Diode Laser for Laser Hair Removal — Transcript

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1. 0:02good evening everyone i'm usoko from
2. 0:04seoul korea after fellowship at
3. 0:06development center i have been
4. 0:07practicing laser hair removal for 21
5. 0:10years
6. 0:10the subject of my presentation today is
7. 0:13diode laser for laser hair removal
8. 0:18my presentation consists of the
9. 0:20following topics basic of laser hair
10. 0:21removal what is a diode and the diode
11. 0:23laser four diode lasers for laser hair
12. 0:26removal including light shear vectors
13. 0:29linscan and soprano titanium and
14. 0:33directly the hair removal techniques and
15. 0:35cases and parameters and side effects
16. 0:37will be discussed and finally
17. 0:40i'm going to talk the summary for best
18. 0:42perpetual hair removal results
19. 0:51the possible mechanism suggested is that
20. 0:53the laser light is observed by melanin
21. 0:55pigments in the hair shaft and heat
22. 0:58energy spread from the hair shaft to the
23. 1:00actual target which are follicular stem
24. 1:02cells and normal popular
25. 1:06after dyeing the hair stem cells are
26. 1:08separated from the hair shaft
27. 1:12to make mechanism more understandable
28. 1:14rox anderson and dieter mindstein's
29. 1:16group suggested the extended theory of
30. 1:18selective autosomal lysis
31. 1:22thermal populations are essential for
32. 1:24hair growth but the mechanism to damage
33. 1:26the popular cells is not clear
34. 1:34what is a diode
35. 1:36diode is an electrical component that
36. 1:38allows the flow of current in only one
37. 1:41direction
38. 1:42most diodes are made with semiconductor
39. 1:44materials
40. 1:45and the most common types of diodes uses
41. 1:48a pn junction
42. 1:52the first semiconductor lasers were
43. 1:54developed in 1962.
44. 1:57visible and infrared diode lasers are
45. 2:00made from elements in groups 3 and 5 of
46. 2:03the periodic table
47. 2:06which are aluminum gallium indium or
48. 2:10nitrogen phosphorous arsenic antimony
49. 2:14bismuth
50. 2:16a diode laser requires a resonant cavity
51. 2:19which is not present in a light emitting
52. 2:21diode led
53. 2:22individual individual diode lasers are
54. 2:25tiny blocks of semiconductor material
55. 2:29two former two-dimensional diode array
56. 2:32bars are stacked together on a common
57. 2:34heat sink
58. 2:38this is a plot of power output
59. 2:40versus drive current of laser diode
60. 2:44which is good to know to understand
61. 2:47laser diode system for laser hair
62. 2:50removal
63. 2:52below threshold it operates as an led
64. 2:55and above threshold it operates as a
65. 2:58laser
66. 3:02common high power diode lasers need many
67. 3:04diode arrays like this picture
68. 3:09the advantages of diode laser is that it
69. 3:12consumes less power for its long life
70. 3:15simple in design complex in size
71. 3:17the disadvantages of diode laser is that
72. 3:20beam difference is much greater and it
73. 3:22is expensive
74. 3:27these are factors to evaluate the diode
75. 3:29lasers for laser hair removal first one
76. 3:32is maximum peak power and spa size
77. 3:34wavelength contact cooling capacity
78. 3:37prostration
79. 3:38all five factories are important
80. 3:43most diode laser systems for laser hair
81. 3:45removal
82. 3:47are 800 nanometer to 810 nanometer and
83. 3:50the penetration of 800 to 810 into skin
84. 3:55is quite comparable to 1064 in this
85. 3:58graph
86. 4:00in this meta-analysis of hair removal
87. 4:03laser trials
88. 4:05the result showed that diode laser is
89. 4:07the most effective and neodymium has the
90. 4:11least effect of hair removal
91. 4:15light shear factors linscan so primary
92. 4:17titanium will be covered in this lecture
93. 4:24fda cleared the diode laser system for
94. 4:27laser hair removal in december 1997 the
95. 4:30first though the laser systems were was
96. 4:34light shear
97. 4:35and after that various light shear
98. 4:38models were introduced into the market
99. 4:42license plus sizes and pieces have
100. 4:44changed
101. 4:46and
102. 4:47if you know the spa sizes of light shear
103. 4:50you can easily understand the various
104. 4:52models of light shear
105. 4:56are several motors of original light
106. 4:57shear
107. 4:58xc model is the most effective because
108. 5:01of the highest maximum peak power of 2
109. 5:03900 watts and the largest pass size of
110. 5:0612 by 12 millimeters square
111. 5:11there are three hand pieces in life your
112. 5:13desire model
113. 5:15still you can choose accessing handpiece
114. 5:18but
115. 5:19the maximum peak power of accessing
116. 5:22handpiece of leisure desire model was
117. 5:25decreased from original 2900 watts to
118. 5:291900 watts
119. 5:34lumenis also introduced infinity motor
120. 5:37which have uh 805 nanometer or 10 16
121. 5:41nanometer wavelength so dual wavelengths
122. 5:44and
123. 5:45um
124. 5:46nine by 12 27 millimeter spot size was
125. 5:50added but i don't have enough experience
126. 5:53to talk about this model
127. 6:03in vectors there are two handpieces
128. 6:05smaller and a larger one
129. 6:07a smaller one is 12 by 12 millimeter and
130. 6:10the large one is 23 by 38 millimeters
131. 6:14per size
132. 6:15smaller handpiece the maximum peak power
133. 6:17smaller handpiece is 2200
134. 6:20watts and maximum peak power of large
135. 6:23handpiece is 3000 watts which is the
136. 6:26highest maximum peak power in the market
137. 6:31small and large handpiece of factors
138. 6:38fourteen or fifty milliseconds
139. 6:39prostrations of vectors are good
140. 6:41parameters for darker skin for example
141. 6:43asian genital area hair removal
142. 6:50the original lens can 808 have a 2000
143. 6:54watt per square centimeter power density
144. 6:56and 50 by 15 millimeter
145. 7:00spar size and also you can choose
146. 7:04uh contact cooling temperature from 0
147. 7:06degree to 20 degrees celsius
148. 7:09high power density with large treatment
149. 7:11area is possible due to the linear
150. 7:13scanning technology
151. 7:17this is the video for explaining linear
152. 7:20scanning technology
153. 7:24small
154. 7:25laser diode bar is moving from one side
155. 7:28to the other side and scanning all the
156. 7:31area
157. 7:50comparing to original
158. 7:52uh linscan new lead scan is equipped
159. 7:54with light handpiece with a 10 by 20
160. 7:57millimeter space size
161. 8:03there are
162. 8:04six supply titanium applicators
163. 8:08i'll talk about quattro handpiece today
164. 8:13the space size of quattro applicator is
165. 8:164
166. 8:17square centimeter and there are three
167. 8:20wavelengths in quadruplicator 755 810
168. 8:25and 1064 nanometer
169. 8:29in motion mode of low fluence multipath
170. 8:31technique is unique in soprano titanium
171. 8:34software suggests the treatment time
172. 8:37depending on the grid size and type of
173. 8:39handpiece
174. 8:44there are two basic laser delivery
175. 8:46techniques the first one is single pass
176. 8:48with high flows the second is multiple
177. 8:50passes with low flows single pass
178. 8:53technique is divided into sliding and
179. 8:55picking place techniques
180. 9:00this video shows
181. 9:02a single pass technique
182. 9:05with pick can place method
183. 9:10this video shows multiple passes with
184. 9:12low flows
185. 9:19contact cooling is the main optimal
186. 9:21cooling techniques
187. 9:23for
188. 9:24diode laser hair removal
189. 9:27cooling technique is divided into two
190. 9:30different methods first one is short
191. 9:32contact time with sliding technique and
192. 9:34second method is adjustable contact time
193. 9:38with the pick and place technique
194. 9:40also cold room temperature is helpful to
195. 9:44lower skin temperature additionally
196. 9:46and the cold room temperature is also
197. 9:49helpful to prevent overheating of diode
198. 9:52laser array
199. 9:55contact cooling is the best for laser
200. 9:57hair removal because it is parallel
201. 9:59cooling
202. 10:00and operators can modify cooling time
203. 10:03during treatment easily
204. 10:06in this article klavon showed that
205. 10:09contact cooling is very effective to
206. 10:11prevent skin damage
207. 10:15in this article
208. 10:16shows that only 20 degree celsius
209. 10:19cooling chill plates also prevent skin
210. 10:22surface damage
211. 10:25this case shows
212. 10:26good enough contact cooling prevents
213. 10:28scar formation
214. 10:30above picture is a helpful to understand
215. 10:33why strong contact cooling is required
216. 10:36to protect interfollicular damage and
217. 10:38prevent scar formation
218. 10:40candlelight is
219. 10:42representing hair follicles
220. 10:46this video shows that the contact
221. 10:49cooling time difference depending on the
222. 10:51skin condition
223. 10:54to get the best permanent hair rainfall
224. 10:56results trying to get a hundred percent
225. 10:58coverage rate as possible is the most
226. 11:01important in other words
227. 11:03no skip terrier
228. 11:05nose kid carrier is not only
229. 11:07mathematically better because of the
230. 11:10hair regeneration property
231. 11:13in this article i reported the device to
232. 11:16measure the scepteria percentage and
233. 11:18confirmed the difference of each
234. 11:20practitioner's treatment pattern
235. 11:24in this article i also reported the
236. 11:26omission and overlapped percentage of 8
237. 11:29physicians
238. 11:30which are very different
239. 11:34to minimize the untreated area
240. 11:37measuring the size
241. 11:39and practicing the moving speed
242. 11:41depending on the laser pulse frequency
243. 11:43is mandatory
244. 11:45usually just one hour of practice makes
245. 11:48the treatment pattern better
246. 11:51to properly evaluate permanent hair
247. 11:53removal results practitioners need to
248. 11:55follow patients more than six months
249. 11:58after the last treatment
250. 12:01in the data of many articles on laser
251. 12:03hair removal we can find the hair
252. 12:05reduction rate is stable six months
253. 12:07after stopping laser hair rainbow
254. 12:09treatment
255. 12:11in this article hair regrowth appears to
256. 12:13plateau
257. 12:14with no statistically significant
258. 12:17difference among the percentage of
259. 12:19regrowth at 3 6 9 and more than 12
260. 12:23months follow the evaluation
261. 12:26in this article even more hairs were
262. 12:29reduced after nine months than after six
263. 12:32months
264. 12:35in this case no hairs grew for three
265. 12:37years seven months after five treatments
266. 12:41which means the results are permanent
267. 12:47now i'll
268. 12:49talk about
269. 12:51conversion rate of loss between diode
270. 12:53lasers for laser hair removal
271. 12:56making your own conversion rate of
272. 12:58fluences
273. 12:59is very important because each efficient
274. 13:01treatment technique is different
275. 13:04depending on moving speed contact time
276. 13:06for skin cooling compression pressure
277. 13:08and contact quality
278. 13:10and also considering the spa size is
279. 13:12very important
280. 13:15theoretically we consider only
281. 13:18wavelengths like this slide
282. 13:21because
283. 13:23depending on the wavelengths
284. 13:25the melanin absorption coefficient is
285. 13:27different
286. 13:29so
287. 13:30usually we think only absorption
288. 13:33coefficient curve and wavelengths
289. 13:38but as i mentioned
290. 13:40each device is different and each fusion
291. 13:45have different techniques so
292. 13:48each vision
293. 13:50if they are using different uh
294. 13:54uh lasers with the same fl same
295. 13:57wavelengths
296. 13:58then it's better to make their own
297. 14:01conversion rate
298. 14:04i'll show
299. 14:06my conversion rates or fluoresces
300. 14:08between diode lasers
301. 14:11if
302. 14:12the light shear flux
303. 14:14is assumed to be one then vectors is one
304. 14:17point one and
305. 14:18lean scan is one point three
306. 14:23and for example
307. 14:25like sure 25 joule is equal to
308. 14:2827 to 28 joules
309. 14:30of factors
310. 14:32and also equals to
311. 14:34uh 32 to 33 joule of lean scan
312. 14:39my flux range for koreans
313. 14:42like
314. 14:43is between 15 to 45 joule
315. 14:47vectors is 16 to 50 joule
316. 14:50lens scan is 20 to 60 joule
317. 14:54usually
318. 14:55i use 30 millisecond prostration of
319. 14:58light shear and
320. 15:0030 to 50 milliseconds of vectors and
321. 15:03turn it to 30 milliseconds of lean scan
322. 15:09i'll talk about spot size and fluency
323. 15:11issue briefly
324. 15:14as we know
325. 15:16if we use the same florence
326. 15:20the light penetrates deeper with larger
327. 15:23spots
328. 15:26i reported in aslms meeting that
329. 15:30three times larger spot size makes 30
330. 15:34percent more hair reduction
331. 15:38and also viktor ross reported in a slms
332. 15:42that the same temperature rise in a
333. 15:44target at three millimeter depths
334. 15:46is realized by increasing area four
335. 15:49times while reducing fluence by half
336. 15:52for example
337. 15:54one square centimeters part and 10 joule
338. 15:57is equal to four centimeters square spot
339. 16:00and fiber joule
340. 16:02so
341. 16:0312 22 by 35 millimeter spot 15 joule is
342. 16:08higher than 12 by 12 millimeters per
343. 16:11saudi joule square centimeter
344. 16:13prosecution if the prostrations are the
345. 16:15same
346. 16:17cases and parameters
347. 16:20these are my experience of diode lasers
348. 16:23from 1998
349. 16:27light shear
350. 16:31underarm
351. 16:32before and two years nine months after
352. 16:35five treatment
353. 16:38another case of underarm beforehand
354. 16:41three years seven months after five
355. 16:43treatment
356. 16:46low leg before and three hours after
357. 16:49three treatments
358. 16:53for
359. 16:53before and
360. 16:55three years two months after five
361. 16:57treatment
362. 17:00widening forehead before and after hair
363. 17:02removal
364. 17:05this is the technique to make a natural
365. 17:07hairline
366. 17:09the wavelengths fluence and persuasion
367. 17:11should be varied to avoid forming a
368. 17:13distinct hairline
369. 17:16before
370. 17:18and three years eleven months after six
371. 17:21treatments
372. 17:24before and after five treatments
373. 17:28this is the male phase health rainbow
374. 17:31case this
375. 17:33the detail is written in the slides and
376. 17:37these pictures are before treatment
377. 17:42seven months after six treatments
378. 17:47before
379. 17:48and seven months after six treatments
380. 17:53before and eight months after seven
381. 17:55treatments
382. 17:58left picture shows
383. 18:01after six treatments in another clinic
384. 18:03with alexandrite laser
385. 18:05write a picture shows
386. 18:08after seven treatments in my clinic
387. 18:10with light shear
388. 18:15vectors cases
389. 18:18before
390. 18:20and three months after five treatments
391. 18:24before and seven weeks after three
392. 18:26treatments
393. 18:29before and thirteen weeks after five
394. 18:32treatments
395. 18:34before
396. 18:35and twenty weeks after four treatments
397. 18:41varicose needs before
398. 18:43and eight weeks after five treatments
399. 18:47lean skin cases
400. 18:50before and six months one year after
401. 18:54three treatments
402. 18:56before
403. 18:58and six months and one year after three
404. 19:00treatments
405. 19:03another case of underarm
406. 19:08low leg before treatment
407. 19:10immediate after treatment six months and
408. 19:13one year after three treatments
409. 19:17before and four months after ten
410. 19:19treatments
411. 19:22side effects
412. 19:26there are many reported side effects of
413. 19:29diode laser hair removal and
414. 19:32proper care side effects is very
415. 19:34important
416. 19:36crust formation usually this kind of
417. 19:38crossed formation happens
418. 19:41because uh the physician do not wipe out
419. 19:45the debris of hair follicles
420. 19:48attached to the
421. 19:49surface of the tip
422. 19:53hyperpigmentation and hypopigmentation
423. 19:57after treatment
424. 20:00bula formation after treatment
425. 20:06erythema and follicle accentuation
426. 20:10and this kind of reactions uh
427. 20:13usually
428. 20:14happen in low lag
429. 20:16and
430. 20:18quite difficult to treat but
431. 20:20usually within one or two months this
432. 20:23kind of reactions resolve
433. 20:26with
434. 20:27oral steroids or
435. 20:30without any treatments
436. 20:34this patient is a case who had a
437. 20:36vitiligo before laser hair removal
438. 20:40new vitiligo legions on the face have
439. 20:43developed due to the laser hair removal
440. 20:46in this case vitiligo responded to xml
441. 20:48laser treatment and improved
442. 20:51doctors can help patients
443. 20:53determine whether taking this level of
444. 20:55risk will benefit them or not
445. 21:01this is
446. 21:02my summary for best perpetual hair
447. 21:05removal results
448. 21:08no skip terrier
449. 21:10is
450. 21:11the most important factors
451. 21:13to get the permanent hair removal
452. 21:15wizards
453. 21:16and
454. 21:17use highest floors as possible
455. 21:21and
456. 21:22bigger spot size as possible if you can
457. 21:24use the same flair fluence
458. 21:26and select proper wavelengths and
459. 21:28frustration
460. 21:30and regular treatments is required
461. 21:33appropriate skin cooling and room
462. 21:36temperature is also important
463. 21:39removing almost all hairs perpetually
464. 21:41with a low very low failure rate is
465. 21:43possible
466. 21:44at least for untangled asians with black
467. 21:47hairs
468. 21:48in my experience
469. 21:50because of time limit
470. 21:52i cannot explain diode laser hair
471. 21:55removal enough
472. 21:56but i hope it helps your practice
473. 22:00thank you for your attention