You are listening to The La Jolla Cosmetic Podcast.

Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And today I have Brittany Haley, you've probably know her as the laser queen. She's a national trainer for Sciton, and she's been working with lasers for a long time. So welcome, Brittany.

Good morning. Thanks for having me.

Good morning. So tell us how long you've been working with lasers.

I was first trained on my first laser back in 2010, so it's been 13 years. It's been a long time. Wow. Yeah.

That's a lot of passes with the wand, right?

That's a lot.

Yeah, thousands and thousands I'm sure. And what I really wanted to talk about today, we've got Halloween season coming up and it's kind of the spooky time of year.

Perfect laser season. No better time.

Oh, exactly. Spooky season. So, I wanted to talk about fears since we're talking about spooky time. What are the common fears that people have? And so any guess what a big fear is or from what your perspective is, Brittany, what is maybe in consult, what you hear from people as their biggest fear?

Definitely. I mean, there's a few things that almost everyone is worried about and is this the right treatment for me? That comes up a lot. Is this the right treatment? And there's so many devices out there, how do I know? I feel like the information out there can be very overwhelming, especially for somebody who has no previous laser skincare experience. And so I think that's the question I get almost right off the bat is there's so many things out there, I'm so overwhelmed, how do I know this is the right treatment for me? And with that, you really have to be talking to somebody who knows their devices and has laser experience and then also that they're really examining your skin. So when I do a laser consult, I talk to the patient about what their main goal is. If they have one spot and they want that spot off and I take a good look at it and I say, this is probably what we need to do to get it off. If that doesn't work, we probably have another option. But I make sure that they have a clear understanding and confidence in me that I know my devices and I know what they can and can't do.

And I think that makes a lot of sense when you're talking about not just like I want to treat sun damage or I want to treat wrinkles, but all the devices that, yeah, it's like will this work for me? But how do I know which one to pick? And then even if I go to some laser center, how do I know that they're not going to sell me the one that they like the best, that might not be the right thing for me. And how many lasers do you work with at La Jolla Cosmetic, Brittany?

We have all of the basic categories. So when I think about lasers, I think about probably six kind of basic categories. And we have one in each category and sometimes we have multiple options in each category. So having that at our facility lets us be able to choose without a sales presence or a smaller practice over our head, which ones we know will work. And I combine lasers for almost every treatment. I have lasers that work really well for red, but they don't do anything really for pores or I have lasers that will really efficiently remove a flat brown spot, but they won't remove a raised one. And I know that and I know how to combine them to make the treatment customized for each patient. When you look at someone who has a smaller office and they don't have lasers or they have one laser, they're not going to have that option. They have what they have and maybe it can do one thing really well and two things kind of well, but they're still going to sell it to you like that. Whereas we have the option with giving you what, in my honest opinion, is the best for each thing.

Yeah, that makes a lot of sense in terms of feeling comfortable that I'll get to my goal. You can use any combination of things to help me get there.

Definitely.

All right. Another big fear, and this is one that I have personally,

I think I can guess I have an idea, but go ahead.

Will it hurt, will it hurt Brittany? And how do we address that? How do you address that during the treatment and even when you go home, what's that like?

Yes, and that's so valid. And in nursing school they teach us that pain is whatever the person experiencing pain says it is. We have different medical conditions, we have different things that affect our pain levels, our pain tolerance in that day, in that hour overall. And so it is what it is. And these treatments are designed to get results. They're not designed to feel good, they're not relaxing treatments, and we want the results. And the question is how much are we able to tolerate? Are we able to feel? And we have so many options from you feel like you're the kind of person who can go get a cavity without Novocaine. Sure you can do anything and not need anything. But then we also have options for people who don't want to feel anything. So if you're one of those people that don't want to feel anything, we can make that happen for you.

(05:42)
We have options from very strong topical numbing creams, different kinds and different strengths. We have options for over the counter pain medication, alternative pain medication, traditional narcotic pain medication. We also offer laughing gas. So that's something else that we offer on top of all that. And then just in general, the provider is very important also in the experience and relieving anxiety in regards to the procedure. So we are all well trained here where we know when you have goggles on and you don't know what's going on, you need to be walked through every step. And sometimes that's all people need is just some comfort that they know what's going on with their eyes closed.

That's a really good point. As you're laying there, you don't know what to expect. And I remember one time you were helping me treat a bruise and you're like, okay, now it's going to snap. And you kind of described it for me so that when it happened, it was like, oh, okay, I've heard it. I can't see it, but I know what to expect and there might be a light that I can see come through or something like that. So I think that's really nice to have the provider walking them through it. I think that's a really good point.

Totally. And it's a skill. I really believe that it is a skill. It can be learned, but it takes practice. And when I'm teaching people how to use these devices, I'm like, this is very important. The last thing we want is our patient to be jumping off the table. I want you to be underwhelmed when you fill the pulse of the laser, that's the goal.

So keeping patients comfortable. You mentioned a whole bunch of ways during when they go home, is there a lot of pain or any pain?

Not usually.

And maybe does it matter which laser they have?

Yes, we have a vast array of lasers. We have ones that are very, very light treatments that will simply maybe remove a freckle. And then we have lasers that are a lot stronger that can help remove wrinkles from your skin. And so based on that spectrum, you might have a little bit of heat swelling, mild discomfort when you are home. But for the majority of our treatments, it feels a little bit warm and that's it. There's not anything excruciating requiring a long course of narcotic pain medication. We don't have anything that really necessitates that.

Well, that's good to know. So then I think another fear is that what if it doesn't work? Or how many times will I need to do this to get to my goal? And how do you address that?

I think that's very valid as well. And maybe someone's had a previous poor experience where they were promised something and it didn't work. So I think this is so important to address in the consultation, number of treatments, being realistic about how many you'll need. And we do consultations for all our laser treatments and we're very upfront about it. And I tell people, yeah, it'd be nice if it worked with one treatment, but it's not a magic eraser. These are devices that we use that help. And we are practicing a type of medicine here so everyone can respond differently. So we try and give really realistic expectations in terms of that. But I know when I, and I am someone who's confident in their device can tell you, Hey, we'll see this with one treatment. We'll see this with two treatments and this is how many you'll need.

(09:03)
So you can set clear expectations about what you'll see with each one. We don't have a treatment I can think of where you won't see nothing from the treatment. And in that case, if something was very wrong, the treatment was done maybe at a different, too low of a setting, that kind of thing, then we are not going anywhere. We're here for you. We're here to take care of you. And I think followup's really important. So having a direct form of communication between the patient and the provider, meeting expectations, all of those go in. And that's something that we do here. We're not going to just zap you and never see you again. Follow up is really important.

And so the next thing that I was thinking is because we're such an outdoor place to live, we have so many beautiful beaches and you can go hiking and all the things that people are doing outside pickleball and all the fun things. How do you help people get over the fear that they'll have to be trapped in their house until their skin is healed?

I love that question because it's totally true. In San Diego, southern California, this is a year round thing. Sometimes we have beautiful warm weather. Today it's probably going to be 80 degrees outside. And so we have to roll with that here in San Diego. And so the reality is there's only one or two treatments we do here where you really have to stay indoors the next day. And I can list them on, there's three I can think of. So we have our Morpheus treatment, we have our Halo laser and our T R L laser. And those specifically, I set a clear timeframe with Morpheus, we need you indoors for 24 hours. With Halo, we need you endorse for 48 hours. With TRL, we need you indoors for six days. So that's a very clear set upfront. This is the exact timeframe. I think it's shorter than a lot of people think it is. In reality, with a morpheous treatment, which is a wonderful transformative treatment, you only have to be inside for 24 hours. That's not too bad. So I think people will end up being encouraged by that. But the most important thing is what I'm seeing in those timeframes, that's the timeframe that you can't apply sunscreen. So when you can apply sunscreen, you can go outside. So with the majority of our treatments, it's 48 hours or less. And a lot of them it's the same day.

So another thing I was wondering, is there a fear that you ever hear of where they think, will it make my condition worse if I'm starting out with acne scars? Will they get bigger or pigment that could come back? Or how do you deal with people who are worried about the result and maybe maintaining it or if the treatment would actually undermine the goal?

I think that's such a valid question. And it can be scary for people who've dealt with acne scarring or pigmentation for a long time. And this is where I really feel as a provider, I have to do my part because for the most part, if people follow directions, then they're okay. And so I'm gauging almost when I'm talking to this person like, Hey, are you asking me these questions? Because you know that you're not going to be following these directions. You know that you can't actually be inside for 48 hours or that you are going to be working out tomorrow at 5:00 AM So is that why you're asked that? And a lot of times I think it is, and then I'm like, you got to be honest. If you can't commit to this, we got to find a different treatment plan for you. Because in my experience, problems happen when people don't follow directions.

(12:40)
And the majority of patients here are very invested in their skin and they pay attention and they do wonderful. And so we give directions for a reason. I always appreciate when people read them ahead of time and we verbally go over them and we repeat them a couple times. I know they have that saying that when you're in office, I think as a patient you remember maybe 15% of what's actually said to you. So we give you several opportunities to read it again and again. But I think that as long as you are committed to following the instructions, you're going to do just fine. And I don't have many, if any, circumstances where there's been issues with things getting worse unless something like that happened. Like somebody went out in the sun and they knew they shouldn't have gone out in the sun.

And what would happen if they go out in the sun too early or they don't have the proper sun protection? What is the thing that could happen?

Adverse reactions could be things like having a blister, having a burn, having no results, which is a huge factor when you're doing these treatments to help remove your symptoms. And if you go outside the next day, you're definitely not going to have the result that we want you to have.

Well, that makes total sense. Follow directions, super easy. So is there anything else that in your experience with vast thousands of patients with lasers over the years, is there anything else that patients are afraid of that we didn't cover?

I think those are really the basics, and a lot of it is just dependent on making sure that you have a clear set communication with your provider that the treatment that you're getting, you know how to follow the instructions. And if you do that, you will have a good outcome. But also being somewhere where you trust. So being at an office where you trust their care and know that this isn't a pop-up offering some treatment, they're not going to be here in a year or I'm not going to have. So we offer that here. And we have been in practice for quite some years and we're not going anywhere and you know that we're going to follow through. And I have patients that I've had on laser plans now for nine years and their skin sometimes it looks than it did nine years ago. It's just amazing. So investing in your skin for a long-term maintenance plan is I think one of the most, is the best thing cosmetically you could do.

That makes so much sense. And I remember a podcast that we did with a patient named Sandra, and she comes every year, she has her halo, it's her birthday present to herself, and it's wonderful. And she looks incredible and she's like, this is what I do for me. And so she talks about her laser journey and the things that she does. And I thought that's such a good mindset and what you're bringing up Brittany of it could be a one and done, but really is it a one and done when you get your hair colored? No.

Love that point.

You're gonna keep it up. And is it a one and done when you get your car oil changed? No, you keep going and doing it. And so I love that you're bringing up, it's a mindset and a plan and we can get you to your goal. And then how do you maintain the goal?

I think maintenance is just so important. It's that everything. And there's certain conditions where you have maybe a birthmark or a brown spot and we can get that gone with your plan and it won't come back. But if you're looking for the real long-term benefits of doing devices and laser treatments for your skin, it is a long-term investment,

(16:21)
But it's such a win. When I can look at a patient, and I actually just had one yesterday that I posted on social media. I know I don't post very often, I need to work on that. But it's a circumstance where we made her a laser plan and it's been four years now and she looks younger in four years, which is just huge. You think about how rapid we lose collagen after a certain age, for you to look the same in a year, that's a win. But for you to look better in four years, it's huge.

That is huge. And all of us, that's our goal, not only to stop time marching maybe, but to reverse it. That's an amazing thing. And you mentioned we've got lasers in all six big categories of probably everything from laser hair removal to the big baddy who's going to really, really resurface the skin. So out of the lasers, which are the most popular for your patients and what are your personal favorites?

Oh, that's a long question. I mean, I like all the devices I use because I can pick and choose from them. But for myself, my favorite laser is Halo. I do Halo once a year and it's does have a little healing time. You have to be indoors for 48 hours, so no sunscreen for 48 hours. However it does so many things helps with my personal skin condition. I have melasma. And so I do one of those a year to keep my pigment, my melasma in check, build collagen, tighten the skin, help with pores and fine lines. I mean all great things. So that one is, we're coming into the season now where that one is very, very popular. We have a lighter version of Halo, I call it a baby halo, it's called Moxie. And that one is very popular year round. So over summer and spring we do a ton of Moxies.

(18:14)
Moxies have no indoor time. You can actually apply sunscreen immediately after a Moxie, so you can go right back to your schedule. You can apply makeup right after. So that's an easy one to do year round. So that one is very popular throughout the year. And our newest device, Morpheus is also very popular throughout the year and easy to do throughout the year because the indoor time is 24 hours, so you do have to stay indoors and you can't wear sunscreen for 24 hours, but after that makeup back to your normal routine. So that's one that is popular year round as well.

And Morpheus, we have a good podcast about that. We also have a live event that we did that we streamed, and you can watch it on demand, so we can put links to those. So if you want to learn more about it, and I know we did some other laser podcasts in the past, and we can put those in there in the notes as well so that people can kind of maybe learn about each one. But I think something you brought up at the beginning is really important, which is the patient, you yourself as a patient, you don't have to come up with which one is the right one. That's what your provider's for. That's what Brittany's for.

That's my job.

Yeah, we don't know, right? There's no way we can say, oh, my friend had a halo. But you might say, yeah, but if your goal is X, then this is how I suggest getting there. So I think that's, you brought up trust, and I think that's a huge thing that to trust your provider to help you get there with whatever device it is or multiple.

I love that. Yeah, I think that's the base of the whole consultation is we want to build trust and have a relationship where we're going to make you happy with your skin for long periods of time.

And if somebody's never had laser before, do you have a certain one that you would start them out on or do you more pick it by the condition?

I do actually. And it's such a great treatment and it's safe for almost every skin type and it's our B B L treatment. So our BBL treatment is a form of an I P L. It's an advanced I P L, and it removes sun damage. So this is one that is super easy, it's very comfortable, there's no really no downtime, and it will help remove sun damage, remove sunspots, and it's a great introductory treatment. So I love that for a patient who is what I call laser naive for their first time trying something. And I'll be upfront, I'll say, Hey, you'll have some sunspots. Some of them will come off with just a BBL, which is so easy. You have some that may not, but let's try this for your first time doing a treatment, let's get you really comfortable with it and get you on that path of taking good care of your skin. And maybe at some point if you want to address something else, we'll talk about doing a treatment that's a little bit stronger with more downtime, but it's just a great treatment to do for the first time.

Well, I can personally attest to that one. So I had that on my chest, just once. I know I need more, but the difference in one treatment, and we can put my before and afters in the show notes, the difference in one treatment on my chest, I was ready to do my whole body. First of all. It didn't hurt during, it didn't hurt after it just sort of did its thing. Love that. And a couple weeks later I looked, I'm like, oh my gosh, I feel like I put makeup on there. The difference between before and after, it was so much better. And I know that was only one treatment, and so maybe that was the perfect laser for my chest.

I love that you had that relatable experience. Yeah, that's great. I mean, that's a device that I've done on literally full bodies. You can do it anywhere on the body.

I was ready to do that, so I think we might have to, but I mean it didn't hurt. There was, it was so easy that it really kind of blew me away. Because way back in the day when we had a dermatology division, I had some Fraxel and pain was a little bit of an issue for me, and they didn't have the pronox all the same fancy things that we do now. But I really didn't expect it to be like nothing. And it did so much and really without any major, any, not even major minor, I had

Like a warm stone massage kind of.

It's just so easy. I was like, okay, let's do more. And so I love that. That's sort of a good starter. And is that something you could do on your hands or on your back or your arms or anywhere?

Absolutely. I think it's beautiful for hands. I do full arms all the time, chest like yourself, and it's a great treatment for body. It really does, it feels like a warm stone massage in my opinion. And it's great. That's the era we're heading to is where these devices are getting perfected major laser companies that are making them more comfortable, more effective, easier to do. So all these wonderful things. I P L treatments in the past were pretty uncomfortable. So this really is the king of all IPLs. It's super comfortable. It's super fast. It's super easy to do.

Yeah, well, it sure was. I had no idea I'd never had that before, so I didn't really know what to expect, but it was a pleasant experience and results, I think that's what really, I just didn't realize. You get used to yourself with sunspots or freckles or whatever you've got, and then to see it all of a sudden in one treatment and it could get better, it's like, oh my gosh. How has your experience as a national trainer for Sciton sort of impacted your knowledge on laser devices and the safety of them?

It's been really interesting. I've got to visit so many places and some places don't have the same regulations as they do in California or certain areas. So I've seen things that scare me. I'll be dead honest. I mean, I've seen things where I'm like, that person shouldn't be doing that, and that frightens me. And also see offices where they're great and I'm like, they are so good here. I want to take home things that I've learned from them and they're doing such a great job. So I love having that experience of getting to poke and peek into other offices and see what they're doing and what's working and what's not. I think it's a really cool advantage and something that's definitely helped shape my practice and get new ideas and things cranking.

So if somebody wants to have a consultation with you, is that something that you can do or do you typically do them like a Zoom consult or do you usually do it in person or some combination?

It's definitely a combination. During Covid, we were doing just virtual consultations, which we do still offer. So we offer Zoom consultations. I think for laser consultations, it is ideal if we can see your skin. And so we are offering in person, and that's what I prefer. So when you come in for a laser consultation, we will actually do your photos on a special device we have called a Visia. And so that shows different things in your skin. It shows really close up areas of redness, areas of sun damage, and we'll do a UV photo, which is always really fun to look at. And so during a consult, I'll use those and I will look in person as well at your skin so we can talk about really detailed information down to a one tiny little dot on your skin. How are we going to take care of this? And so we offer both. A lot of times it's nice if you aren't really sure what direction you want to go to do a virtual first, and then you can really book an in-person and get us some really customized plans for your skin.

Well, thanks Brittany for helping us deal with our fears during this laser season. And we're coming into that time of year where we want to get everything glowing for the holidays and the new year. So it's good to be thinking about this stuff now and getting some treatments booked before the holidays get here and treat yourself trick or treat yourself. So anyway, thank you again, Brittany, and we will have everything in the show notes. And if you have any questions about today's podcast, let us know. We'd love to have you give a review. We'd love to have you be a subscriber, and we do offer a special certificate if you're a subscriber of 25 off 50 or more of skincare products in the med spa. So hit the subscribe button, show us your phone, and we will go ahead and give you the 25 off 50. And I guess if you were going to spend some free money in the products, Brittany, what would you spend it on?

Oh, the best product to do is the T N S for sure. We have that great special right now too. But if you're going to do one thing that's just the holy grail of products in my opinion, is the T N S advanced from SkinMedica.

Yeah, I've put it on this morning. I put it on every day day. And I know Cameron, our beautiful aesthetician, Cameron, she bathes in it. So anyway, thanks again, Brittany, and thanks everybody for listening and we'll see you again on the next one.

Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla cosmetic is located just off the I-5 San Diego Freeway in the XiMed building on the Scripps Memorial Hospital campus. To learn more, go to lj csc.com or follow the team on Instagram at lj csc. The La Jolla Cosmetic Podcast is a production of The Axis, t h e a x i s.io.