D1091 Rev.M August. 2016
PREPARING THE PATIENT FOR HAIR REMOVAL TREATMENT
• Clean the skin by removing all make-up and/or topical anesthetic.
• Ensure that the treatment area is clean shaven.
• Take photographs prior to the initial treatment for future reference.
• Topical anesthetic is optional and must be removed before treatment.
o CAUTION: Toxicity may result from overuse. Consult the product labeling for any anesthetic used.
• Ensure that ALL people in the treatment room are wearing safety eyewear.
SELECTING
TREATMENT PARAMETERS FOR HAIR REMOVAL TREATMENT
• The recommended parameters are provided as a guide only.
• Perform and observe test spots prior to treatment. Potential adverse reactions may take 24-72 hours to
appear. Pigmentation changes for darker skin type patients may develop up to several weeks following
treatment.
o Test spot fluence settings are determined by evaluating skin type and, for hair removal procedures, hair
color, thickness, and density.
o Treatment settings should be selected based on test spot clinical response.
o Perform test spots on the same area as being treated.
o Deliver single pulses to assess clinical response and potential adverse reactions.
o Deliver 3 to 4 adjacent pulses to assess skin’s reaction to bulk heating.
• Start with conservative settings, and observe laser-tissue interaction and clinical endpoints to determine
appropriate settings for each patient.
• Fluence and/or pulse duration adjustments should be performed gradually.
o Adjust by 5 J/cm² or 5 ms at a time, while watching for epidermal response.
Adjust only one parameter (fluence OR pulse duration) at a time.
Shortening the pulse duration by 5 ms is more aggressive than increasing the fluence.
• Patients should be re-assessed prior to each treatment to determine sun exposure and hair density and
coarseness.
o Parameters may need to be adjusted.
• Mild to moderate erythema and/or perifollicular edema are desired endpoints.
o IMPORTANT: Clinical endpoints are not always required for an effective treatment. It is possible for a
treatment to be effective without seeing these reactions.
• If treated area darkens or develops significant erythema or edema, the fluence should be decreased or the
pulse duration should be increased.
• Repetition rate should be adjusted according to patient comfort, skin type, hair density, and user experience.
o Single pulses or low repetition rate are recommended on areas where additional cooling is desired
(such as higher energy settings, sun exposed areas, coarse/dense hair, darker skin, curved or bony
areas, etc.).
o Higher repetition rates are only recommended for experienced practitioners and only when treating
larger treatment areas that allow for easy handpiece motion.
o If using a higher repetition rate, the fluence may need to be lowered.
• CAUTION: When treating darker skin types, additional pre-cooling and lower repetition rates or single pulse
modes are recommended to maximize epidermal protection.
• Re-evaluate the patient prior to each treatment to determine sun exposure and treatment target.
o Parameters may need to be decreased if increased melanin content due to sun exposure is observed.
• Treatment ranges are wide due to significant variations in patient response.
• CAUTION: Sun-exposed areas have a higher risk of adverse events.
• CAUTION: Do not use clinical settings taken from other 1064 nm laser guideline documents. Technology
and performance differences can significantly effect clinical response.
o Excel V contact cooling technology provides refractive index matching improving energy coupling into
skin. Skin compression from the contact handpiece also blanches the skin and reduces the distance to
the hair target reducing losses.
o These effects, for the same displayed settings, result in excel V achieving higher effective intradermal
fluence than seen with other cooling technologies.
o As a result, the same levels of efficacy will be achieved with lower system settings.
o If equivalent displayed settings are selected, the higher effective intradermal fluence will result in higher
follicular and perifollicular temperatures which can improve efficacy but may increase treatment
sensations
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