electrolysis is like mowing grass -- one blade at a time!"

With electrolysis, the operator inserts a needle into the hair follicle and tries to have the needle tip reach the hair root. The operator then triggers a small electrical charge to disable the hair root. The hair from that follicle is then removed with tweezers.

Electrolysis can be an excellent technique for the removal of:

• small numbers of hairs
• hairs from areas where it is difficult to use the laser (under the eyebrows, near the eyes, and in the ears and nose.)
• white, red and blonde hair (which do not absorb laser light efficiently).

Electrolysis can be useful for white or light colored hairs which do not respond to laser treatment, or if there are only a few dark hairs which need to be removed. Some people who have a mixture of dark and white hairs will have CoolGlide® laser or ProWave™ 770 treatment to remove as many of the dark hairs as possible, then have electrolysis to remove any leftover white hairs.

Hair removal is much faster with the CoolGlide® laser or ProWave™ 770 because each "pulse" of laser light disables a large numbers of hair follicles, and pulses can be delivered as often as twice every second. Electrolysis operators can only treat those hairs that they can see and which they can reach the follicle through the hair shaft. The Cutera CoolGlide® laser and ProWave™ 770 treat all "active" follicles, even if the hair has not yet reached the surface of the skin, is "ingrown", or if the hair shaft is not straight.

What are the risks of hair removal?

Short-term side effects may include a slight reddening of the skin or local swelling which typically lasts less than an hour, although it may infrequently last a few days. Long wavelength Cutera CoolGlide® laser and ProWave™ 770 are less likely than older devices to cause prolonged irritation, pigment changes or blistering. Rarely (perhaps 2-4 cases out of a hundred) there can be increased or decreased pigment in the treated area. This is seldom a major cosmetic problem, and generally resolves after several months. Even a single blister (rather like a tiny sunburn) is very rare (less than one in a hundred). The light from the Cutera CoolGlide® laser and ProWave™ 770 is safe, simple infra-red light and does not cause skin cancer.

Unlike plucking, waxing and sugaring, laser hair removal does not run the risk of making hair grow back thicker, darker or quicker.

Is laser hair removal "permanent"?

"Permanent hair removal" means: "ALL the hair is gone, FOREVER!"

There is NO hair removal method (including laser) which can guarantee "ALL the hair will be gone, FOREVER!"

The most realistic description of the results after laser treatment is: "long-term hair REDUCTION". This means: "After three to six treatments most people will see that the total amount of hair is greatly reduced -- generally by 80% to 90% -- and hair which does grow is often much finer and lighter in color."

Lasers have been used for hair removal since at least 1995, and we know that stable, long-term hair reduction commonly lasts for many years. In some cases, dormant follicles will start to produce new hair, or "peach fuzz" follicles may start to produce black or brown hair, and this new hair if it develops will respond well to treatment.

It has been suggested that a 6 month follow-up may be sufficient to assess final outcome after the final laser hair removal session, because once regrowth had stabilized (usually within 6 months), there is usually little or no change in hair counts at 6,12, and 24 months.

How much hair will grow back, and how fast will it grow back?

The Cutera CoolGlide® laser and ProWave™ 770 work by destroying hair roots which are active at the time of treatment, and which are dark enough to absorb sufficient laser energy. The heat from the laser denatures the DNA in the perifollicular cells so that they no longer send a signal to produce the hair protein. The hair shafts in the treated hair follicles will fall out, or be "shed" 1-3 weeks after treatment.

After the first treatment, hair regrowth may resume within a few weeks or it may be anywhere from 2-4 months before any true hair growth is observed, as previously dormant hair follicles become active, and hair follicles which were stunned but not killed recover and start to produce hair shafts again. Some people find that there is not much extra hair reduction after the second treatment, then they notice a substantial further reduction after the third or more commonly the fourth treatment. After four to six treatments there may be little or no regrowth for many years. In other cases you may wish to have additional treatment after a period of time.

Hair that regrows after laser treatment generally is finer and lighter in color, and so is much less of a cosmetic problem. Reductions in coarseness and color can occur independently of each other.

New dark hair appearing in hormone-sensitive sites (mainly the face, axillae and genital area) after successful treatment with Cutera CoolGlide® laser or ProWave™ 770 could result from hormone-stimulated maturation of previously dormant hair follicles and "peach fuzz" follicles.

Why are at least 4 treatment sessions usually needed?

The Cutera CoolGlide® laser and ProWave™ 770 work by disabling hairs that are in their active growth cycle at the time of treatment. Hair follicles in their "dormant" phase have no hair shaft in them and so will not be affected by the treatment. Because hair follicles cycle through "active" and "dormant" phases, additional sessions are usually desired once the "dormant" follicles become "active", and also to deal with hair follicles which were stunned but not killed by previous treatment.

The other group of hair follicles, which could produce dark terminal hair in the future, are the fine "peach fuzz" follicles which have no pigment and so are not affected by treatment. If some of these fine little "peach fuzz" follicles mature into hair follicles which produce black or brown hair, they can be treated with laser at that time.

At any one time, 50 to 85% of your hair follicles are in the active (anagen) phase but only 1/4 to 1/3 of your hairs have enough of the pigment in their ROOTS to absorb the laser beam which destroys the hair root. So, about 1/4 to 1/3 of your hair roots are good targets for the laser beam, and can be damaged or destroyed in a single laser session.

The number of treatments desired will depend on:

• the desired degree of hair reduction (as the amount of hair declines, some people become very enthusiastic and want even LESS hair than they had originally planned on).
• hair color (people with naturally light colored hair sometimes need more treatments).
• ethnic and genetic background (people with dark skin sometimes need more treatments).
• hormonal status
• area being treated
• hair density
• age
• weight (obesity can increase hair growth)
• medication (for example medicines like Dilantin and cyclosporine can increase hair growth)

Additional "touch up" treatments on small troublesome areas can be arranged at relatively low cost. There is no safety limit on the number of treatments a person can have. People who have been partially treated with other types of hair removing laser might in some cases need less than 3 CoolGlide® laser treatments to reach a satisfactory degree of long-term hair reduction.

Previous laser treatment or electrolysis? No problem!

Cutera CoolGlide® laser and ProWave™ 770 have been successfully used on many people who were not able to tolerate -- or did not obtain satisfactory results with -- electrolysis, or with older laser and "high intensity light" systems, including ruby laser, alexandrite laser, 800 nm lasers, and Epilight™ systems.

In fact, depending on how much hair is left, people who have been partially treated with other lasers may need only one or two treatments with the Cutera CoolGlide® laser or ProWave™ 770 to "finish the job".

Am I a good candidate for Cutera CoolGlide® laser and ProWave™ 770 hair removal?

The unique design of the CoolGlide® laser and ProWave™ 770, and the long wavelengths they use, allow treatment of people with all skin colors, and treatment of even light brown hair. Because hair which is naturally blonde, red or white does not have enough pigment in the roots, it cannot be reliably treated with any type of laser or IPL device. Fewer treatments are needed when the hair is dark and the skin is light colored -- so to get maximum effect from each session avoid tanning, but even people who have black skin can be successfully treated with the Cutera CoolGlide® laser, and people with white to moderately dark, untanned skin are treated with the ProWave™ 770.

Children can be treated, for example if they have a congenital nevus or other problem with excessive hair, but the children must be old enough (for example, 12 years old) to understand and cooperate with treatment.

CoolGlide® laser and ProWave™ 770 hair removal are not just for "cosmetic" problems. Patients with excess hair because of medications (for example, organ transplant patients who are taking cyclosporine) can benefit from hair removal; as can patients who have problems with ingrown hair and folliculitis under prosthetic devices.

Which hair colors respond best to treatment?

Because lasers and IPL devices target the PIGMENT in hair roots, they work best on black or brown hair. Naturally red or blonde hair may respond only partially.

White hair does not respond at all to treatment - so get your unwanted hair removed before it turns grey or white!

What are Hirsutism and Hypertrichosis?

Hirsutism is excessive growth of hair in androgen (testosterone)-dependent areas of a woman’s body where terminal hair is not normally found, including the face, neck, chest or medial thighs.

Hypertrichosis is excessive growth of hair in non-androgen dependent parts of the body (i.e. Areas other than the face, neck, chest and medial thighs).

What is Unwanted Female Facial Hair?

Growth of hair on the face which is coarser, longer or more profuse than is "normal" for the age and race of the woman. Unwanted Facial Hair is a chronic problem for about 22 million American women) who remove facial hair at least once a week.

How can I get the best value from each treatment?

To get the best results with the smallest number of treatment sessions, please pay attention to the following guidelines as you work with us:

Avoid waxing / sugaring / plucking / EpiLady and electrolysis
Because the energy from the CoolGlide™ laser and ProWave™ 770 seeks out and destroys ACTIVELY GROWING hair roots, it is important (if you want to get the best value from your treatment) NOT to wax / pluck / sugar / use EpiLady-type pluckers or have electrolysis for at least EIGHT WEEKS before treatment. These things temporarily remove the pigmented part of the hair follicle which the CoolGlide® and ProWave™ need to use as a target when they destroy the hair follicle.

Ideally, minimize tanning prior to treatment
CoolGlide™ laser and ProWave™ 770 are the safest and most effective devices for ALL types of skin, even black people who cannot be safely treated with other hair removing lasers. Many Italian, Greek, and East Asian people have been successfully treated with the CoolGlide™ laser and ProWave™ 770.

BUT: the lighter your skin color at the time of treatment, the better the laser beam can get through the skin to the hair roots, where it is needed.

SO: tanning is not a BIG deal, but if you avoid tanning and stop using artificial "tanning" creams for six weeks before treatment, you will get the maximum possible benefit from each treatment session. People with very dark skin (and people who are really into tanning) sometimes need one or two extra sessions to reach their desired degree of long-term hair reduction.

Shaving or clipping the hair? Good idea!
Shaving or clipping the area to be treated is not a problem. In fact, we like the areas to be shaved the day of treatment or the day before. Some people find that the skin is less sensitive if it is shaved at least a few hours before treatment. Another advantage of shaving the area to be treated BEFORE you come in is that YOU can shape the area to be treated exactly the way YOU want it to be. This is of particular importance in areas like the sideburns, temples, and bikini line / bikini area.

Excess hair should be removed from the treatment area before CoolGlide™ laser or ProWave™ 770 treatment, because hair ABOVE the surface of the skin will simply absorb and waste laser energy and keep it from getting to the hair roots, where it is needed.

Contrary to popular belief, shaving DOES NOT make hair grow back thicker, faster, darker or more profusely! So go ahead and shave before treatment, and between treatments!

Hair Dye and Bleaching? No problem!
Because the beam only acts on the hair ROOTS, it is OK to dye and/or perm hair in the areas to be treated. Likewise, it is OK to bleach hair in the areas to be treated because bleaching will not affect the color of the roots.

Medications?
We are not aware of any medications that should not be taken while you are getting CoolGlide™ laser or ProWave™ 770 treatment. Anabolic steroids should certainly NOT be taken unless medically necessary, because these can increase male-pattern hair growth in some cases. Women to take injections of Climacteron (testosterone & estradiol) as part of therapy for menopause and to increase libido often experience unwanted hair growth, which can be treated with CoolGlide™ laser or ProWave™ 770 hair removal.

Recent studies have confirmed our experience that treatment can safely be done for patients who are taking Accutane™ or using Retin-A™ and similar medications.

Medicines which inhibit hair growth (for example, spironolactone, Diane-35™ birth control pills, Euflex™, Androcur™ and Vaniqa™ cream) might slightly reduce the pigment in hair roots and make laser treatment less efficient, but this seldom interferes with the effectiveness of treatment. Cutera CoolGlide™ laser and ProWave™ 770 hair removal can certainly be done WHILE you are on those medicines, if you wish. These "anti-androgenic" medicines produce gradual but temporary effects, and will not remove unwanted hair from areas that are independent of androgen regulation.

Pre-treatment with medicines like Zovirax™, Valtrex™ or Famvir™ is NOT necessary, unless you tend to get a lot of cold sores in the area to be treated.

Moles, freckles and tattoos in the area to be treated?

Small moles and freckles do not require any special precautions. Large, dark moles and freckles which are to be treated may require a reduction in the intensity of treatment, the same way that the intensity would be reduced when treating a dark-skinned or tanned person. Tattoos will be avoided, because exposure to CoolGlide™ laser or ProWave™ 770 could cause fading of the tattoo, discomfort, or even a burn. Be sure to tell us if you have permanent lip liner or permanent eyebrow liner, because these are tattoos and special precautions may be needed if there will be laser treatment in those areas.

What will happen on the treatment day?

HELLO LASER, GOODBYE RAZOR!
Lasting hair removal has never been this easy!

Other than your regular skin care routine, there is no standard "prep" for this procedure. It is important not to wear any makeup -- or at least wear simple water-based makeup that can be easily removed -- because makeup can sometimes absorb laser energy. This could interfere with treatment, or even cause overheating of the skin surface and burning. Makeup can be re-applied immediately after Cutera CoolGlide™ laser and ProWave™ 770 treatment, if you wish.

There are no restrictions on what you may eat or drink prior to your appointment -- in fact it is a good idea to have a nice breakfast or lunch before coming in for treatment.

Please shave or clip the areas to be treated before you come in for treatment. Freshly shaved skin is more sensitive, and there is less discomfort if you wait at least an hour between shaving and having laser treatment. Shaving also allows you to shape the exact area you want treated -- this is sometimes very useful in the bikini area. Excess hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the hair root, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin.

Everyone in the treatment room must wear protective goggles while the CoolGlide™ laser and ProWave™ 770 are in use.

The length of the procedure itself can range from a few minutes for the upper lip to an hour or more (for example, a man’s chest and back). You may save considerable time, as you reduce or eliminate the need for shaving and other hair removal methods.

If you decide before coming in that you would like to have additional areas treated, please call ahead so that we can schedule enough time to accommodate your needs.

The process is very simple...
Anesthetic cream is sometimes applied to the skin before the area is treated, and sometimes the Zimmer cold air blower is applied to increase your comfort. The CoolGlide™ laser or ProWave™ 770 pulses are quickly and evenly applied by our carefully trained and supervised staff.

You can bring a friend or family member if you like -- quite often mothers and daughters will come in together for treatment.

Does it hurt?

The CoolGlide™ laser and ProWave™ 770 use pure, simple light. You will feel a momentary "snapping" sensation like a rubber band. There is no bleeding and no open wound is created. Some people find the FIRST treatment more uncomfortable than subsequent treatments. Maybe this is because there are more hair roots which are destroyed during the first treatment; and perhaps also because some people are more apprehensive during the first treatment, because they are not sure of what to expect.

Many patients find that they have less discomfort if they shave the area to be treated at least a couple of hours BEFORE coming in for treatment, because freshly shaved skin is often somewhat more sensitive. Shaving before coming in for treatment also allows you to shape the area to be treated exactly the way YOU want it. This is of particular importance in areas like the forehead, sideburns and bikini/pubic hair areas.

While some areas of the body like the upper lip and pubic hair area are more sensitive than others, many patients report little or no discomfort. If there is unusual discomfort, please let us know so that we can apply more cooling or adjust the settings.

People who have had waxing, sugaring, and/or electrolysis (or treatment with other lasers) usually report that CoolGlide™ laser and ProWave™ 770 cause less discomfort, and sometimes there is no discomfort.

Another possible explanation for reduced discomfort with the Cutera CoolGlide™ laser and ProWave™ 770 compared with other forms of treatment is that the long wavelength of this equipment delivers more energy into the deeper part of the skin where the hair roots are -- and wastes less energy in the top 2 millimeters of the skin where many of the nerve endings are.

In addition, both the CoolGlide™ laser and ProWave™ 770 have the ability to reduce the frequency of pulses and increase the cooling time in sensitive areas, to maximize your comfort.

A specially formulated anesthetic cream is occasionally used in very sensitive areas or by those who think they have a very low pain threshold. This cream is a mix of benzocaine, lidocaine, and tetracaine and is very effective.

Many people find it helpful to simply take two or three plain Tylenol and/or Advil a couple of hours before coming in for treatment. A combination of Tylenol and ibuprofen works very well because one is analgesic and other is anti-inflammatory. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time.

Why does the hair sometimes look like it's growing for 1-3 weeks after laser treatment?

CoolGlide® laser and ProWave™ 770 destroy hair roots which are active at the time of treatment, but do not remove hair shafts instantly. Hair shafts in the treated hair follicles will fall out, or be "shed" mostly in the first week after treatment, with all of the treated hairs falling out within 2-3 weeks.

It is normal that some hairs in the treated area may not fall out within 2-3 weeks. These will be treated in the next session.