Goodbye razor, hello laser!

1.  How do the Cutera CoolGlide™ and ProWave™ 770 lasers work for hair removal?

The Cutera CoolGlide™ and ProWave™ 770 are non-invasive light therapy devices specifically designed to eliminate undesired hair from all parts of the body. The Cutera CoolGlide™ and ProWave™ 770 generate a pulse of intense, concentrated light directed through a small, cooled hand piece, which is 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 deeply penetrating long wavelengths used by the Cutera CoolGlide™ and ProWave™ 770 allows us to kill as many hair follicles as possible with each treatment. The Cutera CoolGlide™ and ProWave™ 770 are 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 follicles 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 body reabsorbs the hair roots which have been destroyed.

The surface of the skin is protected by a cooling head which soothes the skin during treatment.

“Goodbye Razor, Hello Laser!”

 

Unlike “hair-by-hair” treatments like electrolysis, the laser uses a wide beam which treats many hairs at once. Because the Cutera CoolGlide™ and ProWave™ 770 treat dozens of hairs with each pulse, it is possible to treat larger areas such as 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 or other treatment. Even sensitive areas such as the nipples, upper lip and bikini area can be treated easily and with minimal discomfort.  The Cutera ProWave™ 770 is custom designed for treatment of large areas like the back and legs, on skin which is not tanned. 

The unique design of the Cutera CoolGlide™ and ProWave™ 770 allow us to customize treatment according to your hair and skin color, hair texture, and location on the body.

Cutera CoolGlide™ and ProWave™ 770  treatments are a safe, fast, gentle and effective method for hair removal. In just a few treatment sessions using the gentle power of this state-of-the-art equipment, you can greatly improve the appearance of skin where you have unwanted hair.

2.  How do the Cutera CoolGlide™ and ProWave™ 770 lasers differ from older technologies?

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.

We waited until the Cutera ProWave™ 770 became available in 2005.

The ProWave™ features programmable long wavelength pulses which can be customized to your skin color, in order to provide the safest and most effective hair removal treatment for your skin type, killing as many hair follicles as possible with each treatment.

Older laser systems include:

• First generation Ruby laser: 694 nanometer (Epilaser™, Epitouch™, Chromos™)
• Second generation Alexandrite laser: 755 nanometer (Epitouch ALEX™, 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. The cooling system in 800 nm lasers usually relies on a sapphire window, which is only 1/10 as efficient as the gold plated copper cooling head in the Cutera CoolGlide™.

Because the sapphire window of the 800 nm lasers has to be pressed on the skin while the laser is triggered, there is a risk that stray hairs will be burned into the skin. By comparison, there is no contact between the laser aperture and the skin when the Cutera CoolGlide™ laser beam is applied to your 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—including 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 us to adjust the duration of the pulse of laser energy to best suit the thickness and colour 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. While using the Cutera CoolGlide™ our operators wear clear UVEX CLT™ 1064 goggles, for better, safer and more effective visualization of your skin than is possible with the dark glasses commonly worn by operators of older, shorter wavelength lasers.

3.  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.

 

4.  What are the benefits of Cutera CoolGlide™ and ProWave™ 770 laser hair removal?

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

• Larger areas may be treated with less discomfort than with electrolysis, waxing or tweezing.
• The CoolGlide™and ProWave™ 770 are both customized for speed, comfort and long lasting results.
• The CoolGlide™ works on any area of the body where a hair-free appearance is desired, and the ProWave™ 770 is customized for treatment of large untanned areas like the back and legs.
• The CoolGlide™ and ProWave™ 770 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 like Nair™, Neet™ and Vaniqa™ are all temporary methods that must be repeated on a regular basis. These methods remove the hair but leave the hair follicles intact. The hair grows back within one to four weeks in most cases.

Hair removal methods which produce irritation like plucking, waxing or sugaring 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 treatments 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 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.

5.  What are the advantages of laser hair removal 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 and very pale blonde hair (which does not absorb laser light efficiently).

I sometimes refer patients for electrolysis, and electrolysis operators sometimes refer patients to me, depending on the needs and wishes of the patient.

For example, 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 laser treatment to remove as many of the dark hairs as possible, then have electrolysis to remove any leftover white hairs.

There can be considerable variation in the results between electrolysis therapists, and the rate of permanent hair loss has been reported to be from 15 to 50%. Electrolysis can be a tedious process and is a difficult undertaking for some patients.

Even a small zone, such as a female patient with heavy facial hair, could require electrolysis for 2 –3 hours per week for 2 years, with further treatments over an undetermined period of time, for a treatment time exceeding 210 hours. Despite its popularity over the past two decades and its use for over 100 years, there is little in the medical and scientific literature about electrolysis.

Hair removal is much faster with a laser 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.

6.  Is laser hair removal covered by insurance or OHIP?

OHIP will not pay for hair removal.

Most private insurance companies do not offer reimbursement for “cosmetic” procedures like hair removal; however, consult your insurance carrier for more information.

The removal of unwanted terminal hair for the management of hirsutism, congenital or drug-related hypertrichosis, pseudofolliculitis, trans-sexual states, and some skin grafts may be covered by some private insurance plans.

7.  Is the cost of laser hair removal a tax-deductible medical expense?

Laser hair removal performed for you by Dr. Smith and his staff may be a tax-deductible medical expense (similar to dental, orthodontic and cosmetic surgery bills) if it is for treatment of a disease, but otherwise it is no longer tax-deductible.

To claim procedures as medical expenses, the total amount or value of the receipts from doctors, dentists, prescriptions etc. must exceed the lesser $1,884 or 3% of your net income.

EXAMPLE 1: Deb’s net income is $48,000. Her medcal expenses are $4,300. She calculates that 3% of her net income is $1,440. Because this is less than $1,884, she uses the $1,440 amount. She subtracts it from $4,300.  The difference is $2,860. She will get a percentage of the $2,860 back, in this case about 22% (federal tax), or $609.

EXAMPLE 2: Karen’s net income is $70,000. Her medical expenses are $4,300. She calculates that 3% of her net income is $2,140. Because this is more than $1,884, she uses the $1, 884amount. She subtracts it from $4,300.  The difference is $2,416. She will get a percentage of the $2,860 back, in this case about 22% (federal tax), or $543.

8.  What are the risks of laser 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. Fourth generation, long wavelength 1064 lasers like CoolGlide™ are less likely than older lasers to cause prolonged irritation, pigment changes or blistering. Likewise, the advanced design of the ProWave™ 770 protects your skin while improving the effectiveness of treatment.

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 pure, simple light from the Cutera CoolGlide™ laser and from the ProWave™ 770 does not cause skin cancer. 

Unlike plucking, waxing and sugaring, Cutera CoolGlide™ laser and ProWave™ 770 hair removal does not run the risk of making hair grow back thicker, darker or more quickly.

After treatment, hair growth will frequently be delayed, and when hair does grow back, it is often lighter, finer and less dense.

9.  Is laser hair removal "permanent"?

“Permanent hair removal” means: “all the hair is gone, forever!”

There is no hair removal method (including laser or IPL) which can guarantee that all the hair will be gone, forever.

The most realistic description of the results after Cutera CoolGlide™ laser and from the ProWave™ 770 treatment is: “long-term hair reduction.”

This means: “After four to eight treatments most people will see that the the total amount of hair is greatly reduced—generally by 70% to 90%—and hair which does grow is often much finer and lighter in color.”

It is important for you to realize that after having between four and eight treatment sessions it is very likely that there will be a very substantial reduction in both the amount of hair and also a reduction in the thickness and color of the hair in the treated areas. You should expect that this reduction in hair may last for many years.

This long-term hair reduction is exactly what most people want, but could be an issue, for example, if you removed hair from an area and later decided that you wanted to have hair in that area.

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.

10.  Should I expect to be "100% hair-free" in the treated area after the series of treatments are completed?

No, you should not expect to become completely hairless in the area treated.  Most patients experience a 70-90% reduction in the amount of hair in a given area after between four to eight treatments, and a reduction in the thickness and color of the remaining hair, but should not expect to be "100% hair free".

A few patients are satisfied in less than four treatments, and some want or need more than eight treatments, in particular in cases where the hair is relatively light colored.

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.

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

The Cutera CoolGlide™ laser and the ProWave™ 770 (and other lasers and IPL devices) work by destroying hair roots which are active at the time of treatment and which are dark enough to absorb sufficient energy. 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.

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 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) could result from androgen-stimulated maturation of previously dormant follicles and “peach fuzz” follicles.

12.  Why are at least four 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.

There is no treatment which will kill 100% of the hair follicles, 100% of the time. Cutera CoolGlide™ laser and ProWave™ 770 use the longest, most deeply penetrating wavelengths and special cooling to maximize the number of killed hair follicles and minimize the number that are stunned during each treatment session.

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. 

Because 1/4 to 1/3 of the actively growing pigmented hair roots are damaged or destroyed in any one session, almost all people will want a minimum of four CoolGlide™ treatments to reach a satisfactory degree of hair reduction.

Many people will wish to have more than four treatments, most commonly 5 to 8 treatments. In some cases another session or two in six to twelve months is desired, to eliminate any black or brown hairs which have developed when dormant follicles started to produce hair, or when "peach fuzz" hair follicles mature and start to produce black or brown hair.

The number of treatments you need will depend on:

• the desired degree of hair reduction (as the amount of hair declines, some people sometimes become quite enthusiastic and want even less hair).
• 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 or IPL device might in some cases need fewer CoolGlide™ laser or ProWave™ 770 treatments to reach a satisfactory degree of long-term hair reduction.

13.  Previous laser or "intense pulsed light" treatment? No problem!

The 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—older laser and IPL systems, including ruby, alexandrite, and diode lasers.

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 and ProWave™ 770  to “finish the job”.

14.  Am I a good candidate for laser hair removal?  Am I being "vain"?

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 child must be mature enough 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.

Many people have fears and doubts at some time before deciding to have laser hair removal of unwanted hair or blood vessels, or before BOTOX^® treatment for wrinkles or excessive sweating. A common concern is that they are being vain. My experience has been that just about all patients who have BOTOX^® treatment, hair removal, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after your appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have laser hair removal, BOTOX^®, and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

The same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and well dressed, and often careful in their diet, exercise, and other aspects of health maintenance leads our patients to seek help for their unwanted hair.

These individuals are normal healthy people, and the same degree of self-interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of treatments to maintain and enhance their apprearance. Our patients simply want to look their best.

15.  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!

16.  Questions to ask yourself when considering laser hair removal

• How much are you bothered by your facial hair or hair on other areas?
• How much are you bothered by the time you spend removing, treating, or concealing your facial hair or hair on other areas?
• How uncomfortable does your facial or other unwanted hair make you feel in exchanges of affection (such as intimate exchanges with your partner)?
• How uncomfortable does your unwanted hair make you feel when you meet new people?
• How uncomfortable does your unwanted hair make you feel when you go to social gatherings, dine out in a restaurant, go to a supermarket or other public place?
• How uncomfortable does your unwanted hair make you feel when you go to work or class? 

17.  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).

18.  What is Unwanted Female Facial Hair?

Unwanted Female Facial Hair is: “Growth of hair on the face which is coarser, longer or more profuse than is “normal” for the age and race of the woman.” This is a chronic problem for about 2 million Canadian women (and about 22 million American women) who remove facial hair at least once a week. 

19.  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:

A.  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 not to wax / pluck / sugar / use EpiLady-type pluckers or have electrolysis for at least 8 weeks before treatment if you want to get the best value from your 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. 

B. Avoid tanning

CoolGlide™ laser and ProWave™ 770 are the safest and most effective devices for all types of skin, including people with very dark or black skin 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.

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.

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.

It is also a good idea to minimize tanning for a few weeks after laser treatment, to reduce the chance that your tan will be somewhat uneven.

Recommended sunscreens include Ombrelle-SPF 60™ and Anthelios-60™.

C. Shaving or clipping the hair? No problem!

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. There may be a small extra charge if we have to shave extensive areas before starting laser treatment.

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!

D. 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. 

E. Timing

It takes 8 to 12 weeks for the next crop of hair roots to become active and develop pigment, which is the target for the laser. So, to get the best value for your money, you should wait 8-12 weeks between treatments.

There is no harm in having treatments more frequently than every 8 weeks, or having CoolGlide™ laser or ProWave™ 770 treatments less than 8 weeks after waxing, plucking, etc, but this is less efficient, and could increase the total number of treatments needed to get a good result.

Also, while there is no harm in waiting more than 8 weeks between treatments (for example, if there has not been much regrowth after your last CoolGlide™ laser or ProWave™ 770 treatment), there is usually no extra benefit to waiting longer than 12 weeks between treatments.

F. Medications

There are no restrictions on medications which should 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 taking 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. 

20.  What is a "test area" and why is it sometimes performed?

"Test areas" are small areas of skin that are treated at various energy levels prior to treatment of large surface areas on darker skin types. "Test areas" are done on darker skin types to determine the level of energy that is best for that individual, and checked up to one week later to make sure there was no burning or pigment change.

Light skin types generally don't have to have test areas done. This may be done at the same time as your consultation, and a $50 fee is required for this test. The fee for the "test area" is deducted from the cost of your first treatment.

21.  What if I have moles, freckles, or tattoos in the area to be treated?

Small moles and freckles do not require any special precautions. Large, dark moles and freckles which are in the area 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 Dr. Smith and his staff 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. 

22.  What will happen on treatment day?

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). In the long run, laser hair removal can save you 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.  Cooling pads are sometimes applied to the skin for a few moments before the area is treated, and sometimes the Cryo-5 chilled air stream is applied to large areas like the back or legs 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.

23.  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 little 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.

EMLA™ anesthetic cream is occasionally used in very sensitive areas or by those who think they have a very low pain threshold. EMLA™ can be purchased without a prescription, and a very thick layer should be applied an hour before the procedure. Most people do best with cooling gel pads and the Cryo-5 chilled air blower, and do not bother with EMLA anesthetic cream.

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. 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. 

24.  What will happen after treatment?

Redness often has faded greatly by the time you get home. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favorite moisturizer, for example, Alyria Hydrating Complex™ Moisturizing Cream.

 The hair follicles may appear slightly more obvious or a bit pink for the next day or two, but this is seldom a cosmetic problem, and generally much less obvious than after waxing or sugaring.

25.  Why does hair sometimes look like it's growing in the treated area for 1-3 weeks after 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 treated in the next session. 

These hairs which are being shed will come out on their own. It is best not to shave the treated area or to wash it with anything but mild soap like Alyria Gentle Cleanser™ and your bare hand (no Buf-Pufs, washcloths or Body Washes) for 3-4 days after treatment, because some people find that their skin is irritated by these things.

26.  Are there any restrictions on my activity after treatment?

Since the CoolGlide™ laser and ProWave™ 770 do not burn or cut the skin in any way, no bandages are necessary. You can return to work the same day and resume all your regular activities. To reduce the chance of uneven tanning in the treated areas, you should minimize sun exposure and tanning for a week or two after treatment.

It is OK to resume shaving or clipping hair in the treated area after 3-4 days. You should not have waxing / sugaring / plucking or electrolysis, because these things will temporarily remove pigmented hairs from the hair roots and reduce the effectiveness of your next treatment. Sometimes after plucking, waxing or sugaring the hair will become thicker and darker, because one of the ways that the body defends itself from chronic irritation is to produce thicker, darker hairs. 

Shaving really is the best temporary way to remove unwanted hair before treatment, and between treatments. Shaving leaves the hair shaft in the hair follicle, so the hair shaft can be a target for laser energy, heat up and kill the hair follicle.

You can shave as often as you want. It has been shown in scientific studies that:

            • Shaving does NOT make hair grow faster.

            • Shaving does NOT make hair grow thicker.

            • Shaving does NOT make hair grow darker.

            • Shaving does NOT make hair grow more profusely.

27.  Pre-treatment instructions

1. Please do not do any waxing, plucking or sugaring for 8 weeks before treatment, because hair follicles which do not have hair shafts in them to absorb energy will not be killed by the treatment.
2. Please try to minimize tanning for a week or two before treatment: a fresh tan can interfere a bit with the effectiveness of the treatment, though this is less of a problem than with older, short wavelength lasers and IPL devices.
3. Please do not wear makeup on the areas to be treated, or at least wear makeup that is easy to remove. If makeup absorbs energy, less energy will reach your hair follicles and hair shafts, and if the makeup heats up it could irritate or burn your skin. Makeup can be re-applied immediately after Cutera CoolGlide™ laser and ProWave™ 770 treatment, if you wish.
4.  Please shave or clip the areas to be treated the day before treatment or on the morning of treatment. This way, the skin will be less sensitive. Shaving before you come in also allows you to shape the exact area you want treated—this is sometimes very useful in areas like the hairline and sideburns, and in the bikini area.  Excess hair above the surface of the skin absorbs and wastes 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.
5. Many people find it helpful to simply take two or three plain Tylenol™ and/or Advil™ 2 hours before coming in for treatment. 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.
6. During the treatment, remember that: We want to be doing this for you, not doing it to you. Unexpected discomfort is Nature’s way of telling us something is wrong, so please tell us and we will go slower, apply more cooling, or adjust the settings for you.

28.  Post-treatment instructions

1. Redness often has faded greatly by the time you get home. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favorite moisturizer, for example, Alyria Hydrating Complex™. The hair follicles may appear slightly more obvious or a bit pink for the next day or two, but this is seldom a cosmetic problem, and generally much less obvious than after waxing or sugaring.
2. Try to avoid tanning for a week or two after treatment, because occasionally the tan could be somewhat irregular (lighter and/or darker in the treated areas.) Ombrelle-60™ and Anthelios-60™ are excellent sunscreens.
3. Hair shafts will be released from hair follicles in the treated area for a week or two after treatment. You do not need to do anything, but you may gently exfoliate or shave the areas if you wish.
4. Shaving, depilatory creams like Nair™ or Neet™, or bleaching are OK between laser treatments. Plucking, waxing and sugaring should be avoided because these things could reduce the effectiveness of your next treatment.
5. Blistering or scaling after Cutera CoolGlide™ laser and ProWave™ 770 hair removal is very uncommon, but usually resolves over a few days or a week with a bit of Polysporin™ cream several times a day. Please call us if this happens, or if you have any other problems or questions.

29.  How much does laser hair removal cost?