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Laser & IPL Transgender protocols

Written by Ruth Nicholson on April 17th, 2019.      0 comments

Laser & IPL Transgender protocols

By Ruth Nicholson – NZ Laser Training Ltd

As professionals offering hair reduction in a modern age, you are likely to come across transgender clients seeking hair removal. These are clients who were born as males but who now seek to live as females, this group may also include people born as males but with some female genitalia, or those who have chosen to identify as female. Should your laser or IPL technology be suitable to conduct these treatments, you may appreciate some tips and guidance from our experience.

Firstly, what does your consent and consultation form state? – perhaps its time to update this to reflect the options people prefer to use. Or at least add ‘prefer not to state’ as an option.

Check out this site for ideas and discussions: UX Collective
Ensure you discuss the use of before and after photos and the reason they are taken – for example stating that these are never used without the persons consent, not shown at staff trainings, or used in media or promotions without permission. You should be able to confidently express that all pictures taken are stored securely on a password encrypted storage system. Explain the benefits of before and after imagery in following progress and celebrating successes.
Ensure privacy for undressing and preparing for treatment sessions – just like all other clients transgender clients may feel embarrassed about revealing areas of their body they do not wish to have treated (yet), in our experience they may even be heavily covered up and it is tricky to get to the area you are aiming to treat. I.e.: neck and face to be treated but wearing a high-necked top, or scarf. Items of clothing can pose a fire risk, especially if they are dark in colour, made from flammable materials or within striking distance of the laser. IPL is much less risk, but you can still singe clothing. Use of light-coloured towels for draping is essential – as is ensuring the client feels comfortable. They might like to keep their shoes on.
Preparing the skin before treatment will mean a better treatment outcome and a safer treatment. Shave the skin smooth on the day of the treatment (think 5 o’clock shadow) – often shaving the night or day before isn’t close enough. Always wash the area to be treated in case of tinted moisturiser, sparkly make-up, bronzers and make-up. We need clean dry skin to treat, then apply a layer of ultrasound gel.
We recommend the use of gel as a buffer for the epidermis, it will not cool the skin down as it will absorb the skins heat within seconds; however, it does provide a little more protection and shows the operator where they have already treated. Select lower fluence settings and lower pulse durations taking into account how dense the hair is, how dark it is, and how thick it is at the time of treatment. Our goal is to change these settings as treatments progress. This information should form part of your clinical training.
Pre-cooling is essential as this provides adequate pain relief and should never be skipped or done too quickly. Taking time to pre-cool the skin before each shot will mean a comfortable treatment and a client who is confident in the operator. Use your handpiece to cool the skin prior to every shot, and place back or keep there for post-cooling. Adequate cooling reduces side effects too.
Communication about hair re-growth and treatment plans form part of every treatment. With beard and chin area hair growth actively growing for 1 year, and 70% of those hairs being present at any one time, you can achieve great reduction especially if you know that waiting 7 – 10 weeks in between so resting (telogen) hairs can come back into growth phase will then be treated successfully too. Spacing appointments further apart is more successful than closer together. For example, it used to be taught that treatments should be conducted 4 weeks apart for every visit on-going, however newer teaching (past 8-10 years) is now based on individual growth phases for each specific area. Clear discussions on what to expect in between sessions is going to include that hair re-growth will be patchy and uneven, and that any red, grey, white or ginger hairs will not be successfully treated and that electrolysis is the only permanent fix for these remaining hairs.
Matching technology to skin type: If you are planning on treating light Fitzpatrick IV skin types with your visible light spectrum device, be that a laser or an IPL, be warned about additional cooling and be on the look out for increased pain feedback from the client, and erythema, this can indicate excessive thermal energy is building up in the upper epidermis and can definitely cause pigmentary issues such as hyper-pigmentation, or hypo-pigmentation.
This is our recommended best practice for skin typing and hair removal:
Device type Wavelength Suitable for skin type Comments

Device type

Wavelength

Suitable for skin type

Comments

Visible light IPL

610nm – 1200nm

FP I- III

Watch out for chronic tanned clients as you will also attract to melanin in sun damage

Visible light IPL

695nm – 1200nm

FP – I - IV

Watch out for chronic tanned clients as you will also attract to melanin in sun damage

Infrared light IPL

750nm – 1200nm

FP I – IV

May be suitable on FP V but with safer settings

Infrared light lasers

755nm (Alexandrite)

FP I - IV

May be suitable on FP V but with safer settings

Infrared light lasers

800nm series (Diode)

FP I – V

Great option for Polynesian and Maori skin types

Infrared light lasers

1064nm (Nd:Yag)

FP I – VI

Great option for Polynesian and Maori skin types, and the only safe option for anyone with African descent, or darker FP V Polynesian, or Maori skin typing

Q – Switched laser

Such as those used for Tattoo removal

FP I- IV (1064nm) – used to treat fluffy vellus hairs such as those seen on then face

Not suitable for darker skin types due to competing targets and ultra short burst pulse durations



































In summary: additional care, respect and safety measures need to be catered for when offering to treat transgender clients, this is not an opportunity to jump on the bandwagon and take advantage of clients desperate for a result with hair removal. If you do not have adequate technology, lack confidence to your clinical approach or do not know where to start, please seek additional training. Providing amazing results in a safe and professional environment is extremely rewarding as is seeing less and less hair on subsequent visits. The expectation should be approximately 10-15% reduction each and every treatment, with a total of between 8-10 sessions in total required. If you are still flashing away after 8-10 and the hair is still coming through, your wavelength is too short and you are waxing with light. Might be time to revise your technology and treatment approach.
Topics: Laser and IPL
 

Comments

Email me when new posts are made to this blog

Laser & IPL Transgender protocols

Written by Ruth Nicholson on April 17th, 2019.      0 comments

Laser & IPL Transgender protocols

By Ruth Nicholson – NZ Laser Training Ltd

As professionals offering hair reduction in a modern age, you are likely to come across transgender clients seeking hair removal. These are clients who were born as males but who now seek to live as females, this group may also include people born as males but with some female genitalia, or those who have chosen to identify as female. Should your laser or IPL technology be suitable to conduct these treatments, you may appreciate some tips and guidance from our experience.

Firstly, what does your consent and consultation form state? – perhaps its time to update this to reflect the options people prefer to use. Or at least add ‘prefer not to state’ as an option.

Check out this site for ideas and discussions: UX Collective
Ensure you discuss the use of before and after photos and the reason they are taken – for example stating that these are never used without the persons consent, not shown at staff trainings, or used in media or promotions without permission. You should be able to confidently express that all pictures taken are stored securely on a password encrypted storage system. Explain the benefits of before and after imagery in following progress and celebrating successes.
Ensure privacy for undressing and preparing for treatment sessions – just like all other clients transgender clients may feel embarrassed about revealing areas of their body they do not wish to have treated (yet), in our experience they may even be heavily covered up and it is tricky to get to the area you are aiming to treat. I.e.: neck and face to be treated but wearing a high-necked top, or scarf. Items of clothing can pose a fire risk, especially if they are dark in colour, made from flammable materials or within striking distance of the laser. IPL is much less risk, but you can still singe clothing. Use of light-coloured towels for draping is essential – as is ensuring the client feels comfortable. They might like to keep their shoes on.
Preparing the skin before treatment will mean a better treatment outcome and a safer treatment. Shave the skin smooth on the day of the treatment (think 5 o’clock shadow) – often shaving the night or day before isn’t close enough. Always wash the area to be treated in case of tinted moisturiser, sparkly make-up, bronzers and make-up. We need clean dry skin to treat, then apply a layer of ultrasound gel.
We recommend the use of gel as a buffer for the epidermis, it will not cool the skin down as it will absorb the skins heat within seconds; however, it does provide a little more protection and shows the operator where they have already treated. Select lower fluence settings and lower pulse durations taking into account how dense the hair is, how dark it is, and how thick it is at the time of treatment. Our goal is to change these settings as treatments progress. This information should form part of your clinical training.
Pre-cooling is essential as this provides adequate pain relief and should never be skipped or done too quickly. Taking time to pre-cool the skin before each shot will mean a comfortable treatment and a client who is confident in the operator. Use your handpiece to cool the skin prior to every shot, and place back or keep there for post-cooling. Adequate cooling reduces side effects too.
Communication about hair re-growth and treatment plans form part of every treatment. With beard and chin area hair growth actively growing for 1 year, and 70% of those hairs being present at any one time, you can achieve great reduction especially if you know that waiting 7 – 10 weeks in between so resting (telogen) hairs can come back into growth phase will then be treated successfully too. Spacing appointments further apart is more successful than closer together. For example, it used to be taught that treatments should be conducted 4 weeks apart for every visit on-going, however newer teaching (past 8-10 years) is now based on individual growth phases for each specific area. Clear discussions on what to expect in between sessions is going to include that hair re-growth will be patchy and uneven, and that any red, grey, white or ginger hairs will not be successfully treated and that electrolysis is the only permanent fix for these remaining hairs.
Matching technology to skin type: If you are planning on treating light Fitzpatrick IV skin types with your visible light spectrum device, be that a laser or an IPL, be warned about additional cooling and be on the look out for increased pain feedback from the client, and erythema, this can indicate excessive thermal energy is building up in the upper epidermis and can definitely cause pigmentary issues such as hyper-pigmentation, or hypo-pigmentation.
This is our recommended best practice for skin typing and hair removal:
Device type Wavelength Suitable for skin type Comments

Device type

Wavelength

Suitable for skin type

Comments

Visible light IPL

610nm – 1200nm

FP I- III

Watch out for chronic tanned clients as you will also attract to melanin in sun damage

Visible light IPL

695nm – 1200nm

FP – I - IV

Watch out for chronic tanned clients as you will also attract to melanin in sun damage

Infrared light IPL

750nm – 1200nm

FP I – IV

May be suitable on FP V but with safer settings

Infrared light lasers

755nm (Alexandrite)

FP I - IV

May be suitable on FP V but with safer settings

Infrared light lasers

800nm series (Diode)

FP I – V

Great option for Polynesian and Maori skin types

Infrared light lasers

1064nm (Nd:Yag)

FP I – VI

Great option for Polynesian and Maori skin types, and the only safe option for anyone with African descent, or darker FP V Polynesian, or Maori skin typing

Q – Switched laser

Such as those used for Tattoo removal

FP I- IV (1064nm) – used to treat fluffy vellus hairs such as those seen on then face

Not suitable for darker skin types due to competing targets and ultra short burst pulse durations



































In summary: additional care, respect and safety measures need to be catered for when offering to treat transgender clients, this is not an opportunity to jump on the bandwagon and take advantage of clients desperate for a result with hair removal. If you do not have adequate technology, lack confidence to your clinical approach or do not know where to start, please seek additional training. Providing amazing results in a safe and professional environment is extremely rewarding as is seeing less and less hair on subsequent visits. The expectation should be approximately 10-15% reduction each and every treatment, with a total of between 8-10 sessions in total required. If you are still flashing away after 8-10 and the hair is still coming through, your wavelength is too short and you are waxing with light. Might be time to revise your technology and treatment approach.
Topics: Laser and IPL
 

Comments

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