Hair Growth Cycles
Long-term hair removal has to affect hair in the active cycle of its growth, namely in Anagen. All long-term epilating methods target hair at this stage; and since the growth cycle differs between body areas, each body area requires retreatment at different time intervals to achieve maximum results. The normal hair cycle is comprised of three stages:
ANAGEN CATAGEN TELOGEN
active growth transition resting
Anagen and Telogen stages are different in various body areas. For example, over 65% of facial hair is in Anagen at any given time, while only 20% of the hair on the legs is in Anagen. This means that one cannot expect long term epilation in a single- or even double-treatment session.
Goals of Permanent Hair Reduction by ELOS Technology
Traditional methods of hair removal by laser or light source rely on photothermolysis to achieve permanent hair reduction. Thermal damage to the follicle and to the hair growing structure must be sufficient for denaturizing, resulting in cessation of the normal hair growth cycle.
Using traditional systems in order to achieve photothermolysis in hair removal, there must be sufficient light absorbed by the melanin in the hair shaft in order to produce heat in the surrounding follicle. In instances where there is insufficient absorption of light, thermolysis cannot be achieved. This explains why poor target hair (low melanin concentration) is not successfully treated with traditional systems. By combining both light and radio frequency (RF) current, the eStyle DS applicator uses two different energy sources to thermally damage the follicle, even follicles growing poor melanin target hair such as grey, blonde and red.
The optical energy, or pulsed light, still abides by the principles of photothermolysis. The light is absorbed by melanin in the hair shaft. Upon absorption the light energy is converted to thermal energy, heating up the hair shaft and dissipating heat to the follicle. Since the light is just half of the equation in elos, lower fluence or less light is used as compared to traditional systems. This has direct correlation with the reduced incidence of side effects using the elos technology. The filtered spectrum of light emitted from the DS applicator is 680-980 nm.
Bipolar RF follows the principles of electrical current. It has no relationship with melanin in the skin, which is why it can be applied to all skin types safely. The bio-electric properties of skin tissue allow the RF current to flow through the dermis. Targets with higher temperature have higher conductivity or lower impedance. Current travels better along the path of least resistance, or where impedance is low. RF heating of the follicle is selective because there is higher current density (producing more heat) where there is low impedance, or resistance. The RF current is like a "heat-seeking missile" that is attracted to these pre-heated targets, namely hair follicles. In addition, the hair shaft has high electrical impedance and will “push” the RF towards the follicle. The synergy between light and RF current results in unparalleled safety and efficacy in hair removal. This process has obvious advantages over traditional photothermolysis:
• Lower optical fluence used, resulting in reduced incidence and reduced severity of blistering, scabbing, crusting, hyper/hypopigmentation. It enables the safe treatment of light and moderately tanned skin.
• Lower optical fluence results in little to no prolonged epidermal effects, such as redness and inflammation of epidermis – no downtime.
• Lower optical fluence often makes the treatment more comfortable than traditional lasers or light sources. Patients do not require topical anesthetics.
• RF is used to compensate for lower optical energy. Treatment is safe and comfortable without compromising efficacy.
• RF provides real-time tissue monitoring by measuring the impedance drop with each pulse emitted, which is inversely proportional to the increase of heat in the tissue, increasing the safety margin of the treatments.
• RF may be effective in treating hair with low melanin content, such as light or fine hair.
• Light and RF energy combinations can be adjusted to all skin types, hair colors and body locations for optimal treatment.
Permanent hair reduction means that when a follicle is thermally destroyed it is not able to grow a terminal hair again. Because there are so many millions of follicles that can potentially grow on the body, it is not realistic to expect that every single follicle in the treatment area will be disabled. Over several treatments at appropriate treatment intervals, many of the follicles that cycle through hair growth will be affected by elos and will be critically injured so they are permanently disabled. The follicles that are dormant or vellus hairs are not affected during these treatments.
It is important to remember that the body can convert these inactive or dormant follicles to grow later in life as a result of many factors: hormonal imbalance, pregnancy, menopause, disease or medications, obesity, or idiopathic causes. This is why there can be no guarantees or promises of "all the hair gone forever" from a certain area. Follicles are closely intertwined with the skin and body and respond to internal physiological changes.
Pre-Post Treatment Care
• The patient should avoid skin irritation or intentional skin tanning.
• The patient should discontinue any irritant topical agents for 2-3 days prior to treatment.
• The patient should arrive for treatment with clean skin. There should be no lotion, make-up, perfume, powder or bath/shower oil present on the skin in the area to be treated.
• The hair in the area to be treated should be clearly seen by the operator. Therefore, it should be shaved ~2 days prior to treatment.
During the first two days following treatment, care should be taken to prevent trauma to the treated site.
The patient should use high factor sunscreen (30 SPF) and protect the treated area from sunlight. Tanning after treatment may cause hyperpigmentation.
The number of required treatment sessions depends on the hair growth cycle, hair color and depth. The average number of sessions for dark and coarse hair under normal hormonal conditions is 3-8. More sessions may be required for light and fine hair and for hormonally controlled areas like the chin. Patients should schedule another session when hair regrowth is observed.
Usual intervals for the first three sessions are 4-6 weeks on the face, 8-10 weeks on the body, increasing the intervals as treatment progresses. Some areas, like legs and back, may require longer intervals of up to 15 weeks.
One touch-up treatment session may be needed when there is sporadic new hair growth due to individual natural physiological processes.
• Pacemaker or internal defibrillator.
• Superficial metal or other implants in the treatment area.
• Current or history of skin cancer, as well as any other type of cancer, or premalignant moles.
• Severe concurrent conditions, such as cardiac disorders.
• Pregnancy and nursing.
• Impaired immune system due to immunosuppressive diseases such as AIDS and HIV, or use of immunosuppressive medications.
• Diseases which may be stimulated by light at the wavelengths used, such as history of Systemic Lupus Erythematosus, Porphyria, and Epilepsy.
• Patients with a history of diseases stimulated by heat, such as recurrent Herpes Simplex in the treatment area, may be treated only following a prophylactic regime.
• Poorly controlled endocrine disorders, such as diabetes or Poly Cystic Ovary.
• Any active condition in the treatment area, such as sores, psoriasis eczema, and rash.
• History of skin disorders, keloids, abnormal wound healing, as well as very dry and fragile skin.
• History of bleeding coagulopathies, or use of anticoagulants.
• Use of medication and herbs known to induce photosensitivity to light exposure at the wavelengths used, such as Isotretinoin (Accutane) within the last 6 months, tetracyclines, or St. John's Wort within the last 2 weeks.
• Use of medications that may stimulate hair growth, such as Minoxidil.
• Facial laser resurfacing and deep chemical peeling within the last 3 months, if face is treated.
• Any surgical procedure in the treatment area within the last 3 months or before complete healing.
• Tattoo or permanent makeup in the treatment area.
• Excessively tanned skin from sun, tanning beds or tanning creams within last the 2 weeks.
• Electrolysis, waxing, and plucking within 4 weeks prior to treatment.