Like many of the technologies cosmetic surgeons buy and lease for their practices, hair removal lasers are evolving to cover more area, in less time and with less discomfort. We asked cosmetic surgery experts to name their favorite brands, share what’s important in hair removal technology and help colleagues decide whether what they have is enough or it’s time to upgrade.
Hollywood, Fla.-based dermatologist Todd Minars, M.D., says that while newer lasers have color screens and more bells and whistles, the foundation of the technology is much the same. The most effective wavelengths for hair removal have not changed in many years, he says.
Dr. Minars says he prefers the 755 nm Alexandrite Candela GentleLase Pro for light skin patients and Candela GentleYag 1064 nm Nd:YAG laser for dark skin.
Alexandrite lasers reign in permanent hair removal because of the technology’s 755 nm wavelength. The laser’s wavelength more easily targets coarse and finer hair, resulting in optimal hair reduction, according to Dr. Minars.
“Both the Alexandrite and the GentleYag are effective workhorse lasers,” Dr. Minars tells Cosmetic Surgery Times. “But you do need both if you want to treat hair in all skin types; the GentleLase cannot treat dark skin safely.”
Surgeons who have one or both of these lasers do not need to upgrade, according to Dr. Minars.
“The only advantage to some newer lasers is a faster pulse rate or a larger spot size which would allow you to finish a large case (like a leg or back) faster,” he says. “Candela has combined these two devices into one laser … but I prefer to have two separate lasers. Combining two lasers into one creates ‘traffic jams.’ When you have two separate lasers in two separate rooms, you can have two doctors treating two patients at the same time, allowing for physician efficiency and minimizing patient waiting time.”
Disclosure: Dr. Minars reports no disclosures.
By the Business Model
“There are so many different laser companies that produce hair removal technology. The key is to determine the type of business model you might want to have as the cosmetic doctor,” says Santa Monica, Calif., dermatologist and UCLA clinical instructor of dermatology Tanya Kormeili, M.D. “If you plan to be (like our office) a high end office where the dermatologist provides the actual treatments, you need to go to the gold standards for laser technology, i.e. Alexandrite and Nd:YAG lasers.”
These devices, she says, are good for most lighter skin types. But as the skin gets darker, they’re less suitable.
“They are safe, fast and effective, but are limited by price, and the fact that they are not as suitable for darker skin types,” Dr. Kormeili says. “If one plans to run the practice by nurses, and be able to provide hair removal to most patients, diode lasers might be a better choice. They need more treatments but can be safer on most skin types.”
Disclosure: Dr. Kormeili reports no disclosures.
For hair removal, Boca Raton, Fla., plastic surgeon Jason Pozner, M.D., uses the Candela GentleMax Pro and Sciton’s BBL and ClearScan YAG 1064 nm Nd:YAG wavelength lasers.
Both company make good hair reduction systems, according to Dr. Pozner.
“The Candela is a workhorse — quick and not painful,” Dr. Pozner says. “I tell most docs to start hair removal with the Sciton BBL, as it is a very useful machine for light skin patients with dark hair and for so many other non-hair related applications.”
Dr. Pozner tells Cosmetic Surgery Times that he rarely upgrades hair removal lasers at his practice. Why? There isn’t an urgent need to upgrade because the advances haven’t been all that significant, he says. “… the devices we have are so good and are workhorses.”
For surgeons who are considering a new hair reduction device, Dr. Pozner says the newer diode devices may be faster than older technologies.
Disclosure: Dr. Pozner consults with Sciton and Syneron Candela.
Fast & Flexible
Chris Robb, M.D., Ph.D., cofounder of the Skin & Allergy Center Spring Hill (a suburb of Nashville), Tenn., says hair removal is a mainstay of any cosmetic practice.
“… you need to be fast, efficient and have happy clients,” Dr. Robb says. “You also need to be flexible with different skin types, and platforms that offer dual wavelengths are often preferable.”
Dr. Robb uses the BBL Forever Bare (Sciton).
“We've found it’s painless and very effective. Large areas can be treated relatively quickly,” Dr. Robb says. “I also have recent experience with GentleMax [Syneron Candela], which I like for its spot size and flexibility. It’s important, whether you use an IPL or a laser, to have some flexibility in treating vascular or pigmented lesions. This is especially true if it’s your first laser.”
According to Dr. Robb, these are important considerations when deciding on a hair removal device: large spot sizes, safe cooling and increased speed.
Disclosure: Dr. Robb is a speaker for Sciton but reports no conflicts of interest with Syneron Candela.
Speed & Comfort
Nashville, Tenn., dermatologist and cosmetic surgeon Michael H. Gold, M.D., says his practice offers several different hair removal devices for patients depending on such things as their skin color and hair color.
“Most of our patients are being treated today with either the 810 nm LightSheer Duet by Lumenis or the Soprano Ice by Alma Lasers,” Dr. Gold tells Cosmetic Surgery Times. “We do use the Cynosure Elite MPX 1064 nm device on darker skinned individuals, as well as the Aerolase [LightPod] Neo 1064 device.”
Dr. Gold says that while there are several new hair removal devices on the market that might prove to be better than what he has, he doesn’t feel compelled to keep up with every new hair removal device that comes to market. The array of technology he has had for several years has stood the test of time, has been upgraded when available and fits the needs of a diverse patient population, according to Dr. Gold.
“The most important things we look for are speed and patient comfort — making sure efficacy is always kept ahead of everything,” he says.
Among the new and potentially attractive features of today’s hair removal devices are speed and virtually pain-free treatment, according to Dr. Gold.
While hair removal has an important place in Dr. Gold’s busy practice, he says that he doesn’t view hair removal in the same breath as fractional laser resurfacing or microneedling. That’s mainly because hair removal has become a commodity and is being done virtually everywhere now, he says.
“In the past, when only laser doctors were offering this, we spent much more time with the technology. And as more and more people started doing it — whether for the good or bad — many doctors stopped paying attention to it, as they feel there is not enough money in it anymore for them,” Dr. Gold says.
Dr. Gold says his practice has maintained a successful hair removal business by focusing on quality and being the best choice for consumers.
Disclosure: Dr. Gold is a consultant for Aerolase Corporation and has ties to the other companies but not specifically in the area of hair removal.
Denver, Colo.-based plastic surgeon Jack Zamora, M.D., says there are many different types of lasers available for permanent hair reduction, which offer safe, effective treatment.
“Some use either laser or light energy, but with the correct modality and settings both can be effective,” Dr. Zamora says. “Finding the best device will depend on the patient's skin type, density of the hair and the melanin in the hair follicle. Even the best machines may not work well if the clinicians are inexperienced and uninformed about which device is best for that patient and which settings will yield the best result.”
Dr. Zamora recommends the Palomar Vectus and Lumenis LightSheer because they are safe options for patients with light and dark skin; they have the FHR technology (fast hair removal treatment time); and cooling chill tip to provide treatment with minimal discomfort.
The plastic surgeon says it is important for providers to update or change their devices to the latest advancements available.
“Older machines don't have larger spot sizes, so treatments take longer. Not all older devices have a cool chill tip and, therefore, treatments are more painful. Out of date devices cannot give the same level of energy or run as efficiently to provide a successful and speedy treatment,” he says. “The longevity of a device depends on how often it is used and it is important to keep your machine maintained through its lifespan.”
Disclosure: Dr. Zamora is a national trainer for Cynosure.