Speaker 1 (00:07):
You are listening to The La Jolla Cosmetic Podcast.

Monique Ramsey (00:14):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. Today we're going to talk about three easy laser treatments. They're going to just change your life, and I'm not joking. They really will. So we are here with Amy Biggs, she's PA in our La Jolla office. Welcome, Amy.

Amy (00:34):
Thank you, Monique.

Monique Ramsey (00:36):
So tell us a little bit about lasers in general and sort of maybe in our own minds, it's like downtime. What's that downtime going to be? Is it going to be too much? And so can you kind of walk us into your experience with lasers and tell us a little bit about that?

Amy (00:55):
Sure. So lasers, there's a whole world of lasers out there. There's so many lasers that we can use for so many different concerns. Most often we're using lasers for the face, neck, chest for rejuvenation. We can also use lasers on the body as well, depending on what we're trying to target. Downtime can vary based upon the type of procedure that we're doing and how the appropriateness of the laser for the concerns. So can be anywhere from practically no downtime all the way up to one to two weeks worth of downtime time.

Monique Ramsey (01:34):
Okay. So in your experience, tell us a little bit about how long you've been treating with lasers and have you done any yourself?

Amy (01:43):
Oh my goodness. So I've been doing lasers. I've been performing laser treatments for about 15 years now. I started out in a practice that had multiple different lasers. I've also worked in a laser center, so with a large variety of lasers for skin rejuvenation, ablative, non-ablative lasers, laser hair removal, mirror dry. I mean, there's just a huge vast array of lasers for vascularity and for pigment. So yeah, about 15 years. And of course I've had pretty much all of them done, so I can speak to them personally.

Monique Ramsey (02:24):
Oh, that's good. That's good. And well, your skin looks amazing, so that makes total sense. But I think that is probably really helpful when you're consulting with a patient that you've already been there and done that. And you know what it was like on the table. It was like when you went home and how you healed. So today we're going to talk about, and really it's for the newbies in the group. Like any of you who've never had a laser treatment done, we want to help you understand the three easy yet very life-changing laser treatments that anybody could fit into their busy schedule. So that's what we're here to explore today. So the first one I want to talk about, Amy, is laser hair removal. So tell us what happens during a laser hair removal treatment and what is that experience like?

Amy (03:09):
So laser hair removal has been around for decades. So there are lasers that target different skin types from the very lightest to the very darkest. So we can treat all skin types very safely. So ideally prior to treatment, you want to avoid sun exposure, you want to avoid any waxing because obviously we need to have the hair there to target. So when you come in, we will numb the area that we're going to treat. I'd say for men, the most common areas that we treat are the face, neck, chest, and back. And for women, the most common areas that we treat are under the arms, the bikini area and the legs. So we will safely numb those areas usually for about a half an hour prior to your treatment. Then we'll remove the numbing and go ahead and get started with the procedure. Procedures last anywhere from I'd say 10 minutes up to an hour, depending on how many areas that we're treating, it's generally very well tolerated.

(04:16)
And then afterwards you might have a little bit of redness, a very small amount of swelling around the hair follicles, and then that typically goes away very quick. Most people tell me, oh yeah, it was gone by the time I got out to the car. And then you typically do not have any after effects, any swelling or discomfort from the procedure. Some procedures have sort of a sunburned appearance or sunburn feeling afterwards, and this one does not do that. And then in the days ensuing afterwards, then the hairs will start to fall out. I usually recommend that you use a loofa or a washcloth to help encourage them to come out, which is a really fun process to see your hair just go away. It's very satisfying I bet. And then you get improvement with each treatment. I'd say we usually do six treatments to start and then everybody goes into a maintenance phase after that.

Monique Ramsey (05:13):
So six treatments, do you have to wait a certain amount of time or can you do 'em every week or something like that?

Amy (05:20):
It depends on the body area that we're treating. So face underarms, bikini are four weeks apart. Larger body areas like chest and back and legs are usually six to eight weeks apart. You have about 20% of the hair follicles that are in the active growth phase at any given time. So that's why we do multiple treatments. So we have to allow enough time in between for those hair follicles to be ready at the appropriate time for the treatment.

Monique Ramsey (05:50):
So do people have to, if you're doing your legs, let's say, do you have to grow it out a certain amount or could it just be that it could be stubble and you're ready to shave it, but instead I'm going to come and have you laser?

Amy (06:04):
We usually request that you shave the area about a day or two prior just so that we can see where the hair follicles are. But we don't want a lot of hair at the surface because one, it absorbs a lot of the energy. And two, it can be more uncomfortable if you have hair at the surface. And then you also don't want to, if you are waxing or using any manipulating products, you want to wait at least a month after that before you have a treatment. So ideally you wouldn't wax or use any ablating products prior to treatments.

Monique Ramsey (06:37):
Got it. So you're saying anywhere from six to eight sessions, but is there any certain type of person or hair, maybe even if it's really wiry hair or very light hair, is there any person who might need more sessions I guess?

Amy (06:55):
So. The hair has to be dark in color for the laser to be able to see it. If it's white, blonde, even a lot of red hair colors, it cannot see it. So it's usually not effective on those hair colors. So I mean, some areas can require more treatments. I find that my male patients that were treating the face and neck usually require more treatments than other areas.

Monique Ramsey (07:23):
Now I remember hearing that certain people should maybe not have laser hair removal. And who isn't a candidate for laser hair removal?

Amy (07:35):
Anyone that has an active infection in the area that we're going to treat, we would not want to do hair removal on. There are some patients that can have the opposite effect with hair removal where they actually end up growing more hair as opposed to reducing the hair. I have seen that in the past. It's very rare.

Monique Ramsey (07:57):
So Amy, is it true that if you have darker skin it's a little more risky procedure or you want to make sure that you're vetting your provider correctly so you don't have the risk of the pigment coming out of the skin in the area that you're treating?

Amy (08:14):
That is correct. So as long as you are with a trusted provider who's been doing these procedures, who's either certified, some states have technicians or who has the appropriate degrees and has had experience with them, there's a specific laser for darker skin types called the ND YAG laser. And it's very safe on the very darkest of skin types. But when you're looking at laser hair removal, yes, it targets the pigment of the hair to get down to the hair follicle. So these lasers don't necessarily differentiate between the color in your skin and the color in your hair. So an Alexandrite laser that would be used for lighter skin types, like myself, would not be safe on somebody who has much darker skin. We'd have to use an ND YAG, which actually penetrates a little bit deeper into the tissue to where the hair follicles are. It's actually very safe.

Monique Ramsey (09:17):
And getting back to that one question about maintenance. So you do your six treatments and then let's say everybody's happy heavy. And then when or how often would you need maintenance? And would it just be dictated by what's growing back or is it sort of on a yearly basis or something?

Amy (09:33):
A little bit of both. So it is definitely dictated by what's growing back. I'd say after those initial six treatments, the maintenance phase is going to be more often than what it will be over time. So I'd say might be every three months. And then slowly that becomes every four to six months and then eventually once a year. And ideally then you only have to come back every so often if you have a few hairs regrowing.

Monique Ramsey (09:59):
And can you think of a success story of a laser hair removal patient of yours that you want to share?

Amy (10:06):
I'd say probably the most rewarding are the patients that have complications because of the hair that are getting folliculitis or infections around the hair follicle, which then eventually can lead to scarring and sometimes even keloid scarring where the scars overgrow. So being able to really help these patients to reduce their hair and get to the root of the cause, it is very rewarding to see these patients become more healthy and not just that, but also become so much more confident in themselves.

Monique Ramsey (10:41):
Yeah, and I think that you mentioned it early on, you were talking about miraDry. So miraDry, and we've got some episodes about it, is the laser that we use to take away the sweat and odor under your armpits. And I happen to have had this treatment. So the side effect of it destroying the sweat and odor glands is that it also takes care of the hair in that area and it's colorblind, so it is safe for everybody. But I just thought I would throw that in because it is something nice, at least if you're thinking about your armpit hair, then all of a sudden you kill three birds with one stone. So the next laser I'd like to talk about is the BBL HERO. So tell us about the BBL HERO, what kind of energy it uses, who's it good for, and what are we treating with that?

Amy (11:35):
BBL stands for broadband light and HERO stands for high energy rapid output. So HERO has been the upgrade to the regular BBL. So we have the option whether we want to do regular BBL or BBL HERO. BBL HERO is great because it's very safe. It rapidly fires. So we're using actually cooler temperatures and lower energies, but then we're getting a lot more coverage of the area. And it's so well tolerated because the energy is lower. So it's not really uncomfortable. Most people say, oh, that's nothing at all. So we get really great results with treating larger areas too on the body, not just on the face, neck and chest. And it pulls up pigment. It can help reduce redness in the area from vascularity and also tightens the skin too. They've actually demonstrated through research that the BBL specifically the BBL HERO does change the gene expression so that, yeah, the gene expressions that affect aging. So you're almost either just slowing down the clock, stopping the clock so that your skin, and they've actually done biopsies to show that the skin is the same as an individual that would be much younger.

Monique Ramsey (13:01):
Wow. Well, I had one and on my chest and I was blown away. So you can do, yeah, I did my chest. I'm like, well, maybe I should get my arms done and you could just keep going. But is sort of the downtime of that just for me, what I experienced was it seemed to flake off or little dark coffee grounds came and then they went and that was at the end of it. Is that typical?

Amy (13:29):
Yes. So wherever you have pigment, it's pulling that pigment out, pulling it out of the tissue so that your body will exfoliate it off. So it usually looks kind of like pepper, exactly like pepper on the skin. And then that starts to flake off on the face. I'd say about three, four days later, you start seeing it coming off. As we go down the body, it takes longer to heal. So neck is usually about nine to 10 days. Chest might be two to three weeks, and then the rest of the body can be three to four weeks.

Monique Ramsey (14:02):
And then does everybody need a different amount of sessions or is that similar to when we were talking about laser hair removal? Like you start with six? Is it the same as that or they could do one and be happy?

Amy (14:14):
I would say generally we're doing about two to four treatments with most people being four treatments, we're spacing them about a month apart. You can do them as soon as two weeks, but generally we do them once a month. It depends on how much damage you have. If you have a lot of sun damage, then we really need to pull a lot of that out, then it's going to require more treatments. If you have very minimal sun damage and you're just doing this just to improve the appearance of the skin, then maybe you might be able to get away with two treatments. Once you get to the result that you want, then you just maintain it. And you can do that anywhere from four times a year to down to two times a year. And that will really do a good job, put you on a good anti-aging regimen.

Monique Ramsey (15:01):
Well, especially with that little nugget of excitement that we heard about it tightening and changing the structure of the skin and really helping it to be an anti-aging, not just thinking of it in it terms of pigment. So who would be your ideal candidate for this?

Amy (15:20):
So anyone that has a lot of pigment and that has some vascularity or redness, superficial redness, like broken capillaries on the skin. I would say that most skin types can do BBL, not all skin types. It's not as safe as the skin gets darker, but it is still, when you're using the hero, it's very, very safe. So traditional IPL, you want to be very careful with darker skin types, but with BBL, because it's so safe on the skin, you can treat most skin types with it.

Monique Ramsey (15:55):
And can you think of a success story of a BBL patient of yours?

Amy (16:00):
Yeah, I mean, I've had many patients that have been preparing for events where they just wanted to brighten up their skin and look better that maybe didn't have enough time to do other treatments. And the deeper, more ablative lasers that were extremely happy. It's just so fun to see everything peel off and come off. And I'd say probably the body treatments are almost a little bit more rewarding to see because that's an area that's been more difficult to treat with other lasers. So to see such a big improvement with minimal treatments, it's really impressive to see how excited patients get. And again, the transformation.

Monique Ramsey (16:43):
Yeah, I know in my own experience, and that's sometimes true, that a lot of us will take care of our face more than we kind of, you know, how do you slather yourself all the time in SPF on our body, but is it something you could do on your hands too? Because hands sort of can give away your age, even if your face looks great, your hands will tell the real story. So is that something you could do for the hands as well?

Amy (17:07):
Absolutely. You can do it almost anywhere on the body, arms, legs, hands, back, chest, neck, chest and neck are really important to treat because those are areas that it's really hard to reverse the signs of aging. So if you start treating a lot sooner when you're just starting to see some signs or even preventatively, that would be ideal because neck and chest are just so hard to treat once you have done the damage.

Monique Ramsey (17:35):
Good point. So our third and most exciting little great laser treatments to start with is the Moxie. And so the Moxie, is that something that is newer? Right. I mean new in the scope of years and years, it's pretty new.

Amy (17:53):
It is pretty new. And the Moxie is on the same device as the BBL hero. So they often work hand in hand. But the Moxie has been one of my favorite lasers to use because you can just get amazing results in such a short period of time with very minimal downtime just like the BBL.

Monique Ramsey (18:15):
So what is Moxie doing that BBL isn't?

Amy (18:20):
So Moxie is a fractionated non-ablative laser. So it's heating the tissue. It is creating little micro injuries in the tissue that are very gentle, and it's just working on the more superficial layers of the tissue, and it's actually penetrating to the depth where the pigment cells are. So it does a beautiful job of pulling out the pigment. It also helps to improve the pores, any little fine lines and wrinkles. It's great for patients that are just starting out, that are just trying to dip their feet in and are not sure about lasers. So it's a great starter laser. It's also great for maintenance in between your bigger lasers and it's great for rejuvenation. If you just want to prevent the signs of aging, it's great for those patients too. So really it's the laser for everyone.

Monique Ramsey (19:21):
Oh, nice. And is that something where your downtime is relatively short, also?

Amy (19:28):
Very short. It's a very easy recovery. So after your treatment, you have a little bit of a sunburn appearance, a little bit of a burning sensation, which goes away fairly quickly. And then the next day you might have a very small amount of redness, very small amount of swelling, if any at all. And wherever you have pigment, it does pull it out. So similar to the BBL where it looks kind of peppery, it will look peppery as well with the mxi laser. And then you have sort of a sandpapery feel to the skin, which is the little areas that are going to peel off or really just rub off of the skin, which usually starts around day three or four. And then by day five to seven, your skin is gorgeous and glowing.

Monique Ramsey (20:16):
Nice. So if somebody wanted to, let's say prep for an event, they've got a wedding and they're trying to get their skin ready for that, is this one of the things that you could do? Let's say we're going to do one once a month before the wedding.

Amy (20:34):
You could do one treatment, you are going to see results with one treatment, but ideally where you're going to see the best improvement is if you do it in a series usually of three to four treatments, and we space 'em out once a month.

Monique Ramsey (20:48):
Okay. And is there an ideal candidate for this, or is it just for everyone?

Amy (20:54):
Everyone. All skin types, all ages, everyone.

Monique Ramsey (20:59):
So let's say we've dipped our toe in and we did Moxie, and we're like, okay, I can do it. But now maybe you're wanting a step up to treat. And is that where you would then do the Halo? Because is that part of the same platform?

Amy (21:17):
Yes. So Halo is actually also a Sciton laser, but it's on a different platform. But yes, Halo is the big sister to the Moxie. So Halo is also fractionated, but it's ablative as opposed to non-ablative. So Halo actually has two wavelengths, and it's going to penetrate superficially where it's going to remove little portions of the tissue to stimulate the wound healing process, which then stimulates collagen and healthier tissue. And then it also penetrates deeper to heat the tissue to help pull out pigment to help with stimulating collagen at a deeper level for deeper wrinkles for scars, acne scars, it's an incredibly versatile laser because it does have the dual wavelengths. So yes, it would definitely be the big sister to the Moxie and a different platform and perfect for those that want a little bit more of an appropriate result based upon what we're treating.

Monique Ramsey (22:18):
Got it. And can you think of a success story with a laser patient who had Moxie?

Amy (22:25):
Oh, yes. So I had a patient that came in with a lot of sun damage, actually some very superficial skin lesions that are benign, and then also melasma. So she had a lot going on and we were able to get such an incredible result. I think that her results are posted on our Instagram site.

Monique Ramsey (22:45):
Oh, good.

Amy (22:46):
And she was just so over the moon, happy with her results. She was telling all her friends and family referring everyone. But yeah, we were really able to get her skin so beautiful and glowing and bright and healthy. And then of course we put her on a maintenance plan to maintain it.

Monique Ramsey (23:08):
Yeah. Once you get there, you want to keep it.

Amy (23:10):
Yes.

Monique Ramsey (23:11):
Protect that investment.

Amy (23:12):
Correct.

Monique Ramsey (23:13):
So Amy, even though we call these laser treatments easy, they should always be kind of in the hands of somebody who's trained and has experience and is specializing in these procedures. So how do you suggest people go about finding a good provider for laser treatments?

Amy (23:32):
Yes, absolutely. Very important to be in the right hands. So I always recommend that you vet your providers and your practices. So you want to go online, you want to read reviews, testimonials from patients, recommendations from friends. Those are always great because you know that you can typically rely on their experiences. It's better to have a provider that has more experience for obvious reasons, because they understand the devices and how they work, not just following a sheet or a guide that tells you these settings for this concern for this person. It's important to really understand the lasers. And that's something that I really appreciate about Sciton lasers because they don't really come with guides. You really have to understand the technology and how it works and the depth that it's going to penetrate, what it's doing, how it's doing it. So it is so important to make sure that you have somebody that knows what they're doing. So rely on reviews, rely on recommendations, and ask questions.

Monique Ramsey (24:42):
Yeah, and it's interesting you're bringing up, we're talking about how to find a provider, and I remember in the early days of the CO2, the fractional CO2 lasers with a Fraxel specifically, and there was people online who were saying, oh, it just doesn't work. I spent all this money and it doesn't work. Well. We dug a little deeper, and what we found was at some of these practices, the doctor in charge didn't want the nurse using anything at a level that would be sort of risky. So therefore, unfortunately, these patients are paying all this money and they weren't really getting the full treatment because the doctor had them dialed back so much that it wasn't going to produce a problem, but they also weren't getting the benefit of the result. So it was sort of like, okay, it's not the Fraxel that's the problem, it's whose hands that Fraxel is in. And whether you're talking about BBL or Moxie or Halo or any of the lasers that we have, the TRL, it's really that experience factor and that you've done hundreds and hundreds of them and thousands because everybody's skin is so different. And so really having, you've used it and you've used it at different levels, and it's safe in your hands because you have the experience and the training, but it's also sometimes what you read online isn't necessarily the right thing either.

Amy (26:06):
Yeah. So it's a great start, but definitely you want to go and make sure that the providers understand the machines. So like I said, asking questions and educating yourself are really going to help you to choose the best provider for you.

Monique Ramsey (26:24):
And I would think that, I hear you guys talk about doing combinations of things a lot where like, oh, well, we're going to do a little hero here and we'll do a little this over there. Depending on what their concerns are, sometimes it's more than one thing might be the right answer, it might be a combination. And I think when you're looking for a provider, if a certain office only has one thing, they're going to use that one thing for every single problem you have. Whereas we have several different devices that we can mix and match and sort of get you to your goal. I think with the right technologies,

Amy (27:03):
Yes. And combination lasers have become so much more prominent, and we use lasers in combination all the time to achieve those goals in a shorter period of time. And like you said, no one laser typically, one laser can't do everything. You have to rely upon different lasers to treat different concerns, and you want to use the best laser for that concern. You don't want to spin your wheels with a laser that treats it okay, but not great. You want the best results, especially when you're investing a lot of money in these treatments. And really, people just want results. We all just want results. So using lasers in combination get us better results typically in shorter time.

Monique Ramsey (27:52):
Yeah. Now, if somebody's thinking about having a consultation for a laser, what's their first step?

Amy (27:59):
Just to call the office, make an appointment, let us know what your concerns are so that they can help to educate you a little bit on the phone prior to a consultation. But definitely just give us a call. Send us a message on Instagram. You can also book online too. We do zoom consults, so if you want to just do it from the conference of your home just to get some more information, decide if it's going to be right for you, then we have several different avenues to book.

Monique Ramsey (28:32):
Perfect. And is there anything that we missed on our easy breezy laser podcast?

Amy (28:39):
No, I think we covered everything. I mean, these are all really great procedures. We have so many more procedures in addition to these. So this is just one little portion of what we do. But I can definitely say that we have really great providers. We all love doing these procedures. It's so much fun to see the transformations so gratifying, and we are always looking for more patients though.

Monique Ramsey (29:05):
Yeah, come be one and maybe come on the podcast and talk about it. So we've actually done several podcasts with laser patients, and we'll put those in the show notes so that you guys can refer back. And I know this particular episode's part of a laser series, it's laser season, so we did a little laser series. And so we'll also put links to that in the show notes. And we'll also put the links to the Instagram where you can see some of these before and afters. And we also have them on our website, but certainly connect with us on social media at Ljc Med Spa, at Ljc Med Spa. And also just one more thing. So we'll put a link in the show notes. When you go into the website, each procedure that you can read about will have ratings and reviews by procedure. So if you go into the Halo procedure, then you'll see people and all the recent and past reviews for that particular device of our patients. So it's really helpful to be able to go and see, okay, here, here's what they had to say. So you can go on those procedure pages and we'll put the procedure page links in our show notes for the three that we talked about today with the laser hair removal, the BBL HERO and the Moxie. Thanks, Amy. This was fun. Great to have you on the podcast.

Amy (30:32):
Thank you, Monique. It was fun today. I enjoyed it.

Monique Ramsey (30:35):
Yeah. Well, we'll see you all on the next one. Thanks.

Speaker 1 (30:43):
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 ljcsc. The La Jolla Cosmetic Podcast is a production of The Axis, T H E A X I S. io.