Anyone out there with novel ideas about distracting about easy topical anesthetic application or distraction methods such as virtual reality head monitors for games or movies to ease clients (and thus the laser device operator's) experience during treatment of legs or back? We ice, and have a chill tip but if someone is dark skinned, has dense hair, or is just plain anxious by nature topical is needed. Many of our people come from work so pre-applying topical is not viable for many. Of course there is the necessity of avoiding the application of the more effective topical on such large body surfaces too.
Light oral sedation for our most anxious patient works very well and of course is a clean easy method but for most this is impractical (needing a second person to take her home etc.) I use a cooling blanket on some as alternative to ice packs but then one runs into clients sometimes feeling too cold when the whole lower half of a leg is chilled.
We treat safely but have valued aggressive treatment to get the desired peri-follicular edema and best treatment at each visit. However, the trade-off, since most of our clients have dense hair, is discomfort. By treating lower than a uniform peri-follicular edema are some of you still seeing excellent long-term results after 6 treatments or so? ...That is, people with reduction lasting a year or more?
Would like to see some brainstorming in this area.

Hi DocT,

What device are you using? We have an IPL system and I usually treat patients to a pain level of 3-4. 0=nopain, 1=pinch, 2=warm, 3=hot, 4=burning. For large areas such as the back, I instruct them to take a couple of tylenol about 30 minutes before their appointment. We also have a zimmer, which is a patient pleaser and easy distractor. I enlist the patient's help and instruct them to blow wherever they feel pain. Finally, for sensitive areas such as the bikini, I always 1) give them tylenol, 2) apply topical anesthetic; and 3) pre-cool with a zimmer. Regarding clinical endpoints, I use the patient reported pain level as well as the physical indicator (peri-follicular edema) to find the correct setting. I do explain to the patient that we want that hot/almost burning sensation because it will get them better results. With that understanding, the patients typically tell me to give them more, rather than less power. Finally, I try to minimzie treatment time and perform the procedure as quickly as possible, explaining to the patient that longer treatment times do not necessarily result in better outcomes - just more pain.