In today's episode, Mike and Lisa look at the complexities of safely and effectively treating deeper skin tones, particularly those with higher melanin concentrations. They discuss the importance of understanding how melanin affects laser treatments, noting that darker skin absorbs more energy, which can lead to increased risks of cellular damage and pain. Both Mike and Lisa challenge common misconceptions about using lower fluences for darker skin, advocating instead for higher fluences combined with enhanced cooling techniques to achieve optimal results.

KEY TAKEAWAYS

• Darker skin has a higher concentration of melanin throughout the epidermis, which absorbs more light energy from lasers, potentially leading to increased temperatures and a higher risk of cellular damage.

• Contrary to common training advice, using lower fluence and longer pulse widths on darker skin can be counterproductive. Lowering fluence reduces the total energy available for treatment, making it less effective.

• The ND:YAG laser at 1064 nanometers is preferred for treating darker skin tones because it is absorbed less by melanin, allowing more energy to reach the dermis where treatment is needed.

• Increased cooling time is essential when treating darker skin to mitigate the higher temperatures generated by increased melanin absorption. Recommended cooling times may be longer for darker skin compared to lighter skin.

• Practitioners should exercise caution when treating darker skin tones, especially if they are inexperienced. It is advisable to gain more experience before attempting treatments on darker skin to ensure safety and effectiveness.

BEST MOMENTS

"Darker skin has more melanin than lighter skin. In lighter skin tones, we tend to find most of the melanin resides in the basal layer."

"Lowering the fluence is a bad idea. That's just never going to work. You'll end up doing many, many more treatments and you might never get a good result."

"If you're going to use high fluences, then you must use much more cooling to compensate before and after the treatments."

"The melanin is a barrier, yes, essentially, and it steals energy."

"As the skin tone gets darker, you just got to be much more careful. That's basically it in a nutshell."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa delve into a concerning trend in the laser and IPL industry: the potential capping of fluence output by machine manufacturers. They discuss recent experiences shared by practitioners who found their machines unable to deliver the higher fluences promised in their manuals, raising questions about the implications for treatment efficacy. Mike and Lisa advocate for the need to empower users with the ability to access the full potential of their devices, rather than imposing arbitrary limits that could hinder results.

KEY TAKEAWAYS

• There is a growing concern in the industry regarding laser suppliers potentially capping the fluence output of their machines, which may limit practitioners' ability to achieve optimal results.

• Limiting the fluence can significantly affect treatment outcomes, particularly in procedures like hair removal and vascular treatments, where higher fluences are often necessary for effective results.

• The practice of capping machine outputs suggests a lack of trust in practitioners' abilities and highlights the need for better training. Proper training should empower users to operate machines at their full potential safely.

• The analogy of buying a car that is limited to a certain speed illustrates the frustration practitioners may feel when they are sold equipment that cannot perform to its advertised specifications.

• Effective cooling techniques are crucial when using higher fluences. Practitioners should be trained to understand the balance between delivering effective energy and ensuring patient safety through proper cooling methods.

BEST MOMENTS

"Are laser suppliers capping the amount of fluence that their machines are putting out for their clients or the practitioners?"

"It's kind of like the manufacturer saying, well, we don't trust you to use the machine to its full capacity."

"If you're being limited in what you can deliver to the skin, then that will limit your results, no doubt about it."

"If the company is selling you a machine and they are either capping or limiting it, then the company is not providing you with the proper service."

"It shows a lack of trust in your customers, and it also shows, to me, a lack of proper training."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa delve into a recent critique of their training methods regarding laser hair removal, specifically addressing concerns raised by a laser supplier about their promotion of higher fluences and external cooling techniques. Mike & Lisa clarify the science behind pulse widths, fluences, and the importance of targeting stem cells rather than just the hair itself. Mike and Lisa also touch on the implications of using higher fluences on handpiece longevity and the overall effectiveness of treatments, encouraging practitioners to prioritize results and client satisfaction.

KEY TAKEAWAYS

• The relationship between pulse width and fluence is crucial in laser hair removal. A higher fluence can lead to longer pulse widths, but the key factor is ensuring that the energy delivered is sufficient to heat the stem cells effectively, regardless of the pulse width.

• Pre-cooling the skin with ice packs before treatment can significantly reduce pain and the risk of unwanted side effects, such as blistering and pigmentation changes. This allows practitioners to use higher fluences safely.

• The denaturation time, which is the time required to irreversibly damage the target cells, is more critical than the pulse width alone. The temperature and duration of exposure are what ultimately determine the effectiveness of the treatment.

• The podcast discusses criticism of their training methods, particularly regarding the use of higher fluences. They argue that using higher fluences with proper cooling leads to better results, even if it may reduce the lifespan of the handpieces.

• There are common misconceptions in the industry about starting with low fluences and gradually increasing them. The podcast emphasizes the importance of starting at the correct fluency from the beginning to achieve effective results without unnecessary delays.

BEST MOMENTS

"We promote skin cooling, higher fluence, which in diodes equals longer pulse width. They're saying that will be bad for the treatment because they believe you should have a short pulse width."

"If you use a lower fluence, that means you're firing in less energy. And less energy means lower temperatures. Lower temperatures mean you need much longer times to cook the cells."

"The temperature of the hair is, like I said, pretty much irrelevant. What is important is getting the right amount of energy into the hair."

"If you're going to end up sitting there with a lot of disgruntled clients... then that's not good for your business or your reputation."

"The higher the fluence, the shorter the time you need to denature the cells. And that's why the pulse width becomes unimportant."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com