In today's episode, Mike and Lisa look at the complexities of safely and effectively treating deeper skin tones, particularly those with higher melanin concentrations. They discuss the importance of understanding how melanin affects laser treatments, noting that darker skin absorbs more energy, which can lead to increased risks of cellular damage and pain. Both Mike and Lisa challenge common misconceptions about using lower fluences for darker skin, advocating instead for higher fluences combined with enhanced cooling techniques to achieve optimal results.

KEY TAKEAWAYS

• Darker skin has a higher concentration of melanin throughout the epidermis, which absorbs more light energy from lasers, potentially leading to increased temperatures and a higher risk of cellular damage.

• Contrary to common training advice, using lower fluence and longer pulse widths on darker skin can be counterproductive. Lowering fluence reduces the total energy available for treatment, making it less effective.

• The ND:YAG laser at 1064 nanometers is preferred for treating darker skin tones because it is absorbed less by melanin, allowing more energy to reach the dermis where treatment is needed.

• Increased cooling time is essential when treating darker skin to mitigate the higher temperatures generated by increased melanin absorption. Recommended cooling times may be longer for darker skin compared to lighter skin.

• Practitioners should exercise caution when treating darker skin tones, especially if they are inexperienced. It is advisable to gain more experience before attempting treatments on darker skin to ensure safety and effectiveness.

BEST MOMENTS

"Darker skin has more melanin than lighter skin. In lighter skin tones, we tend to find most of the melanin resides in the basal layer."

"Lowering the fluence is a bad idea. That's just never going to work. You'll end up doing many, many more treatments and you might never get a good result."

"If you're going to use high fluences, then you must use much more cooling to compensate before and after the treatments."

"The melanin is a barrier, yes, essentially, and it steals energy."

"As the skin tone gets darker, you just got to be much more careful. That's basically it in a nutshell."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa delve into a concerning trend in the laser and IPL industry: the potential capping of fluence output by machine manufacturers. They discuss recent experiences shared by practitioners who found their machines unable to deliver the higher fluences promised in their manuals, raising questions about the implications for treatment efficacy. Mike and Lisa advocate for the need to empower users with the ability to access the full potential of their devices, rather than imposing arbitrary limits that could hinder results.

KEY TAKEAWAYS

• There is a growing concern in the industry regarding laser suppliers potentially capping the fluence output of their machines, which may limit practitioners' ability to achieve optimal results.

• Limiting the fluence can significantly affect treatment outcomes, particularly in procedures like hair removal and vascular treatments, where higher fluences are often necessary for effective results.

• The practice of capping machine outputs suggests a lack of trust in practitioners' abilities and highlights the need for better training. Proper training should empower users to operate machines at their full potential safely.

• The analogy of buying a car that is limited to a certain speed illustrates the frustration practitioners may feel when they are sold equipment that cannot perform to its advertised specifications.

• Effective cooling techniques are crucial when using higher fluences. Practitioners should be trained to understand the balance between delivering effective energy and ensuring patient safety through proper cooling methods.

BEST MOMENTS

"Are laser suppliers capping the amount of fluence that their machines are putting out for their clients or the practitioners?"

"It's kind of like the manufacturer saying, well, we don't trust you to use the machine to its full capacity."

"If you're being limited in what you can deliver to the skin, then that will limit your results, no doubt about it."

"If the company is selling you a machine and they are either capping or limiting it, then the company is not providing you with the proper service."

"It shows a lack of trust in your customers, and it also shows, to me, a lack of proper training."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa delve into a recent critique of their training methods regarding laser hair removal, specifically addressing concerns raised by a laser supplier about their promotion of higher fluences and external cooling techniques. Mike & Lisa clarify the science behind pulse widths, fluences, and the importance of targeting stem cells rather than just the hair itself. Mike and Lisa also touch on the implications of using higher fluences on handpiece longevity and the overall effectiveness of treatments, encouraging practitioners to prioritize results and client satisfaction.

KEY TAKEAWAYS

• The relationship between pulse width and fluence is crucial in laser hair removal. A higher fluence can lead to longer pulse widths, but the key factor is ensuring that the energy delivered is sufficient to heat the stem cells effectively, regardless of the pulse width.

• Pre-cooling the skin with ice packs before treatment can significantly reduce pain and the risk of unwanted side effects, such as blistering and pigmentation changes. This allows practitioners to use higher fluences safely.

• The denaturation time, which is the time required to irreversibly damage the target cells, is more critical than the pulse width alone. The temperature and duration of exposure are what ultimately determine the effectiveness of the treatment.

• The podcast discusses criticism of their training methods, particularly regarding the use of higher fluences. They argue that using higher fluences with proper cooling leads to better results, even if it may reduce the lifespan of the handpieces.

• There are common misconceptions in the industry about starting with low fluences and gradually increasing them. The podcast emphasizes the importance of starting at the correct fluency from the beginning to achieve effective results without unnecessary delays.

BEST MOMENTS

"We promote skin cooling, higher fluence, which in diodes equals longer pulse width. They're saying that will be bad for the treatment because they believe you should have a short pulse width."

"If you use a lower fluence, that means you're firing in less energy. And less energy means lower temperatures. Lower temperatures mean you need much longer times to cook the cells."

"The temperature of the hair is, like I said, pretty much irrelevant. What is important is getting the right amount of energy into the hair."

"If you're going to end up sitting there with a lot of disgruntled clients... then that's not good for your business or your reputation."

"The higher the fluence, the shorter the time you need to denature the cells. And that's why the pulse width becomes unimportant."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa interview Caroline McLean, an advanced skin practitioner from Skinology in Glasgow, who shares her extensive 20-year experience in the industry. They discuss Caroline's unique approach to using IPL for pigmentation, which contrasts with Mike and Lisa's established protocols. Caroline elaborates on her combination therapies, including the use of a cold laser bionic and CO2 treatments.

KEY TAKEAWAYS

• Caroline McLean utilises a unique IPL protocol for treating pigmentation, which involves higher fluence settings and double passes, contrasting with traditional methods. This approach allows for immediate darkening of the pigment, indicating effective treatment.

• Cooling the skin before, during, and after IPL treatments is crucial. Caroline emphasises the need for thorough cooling to minimise erythema and edema, ensuring client comfort and optimal results.

• Clients are advised on aftercare, including cooling the skin, avoiding acids and retinoids, and using recovery balm. This helps manage expectations regarding the healing process and potential side effects like tenderness and swelling.

• Caroline integrates various treatments, such as LED therapy (Dermalux) post-IPL, to enhance healing and monitor skin reactions. This holistic approach combines skincare, lifestyle factors, and treatment modalities for better outcomes.

• A significant part of Caroline's practice involves educating clients about their skin conditions, treatment processes, and realistic outcomes. This includes discussing the importance of skin preparation and the potential need for multiple sessions to achieve desired results.

BEST MOMENTS

"I will usually do two passes and kind of cross hatch them. I want to see that pigment getting darker."

"I don't treat darker skin tones, so I wouldn't treat any sort of Asian skin tones or any mixed skin tone with an IPL."

"The biggest combination therapy is combining your skincare with your treatments with your lifestyle and your holistic sort of side of it as well."

"I want to know how they're going to respond to something. If they then come back to me and their skin is not recovering, then that's on me."

"I think it would have to be my severe inflammatory acne clients, being able to help somebody heal their skin is pretty amazing."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In today's episode, Mike and Lisa dive into the fundamental concepts of laser physics through a fun "Explain Like I'm Five" format. They explore key terms such as fluence, pulse width, and wavelength, breaking down complex ideas into simple analogies. Mike explains how fluence, measured in joules per square centimeter, is crucial for achieving effective results in laser treatments, while pulse width is likened to the duration of a bus journey delivering energy to the skin.

KEY TAKEAWAYS

• Fluence refers to the concentration of energy delivered to the skin during laser treatments, measured in joules per square centimeter. It is crucial for achieving effective results in procedures targeting hair follicles, blood vessels, and pigmentation.

• There is a minimum threshold fluence that must be exceeded for a treatment to be effective, as well as a maximum threshold to avoid causing damage to surrounding skin tissues. Finding the right range of fluence is essential for successful outcomes.

• Pulse width (or pulse duration) is the length of time that energy is delivered to the skin. It can vary significantly depending on the type of laser used, and it does not directly correlate with the reaction time of the tissues being treated.

• Wavelength determines the color of the light used in treatments and is measured in nanometers. Different wavelengths penetrate the skin to varying depths, which affects their effectiveness in targeting specific structures like hair follicles or blood vessels.

• The concept of useful penetration depth combines both wavelength and fluence. It is important for ensuring that the energy delivered can effectively reach and treat the intended target within the skin, especially for deeper structures.

BEST MOMENTS

"Fluence is basically how concentrated the energy is on the skin surface, in a spot."

"To me, fluence is king. That's the main driver of pretty much all these reactions."

"So fluence is basically your make or break for any of these treatments that we are doing?"

"Pulse width is just a technical thing designed into the laser, but it doesn't actually translate into the cooking or the denaturation process within the tissues."

"There's no point the bus of photons reaching the target if they're all tired and they can't do anything."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa delve into the complexities of online forums related to laser treatments, including laser hair removal and tattoo removal. They express their concerns about the often toxic environment of social media, where misinformation can spread easily and new practitioners may take inaccurate advice as gospel. The duo emphasise the importance of conducting thorough research and seeking multiple perspectives before accepting any information found online.

KEY TAKEAWAYS

• Social media forums, especially those related to laser treatments, can provide both valuable information and misleading advice. It's important to verify information from multiple sources rather than accepting it at face value.

• When seeking information, it's advisable to consult scientific literature and various reports from different researchers to form a well-rounded understanding, rather than relying on a single source.

• Healthy debate and discussion in online forums are crucial for community learning. However, some groups may suppress differing opinions, which can hinder the sharing of accurate information.

• It's important to recognise that even experts can be wrong. Updating knowledge based on new evidence is a sign of growth and should be embraced.

• Many individuals in these forums are seeking support and guidance. It's essential to foster a respectful and helpful environment rather than engaging in ego-driven arguments.

BEST MOMENTS

"I'm just getting a bit sad about some stuff online and want to put it out there, really, see your thoughts."

"If you do see stuff on the Facebook forums or any kind of forum, do your own research to back it up or get some different opinions."

"The problem is that if people are just being deleted or blocked, then the argument is essentially being shut down."

"I'm happy to say that previously, a couple years ago, my information was incorrect. I've updated it and now the information I'm putting out there, hopefully, is correct."

"Some people are just like arguing in the comments about who's better."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this week's episode, Mike and Lisa look into the intriguing relationship between waxing and laser hair removal treatments. They explore the traditional belief that waxing should be avoided before laser treatments due to the risk of removing the hair target, but Mike presents a compelling argument based on the biology of hair growth phases. They discuss the importance of melanin in targeting hair follicles and suggest that waxing may actually enhance the effectiveness of laser treatments by reducing pain and minimizing harmful plume exposure for operators.

KEY TAKEAWAYS

• Traditionally, it has been advised not to wax before laser treatments because waxing removes the hair, which is the target for laser energy. However, recent discussions suggest that waxing may not be as detrimental as previously thought, and could potentially be beneficial.

• The hair growth cycle consists of three main phases: anagen (growth), catagen (transitional), and telogen (resting). Only hairs in the anagen phase can be effectively targeted by laser treatments, as they contain melanin, which is necessary for the laser to work.

• Melanin is the target chromophore for laser hair removal. While it is typically found in the hair shaft, significant amounts of melanin are also present at the base of the hair follicle, which can be targeted even if the visible hair is not dark or fully developed.

• Waxing can reduce pain during laser treatments by removing visible hair that could generate heat and discomfort. Additionally, it minimizes the amount of plume (burnt tissue) released into the air, which can be harmful to both clients and operators.

• There is speculation that waxing may help synchronize hair growth cycles, leading to more effective laser treatments. However, more research and real-life examples are needed to confirm this theory and determine the best protocols for combining waxing and laser treatments.

BEST MOMENTS

"So the interesting thing that I realised while studying all this was that the new hair shaft is growing or starts to grow in anagen 3. It's not fully melanised until late in anagen 3."

"So, any hair we can see that's not in catagen or telogen must be in late anagen. And that's good for us."

"If you hit those with laser IPL light, it makes no difference. If it's an anagen, it means the follicle is already in the subcutis, in the fatty tissue."

"If you wax them before you do the treatment, then immediately after the treatment, there's no visible hairs at all."

"So I suspect that if you were to wax and then treat with laser IPL, you'd probably have a hair-free environment for quite some time."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com

In this episode, Mike and Lisa discuss the exciting news of Mike's recent election as chairman of the Association of Laser Safety Professionals (LPA). They talk through the organisation's mission to promote laser safety across various sectors, including clinics and industrial settings. Mike shares insights about the role of Laser Safety Officers (LSOs) and the new online course he's developing to train them, emphasising the importance of safety in laser use.

KEY TAKEAWAYS

• Mike Murphy has been elected as the chairman of the Association of Laser Safety Professionals, which aims to raise awareness of laser safety across various sectors, including clinics, scientific establishments, and industrial settings.

• The organisation is looking to modernise its approach by utilising social media and enhancing its online presence, with plans to offer a new course for Laser Safety Officers (LSOs) that will be available on an online teaching platform.

• The new course for LSOs consists of four modules and includes a multiple-choice exam with 50 questions and a 90% pass mark. It is designed to be an open book exam, allowing participants to reference course materials.

• There is a distinction between Laser Protection Advisors (LPAs) and Laser Safety Officers (LSOs), with LPAs providing support and conducting assessments, while LSOs are responsible for ensuring safety on the ground in facilities using lasers.

• The chairman aims to engage insurance companies to recognise the value of accredited LSOs, potentially providing benefits to clinics that employ them, thereby enhancing safety standards in the industry.

BEST MOMENTS

"I was elected as chairman of the association of laser safety professionals, which is a small organization of laser protection advisors based in the UK."

"We're going to start using this new thing that we just heard about. It's called social media."

"Laser Protection Advisors are there to support Laser Safety Officers."

"If you get the passport, then you've got a certificate. But we're always here behind that to support you."

"It's important to have even more strings to your bow to help with that."

ABOUT THE HOSTS

Mike began his career in medical lasers in 1986 with a physics degree and a post-grad in bioengineering. He helped develop the scar-free removal of tattoos using a Q-Switched Ruby Laser in Glasgow, and the world's first IPL system. Known well in the industry for his hard truths, no BS attitude and logical answers. As the author of three books, articles for medical journals, a well read blog, a Laser Protection Advisor and contributor to the BMLA, Mike is the Laser Guru.

Lisa's claim to laser fame is being Mike's daughter. Growing up with lasers and never avoiding a physics lesson from her Dad, it was natural to enter the industry. Leaving a corporate career with a baby to jump into self employed life came with challenges. Despite that Lisa has been well recognised for her teaching style, practical tips, bringing the compassion to the science, and laser mentoring.

Instagram: @dermalase_lasertraining

https://mikemurphyblog.com

https://www.dermalasetraining.com