In light of COVID-19, a majority of states and local governments have issued some sort of “stay at home” or “shelter in place” order, causing many non-essential businesses, including numerous aesthetic practices, to temporarily close their doors. Even if your business isn’t experiencing these kinds of mandates, your patients may have decided to put their treatment on hold for safety reasons.
As a response, we received questions from clients and aesthetic practitioners asking, “How do I continue treatments safely for clients who missed treatments due to COVID-19 or other reasons?” and “How do I alleviate the concerns of my patients who are worried this lapse in treatment is going to affect their overall results?”
In response, Amy Yan, Astanza Client Marketing Manager, and Justin Arnosky, Astanza VP of Clinical Education, sat down and answered questions for both laser practitioners and patients regarding paused laser hair removal and laser tattoo removal treatments due to the coronavirus pandemic in our latest "Ask Astanza" video! This video series was created to answer some of the most pressing questions we receive from Astanza clients and anyone interested in the aesthetic laser industry.
In this article, we focus on the laser hair removal section of the video and discuss the physiology of hair growth, clinical recommendations for safe treatment, and what expectations to share with concerned patients. For more information on laser tattoo removal clinical recommendations, watch the full video "Ask Astanza: Aesthetic Treatments in a Time of COVID-19" below.
Watch the full video #AskAstanza - Aesthetic Treatments in a Time of COVID-19:
Laser Hair Removal Physiology
Laser hair removal works by targeting hair shafts in the anagen phase. The laser energy is distributed to the papilla, which disrupts the growth cycle and damages the follicle to the point where future hair grows thinner, less densely, or perhaps not at all.
Hair growth occurs in cycles and has three distinct phases: telogen, anagen, and catagen. The telogen phase involves shedding fully-grown hair, the anagen phase is when hair is actively growing, and the catagen phase is the resting phase when hair detaches from the papilla and blood flow. Because this growth occurs in cycles, only a percentage of hair is in the targeted anagen phase at one time, which is why multiple treatments are necessary to achieve desired results.
Clinical Recommendations for Practitioners
Upon re-opening, you are probably going to see patients return with more hair growth than if they maintained their regular treatment schedule. While some patients may require an additional treatment or two, this won't be the case for everyone. Many patients will continue to see fantastic reduction throughout their process, despite the pause in their treatment.
That said, there are a few combinations we need to consider. If a patient has exceptionally dense hair and is at an early stage of treatment, they may require an additional session because beginning treatment settings tend to be a little more conservative. Patients who are further along in their process may have likely seen a significant reduction in their hair density. In this case, you can continue to advance the protocols and use more aggressive energy, pulse formatting, or both.
The rule of thumb for treatment protocols is “treat the hair you see.” Regardless of the number of sessions they’ve had or how they presented during their first treatment, use your clinical judgment and rely on your training to assess the coarseness, density, and other hair factors and adapt your protocol accordingly.
Another consideration to keep in mind is the tanning level and sun exposure of your patient. Despite the "shelter at home" mandate, many people are spending more time outside to stay sane during this time of isolation. If you treated a patient in February and expect to treat them in May, June, or even July, you should expect them to have more melanin in their skin in addition to more hair growth.
If this is the case for many of your patients, definitely consider reducing your energy settings (1-2 J/cm2) or using more conservative pulse formats (double instead of single pulse) once you resume treatment. Also, make sure you emphasize and remind your patients the importance of avoiding UV exposure at least two weeks after their treatments and before their next treatment. Remember, laser hair removal works best on contrasting skin and hair pigments. For example, a patient with skin type I and black hair will have much better results than a patient with skin type 4 and light brown hair.
Setting Patient Expectations for Results
As for patients who are concerned that the current pause in their treatment schedule is going to affect their results, remind them that laser hair removal only targets hair in the anagen phase, aka the active growing phase. Once hair is treated, you've damaged the follicle and reduced its ability to regenerate hair. This fact will not change no matter how long a patient waits or how long their treatment is delayed. Hair emerging from that follicle will be permanently reduced. Simply put, skipping or delaying appointments should not significantly affect a patient's overall results.
The hairs that grow during this treatment lapse are hairs that were missed during their previous treatment(s) due to the growth cycle they were in and possibly their location on the body. However, the hair density will be less than before, depending on the stage of treatment the patient is in. For example, a patient who's had 1 to 2 treatments will still show new growth while a patient who's had five sessions will have a significant reduction in density and hair thickness.
Assure patients that you will continue to treat and remove the actively growing hair and resume treatment intervals once your doors open. They may need additional treatment to get their desired results; however, it's equally likely that this period will be nothing but a pause in treatment, and they'll still attain great results in their predetermined number of treatments.