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Get Your Legs Ready for Summer

North Idaho Business Journal for Women. Feb 2006.
by Kevin M. Johnson

It's still pretty cold outside and the last thing most people are thinking about is how their legs look in shorts. Aside from a few brave members of the Polar Bear Club, after a holiday season of treats of all kinds and Mom's home cooking, the thought of putting on a swimsuit or is downright horrifying to many. Well, believe it or not, now is a great time to start working on the appearance of your legs for the upcoming spring and summer months. We all have the New Years resolution to eat right, exercise and shed some excess pounds. But what are we doing about the outward appearance of our legs. Two major areas of improvement can be focused on during the dark winter months: removal of unwanted hair and elimination of varicose and spider veins. Both of these common problem areas can be easily treated with lasers.

Laser hair removal (LHR) is the most commonly performed procedure in the rapidly growing field laser aesthetics. Of the 4.4 million laser aesthetic procedures performed in 2005, 1.5 million were for hair removal. LHR can be performed with a variety of different lasers varying in wavelength, strength and depth of penetration. Meaning: "Not all lasers are created equally."

Here is a limited list of the oldest to newest hair removal lasers:

  • 1st generation Ruby lasers with a 694 nm wavelength (Epilaser™, Epitouch™)
  • 2nd generation Alexandrite 755 nm wavelength (Epitouch ALEX™, Photogenica LIPR™, Gentle LASE™)
  • 3rd generation Diode lasers with an 800-810 nm wavelength (LightSheer™, Apex™) and now the most versatile and powerful
  • 4th generation Nd:Yag 1064 nm laser (Cutera Coolglide™)

The older generations with flashlamp intense pulsed light and shorter wavelengths can produce good results in some cases, but because of the lower energy delivered can scatter and not penetrate the roots of the hairs. This results in a "stun" of the hair follicle and root as opposed a "kill." This results in an unacceptable amount of hair regrowth even after many intense pulsed light hair removal treatments. The 1064 nm laser's single longer wavelength allows greater variability in energy delivery. The energy delivered and the pulse width (the split-second time period the laser is delivering energy) can be adjusted based on skin type, hair color, and hair density in order to achieve the best results for each patient. And the contact cooling of the Cutera Coolglide™, laser is rated 10 times more effective than the 800nm lasers, resulting in more comfortable and safe treatment.

The most common areas for LHR in women are: upper lip, chin, bikini line, under arms, and of course legs. In men, the most common areas are: shoulders, back of neck, back and the beard area of the neck and face. The benefits of LHR compared to electrolysis, waxing and tweezing are: longer lasting results, less discomfort and less hair regrowth. The best anyone doing LHR can guarantee is permanent hair reduction. If you are told something different, you may want to do some more research. One can achieve excellent results with appropriate treatment and attention to detail. If hair does grow back after a series of effective treatments, it is usually finer in texture and lighter in color than the original hair. LHR should be performed in a series of at least five treatments spaced six weeks apart, so it's not too early to start.

Varicose veins, A.K.A. "very close veins" affect roughly 50 percent of the adult population of the U.S. Until recently surgical or medical treatment was rarely offered to patients with asymptomatic varicose or spider veins and as for the symptomatic varicose veins, patients could look forward to having their veins "stripped" out under general anesthesia in a hospital with a difficult recovery and sometimes marginal results. During the last five years new technology and treatment strategies have revolutionized the field of varicose vein treatment. Asymptomatic vein therapies are still not covered by medical insurance. However, less invasive procedures can eliminate unsightly veins that tend to make many people hesitate to put on a pair of shorts when the weather improves. Using a long wavelength 1064 nm laser, a surgeon can eliminate these superficial veins by delivering laser energy through the skin targeting only the vein. The science behind this phenomenon is called selective photothermolysis. Laser energy is absorbed by hemoglobin in the blood of the targeted vessel causing the vessel to disappear. Larger, symptomatic varicose veins can be very carefully evaluated with respect to their source. Back pressure in the veins is the root cause of worsening appearance and symptoms of these large ropey veins. Using ultrasound, one can determine the location of the faulty valve and tailor treatment to the individual patient. Treatments for these larger veins are in fact covered by insurance, including Medicare, and are performed now in the office, under local anesthesia, as an outpatient, with minimal discomfort and down time. Other forms of minimally invasive interventions in our arsenal for varicose and spider veins include microphlebectomy and sclerotherapy.

Microphlebectomy involves the physical removal of enlarged varicose veins through tiny incisions under local anesthetic. Sclerotherapy is performed by injecting an irritating solution (sclerosant) into spider veins with very small needles. The vein lining is irritated, it clots and eventually disappears. Based on these minimally invasive approaches to varicose veins, physicians, in increasing numbers are now more likely to refer patients for treatment and patients are now more frequently than ever before seeking out help for their unsightly and symptomatic varicose veins. Lasers are powerful tools. As always, with any aesthetic laser procedure being offered, it is essential for you to find out about the laser being used, the training and experience of the person performing the treatments, and the presence and degree of oversight by a medical doctor in the facility where laser procedures are being performed.

- Kevin M. Johnson, M.D., F.A.C.S. is a general and vascular surgeon and co-owner of Reflections Med Spas / The Laser & Vein Center, PLLC, in Coeur d'Alene. He can be reached at (208) 676-8346.

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