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Laser Removal of: Vein, Tattoo, Freckles, Age Spots, Pigmented Lesions I have worked since 2000 with the Cutera CoolGlide® laser for hair removal, and have found that this is reliable and cost effective for my patients. In 2005 we added the Cutera ProWave™ 770, which allows for quick treatment of large unta We are pleased that physicians and their staffs from the United States and from various parts of Canada have recognized our expertise in hair removal and laser removal of unwanted blood vessels, and have visited the Niagara Falls Dermatology and Skin Care Centre to study our techniques, and to learn our systems and procedures. Many people in Ontario are interested in learning more about laser hair removal. I have prepared this detailed information, including prices, to help you understand this major advance in laser hair removal. You can click on any of these topics, and the full discussion will appear below. Or you can simply scroll down in this window to read the entire discussion from start to finish. 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. The surface of the skin is protected by built-in cooling systems which help to protect and soothe the skin during treatment of your unwanted hair. 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 colour, hair texture, and location on the body. Cutera CoolGlide® laser 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 one of these systems, you can greatly improve the appearance of skin where there is unwanted hair. How do Cutera CoolGlide® laser and ProWave™ 770 differ from older technologies? Other laser and intense pulsed light systems include:
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.
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.
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:
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:
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 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. 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 an difficult undertaking for some patients. Even a small area like the face, for example, in the case of a woman 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 total 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 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. Many people want Cutera CoolGlide® laser and ProWave™ 770 hair removal, but everyone wonders You will find that the fees listed below for laser hair removal using the efficient, effective, fourth-generation Cutera CoolGlide® laser and ProWave™ 770 are surprisingly affordable. Fees are per treatment session, plus GST, and can be paid at the time of treatment with Interac, Visa, MasterCard, or cash. No cheques please. Fees paid for Cutera CoolGlide® laser and ProWave™ 770 hair removal are a tax deductible medical expenses when done under the supervision of a physician for treatment of medical conditions like folliculitis, ingrown hairs, pseudofolliculitis barbae (PFB), pilonidal sinus, etc. Professional services provided by appointment only. There is no fee for pre-laser consultation. Consultations about Cutera CoolGlide® laser and ProWave™ 770 hair removal can usually be arranged within a week or two simply by calling our special LaserLine Toll Free: 866 707 3222where our staff who have had Cutera CoolGlide® laser hair removal themselves can take the time to discuss your wishes and options, and answer your questions. No referral is required. Treatment may be scheduled for the same day as the consultation if there is a time slot is available, or may be scheduled for a later date. What are the prices for the most commonly treated body areas? The most commonly treated body areas include (per treatment session): Is Cutera CoolGlide® laser and ProWave™ 770 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. Some health spending accounts (HASs) cover the cost of cosmetic treatments, like laser hair removal, under the supervision of a physican. The removal of unwanted terminal hair for the management of hirsutism, congenital or drug-related hypertrichosis, pseudofolliculitis, trans-sexual states, and skin grafts may be covered by some private insurance plans. When is the cost of Cutera CoolGlide® laser and ProWave™ 770 hair removal a tax deductible medical expense? Like fees paid to physicians, dentists and orthodontists for other medical services, fees to physicians for Cutera CoolGlide® laser and ProWave™ 770 hair removal services are tax deductible medical expenses, so save your receipts! What are the risks of Cutera CoolGlide® hair removal laser and ProWave™ 770 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. After Cutera CoolGlide® laser or ProWave™ 770 treatment hair growth will be delayed, AND when hair does grow back, it is often lighter, finer and less dense. Is Cutera CoolGlide® laser and ProWave™ 770 hair removal "permanent"? The most realistic description of the results after laser treatment is: "long-term hair REDUCTION". This means: "After four to eight treatments most people will see that 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. 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. Should I expect to be "hair free" in the treated area after the series of treatments? How much hair will grow back, and how fast will it grow back? No, most patients experience an 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 "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. How much hair will grow back, and how fast will it grow back? 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. 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 between 4 - 8 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. 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.
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. 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. 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. Am I being vain? 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. Because hair which is naturally blonde, red or white does not have enough pigment in the roots, those hair colors cannot be treated with any type of laser or IPL device.
Questions to ask yourself when considering Cutera CoolGlide® laser and ProWave™ 770 hair removal:
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 (ie. 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 2 million Canadian women (and 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 Tanning should be avoided! 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™. Shaving or clipping the hair? Good idea! 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! Timing 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. Medications? 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. 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. 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 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. What will happen on the treatment day? HELLO LASER, GOODBYE RAZOR! 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. 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... You can bring a friend or family member if you like -- quite often mothers and daughters will come in together for treatment. 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. 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. 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. 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. 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. 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 treated in the next session. 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. Please do not do any waxing, plucking or sugaring for 6 weeks before treatment, because hair follicles which do not have hair shafts in them to absorb energy will not be killed by the treatment. 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. 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. 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. 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. 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. Our staff can take the time to discuss your wishes and options, and answer your questions. No referral is required. Niagara Falls Dermatology & Skin Care Centre Limited Kevin Smith, MD, FRCPC Dermatologist Licensed and inspected by the College of Physicians and Surgeons of Ontario Fellow of the Royal College of Physicians and Surgeons of Canada Board Certified in the United States by the American Board of Dermatology Suite 201, 6453 Morrison Street, Niagara Falls, Ontario Please call us Toll Free: 1-866-760-1000 if you have any questions, and to arrange for a prompt, confidential consultation and treatment. No referral is needed. |





















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.
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.