Cynosure hair removal lasers + service

Buying used cosmetic lasers can be tricky.

For those of you that have had problems with Cynosure there is help, for those that do not or have not had problems you are lucky.  Not all of Cynosure service department is bad, there are a few good technicians and some that are just there for a job. 

Cynosure hair removal lasers are very good if maintained properly.  There are few things that you must be aware of:

  1. Flash lamp pulses on the Cynosure: Do not go over 1 million on the yag and 750,000 on the alex.
  2. Keep track of your voltage: Do not run the laser over 820v, this could lead to pump chamber failures and blown power supplies.  These will be very expensive repairs.
  3. Inspect your hand pieces every time you use them, making sure that there are not large pits and / or burn spots inside.  Keep your windows clean and change frequently.  If your hand piece is getting hot during use, then you have problems with it, and the hand piece needs to be checked.

If you are thinking of having your Cynosure laser service by a third party company, just remember not everyone can work on them, even some of the manufacture’s technician have problems working on them. There are many after market parts available as well but you get what you pay for. Would you take your Mercedes to Bob’s Auto for service?  I know of only a couple technician outside of Cynosure who can repair them.  We make sure that you get what you would expect from the manufacture.   

If you are thinking of purchasing a used Cynosure laser or other cosmetic laser, please have a technician that knows the laser look at it for you before you put any money down.  Would you buy a used car from a fly by night dealer without having your mechanic look at it? I have seen and heard every nightmare you could think of, I have also seen some very good deals.  I had a lady call me that purchased a laser that had blown the power supply on it 2 weeks after purchasing the laser.  That same laser was about to be sold to a customer of mine that wanted me to help him find a laser.  I told him that this laser in poor shape and that it would need very costly repairs.  I was not surprised when the lady called me and gave me the serial number of the laser.  It does not cost to get a second opinion on something that could save you in the long run. 

When it comes to Cynosure, Candela and Deka lasers if you are having problems or need support please feel free to contact us at Integrity Laser Inc.

Note: The above is a guest post from Integrity Laser. If you would like to write for Medical Spa MD please contact Medical Spa MD here.

The Hidden Dangers of Beauty

Normally, I barely listen to the radio when driving in my car, but today on the John Tesh Radio Show (Sunday) my ears perked up when he started to discuss the hidden "dangers" of young girls using makeup too early. Dangers in makeup? Really?

The broadcast was entitled "The Ugly Truth About Young Girls Wearing Makeup". The line that grabbed my attention was "the sooner your daughter starts wearing makeup, the sooner it might kill her!" This was a quote coming from Stacy Malkan, a cosmetic expert who wrote the book Not Just A Pretty Face: The Ugly Side of the Beauty Industry. According to the John Tesh website, Malkan states "by the time most North American girls become teenagers, many have a daily make-up ritual that includes lipstick, mascara, eyeliner, nail polish and perfume, not to mention skin lotion, shampoo, conditioner, and hair color treatments." She goes on to say "in fact, experts estimate that a typical young girl now walks around with at least a dozen layers of beauty products on her body! As the makeup layers add up, so does her exposure to dangerous chemicals, and that’s very bad news for a young girl’s health."

Apparently the culprits are chronic exposure to parabens and phthalates which have been found to disrupt hormone levels during adolescent years which may result in early puberty. Malkin continues to state "one study found that HALF [sic] of all North American girls now begin to show signs of breast development by the age of 10 – which is more than two years sooner than females from our grandmother’s generation. Other studies link those unusual hormone levels to a higher depression rate among young girls, and a higher risk for breast cancer! That’s why experts recommend women of all ages find out exactly what chemicals go into their makeup."

There is a website suggested for reference to verify the ingredients in certain beauty products and cosmetics and it is called the Skin Deep Cosmetic Safety Database. I was instantly intrigued and raced to my Mac when I got home to give it a try! Here's how my products scored:

(Scale: 0-2=Low hazard; 3-6 Moderate Hazard; 7-10 High Hazard).

  • Cleanser: 3 (moderate hazard) 
  • Toner: 7 (high hazard) 
  • Moisturizer: 5 (moderate hazard) 
  • Eye Cream: 6 (moderate hazard) 
  • Lip Cream: 7 (high hazard) 
  • SPF 30: 7 (high hazard) 
  • Concealer: 4 (moderate hazard) 
  • Foundation Primer: 5 (moderate hazard) 
  • Foundation: 9 (high hazard) 
  • Loose Powder: 5 (moderate hazard) 
  • Blush: 7 (high hazard) 
  • Bronzing Powder: 8 (high hazard) 
  • Eyeshadow: 7 (high hazard) 
  • Mascara: 8 (high hazard) 
  • Lipstick 6: (moderate hazard) 

My gosh, I'm a walking carcinogen!!! Like most women, I use an array of products, from medical grade like Obagi, spa grade like SkinCeuticals, high end department stores like Merle Norman, Estee' Lauder and Laura Mercier, right down to drug store brands like Maybelline. It seems no company's products were completely safe. And, makeup is just the beginning for young girls!

More and more young girls are taking their skin care regimens to the next level by having microdermabrasion treatments and chemical peels, with some escalating to laser and injectable therapies. Putting aside the various protocols for acneic adolescents, there has actually been a rise in the U.S. of young girls undergoing laser hair removal, photo facials, dermal filler procedures, even laser lipolysis. Where do we draw the line as clinicians? 21? 18? 16 with parental consent? I know in our medical spa we have been approached by parents inquiring as to what our policy is for treating adolescents for non-medical related conditions. The number one request is laser hair removal for ethic skin types predominately for excess facial hair. Many clinicians feel it is a low-risk procedure which can lift a child's self-esteem. Some clinicians disagree and feel a child is much too young to be exposed to laser therapies.

I'm not a laser expert and am uncertain as to if many aesthetic equipment manufacturers have performed clinical trials on adolescents for laser procedures (other than port wine stains). I'm more apt to believe the answer to this questions will become clearer as the years go on and by remembering the first rule is to "do no harm".

That, and to throw away your teenager's makeup!

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Do it yourself laser hair removal... Unhappy medical spas?

silkn

The're are a growing number of 'home laser hair removal' devices appearing on the market. This article on do it yourself laser hair removal supposes that medical spas and laser clinics are feeling the heat.

Want to get rid of some unsightly hair, but don’t want to spend the big bucks for electrolysis or a laser clinic? Now, you can buy your own laser and do it yourself.

And people are.

The growth of the at-home cosmetic-device market, which includes personal lasers, has some professionals buzzing. At an annual conference hosted by the American Society of Plastic Surgeons, Barry DiBernardo, a New Jersey surgeon, delivered a talk in Seattle about the pros and cons of the DIY market on the ASPS’s “Hot Topics” panel.

“We have to make sure that the patients are getting good, safe treatments. If they are getting good, safe treatments, then whether they are doing it at home or not, I’m not as worried,” DiBernardo told Wired.com by phone. “What I’m worried about is that they are seeing things in the Skymall on the airplane and spending hundreds of dollars, thousands of dollars on something that is not going to work or is unproven.”

New cosmetic medical devices including DIY lasers are expected to explode into a $1.3 billion market 2013, up from just $296 million in 2008, according to the analyst group Medical Insights. The growth in the market appears to be coming from light-based products that claim to either remove or grow hair on the human body. The Silk’n Hair was the first at-home laser device to be approved by the FDA, in 2006, although it didn’t come on the market until early 2008.

The laser hair removers damage the hair follicles that are in their growth phase, generally leading to some permanent reductions of body hair. DiBernardo questioned whether the lasers used in the home devices were powerful enough to get the kind of results that clinics achieve.

“In general, these devices are low-powered versions of the doctor versions. We’ve been doing hair removal since 1998, so we know that they work and how well they do,” he said. “I think these home devices have some effect, but they legally can’t have the power of what we fire at people.”

From nother nice post from Wired:

My own experience is that people looking to do it yourself home laser hair removal (or skin tightening or complexion light-based photo-therapies) are really looking to save money and are buying a device in the hope that it will work. Patients who are actually interested in laser hair removal or skin tightening are put off by these types of home remedies. I've never heard that a laser clinc or medical spa is suffering from this, but I may be wrong.

Does anyone running a medical spa or laser hair removal clinc feel differently? Is laser hair removal at a medspa moving to home laser hair remvoal that a do it yourself laser treatment?

Brazilian & Bikini Line Laser Hair Removal

Brazilian or bikini line laser hair removal can be classified in four types that has variable names depending on the med spa or laser clinic visited.

It has been claimed that Brazilian laser hair removal, the most renowned form, was named after a pair of Brazilian sisters who delivered the service  as a waxing treatment in New York.

  • The American: bikini line laser hair removal is removal of hair at the top of the thighs and under the navel when wearing a bikini. It is also known as a basic bikini line.
  • French bikini line: leaves a vertical strip in front (a landing strip), two to three finger-widths in length just above the vulva. It is also known as a partial Brazilian laser hair removal. Hair of the peri-anal area and labia may be removed. Removal of hair from these areas is also known as the 'Playboy' or 'G-waxing'.
  • Brazilian refers to a removal of everything, front to back, while sometimes leaving a thin strip of hair on the pubis. An extreme form of bikini line laser hair removal, it involves complete removal of hair from the buttocks and adjacent to the anus, perineum and vulva (labia majora and mons pubis). Laser hari removal reatments that remove all of the pubic hair are known as a full Brazilian, full Bikini line, Hollywood wax or the Sphinx.

Further subgroups has been proposed by Anthropologist Desmond Morris, while referring to inconsistency in nomenclature:

  • The Bikini Line: This is the least extreme form. All (most) pubic hair covered by the bikini is left in place. Only straggling hairs on either side are removed, so that none are visible when a bikini with high-cut sides is being worn.
  • The Full Bikini: Only a small amount of hair is left, on the Mount of Venus (the mons pubis)
  • The European: All pubic hair is removed 'except for a small patch on the mound'.
  • The Triangle: All pubic hair is removed except for a sharply trimmed triangle.
  • The Moustache: Everything is removed except for a wide, rectangular patch. This is sometimes called 'The Hitler's Moustache', sometimes 'Chaplin's Moustache'.
  • The Heart: The main pubic tuft is shaped into a heart symbol.
  • The Landing Strip: The central hair is trimmed into a narrow vertical strip and all other pubic hair is removed. This has become popular with models who must wear garments of an extreme narrowness in the crotch.
  • The Playboy Strip: Everything is removed except for a long, narrow rectangle of hair.
  • The Brazilian: This is the most famous of the bikini line laser hair removal styles but there is some confusion about its excact form. To some it is the same as the Landing Strip, leaving only a 'vertical stripe of hair'. To still others it signifies the complete removal of all pubic hair.
  • The Sphynx: This is unambiguously the 'everything off' style, leaving a completely hairless pubic region. The name is derived from that of a naked breed of cat from Canada. Some laser clinics and med spas refer to 'the Sphynx' as 'the Hollywood'.

1800LaserHair.com: Another laser clinic directory wannabe spamming Med Spa MD.

Ok, I'm more than just a little tired of some of the bull shit that certain laser clinic and plastic surgery directories spamming the site and posting positive anonymous reviews of their services and laser hair removal listings.

So, there are about to be some very public spankings.

Medical Spa MD has attained some popularity, and some clout with physicians running laser clinics. I receive regular iquiries from docs looking for advice on cosmetic lasers and I personally know of a number of doctors who have printed out reviews from Med Spa MD and asked cosmetic laser sales reps about them. There are laser companies who are now Medspa MD members and (to my current understanding) are welcome members to the community.

However, there are some cheap laser clinc and plastic surgery directories that think that you're an idiot and post comments like those below. (There've also been some physicians offering their 'expertise' as trainers who have tried this to promote their training.) Don't. You've been warned.

1800laserhair.com: I don't know if 1800laserhair.com is posting these comments as part of their corporate policiy or if it's just a rogue individual salesman who's doing it for them. I also don't care. My guess is that they're some small little hack job outfit. It pisses me off personal that whoever this is thinks that this won't be found out.

Here's an example of laser clinc directory, 1800laserhair.com who posted this rave review to Med Spa MD under the name Dr. Don:

I have the two Candelas yag alexandrite and a light sheer diode. I use a service tech that is awesome and reasonable. I can't remember his name right off but I got his name from this great referral network I belong to. Call 1-800 Laser hair ask for Nancy or go to their website WWW.1800laserhair.com There may be a link but I think I got the guys name directly from Nancy. His name is Robert something... BTW anyone slow or having advertising or marketing issues, I am getting tons of referrals from the 1-800-laser hair network. You have to meet their criteria, they are very picky and exclusive but if they will accept you join!!! Two colleagues of mine were denied I am not sure why. The leads are great worth every dime. I resisted their advice at first, them I put my wife in charge of all of it, she followed their program to the letter now we are so overwhelmed with calls for laser (Not really what I want to be doing but I better not complain because laser hair removal is supporting my practice through this crappy economy. Nice plug for them...tell them Dr. Don sent you...I may get some referral bonus!! LOL

Back to Laser Hair removal service. I don't have a service contract. Don't get them. I regularly get laser check-ups. Robert (the service guy) calls my office when he is in my area. By getting him in when he is already in my area he gives me a break on service costs. I get the check-ups and do preventative laser maintenance. Also Nancy (the 1-800 laser hair removal lady) gave me a monthly weekly and daily check list that tells us how to properly maintain our lasers in between service visits. I have not had a significant laser repair cost in 7 years and I haven't had to replace a laser yet going on 10 years. After we got our staff to follow the checklist diligently we saw a significant drop in repair costs. My staff was going through thousands of dollars worth of parts yearly and I was watching our profits go to Candela, I too despise them. They have terrible service and they have been so shady. I think they would sell their grandmothers if they could make a buck!!! Their service contracts are totally over priced. bad plug!!

I really don't use the light sheer much but I keep it for a back up, just in case. Robert can usually fly in for emergency repairs next day. So I have never really needed it.

Posted As: DrDon

Posted Email: wtawtawdba@yahoo.com

Posted Link: www.1800laserhair.com

Comment Posted From This IP Address: user-24-96-114-40.knology.net (24.96.114.40)

I have to laugh at these claims of exclusivity. "You have to meet their criteria, they are very picky and exclusive but if they will accept you join!!!" Sure.

If I were Candela I'd be contacting my legal department about now. This is a perfect case of liable; posting damaging comments as fact under an assumed name. Candella can't be happy that these laser hair removal guys are bad-mouthing them and servicing their lasers at the same time.

Does anyone fall for these laser hair removal guys? I'd be interested in hearing what any identified physician using 1800laserhair.com thinks about their "tons of referrals from the 1-800-laser hair network."

If anyone has an email from 1800laserhair.com that they have archived in their inbox, I'd be interested in seeing it since the IP address is included. We could compare the two. I'd expect that they change their IP address shortly if they happen to match.

PS: This IP address has been banned.

Laser Hair Removal in New Jersey

Via a comment via Andrew D. Swain, Esq.

In New Jersey, laser or IPL hair removal can only be performed by a physician, and the term physician is defined as a person holding a plenary license issued by the New Jersey State Board of Medical Examiners.

New Jersey has consistently recognized that the use of a laser or light based device on a patient’s skin can only be used by a licensed physician. The use of a laser or light based device in a physician’s office is regulated by the State Board of Medical Examiners.

The State Board of Medical Examiners reviewed prior inquiries to determine whether non-physicians can use laser or IPL devices for hair removal. According to published Minutes, the Board has determined that only licensed physicians can use such devices for hair removal. On June 20, 2003, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that laser hair removal can only be performed by a physician.

The June 20, 2003 minutes stated:

b. The Committee reviewed a fax from Wanda Cooper, Sona International Corporation inquiring (1) as to whether a physician assistant is considered a nurse and therefore subject to the ruling of the Board of Medical Examiners regarding Thermolase laser; (2) as to whether the Board of Medical Examiners governs the Physician Assistant Committee and (3) whether a physician assistant can perform laser hair removal under the direct supervision of a physician.

As to the first question, it was the consensus of the Committee that physician assistants are not nurses.

As to the second question, the Board of Medical Examiners governs the Physician Assistant Advisory Committee.

As to the third question,consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform Thermolase laser hair removal as these procedures are deemed the practice of medicine and may not be delegated to a nurse or any other licensed health care professional other than a "physician".

A letter will be sent to Ms. Cooper so advising along with a copy of the statutes and regulations which govern the practice of physician assistants in the State of New Jersey.

On September 19, 2003, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that laser hair removal can only be performed by a physician, and that IPL photofacial or IPL procedures would be referred to the Medical Board to determine their position.

The Board stated:

c. The Committee reviewed a fax from Bryan A. Manhardt, PA-C, Allergy Asthma & Sinus Center, Somerville, NJ 08876, inquiring as to whether procedures for Microderm abrasion, Laser hair removal, IPL photofacial, Botox injections and Collagen injections can be performed under the supervision of a physician. The Committee determined, as to Laser hair removal and Botox Injections, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform these treatments as these are deemed the practice of medicine and may not be delegated to a nurse or any other licensed health care professional other than a "physician".

As to procedures Microderm abrasion, IPL photofacial and Collagen injections there is no policy statement from the Board of Medical Examiners at this time. A letter will be sent to Mr. Manhardt so advising, along with a copy of the draft proposal as it relates to these procedures which is not yet law.

d. The Committee reviewed a letter from Dr. Edwin P. Schulhafer, Allergy, Asthma & Sinus Center, inquiring as to whether nurses, physician assistants or nurse practitioners in the State of New Jersey can perform the following procedures: Laser hair removal; Laser skin rejuvenation; Endomology; Intense Pulse Light (not a laser but a visible light); Botox injections; Collagen injections and Microdermabrasion.

It was the consensus of the Committee that, as to Laser hair removal and Botox Injections consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform these treatments as these are deemed the practice of medicine and may not be delegated to a nurse health care professional other that a "physician". The Committee has no jurisdiction over nurses and nurse practitioners. This inquiry will be referred to the Board of Nursing.

As to laser skin rejuvenation, Endomology, Intense pulse light (not a lser but a visible light), Collagen injections and Microdermabrasion, there is no policy statement from the Board of Medical Examiners at this time. A letter will be sent to Dr. Schulhafer so advising along with a copy of the draft proposal as it relates to these procedures which is not yet law.

On April 16, 2004, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that IPL devices used for hair removal can only be performed by a physician.

The published minutes from April 16, 2004 stated:

b. The Committee reviewed a letter from Jason Staback, PA-C, inquiring as to whether it is legal for physician assistants in the State of New Jersey to use IPL (Intense pulse light) device for the purpose of hair removal, made by Palomar. He stated that it is categorized as a category 2 device. It was the consensus of the Committee that a letter be sent to Mr. Staback advising based on the limited facts presented, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform laser treatments as these procedures are deemed the practice of medicine and may not be delegated to a nurse, or any other licensed healthcare professional other than a "physician". To the current time, the performance of microdermabrasion and glycolic acid peels have also been considered the practice of medicine but unlicensed personnel have been permitted to perform theses procedures under the supervision and direction of a physician . However, please be advised that the Board is further investigating this latter issue and obtaining opinions from appropriate expert professionals. If the Board promulgates a regulation in this regard in the future it will be noticed in the New Jersey Register. Mr. Staback will be so advised.

On September 17, 2004, the committee stated:

The Committee reviewed a letter from Thomas Geary, PA-C, inquiring as to whether a physician assistant in the State of New Jersey can perform hair removal, tatoo removal and resurfacing if the supervising physician is a D.O. The Committee determined that based on the limited facts presented, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform laser treatments as these procedures are deemed the practice of medicine and may not be delegated to a nurse, or any other licensed healthcare professional other than a "physician".

In New Jersey, a physician cannot delegate laser hair removal procedures, laser skin resurfacing, or laser skin rejuvenation, to a physician’s assistant, a nurse, or any other licensed healthcare professional other than a "physician", which is defined as a licensed medical doctor. This position was stated on October 21, 2005, May 18, 2007, and reaffirmed again in September 2007. See Minutes, Physician Assistant Advisory Committee, September 21, 2007.

As recently as January 15, 2008, the New Jersey Board of Nursing did not approve of a licensed practicing nurse to administer IPL therapy. The Nursing Board Minutes stated:

Re: Inquiry from Doug Doyle, Esq., questioning whether Licensed Practical Nurses may administer “intense light pulse” therapy.

The Committee reviewed the e-mail and an article regarding Intense Pulse Light Therapy (IPL). The article stated that “IPL systems work on the same principles as lasers in that light energy is absorbed into particular target cells with color (chromophores) in the skin. The light energy is converted to heat energy, which causes damage to the specific target area.”

The Board of Nursing does not have regulations regarding administration of intense pulse light. On November 16, 2004, the Board of Nursing discussed this issue and made a motion to refer the issue to the New Jersey Board of Medical Examiners concerning the use of medical light–emitting devices (Lasers).

Consistent with the Board’s decisions of November 16, 2004, the Committee recommends that Mr. Doug Doyle’s question be forwarded to the New Jersey Board of Medical Examiners for review and comments.

As of 2008, the New Jersey Board of Medical Examiners consistently has taken the position that the use of laser or IPL device is the practice of medicine.

You can search the website of the New Jersey Board of Medical Examiners to review meeting minutes to update the above research. http://www.state.nj.us/lps/ca/bme/minutes/bmemin.htm. And, you and your employer should consider consulting an attorney or the medical board in your state for further clarification.