Kerry Belba, Laser practitioner, Laser trainer and Key Opinion Leader (KOL) dispels the myths and confusion around which laser and IPL is right for your clinic.
Deciding to offer laser hair removal for your clinic is easy. Deciphering which laser or IPL is the ‘right one’ for your business can be daunting and confusing, not to mention incredibly time-consuming. Doing your homework beforehand, however, ensuring you choose the right system for you, can not only save you time and money but can be the making (or breaking) of your clinic and its reputation.
Back in 2004/2005 when I first opened my laser and skin clinic in Bournemouth there weren’t as many laser and Intense Light Source (ILS), commonly known as ‘IPL’, suppliers in the industry as there are now. Having a choice of where to buy can only be a good thing of course, but it can make your purchasing decision even more confusing especially when each manufacturer professes that their laser or IPL is the best, when in reality they are not all created equal. My advice? Know your lasers and wavelengths before contacting any laser manufacturers, as this will not only empower you as a consumer, but will provide you with clear direction as to which laser and/or IPL is right for you.
Know Your Light
So let’s talk wavelengths. In simple terms, a wavelength is the distance between two points on a wave, which are separated by a complete cycle, and visible light is measured in nanometers (nm).
Different wavelengths produce different colours of light. Each colour of light will be absorbed by different targets of colour. For instance, a red tattoo would need to be treated with a laser emitting green light, and vice versa. The light is absorbed by the coloured target, (e.g. a red vein, a green tattoo) and either heats it or shatters it into tiny particles.
In the case of hair removal, the chromophore (i.e. the target of colour) is the pigment in the hair. The pigment can be absorbed by a wide range of wavelengths in the visible and near-infrared spectrum, which is why when it comes to the choice of device, there is an array of both lasers and IPLs to choose from.
The technical term for what is happening when we laser or IPL hair is called ‘selective photothermolysis’. We are ‘selectively’ heating a hair (the target) whilst protecting the surrounding tissue in the skin. Without selective photothermolysis, we would be heating up both hair and skin, risking burns and blistering.
Whilst all wavelengths used for laser and IPL hair removal are suitable for the removal of the hair itself, they are not all necessarily appropriate for all skin types I – VI on the Fitzpatrick Skin scale. Lighter coloured skin can be treated with any of the wavelengths, whilst darker skin requires wavelengths that are not as well absorbed by melanin, which means they go deeper into the skin, bypassing most of the skin’s epidermal melanin.
So which wavelengths are suitable for laser/IPL hair removal?
Lasers and IPLs emitting light between approximately 650nm and 1100nm can all be used to permanently reduce hair. Each has its advantages and limitations depending on the intended use as indicated in the table below.
Suitable for skin types:
Ruby laser 694nm
I and II
High melanin absorption heating follicles very effectively
I, II, III (can be used for skin type IV with extreme caution)
Considered the gold standard treatment for hair removal, this laser can effectively treat all hair colours, including finer, lighter hairs providing there is some melanin present.
Short pulse durations with Alexandrite lasers means they are incredibly effective at permanently reducing unwanted hair
An aggressive laser which can be uncomfortable (unless in ‘pain-free mode’)
Only really suitable for white skin types I to III.
I to V
A popular choice due to its ability to treat a wide range of skin types.
The first lasers to be used for ‘in-motion or ‘pain-free’ modes with energy being delivered gradually to the skin for maximum comfort.
I to VI
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Due to the depth of penetration of this wavelength, it can make treatment more uncomfortable.
Low melanin absorption means efficacy can be limited on fine or fair hairs.
Approx. 650nm – 1100nm (for hair removal)
IPLs use a flashlamp emitting a range of wavelengths from the UV spectrum up to near-infrared, with a filter to cut out wavelengths below 650nm.
I to V (depending on individual IPL technical spec)
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Depends on the laser type.
Up to a skin type 6
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It should be noted, however, that towards the end of a course of treatment, when the hairs are finer, it is often necessary to switch back to the traditional single-shot method of delivering the light into the follicle rendering it no longer ‘pain-free’.
Education, Education, Education
One of the most important considerations when choosing a laser or IPL is the training that comes with it. Back in 2004/2005 when I was looking at purchasing my first laser, the manufacturer training varied enormously. One particular company, still going strong today, and a company I would consider to be one of the ‘key players’ in the industry, provided a mere 3 hours’ worth of training, which unbelievably included time for PAT-testing the machine. This, in my opinion, is nothing short of irresponsible. To think that a practitioner who is completely new to laser and IPL, (having never lifted a laser handpiece let alone fire one), could be treating members of the public with less than 3 hours of training, doesn’t bear thinking about. Lasers and IPLs are the most incredible pieces of engineering genius, which have revolutionized aesthetics, but they also come with the potential for serious side effects especially when insufficient training is provided.
As such, any laser or IPL manufacturer, not providing an absolute minimum of one to two full days of training are not, in my opinion, worth considering.
In addition to initial training, a good equipment supplier will provide excellent ongoing clinical support and training, not only for tips on getting the best possible treatment outcomes, but for ‘if and when’ things go wrong. Your equipment should come with medical protocols, written by an Expert Healthcare Practitioner (EHCP) as these will form the basis upon which your insurance is provided. In addition, they should be able to provide you with a Laser Protection Advisor (LPA) which is also a requirement if you are Care Quality Commission (CQC) registered.
Lastly, whilst not essential, choose a laser/IPL supplier with an active customer forum/group where you can tap into a wealth of clinical knowledge and support, whose members are only too keen to help and impart their knowledge to you, the latest ‘family member’ to enter the fold.
Any equipment supplier worth their salt will naturally provide you with outstanding marketing support.
Choose only suppliers who make your success, their absolute mission. Expect to be able to access a customer portal with an abundance of high quality, downloadable marketing materials which are free of charge. Also look for suppliers that hold regular clinical update seminars, which count towards your continual professional development (CPD).
Still confused? My advice would be to look at your demographics and choose a system that allows you to treat as many skin types as possible. Ideally, and if you wish to expand into other treatment areas like skin rejuvenation, choose a laser or IPL which comes as part of a system platform where you can add handpieces as and when you wish. I have a total of eleven different lasers and IPL handpieces on two platforms in my toolbox, three of which are for hair removal.
In 2005 I started out with a long-pulsed Nd:YAG 1064nm and a superb IPL 650nm which produced sub millisecond pulses durations. Three years later I introduced an additional but far more aggressive IPL, the 650nm Advance to tackle finer lighter hairs. At the time I was considering an Alexandrite but when I discovered that one of the laser nurses at a large NHS laser centre preferred it to the Alexandrite for results and speed of treatment, it was a no brainer. After all, I had the platform ready to receive this new IPL, the clinical white papers and the endorsement of an experienced laser nurse to back it. It was the natural and obvious progression with an outstanding and trusted equipment supplier.
With a total of three laser and IPL handpieces, it meant I could treat any skin type walking through my clinic door, despite the fact that Bournemouth is sadly, not that ethnically diverse. For me, however, it was hugely important that I didn’t have to turn away any clients based on their skin type. It also meant of course, that by having a long-pulsed Nd:YAG, I was also able to treat leg veins. These kinds of small considerations and knowledge, in terms of equipment versatility and application prior to your equipment purchase, can have a big positive impact on your business. Lastly and most importantly, take great care and time in choosing your equipment provider.
Making good choices in terms of your laser and IPL supplier is absolutely key in terms of the quality of the machine, your treatment outcomes, the reputation of your clinic and ultimately the longevity of your business. I currently work with two fantastic UK suppliers who provide me with my light sources. I do not allow any suppliers who do not share my ethics, into what I call my ‘circle of trust’. It should be an absolute privilege for suppliers to earn a place in your portfolio of clinic equipment and vice versa.
When I invite a supplier into my circle, I don’t just buy a piece of equipment, I expect to buy into a family whose members have my back. A family that is as keen as I am to get incredible results for my clients. There are very few suppliers out there that are in my opinion, worthy of my custom or that tick all the boxes. Expect more, however, and with a bit of research, you will attract the right supplier and the perfect system for your clinic.
Kerry Belba, Director at Laser Skin Solutions Ltd., Bournemouth.
Before and After Photos
Female Skin Type V, chin and neck area. After 6 sessions, at Laser Skin Solutions Bournemouth, treated with the Lynton Lumina DynamicReflex® Technology IPL 650nm .
Male Skin Type II, chest area. After 6 sessions, at Laser Skin Solutions Bournemouth, treated with the Lynton Lumina DynamicReflex® Technology IPL 650nm Advance.