Finding the Gold Standard

Legs

As practitioners and engineers continue to refine both techniques and technologies, opinions vary regarding the most effective wavelengths for permanent hair reduction. “We have sorted out over the years that the alexandrite, ruby and YAG lasers can do a good job, but we can argue that the diode 810nm wavelength is the best,” says Corey S. Maas, MD, FACS, Maas Clinic, San Francisco. “One of the newest laser hair removal devices is the LightSheer Duet from Lumenis. Combining vacuum with lower power settings has added considerably to advancing this technology by reducing pain and increasing the speed of treatment. In practiced hands, many devices can produce comparable results, but in my opinion the Duet system is the best.”
The LightSheer Duet (aesthetic.lumenis.com) was introduced in March 2009 and features two hair removal systems on one platform. In addition to the LightSheer ET system—which is ideal for smaller or bony areas such as the chin and ankles—the new high speed (HS) handpiece features a 22mm by 35mm diode array designed for large areas, such as the legs and back. The HS handpiece also employs vacuum assist technology, which lifts the skin into the treatment aperture before applying laser energy. This has been shown to decrease pain and improve energy delivery, allowing clinicians to treat large areas quickly with minimal discomfort to patients.
“The pain factor is big for patients,” continues Dr. Maas. “With the Duet you don’t need a topical painkiller in most cases, although I do often suggest one for patients having hair removal done in sensitive areas such as the bikini line.”
Dr. Katz also likes the 810nm wavelength but prefers a newer system. “Since its introduction in 2010, the SopranoXLi from Alma Lasers (almalasers.com) has been the gold standard in laser hair removal,” he says. This system combines up to 20 J/cm2 power with the company’s IN-Motion sweeping technology, and it includes pre-programmed settings for all male and female face and body parts.
“Unlike earlier systems, the SopranoXLi uses high power and a rapid, 10 pulse-per-second repetition rate to penetrate deep into the dermis where hair follicles are located. This diode laser is FDA-cleared for Fitzpatrick skin types I-VI—even patients with tanned skin—and has consistently positive results. In addition, patients have indicated that SopranoXLi offers a comfortable treatment, especially compared to other hair removal procedures they have experienced in the past,” adds Dr. Katz.
“I think it’s a common misconception that the gold standard in laser hair removal is the diode laser,” says Shino Bay Aguilera, MD, Cosmetic Dermatology & Laser Institute, Fort Lauderdale, Florida. “What you are trying to do with the laser is deliver enough energy to the hair bulb to destroy the root of the hair, and the 755nm alexandrite does this the most efficiently. To me, physics proves that the 755nm alexandrite laser—which has more affinity for melanin—is the ideal wavelength for hair removal and should be considered the gold standard for hair removal on lighter skin types.”
Dr. Aguilera prefers the Elite MPX from Cynosure (cynosure.com), which includes both the 755nm alexandrite wavelength and the 1064nm Nd:YAG wavelength. Introduced in March 2009, the Elite MPX incorporates Cynosure’s proprietary MultiPlex technology, which sequentially fires two wavelengths, a built-in Zimmer SmartCool skin cooling system and eight different spot sizes. “The 755nm alexandrite is ideal for skin types I-III; the 1064nm is safest for skin types IV and above,” says Dr. Aguilera.
“In my opinion, the two most popular devices for hair removal today are the Lumenis LightSheer Duet and the Candela GentleLase device (candelalaser.com). However, there are many devices on the market that can be used to achieve hair removal with high patient satisfaction,” says Dr. Ibrahimi.

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