Which LASER will be used for my treatment?

Vascular LASER – Pulsed Dye Laser (PDL), KTP, Long pulsed YAG

Vascular LASERs target red-coloured haemoglobin in blood running through the vessels just below the surface of the skin. The high energy produced by the LASER heats up the blood vessel which then results in either vessel rupture or clotting withn the vessel such that the visibility of the vessel is reduced.

Treatment with a vascular LASER will often result in swelling and redness of the skin for 3 to 5 days afterwards. For Pulsed Dye LASER treatment specifically, you would expect to have dark purple bruising (purpura) in the treated area which lasts for 10 to 14 days.

LASER treatment to Pigmented Lesion

Pigment LASERs target natural skin pigment (melanin), ink or debris in the skin. They work by breaking up pigment by vibration. The fragmented pigment is then gradually cleared by the body over several weeks.

After treatment with a pigment LASER, you would expect to see a white ‘frosting’ over the surface of the treated area and surrounding purple bruising. The surrounding skin is likely to be red and swollen. The initial colour changes should settle after 10 to 14 days. Less commonly colour changes following pigment LASER treatment can last for several months or more.

Rarely treatment of pigmented lesions (mainly tattoo ink) can result in a phenomenon known as ‘paradoxal darkening’ of the pigment producing a dark brown/black colour. This can be reduced by subsequent treatments but may remain. 

Ablative LASER treatment (Erbium YAG)

Ablative LASERs are absorbed by water in skin structures resulting in ‘vapourisation’ of the target tissue. This means that treatment with ablative LASERs is a more invasive and ‘surgical’ based treatment resulting in a break in the skin.

Focal Ablative treatment

This treatment can be used to destroy discrete skin lesions and smooth out textural irregularities, as well as remodelling of larger areas of tissue. Such treatment requires a local anaesthetic injection or a general anaesthetic before the start of treatment.

As the treatment creates an open wound, a dressing will be applied for 24 to 48 hours and you will be advised to use Mupiricin ointment or similar to keep the area clean and moist for several days. It is not uncommon to see some oozing/bleeding for a few hours after treatment. Frequently, focal ablative treatment results in scar tissue.

Fractional Ablative treatment

This treatment splits the Erbium YAG beam into a series of tiny LASER beams which are equally spaced apart. The laser creates a number of small vapourised channels in the skin which produce a mild heating effect. This has been shown to aid wound healing and the remodelling of scar tissue. Creation of the small channels also allows the delivery of topical treatments (e.g steroid) deeper into the skin. Fractional treatments are most commonly used to treat thickened/inflamed scar tissue.

The treatment is frequently tolerated without anaesthetic but, if necessary, a topical anaesthetic cream (obtained from your GP) can be applied under a dressing for 1 hour before the start of treatment.

There will often be a small degree of oozing of blood from the ablated channels for a few hours after treatment and therefore, a dressing will be required for 24 to 48 hours after treatment. 

Laser Hair Reduction

Hair reduction Lasers use a concentrated beam of light, which passes through the outer layer of the skin and is absorbed by the dark pigment (Melanin) in the hair follicle.

The light energy is converted to heat and it is absorbed, which in turn, damages the hair and the base of the hair follicle where the cells and the blood supply responsible for the new hair growth are situated.

This causes the hair growth cycle to slow down and also damages the small percentage of hairs in the ‘active’ growing stage (anagen phase) at each treatment.

Not all the hairs are in the anagen phase at any one time, which is why a treatment course consists of three treatments. The laser will not have any effect on white grey or blond hair: fine, downy hair is not amenable to Laser treatment.

What does the treatment involve?

Because Laser light is very bright your eyes need to be protected by wearing goggles during treatment. In order to comply with Laser safety rules, you cannot be accompanied by friends or relatives in the treatment room.

Treatment involves a number of pulses of Laser light depending on the size of the area treated. Each Laser pulse causes a brief stinging sensation and after treatment the area feels hot for a period of time. Although uncomfortable most people tolerate the treatment well. Cold air and Gel or a cooling spray are routinely used to protect the top layer of the skin (epidermis).

We do not offer local anaesthetic, however if you find the treatment particularly painful, your practitioner can advise you about suitable analgesia (pain relief).

Immediately after treatment, the skin usually looks pink and there is usually some swelling (like nettle rash) which lasts for a few hours. Some damaged hairs may be visible in the skin for a few days until they are shed. Do not be tempted to remove these, they will fall out naturally after 5 to 7 days. Some patchy pinkness may also be present for 7 to 10 days or occasionally longer.

Prior to treatment you will be asked to sign a consent form. We work to a strict protocol with regard to treatment parameters and cannot deviate from this. Treatment parameters will be explained to you when you sign your consent form. Part of the consent process is the agreement between practitioner and patient as to which areas are suitable for treatment.

Before your first full treatment, you will need a test patch so we can assess the reaction of your skin and ascertain of the treatment will be effective. At this appointment we will also take photographs of the are to be treated. This will help us assess response at your subsequent visits. These photographs are kept in your medical records to be viewed only by the staff involved with your care.

We will assess your response at your first treatment appointment. If you have not had any problems in the test area and we can see an obvious improvement, we will deliver your first full treatment to the area agreed at consent. Evidence shows that the maximum benefit is achieved after 3 full treatments. We cannot predict how long the improvement may last. It is unrealistic to expect all unwanted hair to disappear with Laser treatment.

Complete removal of hair cannot be achieved and some people only get temporary reduction lasting a few weeks or months. On average you may expect to see up to two thirds reduction in hair growth. The treatments will be carried out by practitioners or doctors who are trained in Laser treatments.

What are the side effects?

Scarring is a potential problem following any Laser treatment but is very uncommon. When it does occur, it is usually a slight depression in the skin or a texture change, which may return to normal in time. A thickened scar of loss of pigment in the treated area are also possibilities but very rare indeed. In some people a brown stain can develop after treatment. This generally fades over time but can take a number of months to do so.

Ingrowing hair can cause a red rash like acne which could last several weeks. Increased hair growth has been reported rarely. A lack of adverse reactions or scarring after a test, or any treatment does not fully exclude this risk with subsequent treatments.

Before your treatment

To ensure that you receive the best possible results, please follow the advice for the preparation, prior to and during treatment, as well as aftercare. This is a vital part of the process. It is important that you read through the following information and let us know if you have any questions or queries.

Please notify your practitioner if your medical status changes. Please notify your practitioner if you have a history of seizures or fainting.

Before and during a course of Laser hair reduction treatment

Wear fragrance free (if possible) SPF50 sun protection on a daily basis to ensure that your skin is not tanned. We are unable to treat tanned skin, this includes natural tan, sunbed use and fake tan. These must be avoided for a minimum of 6 weeks, prior to treatment.

Please notify the clinic in good time of any medications that you are taking. Taking certain prescription medications (for example those that increase the skins sensitivity to sunlight) may mean that you cannot be treated..

Ensure the treatment area is free from make-up, moisturiser and sun cream.

If you wish to wear make-up prior to your appointment, please attend the department half an hour early to allow you to remove it and allow your skin to settle before treatment (please bring your own products).

If other methods of hair removal are being used, it is best to allow a little hair stubble to be present at the time of treatment. Hair removal creams should be avoided in the 2 weeks before treatment. Plucking, waxing and bleaching should be avoided in the 8 weeks before your treatment course commences. Shaving up to 1 to 2 days before treatment is acceptable.

This regime must be adhered to throughout the course of your treatment. Failure to follow the above advice is likely to mean that we will be unable to carry out your treatment when you attend.

After your treatment

The skin may be sensitive to injury in the first few days after treatment and should be treated delicately. Avoid any injury, rubbing and scratching.

Avoid shaving the area for 5 days.

Avoid strenuous exercise, swimming. saunas, steam room, hot baths/showers and fragranced products for 7 days.

Avoid make-up, moisturiser and sun cream for 48 hours following treatment, to prevent any rubbing/ friction to your skin.

If any scabs or blisters develop, we request that you contact the department for further advice.

The treated areas will be sensitive to sunlight after treatment. Fragrance free factor 50 sun block with 5 star UVA protection should be used for 6 months following the end of your treatment. Strong sun exposure should be avoided wherever possible.