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Laser Treatments

I.P.L./B.B.L.

Frequently Asked Questions

How does the I.P.L./B.B.L. work?
The I.P.L./ B.B.L. laser delivers a burst of energy to restore skin to a more youthful state. It efficiently heats up the darkly pigmented spots and the dilated blood vessels causing unwanted marks to gradually fade after each treatment.

How many treatments will I need?
Typically five treatments are needed to effectively even skin tone. However, depending on the severity of the problem, additional treatments may be needed, for which there is an additional charge. Maintenance treatments are recommended.

Where on the face or body can the I.P.L./B.B.L. laser be used?
The I.P.L./B.B.L. laser can be used anywhere on the body. The face, neck and chest are common treatment areas. At any one treatment session we can treat up to two areas: for example, face and neck or arms and hands…..

How long does each treatment session take?
A typical face treatment is completed in about 30 minutes. However, you can expect to be at our office for a total of one hour. This includes the prep time and the treatment.

When will I see the results?
You will notice your skin feeling smoother immediately following your treatment. Dark spots and broken capillaries will appear more noticeable for the first week but then will begin to fade. Your skin tone will begin to look more even after a week or two. After each additional treatment you will see more and more gradual lightening and improvement of your vascular and pigmented imperfections.

What can I expect my skin to look like after the I.P.L./B.B.L. treatment?
There may be some redness, swelling and a mild sunburn sensation in the treated areas. The mild burning usually disappears in a few hours. You may notice the brown spots appear darker immediately after your treatment and will fade over the following week or two. Rosacea patients may notice some bruising over the area that was affected by rosacea. The bruising will fade over the next two weeks.

How do I maintain the results after the I.P.L./ B.B.L. laser treatments?
A lifetime commitment to aggressive sun protection is the single most important step in maintaining the positive results of your I.P.L./B.B.L. treatments !!! We also recommend a good skincare regime and one maintenance I.P.L./B.B.L. treatment every six months. If this maintenance treatment is missed, you can ‘catch up’ by getting one laser I.P.L./B.B.L.treatment approximately one year from your original series, followed by one more treatment 4-6 weeks later.

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Profractional with Microlaser Peel

Frequently Asked Questions

What is the Sciton Laser?
The sciton laser is an innovative new laser system that can rejuvenate or “resurface” damaged skin without causing a prolonged uncomfortable healing period.

How does the Profractional and the Microlaser peel work?
First, the microlaser peel is performed on the skin. The microlaser peel is an erbium laser that removes 10-30 microns from the entire surface of the skin, allowing the profractional treatment to be more effective. Second, the profractional laser is performed. It is also an erbium laser that passes through the top layer of the skin, reaching into the dermis 20-150 microns below. It creates thousands of tiny microscopic thermal wounds. This damage stimulates the body’s own collagen production deep within the dermis. It repairs structural damage, improves texture and promotes stronger more elastic skin.

How many treatments will I need?
Each microlaser peel with profractional session treats approximately 15-20% of the skins surface. Typically 3-4 treatments are recommended, depending on the severity of the problem. Treatments are performed 4-6 weeks apart. Maintenance treatments are recommended on a yearly basis.

Where on the face or body can the microlaser peel with profractional be used?
Because most of the skin is left undamaged after each treatment, the Sciton Profractional Laser can be used anywhere on the body. The face, hands, neck and chest are common treatment areas. Traditional laser resurfacing, which removes the entire skin surface, is limited to treating only the face.

Are the microlaser peel with profractional treatments painful?
Some people say that there is a mild stinging during the treatment. To help with this we give a pain pill (vicodin or similar medication) and apply a numbing cream to your skin one hour prior to the treatment. For deeper treatments, we may provide a regional nerve block with Lidocaine. General anesthesia or IV conscious sedation can also be made available on special request.

How long does each treatment session take?
A typical face treatment is completed in about 30 minutes. However, you can expect to be at our office for a total of 1-11/2 hours. This includes the prep time and the treatment.

What can I expect my skin to look like after the treatment?
There may be some redness, swelling and a mild burning or itching sensation in the treated areas. The mild burning usually disappears in a few hours, the redness may persist for up to five days. As the redness disappears the skin may take on a ‘bronzed’ appearance. As the microscopic spots are shed, the top layer of the skin may begin to slough off. Rarely, there may be crusting or blistering in some areas, especially if high powers are used. This whole healing experience may take up to seven days.

How soon can I return to my normal activities?
If you have been given oral medication for pain or sedation you may not drive until the next morning. We would prefer that you go home after the treatment and rest. We ask that you avoid strenuous activities such as, exercise, bending, stooping, or lifting heavy objects for three days after the treatment. This will help reduce swelling and pain.

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Sciton Microlaser Peel

Frequently Asked Questions

What is a Sciton Microlaser Peel?
The sciton laser is an innovative new laser. The microlaser peel is for those of you who have a busy lifestyle and are looking to improve your skin’s texture, color and tone. It is sometimes called the ‘weekend’ peel, the results can be visible in just a few days, without causing a prolonged uncomfortable healing period.

How does the Microlaser peel work?
The microlaser peel is an erbium laser that precisely removes 10-50 microns from the entire surface of the skin. It uses a computer-guided scanner to ensure maximum precision and treatment uniformity. The procedure is individually tailored to address the specific problems that you would like improved. Some may need improvement with fine lines and wrinkles, while others may need improvement with uneven skin color or overall sundamage.

How many treatments will I need?
Typically 2-4 treatments, however, like most cosmetic treatments this depends greatly on the skin condition being treated. Treatments are performed 4-6 weeks apart. Maintenance treatments are recommended twice per year (approximately every 6 months).

Where on the face or body can the microlaser peel be used?
The microlaser peel can be used virtually anywhere on the body. The face, hands, neck and chest are common treatment areas. Traditional laser resurfacing, which removes the entire skin surface, is limited to treating only the face.

Are the microlaser peel treatments painful?
Some people say that there is a mild stinging during the treatment. To help with this we apply a numbing cream to your skin one hour prior to the treatment. For deeper treatments, we may provide a regional nerve block with Lidocaine.

How long does each treatment session take?
A typical face treatment is completed in about 15-30 minutes. However, you can expect to be at our office for a total of one hour. This includes the prep time and the treatment.

What can I expect my skin to look like after the treatment?
Immediately after the treatment you may have a mild burning sensation that can last for a few hours. The next day you may notice some sloughing of the skin. By day three the redness should begin to fade. The entire healing process varies depending on the depth of the microlaser peel performed. Typically healing will take from three to five days. The procedure can be performed on Thursday or Friday and by Monday most patients can return to work. The end result will leave you with healthier more vibrant skin.

How soon can I return to my normal activities?
We would prefer that you go home after the treatment and rest. We ask that you avoid strenuous activities such as, exercise, bending, stooping, or lifting heavy objects for 1-2 days after the treatment. This will help reduce swelling and pain.

FotoFacial™ RF and Laser Hair Removal Treatments

Cindy Dumon, RN, BSN

165 Rowland Way, Suite 303
Novato, CA 94945

415-310-2862

www.cindydumonrn.com

Supervising Physician: Peter N. Bretan, MD

How does Laser Hair Removal work?
The laser light passes through the skin, but when it comes to a dark pigmented hair, that light turns to heat. The darker a hair is, the hotter it will heat. That hot hair is what essentially cooks the lining of the hair follicle and destroys structures that allow the hair to grow, namely certain cells and the blood supply found at the base of every hair follicle. This heating process only works on hairs that are actively growing and getting longer. Since only 15-30% of your hair is actively growing at one time, it is necessary to wait for another batch of treatable hair to come into that “magic moment,” that treatable phase, before doing the next treatment.

The hair you see growing when you start your treatments may represent only one third of the active hair follicles you own. That is, you may have three times as much hair growing potential than you actually see as hair present on the skin surface at any one time.

Hair sticks tight in the follicle even after it stops actively growing and getting longer. A laser treatment of hair that is present in the follicle, but not actively growing anymore, will not give optimal results. Why? This is because once the hair is not actively growing anymore, it starts pulling away from the base of the follicle. It is no longer in contact with the cells in the base of the follicle that generate hair growth, nor the blood supply at the base of the follicle. That means that hot little hair is not touching the lower parts of the follicle, those parts that are critical to hair growth. Depending on how low the hair might still be sitting, the follicle may be partially treated. This means that hair will still grow, but it will be smaller in diameter and lighter in color.

If the hair is close to the shedding stage, or the follicle is empty of hair at the time of the treatment, the laser treatment will have no effect on those follicles.

Any hair that is present in the follicle will be cooked, causing it to loosen from the follicle and be shed pre-maturely. This means you will not be bothered with the presence of hair until the next batch grows in, about 3-4 weeks later for the face and neck and 6-8 weeks later for areas below the neck.

The laser light is effective to heat hair only 3-5 millimeters below the skin surface. After that, the light fizzles out and is ineffective. Fortunately, 3-5 millimeters is exactly the depth of hair follicles. The laser light impacts nothing under the skin except the dark hair. It does nothing to blood, because this wave length is not absorbed by the color red. For this reason, it cannot treat red hair either. It does not affect oil glands or sweat glands, because they are not pigmented. It can lighten freckles or make them disappear altogether. The pigment in freckles absorbs the laser light, heats up and cooks off. Freckles might look a little darker the day after a treatment and then they just flake off. If you are fond of your freckles, don’t worry. A little sun exposure and they will come back again.

How much of my hair is in the actively growing, treatable, “magic moment” stage at one time?
This depends greatly on the area of the body. Generally, 20% of your hair is in the actively growing stage at one time. The sides of the bikini area have 30% of the hair actively growing at one time. Sometimes only 10-15% of the facial hair is actively growing at one time. What does this mean? The sides of the bikini can be completed in fewer treatments than most other body parts and facial hair may require more treatments than areas on the body.

How close can laser treatments be spaced?
Hair is most susceptible to laser treatment when it first starts growing. This is because the hair contains more pigment when it first starts growing than it will at any time later in its growth cycle. The more pigment present, that is the darker it is in color, the hotter it will heat and the better the laser light will be able to treat the follicle so that it will not grow hair anymore.

Ideally, every hair should be treated as soon as it breaks the surface, or even before it breaks the surface. This may not be practical time-wise or money-wise. Therefore, you should wait until the next batch of hair just starts to grow in. For the face and neck, this will be every 3-4 weeks. The hair on the body grows much more slowly. Treatments on body areas are usually best done every 6-8 weeks.

Is laser hair removal permanent?
It is certainly WAY more permanent than waxing, threading and tweezing. It is as permanent as electrolysis. Will you never see a hair grow again in a treated area? It is very likely that you will not. You certainly should not have laser hair removal in any area where you might want hair again!

On the underarms, for example, a few random fine, light colored hairs can crop up even after a series of 5 to 8 treatments is completed. Touch-up treatments at a nominal charge will eventually totally clear this area of any dark hair. Any white hairs will remain untouched.

Legs can be effectively cleared of dark hairs, although occasional hairs will appear, even after 5-8 treatments are completed. This is because hair follicles on the legs can remain dormant (and untreatable) for up to two years. However, if you persist with touch-ups, you can be entirely dark hair free. You may have some fine, colorless hairs that are noticeable in bright sunlight. The best option for these is to shave them.

One beauty of laser hair removal on the legs is that the skin is free of the little dots of hair seen in the follicles. Look at your legs after you have just shaved. You will see little dark spots where each hair is below the skin. If you have black hair, your skin will have very noticeable polka dots. After laser hair removal is completed, not only is stubble a thing of the past, but those little dots are gone.

How many treatments will I need?
This is a tough question. Most patients will need 5-8 treatments to completely clear an area. These are the factors that might require more treatments:

  1. Facial hair on peri-menopausal and post-menopausal women. This is because the ovaries, the primary estrogen factories for women, are not as frisky as a woman approaches menopause and after menopause, they shut down altogether. A woman is left with what her fat cells might produce for her and that is miniscule compared to what her ovaries produced. That little bit of testosterone she always had is no longer overpowered by the presence of estrogen. With the more dominant influence of testosterone, hair follicles that never grew a hair before, start maturing and growing hair. Fine, angel fuzz hairs start maturing into coarser, more pigmented versions of their earlier selves. For this reason, removing unwanted facial hair on women can be a prolonged project. Some patients start to view it as maintenance rather than a cure. Still, it is the most satisfactory way to deal with this kind of unwanted hair. Even if the hair is not completely eliminated, it is far finer, lighter and sparser than it would have been without treatment.
  2. Hormone imbalances. This is actually quite rare. However, women with polycystic ovary disease, women who have had to take certain kinds of chemotherapy, untreated thyroid conditions, women who have been on DepoProvera for birth control or to control cysts or endometriosis, women who take testosterone supplements to stimulate libido, for example —these sorts of things can cause unwanted hair to start growing.
  3. Genetic predisposition. This is the cause of most unwanted hairiness. Certain ethnic groups are more prone to hair growth than others. Some families just have hairier bodies and faces.
  4. Men. Testosterone causes hair to grow and men have a lot of it. Nevertheless, unwanted hair on the back, chest, ears, face, neck, nose and other areas can all be successfully treated.
  5. The hair is light. Black hair does respond the best to laser treatment, because it heats so well and treats the follicle so thoroughly. Dark brown hair works very well, too. When you get into the light brown or dark blonde hairs, laser treatment does work, but more treatments may be necessary. Very light hairs may just get lighter, to the point where they are not treatable with laser at all.

What if I have dark skin?
If you have unwanted dark hair and relatively light skin, you are a good candidate for Cindy’s laser. There is no better laser than the Candela GentleLase for treatment of this combination of hair color and skin type.

Patients with dark skin will be more safely treated with a different type of laser, such as a Light Sheer, which has the capability to keep the surface of darker skin cool while it heats the dark hair beneath. A 1064 Yag laser is another option for hair removal on dark skin. Mt. Tam Laser & Skin Care (415-482-3888) has a Yag laser that can safely treat dark skin.

In general, if you have never gotten a sunburn, you are probably not a good candidate for the Candela GentleLase. If you aren’t sure, Cindy offers free consulations at which she will assess your skin type and whether you can be safely treated with the Candela GentleLase or would be better referred to a provider who has the appropriate laser for you.

What if I am tan?
If you are tan, you need to wait until your tan fades completely before you have laser hair removal. Even the lasers designed to treat darker skins are not that safe on tanned skin. The problem is that the pigment on the surface of your skin is absorbing the laser light and getting hot. You can get burned. The skin will scab and when the scab falls off, your tan will be gone in that spot. Eventually, the pigmentation will even out, but meanwhile, your skin looks pretty weird. You want to avoid this scenario.

What are the side effects?

  1. Hyper-pigmentation. This is a rare side effect, but it is always TEMPORARY. Still it can look pretty weird, too. It can take from a couple weeks to one year (or more) after your last treatment for it to resolve completely. Protecting the treated area from sun exposure after a treatment can greatly reduce the risk of hyper- pigmentation. However, some areas of the body, like underarms and bikini areas, are more prone to this side effect, even in the absence of sun exposure. Hyper- pigmentation looks like a light colored bruise or like the hyper-pigmentation seen with birth control pills or the mask of pregnancy. Although not desirable, most patients feel that the benefits of laser hair removal far outweigh the inconvenience of temporary hyper-pigmentation. Not every patient experiences hyper-pigmentation and it is very minimal in most of those who do experience it.
  2. Hypo-pigmentation. This is not common, but it can happen if too much tan is present when a treatment is done. Again, this is temporary. Your skin tone will even out in time.
  3. Redness and swelling. This is a good sign. That means that the treatment was effective. The laser heated the hair enough to cause redness. Also, the hair was hot enough that fluid from the tissues was pulled into the hair follicles, making little bumps over the hair follicles. This redness and swelling (little bumps) disappear in a few minutes. More sensitive skin may stay red for a couple hours. Extremely sensitive skin may stay red and irritated for up to two days.
  4. Infection. If you get a blister or a scab from a laser treatment, which will not happen unless you are too tan and you pick at it with less than clean hands, it is possible to get the area infected.
  5. Scarring. See number 4. There are those of us who are “pickers.” We know if we are one of these. Scars do not happen unless one picks at a blister or scab and gets it infected. The way to treat any break in the skin from a laser treatment is to keep it clean, do not pick at it and perhaps apply an anti-biotic ointment. If treated in this fashion, no scarring should occur.
  6. Folliculitis. Very rare. For some reason, the hair follicles look red, inflamed and irritated three days or longer after your treatment, when even the most sensitive skin will have settled down. When this happens, call Cindy. She will get you a prescription for an antibiotic lotion, such as Cleocin and the condition will clear up promptly. It will also clear up on its own. This condition is more common on the bikini and inner thighs than anywhere else.

Does laser hair removal work on blonde or white hair?
No. Laser hair removal will work on medium brown hair, but it will take more treatments than dark hair, because it does not heat as well. White hair lasers are so ineffective that you are far better off having electrolysis. White hair just does not heat up well with lasers, even when radio frequency energy is added. Laser hair removal does not work on red, auburn, gray, white and blonde hair. For these hair colors, it is best to see a registered electrologist. I highly recommend Mary Clifford, RE (415-892-7776). Mary has 25 years experience as a registered electrologist and is a very knowledgeable and professional provider. Her office is located at Spa de Marin County on Grant Avenue in Marin County.

What does it cost?

  • Laser Hair Removal costs $100 for a 20 minute treatment.
  • Approximate costs:
    • Face $50-100 (10-20 minutes)
    • Underarms $75 (15 minutes)
    • Bikini Line $100 (20 minutes)
    • Brazilian-style Bikini $150-200 (30-40 minutes)
    • Lower Legs $200-300 (40-60 minutes)
    • These costs are very approximate. They could be higher or lower. The best way to get an accurate quote is to book a free consultation with Cindy.

Cindy’s Hours
Monday: 5:30pm-8pm
Tuesday: 5:30pm-8pm
Wednesday: 10am-8pm
Friday: 2pm-8pm
Saturday: 10am-7pm

Education and Professional Experience

University of California, Davis
University of California, San Francisco School of Nursing, BSN
Marin General Hospital, Medical Surgical Nurse
Marin Head Start, School Nurse
Kaiser Permanente, San Rafael
Telephone Advice Nurse, OB-GYN
Genetic Counseling and Amniocentesis Assistant
SunPlus Home Health, Staff Nurse
Simple Radiance, Staff Nurse
Laser Hair Removal with Candela GentleLase, Syneron Aurora and Light Sheer lasers, Diolite, Botox and Restylane
Marin Cosmetic Surgery Center, Staff Nurse

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