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Physician to Physician Discussions > What is the best laser for the following: Hair removal, non-ablative skin treatments, wrinkle reduction?

I'm in the process of looking into the purchase of a laser for my practice.

I want to know what is the best laser for hair removal, acne, non-ablative procedures?

How much should I be spending on these items? How much is too much?

Thank you.
06.5 | Unregistered CommenterM.D.

Hi, M.D.

Your question is a common one. Here's my answer.

Doctors always think of the problem as technology. It is not. If you're going to be successful, you're going to learn how to drive patient flow into your clinic. That being said...


If you're going to poke your toe in the water with one device, it's going to be an IPL, not a laser. There's a wealth of information on companies web sites but they lack in details.

Number of hits the heads will take before they need to be rebuilt, etc.

My choice was Palomar, www.palmed.com, although opinions vary. (Note: None of the devices work as well as injections with veins.)

(Palomar is getting big for their britches. The new starlux was introduced less than 18 months after the Medilux caused a lot of anger with docs irritated at another 85k purchase.)

The Starlux is designed with a better, modular system that's supposed to be easier to update. I'll wait and see.

The best place to buy (or sell) your device is from Justin Williams at http://www.aesthetic--equipment.com (http://www.aesthetic--equipment.com)

He buys equipment from docs going out of business and sells them to docs going into business. He's a wealth of information.

(Disclosure: I've bought and sold devices to/from Justin. No other relationship exists.)

thank you for your reply.

One more question?

Why an IPL over a laser?
06.10 | Unregistered CommenterM.D.
Good question.
Lasers are an older technology that's being replaced by IPL.


Lasers deliver energy into the dermis as a coherent light frequency (think spike) that can be very painfull.

IPLs are filtered white light (think spike) that is less painfull and has "spillover" across the targeted frequencies.

IPLs are usually sold with multiple heads allowing you to use one base unit and treat multiple conditions.

06.10 | Unregistered CommenterDocsocks
But, in regards to hair removal, IPL is definately NOT the most effective method. Diodes, Alexandrite, and Nd:Yag lasers are skin type specific, but give the best results. And if you want to offer the best for your patients, IPL will not give results for hair removal, every physician and rep I have come across has confirmed this.
Would have to agree that for hair removal IPL is not the way to go. We have many clients who come to us because of their dissatisfaction after 10 or more IPL treatments elsewhere, both at doctor offices and salons, with minimal results. These are our easiest clients to please as they are always amazed at how much more effective the results are after laser diode treatment. Many of our clients are women with stubborn facial hair resulting from polycystic ovarian syndrome but we see men disappointed by IPL treatment of their backs also. The IPL treatments are invariably less expensive (and usually faster) up front but in the long run the client is usually quite unhappy. IPL is one of the reasons people think laser hair removal doesn't work. Offices using IPL market it as "laser" hair removal when it is not. Perhaps IPL works on the palest skin types with sparse black hair but otherwise no. Logiclly speaking how can a broad spectrum light of which the bulk of the wavelengths do not penetrate to the depth of the hair's matrix work well?
As for pain, this perception of course varies widely from person to person and also is influenced by skin type and/or coarseness of the hair. Skin types I-III women who were waxing all the time do not have any problem tolerating the laser. Otherwise pre-icing is effective and if necessary a topical anesthetic will help (a whole other topic altogether).
We use a Lightsheer diode (Lumenis) and have been pleased especially with the adjustable pulse delays that allow safe treatment of darker skin types.
01.10 | Unregistered CommenterdocT
You may wish to view the elos technolgy

www.syneron.com
01.21 | Unregistered CommenterLaserMan
In an ideal world you would have an Alexandrite (710nm) for hair removal on your lighter skin types (I-III). An Nd:YAG (1064nm) for hair on darker skin (IV-VI) and leg veins.

A pulsed dye for facial veins. An IPL for photorejuvenation. That would cost too much IMO unless you are a derm or plastic office.

A combination of IPL and Nd:YAG gives you a good middle ground that will allow you to treat most everything effectively without bankrupting your clinic.
02.21 | Unregistered Commenterelliot
Everyone:

Some of the comments above and at other locations on this web site jibe with my experience operating a busy med spa for the past 4 years. What you are noticing is a significant variation in opinions regarding efficacy of many of the popular devices. You will notice -- however-- a virtually unanimous accord regarding other issues. I don't think ANYONE willl argue - for example- about the 1064 devices being the preferred choice for Fitz IV and V skin. I have noticed that many of the contributors to the web site seem to be lumping all pulse light devices into one generic category called "IPL". Be advised that the differences between the 99 broadband devices on the market place are HUGE. There are a lot of wild arguments and justifications being made by certain companies and their reps-- it will be up to YOU to do your reading and testing and see what is B.S. and what is real. Once you truly understand the basic principles of light technology and tissue interaction, you will be able to separate the ones telling the truth from the others. Most of the experienced clinicians will tell you- for example-- that direct contact/integrated epidermal cooling is a critical feature. A variety of different cut-off filters is also necessary. There is also a great deal of research being done by a number of the leading companies validating the benefits of having pulse train options to allow the epidermis to cool while continuing to heat the target chromophores. And the most important factor of all may be solid training and experience performing the treatments. No matter what the specs of the device say-- the true test is how the tissue responds to the light pulse.
ELOS, SYNERON ?????? Let go over the company history:
started by Dr. Bitter - los gatos , ca and Mullhouland Canada plastic surgery both NOT RESPECTED and CHASED out of Newport beach California for their crappy ELOS, EMAX, Ewater. Never any good peer reviewed articles from AMLS. POOR technology no proof that added RF to everything makes anything any better than simply a diode or YAG or IPL. Why do you have to add RF to everything ???? Its the patent and the money scam both of these clowns invented. This company is NOT very well respected in the laser world. Go to the AAD meetings or Conversations and Controversies meeting and ask the docs. SYNER-GONE....... Laserscope merged out due to financial problems (LASERSCRAPE)...and finally ORION/Harmony the HUYNDAI of lasers....

The real players: Lumenis, Cutera, Palomar, Candela,.....
Final Advise: never buy cheap stuff you get burned in the end and your competition will eat you up with better results.

Final comment: CO2 will always kick over any nonablative for full skin rejuvenation. (not for everyone) only skilled physicians can play......
02.22 | Unregistered Commentermdlaser
If you are going to bash Syneron get your info correct. Bitter and Mulholland had nothing to do with inventing the Elos techonology - they are users who represent them for training purposes. Dr. Shamon Eckhouse and Dr. Michael Kreindel invented the Elos technology. In fact Eckhouse invented IPL. RF is proven to increse deep dermal heating. Look into the physics behind it and you will understand its benefits. You can only do so much with fluences and pulse durations - RF allows you to do more while protecting the epidermis.
02.28 | Unregistered CommenterDr. Lu
I guess I'd love to hear feedback from people who have used Syneron's technology for over one year. Anyone out there? What pro's and con's have you encountered?
03.1 | Unregistered CommenterMidwest
Wow, some of these answers surprise me... I use the Candela and for 7+ years I have had GREAT results with laser hair removal, even better results for clients who previously had IPL treatments that didn't work for them...As the rule of life, not one things works for everybody it takes different technologies to treat every different situation.
03.1 | Unregistered CommenterStacey
Wow, some of these answers surprise me... I use the Candela and for 7+ years I have had GREAT results with laser hair removal, even better results for clients who previously had IPL treatments that didn't work for them...As the rule of life, not one things works for everybody it takes different technologies to treat every different situation.
03.1 | Unregistered CommenterStacey
MDLaser,

What's your opinion of Lumenis Quantum?
03.1 | Unregistered CommenterMichMD
Stacey,
I also loved working with the Candela Gentlelase! (for fitzI,III, and love III) I'm considering buying a used unit now.

What model were you working with?

Any other Candela modalities?

Thanks!
03.1 | Unregistered CommenterMidwest
If I may, I would like to add a little to this conversation. Dr. Lu is correct that Bitter and Mulholland did not invent Elos technology. They trademarked the term FotoFacial (and Photofacial before with ESC which was before merger of Coherent and ESC to become Lumenis). They are businessmen who are also doctors. They understand that IPL means nothing and is not very marketable to patients, but if you give a specific procedure a name, like FotoFacial, there is something marketable and money to be made. Nothing wrong with this, but just a fact. Mulholland also recreated the barb/sutur lift and called it Featherlift. I was in this business for ten years before opening my own medical spa. It's a ruthless business and he/they (in my opinion) lead the way. There are definitely kick backs and Bitter or Mulholland come with a substantial price tag to the manufacturer. Trust me, I am being very kind. Here is what you need to know. Syneron is a marketing company first and a medical laser company second (or maybe third or fourth). Their goal is primarily to go public, not produce great equipment. They are high on the list of investors right now. Problem is that has no relevancy when it comes to lasers. Wall Street doesn't have a clue and doesn't care about good equipment. They evaluate companies on paper. Having a home product is great for them, just look at Palomar stock. However, I have never seen a "physics" paper from Syneron that was not written by a Ph.D with a direct link to Syneron. Michael Kreindel Ph.D. has written several Physics papers, problem is he has a financial interest. None of those studies have ever been peer reviewed. Syneron recently had a management overhall and have reinvented themselves. The fact is all those managers left for Alma. Their new "E" line is a simple repackaging of their old products (for the most part).

With that said, when you look back in a few years to determine if you were successful it will have very little to do with the laser you choose. There are too many other important aspects. Personally, I would not hesitate to invest in Syneron. I just wouldn't buy their equipment. There are too many other good laser companies out there. Go look at the used market. It is full of old Syneron products. It was genius of them to repackage and rename their systems even though they are still the same technology. This makes the lasers on the secondary market look like old models.

I do not envy anyone who have to evaluate the different companies in the laser industry. Your hope is to get clarity, yet you can walk away more confused. It's tough. However, do the best you can, follow the advice of people you respect and listen to your gut. Make your decision and don't look back.

03.1 | Unregistered CommenterDexter
Dexter,
You are incredibly well spoken. I agree wholeheartedly. I find myself getting incredibly frazzled dealing with all these reps, but in the end, I know it will come down to the intelligence and skill of the provider more than the reputation of the machine.
03.1 | Unregistered CommenterMidwest
Thank you for that reply Dexter. Well said and very accurate.

I am an RN in LA looking at starting my own practice. I have spent the last 4 years working as an independent contractor for many MedSpas, Dermatologist and Plastic Surgeons. I have worked with many laser and light based platforms. The transient nature of my job means lots of exposure to different machines. I know some better than others, however, I have two cents to offer.

I have used the Syneron Polaris and Aurora and hated the experience. Clients found hair removal on both machines extremelly painful even after using pre-cooling. The results of Fotofacials after 6 treatments on Skin Types 1 - light IVs was ineffective. No great difference seen. The training at their facility in Orange County was jam packed with participants so there was very little opportunity to get hands on practice unless you were assertive. Subsequently, I was never truly comfortable using the systems and felt badly for the clients.

Also for consideration is my experience working for one doctor and another medspa chain in California that used the the Aurora and Polaris for hair removal on skin type VI. When I left these jobs (inadequate training and poor ethics) they were receiving the first of several law suits and television exposure for burning their clients. However, that was my experience.

I must say that I am not surprised that Syneron has repackaged itself. The word on the street in LA is that Syneron is now irrelevent and a mistake that many do not want to talk about.

For the last two years I have worked with Cutera Vantage, XEO and Titan, all of which I would not buy for any practice unless you can afford the learning curve. The hair removal spot size is small and one size fits all. The XEO has an ND: Yag 1064 that was used on all skin types for hair removal. After a series of 6 treatments, I noticed that skin types I - III needed more maintenance, more often. Inadequate cooling by the tip of the handpiece made treatments painful and slow. Extra time had to be worked in for icing and/or topical anaesthesia application. I have also seen many Cutera products collecting dust in the offices I have worked in.

Many offices I know of are switching to the Cynosure Apogee Elite. For the past two years, hair removal results are terrific. Multiple spot sizes, 755 Alexandrite and 1064 ND Yag for hair removal of all skin types, tanned and untanned. It is dramatic in the removal of pigmented legions in all areas. The downside is that you have to purchase a seperate cooling unit. It has a feature for deep collagen stimulation using 1064/50j/50pw. I have seen slight tightening after 2 treatments. Unfortunately, I have not seen this treatment past that. Clients of all skin types seem to like the LaserFacial feature. The treatment is very comfortable without the cooling and over 3-5 treatments you can see modest tightening and fine line reduction and rosacea clearing. Skin types I-III see fabulous pore tightening and sun damage clearance when the LaserFacial settings are cranked up .

My personal preference for photo rejuvenation is the IPL. Palomar was very good and at the moment the Alma/Orion Harmony is my favorite. For hair removal: the Alex and 1064. For superficial vein treatments, I like the 1064. Just educate your clients that all treatments may require maintenance within a year of regular treatments. Don't use Harmony or Palomar for hair removal. Your clients will not be pleased.


I also observed a great deal of patient satisfaction with Candela products. I have used the GentleLase, V-Beam and Smoothbeam. I just checked their website and found they have a combo system called the GentleMax. It combines their best sellers the GentleLase (755) and Gentle Yag(1064). I am not familiar with this combination.

If anyone has a Cynosure Apogee Elite, Candela product or GentleMax, I would like to know if you are satisfied with its skin rejuvenation capabilities or have you considered using a seperate IPL unit for skin rejuvenation.
CANexpatRN,

Thank you so much for taking the time to write up your experiences and opinions!

We are in the market for purchasing right now...

My experiences with the Candela Gentlelase reflect your sentiments. It's a dependable machine..pure and simple. I lived out in LA for two years and would assume that you would need a laser that treats Fitz II-IV safely. Alexanderites make me nervous with those skintypes. What's your experience?

Cynosure was the first company we demo-ed back in November. I used my poor boyfriend as a model with the Apogee Elite for laser hair and the patch on his stomach still hasn't grown back!

I realize their cooling comes from the zimmer, but I find the Zimmer so helpful with other services around the clinic. Fillers, post cooling, etc... Plus, I think the patients like controlling where the cooling goes sometimes...lol...

I have been disappointed with my hunt for the perfect IPL fotofacial modality at this point. My experience is with the Palomar Starlux green handpiece. I loved how small the headpice was on the handpiece. It was so easy to get around the nose and spot treat. It just made me nervous how the handpieces literally 'break in' though. What was once a 36 Joule/ 20 ms reading on Monday, now would be needed to be bumped up to match the results the following week. I am a conservative technician and don't like playing with that kind of maragin of error. WHY CAN'T ANYONE ELSE REPLICATE THE HEAD SIZE OF THAT HANDPIECE!!!!! argh....

It was hilarious when I demo-ed Cutera last week because their IPL handpiece is like trying to work on the skin with a softball blocking your view! The rep said that most people get used to it and that you'll really just become a pro at 'feeling' the spacing. WHAT?! I don't what to feel...I want to SEE! THAT IS NOT GOOD ENOUGH! Especially when working on faces. Hold up...everyone needs to check out the size of this sucker...

(it's the limelight on the upper right side of the screen)

http://www.cutera.com/

Please! Someone tell me how to adequately treat a schnoz with that sasquatch! lol...

To be fair, our model got an awesome response on the sun damage onthe back of her shoulder with the Cutera. I am just obsessive compulsive about work on faces and want something smaller and detail oreinted.

If anyone is using Cutera how is it going treating faces with that handpiece? What's your technique? Is the size a problem for you, or am I just being a big baby?

Regardless, thanks so much CANexpatRN. I really appreciate your insight and would love to hear more.
03.2 | Unregistered CommenterMidwest
Midwest, thanks for appreciating. I learn a lot from you as well.

I have used the Alex on the Cynosure Apogee Elite for Skin Types I-III without a problem. It is quite painful, but I rarely go above the lowest setting for the first 3 treatments. After the density of hair is reduced then I can go up a bit. There are parameters outlined by Cynosure, but if you have a particularly sensitive client, you can treat below the recommended settings for the first 2 treatments. This knocks down the density, then you can go up again while assessing patient comfort.

FYI, I don't particularly encourage my clients to use topical numbing because it removes one of my assessment tools. With experience you learn to treat what you see i.e. do test patches and wait for skin response. Also, start low and go up. Following these rules has saved my butt many times.

Los Angeles now has many Type IV-VI people seeking hair removal. Beverly Hills is now 30% Persian not to mention LA's large Mexican population. For all of the treatments, I use the ND Yag 1064 with great results. The Cynosure rep and the clinical trainer tell me that IV-VI can be treated with the Alex at treatments 5 and 6. I have not done this yet for good reason. I'm scared. I recall one of my first laser machines was a Luminus Vasculight. We treated a Type VI beard with a 755 wavelength and to this day I regret having participated in that. The man, bless his heart, kept coming back even though he spent many months recovering from burns. He didn't know that burns were a bad thing.

What I have learned is that with respect to all treatment questions, always ask for the contact information of the Clinical person for the company and make them your best friend. I did this recently with the Orion Harmony and my whole relationship with the machine has changed. The clinical person will usually tell you the truth re the capabilities of the laser because, like you, they have a license to protect.

I have worked with the Cutera IPL hand piece and it takes some time to find your best grip. In addition to that, you need to position the patient just so in the chair and then walk around a lot to make just the right contact with the surface. There are two lines on the hand piece to guide you re spacing. Keeping them in your sight is where the walking around comes in. The best hand hold is not by the handle, but by the big fat head it self. Think of yourself as a baseball pitcher holding the ball right before you throw it. Adjust your fingers and palm as you navigate the face, making sure you can see the two lines.

I have seen decent results with it, but it is a painful procedure. You are either removing the hand piece to ice the next area and hoping to place it back down in the right spot or you have to use topical numbing cream.

My husband is a skin type IV and I used the Cutera XEO on his back for hair removal. We had to use numbing cream, ice and the stop and start method. A Zimmer would have helped. Don't let the reps tell you that you don't need a cooling device. You do. Anyway, after one treatment with the ND YAG, it took about 3 months for any hair to grow back. The ND YAG works really well on spider veins as well. Just remember that your lighter skin types will not have great results for hair removal.

And yes, I had a similar experience with the Palomar hand pieces. I don't know when you bought your hand piece, but late last year, the rep for Palomar recalled all of our handpieces (yellow, green, red) so they could be reconfigured at the new, more powerful levels. I don't work with the Palomar anymore but I believe it was called Series II. Check it out.

I think the best scenario for a practice would be to use the bulky IPL hand pieces for general skin rejuvenation and then use lasers for stubborn pigmentation, skin tightening, hair removal, and spider veins.
HELP!!! I am a young latina and I am in desperate need of hair removal. I have found your posts very helpful and informative, but I am still undecided about what type of laser would be best for me. I dont want to spend my money and get no results. Please, Please PLEASE help! Any advice is greatly appreciated! Thank you!
03.16 | Unregistered CommenterBrenda
Brenda,
I have been very successful with the 'YAG' laser or '1064 wavelength' laser for hair removal on latinas. You may do well with the IPL handpiece but it would depend on how dark your natural skin tone is. A test spot would be a good idea if you are steered toward the IPL (ie cutera's ProWave770 IPL handpiece) The downside of the 1064 is the procedure is a little bit slower to do and by some accounts a bit more painful. Lasers work great for hair removal on darker skin types, just a matter of playing it safe. Good Luck!

And don't be afraid to inquire as to the person doing the procedure and their training/experience. If there is any avoidance in answering, you would probably do well to look elsewhere. I am fixing scars left by other less 'ethical' hair removal facilities, including one mentioned in recent posts by the blog master.
03.16 | Unregistered CommenterDermaDoc
Why does everyone refer to me as the blogmaster. It sounds like the bad buy from an early 80's sci-fi flick. Beastmaster or some such.
I was wondering if anyone has experience with both the Apogee Elite and Candela's new GentleMax. I am debating between the two units. They seem to be pretty comparable. I was also considering buying a used machine. Any advice??
03.16 | Unregistered CommenterHeather
Heather: I have heard that the Elite Laser is decent. There is no perfect device out there, but I have spoken with several users who are pretty high on the Elite unit. I also have a connection with a med spa which recently re-located and scaled back from four treatment rooms to three. As a result they are trying to sell an Elite unit- which is almost new and in very good condition. Send me an e-mail if you are interested.
Ron-
LOL... sorry about that! No offense of course. Some of my patients have some interesting 'pet' names for me too.
03.17 | Unregistered CommenterDermaDoc
I would use a 1064 for Fitz 4-6 and Alex for 1-3. I initially bought the Cutera 1064 for LHR. I live in the midwest and of course most people are Fitz 1-3. I should have bought an Alex but needed the multiple platform unit to get started on my own. It has worked best on my Fitz 4-6 and even fine hair on the face.

I am currently adding the Sciton BBL to my stable and hope it will benefit those Fitz 1-3. I have talked to multiple people and they feel the BBL should perform well. The 1064 just isn't doing a great job. If the BBL doesn't work, I will likely buy a used Alex.

The biggest issue with Alex's is the maintenance. I hear they are a pain to keep up and running.
03.19 | Unregistered CommenterLH
Hair removal is so cheap we have eliminated it from our office . For the time spent and equiptment maintenance it is nonprofitable. Areas that are remote, keep going until everyone has a "laser hair" too then cut it. Then laser hair should be done for free. Hair removal is such a joke.
03.20 | Unregistered Commenteroutofhair
I am not sure I agreee with outofhair. I already have the lasers that I use for multiple other treatments so why not use them for hair removal? The hair removal helps pay for the lasers. I agree that hair removal doesn't make us a lot of money but it does help offset the costs of the lasers.
03.20 | Unregistered CommenterLH
Someone mentioned 'internal marketing' as a way to build an aesthetics practice - hair removal is a great way to do it. Patients come in for de-hairing and they get to talking about other issues and Voila! - a resurfacing package, a vein treatment, etc. It pays the bills, barely, but we look at it as an investment in developing customer credibility and moving them into a bigger package of something they can really benefit from. I reiterate - SOMETHING THEY CAN BENEFIT FROM, NOT JUST AN 'UPSELL'.
03.21 | Unregistered CommenterDermaDoc
There are a lot of companies selling used laser equipment. How do you know who is on the up and up?
03.21 | Unregistered CommenterNina
You can save a lot of money buying used equipment-- but your risk will be greater and the cost of keeping the equipment serviced and maintained may be surprisingly high. Always find out what happens with lamp and "head" replacement down the road. The variations from company to company for flash lamp costs and pulses "guaranteed" will also surprise you. To some extent the dilemma is similar to buying a used car. Some cars will run OK for 300,000 miles. Others give you headaches from day one.
I would like to ask something if someone Knows about it.What are the consumers for the new Alex from Cynosure and Candela?What is the cost for the flash lamps and after how many shots there is a need for replacement?
03.22 | Unregistered CommenterCharry
Charry: I had several Cynosure Apogee 9300 Alex lasers. The new Elites are probably similar in this regard. My flashlamps were usually OK up to about 400,000 pulses and then required replacement. The cost of the lamps (two each time) were about $900 total but there was also te cost of the service call each time. Sometimes the company had a tech in Minneapolis but on other occasions they would charge me for the time and travel of the technician coming from Chicago or whereever. On site service can be a horrible thing. Many of the other devices today can be shipped overnight via FedX, etc. which is a huge advantage.
Ron Berglund:OK for Cynosure Apogee.Do you know if the cost of the lamps for Acclaim is the same as it is in Apogee?The services of Candela lasers Alex or Nd YAG(excluding the cost of service call) are egual to Cynosure?
03.23 | Unregistered CommenterCharry
Ron Berglund:OK for Cynosure Apogee.Do you know if the cost of the lamps for Acclaim is the same as it is in Apogee?The services of Candela lasers Alex or Nd YAG(excluding the cost of service call) are equal to Cynosure?
03.23 | Unregistered CommenterCharry
Charry: The cost of the Acclaim lamps should be equivalent to Apogee. Acclaim is a 1064 nd:YAG laser and is great for Fitz 4 and 5. I am sorry but I don't know anything about Candela. You can find out from a Candela rep-- but it will be like pulling teeth to get the details. Laser reps don't like to get into these "negative" details. But you need to know before you buy. They should offer extended service agreements so you don't get surprised in the future (like I did).

For what it is worth, I have to disagree with the comment that a laser is always a better choice than IPL for permanent hair reduction. The follicle does not know if the photons came from a laser or an IPL device. Once the photons hit the skin, they are no longer coherent, they scatter. To achieve permanent hair reduction requires that you injure or destroy hair follicles and stem cells that surround the hair shaft without destroying the skin itself. Rox Anderson coined the term selective photo thermolysis which pretty well describes the process. To get the job done, you need to deliver enough photons to heat the follicle and to heat the hair shaft. If you don't heat the hair shaft, the stem cells will not be affected. Furthermore, the skin, follicle and hair shaft are all going to get hot. Since the follicle and hair shaft have more melanin than the skin, they absorb more energy and get hotter faster. By cooling the skin, you have a little more time to get the temperature of the follicle and hair shaft to get to the critical level before the dermis gets too hot. The point is that none of these basic requirements require the light to be produced by a laser. If an IPL does not do a good job, it is because of inadequate fluence, inadequate filtering, inadequate cooling or all of the above, not because it is an IPL. I spent a lot of time shopping before I purchased my IPL (Starlux 500) and I am very happy with the results. So are the patients.

09.28 | Unregistered CommenterMJS MD PA

Tell me more about syneron.

10.5 | Unregistered Commenterspagirl

help - thanks i find your web site very helpful - but I~ am comfused as whethre to go with the DIode laser or IPL ?? I have fair skin and dark hair and want to remove my dark fascial hair! any help greatly appreciated!! thanks

I've purchased and worked with non-ablative lasers and IPL for hair removal and skin rejuvenation for 10 years. My opinion is as follows: I started with ESC Epilight in 1998. Initially there was alot of disappointed people (esp. myself)however, the learning curve was long and complicated. From there I had Vasculight (I guess ESC felt bad for me and cut a great deal)and started doing more hair removal and FotoFacials (and trained by Bitter and Mulholland)....results were improved. However, until I used a Light Sheer Diode (only 9mm, 100ms, 60jcm/2max.)did I feel confident that I was giving the patient great results....esp. coarse hair...unfortunately it HURT TOO MUCH!!! and doing large areas was extremely tedious and time consuming.. I now have the Lt. Sheer, Syneron Aurora (since 2003), Candela's Gentle Lase and Gentle Yag SR (since late Spring 2007). In addition to HR, I'm using the Gentle Lase for benign pigmented lesions and the Gentle Yag for HR, facial telangectasias, and <than 3mm leg telangectasias and SKIN TIGHTENING!. The Candela G.L. and G. Y. are far superior in results and patient comfort...great for "spot welding" stubborn telangectasias on the face...However, The Syneron Aurora for FotoFacialRF proved approx 60 percent better results than IPL alone. THEN if there are stubborn Hyperpigmented lesions or telangectasias I'll bring in "the Candela "big guns"...for really great results. I've used my Lt. Sheer only twice for HR since aquiring Candela's GL and GY.

I have no vested interests in ANY manufacturer...just lots of experience with several manufacturer's and various aesthetic lasers. There is no one single laser that does everything.
Sorry so long-winded....hope it helps somebody!

Has anyone had any experience with the Naturalight IPL? Is it effective for hair removal? What about the new skin tightening system?

12.30 | Unregistered CommenterCB

Has anyone any experience or comments about the new Soprano Diode laser from Alma? Am trying to decide between this and the Apogee Elite.

05.9 | Unregistered CommenterRKP

RKP,

If you are looking to do hair removal only then I would choose the Elite. It wall allow you to treat Fitz patrick 1 to 6 vs the diode which is best for fitz 1 to 3. If you look at the studies, the 755 wavelength works a little better for hair removal then the 810 diode.

If you are looking to do more than hair removal then there are better systems out there.

05.9 | Unregistered CommenterLH

SYNERON IS GARBAGE! Owned the entire package. It is by far a waste of money! Your best route with Syneron is the Vela Shape ONLY!

I am only a patient who had her first photofacial. I have rosacea and melasma, but after one treatment with the Syneron laser, I feel like I look five years younger in that my skin "wore" like it did back then. It doesn't feel tighter but it almost looked like I had a brow lift. The deep grooves in my brow are hardly discernable. Now I am moving and I found a doctor with a Medilux and I am worrying that the treatment might be a dissapointment by comparison. I had messing with a good thing but the drive to see my old doctor is cost prohibitive. Any suggestions or assurances?

Thanks,

Kara

06.25 | Unregistered Commenterkara black

Hi,
does anybody

know about aria-shr from Alma?

06.25 | Unregistered Commenterdorit

Dorit: I just read that Lumenis has recently sued the entire Alma executive team for many hundreds of thousands of "sheckels" for violating their patents, etc. Maybe if I find out how much a sheckel is worth I can translate "aria-shr". I checked the English version of the Alma web site recently and I can assure you that there is no such product. They did recently get a new 510(k) for their souped up Harmony System. They are going way overboard on the "optional hand sets" (up to 19 now) in my opinion. It is hard to believe they stole all the key patents from Lumenis but yet nobody seems that excited about their devices.

Dorit: I just came across a bit of information published by Alma which indicates that the ARIA system is "an international version of the Harmony" system that is specifically sold to the aesthetic spa market...

I believe they use SHR as a way of highlighing the indications such as HAIR...

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