Laser platform
Candela's GentleMax Pro Plus pairs a 755 nm alexandrite laser with a 1064 nm Nd:YAG laser and cools the skin with a burst of cryogen before every pulse. Having both wavelengths on one machine means the treatment can be matched to your skin and to the target, rather than the other way around. Dr. Paul Kuzel uses it for hair removal, vascular lesions, pigmented lesions and skin rejuvenation.
What it is
A laser works by putting energy into one specific thing in the skin and heating it faster than the surrounding tissue can carry the heat away. The thing it heats is called the chromophore. For hair and for brown spots the chromophore is melanin. For a broken capillary or a leg vein it is the haemoglobin inside the vessel. Different wavelengths of light are absorbed by those targets to very different degrees, and they reach different depths.
Melanin absorbs 755 nm light strongly. That makes the alexandrite efficient and comparatively comfortable when there is a clear contrast between a dark target and pale surrounding skin.
At 1064 nm, melanin absorbs far less of the light, so the pigment in the epidermis is largely bypassed and the energy travels deeper. That is the whole reason this wavelength exists on the platform.
Who it suits
What happens
The safety of this treatment is decided before the laser is switched on. Most laser injuries are not equipment failures. They are the result of settings that did not match the skin in front of the operator.
Fitzpatrick typing asks how your skin behaves in the sun, and it is a starting point rather than an answer. Two people can both call themselves type IV and have very different amounts of melanin sitting in the epidermis on the day of treatment. We assess your baseline colour, your recent sun exposure, your ethnic background, your tendency to darken after any injury to the skin, and whether you have ever had a pigment change after a burn, a spot or a previous laser. That last question predicts trouble better than the questionnaire does.
Photosensitizing medication, recent isotretinoin, gold-containing drugs, a history of cold sores in the area, keloid tendency, current pregnancy, previous laser reactions and any recent tan all change the settings or delay the treatment. Tattoos and permanent makeup in the field are covered or avoided, because ink absorbs the light violently.
A small area is treated at the intended settings, usually somewhere inconspicuous within or near the treatment zone. The point is not the immediate reaction. The point is what the skin does over the following days. Redness and swelling around the follicles settle quickly, but post-inflammatory hyperpigmentation takes several days to declare itself, and a blister may not be obvious for a day. Waiting roughly a week before treating a full area is how a small, contained problem is prevented from becoming a large one. In darker skin types this step is not optional here.
Everyone in the room wears wavelength-specific eye protection, including you. The area is shaved for hair removal, cleaned, and mapped. The handpiece is placed against the skin, and each pulse begins with a millisecond burst of cryogen delivered by the dynamic cooling device, then the laser fires, then the handpiece moves on. Sessions run from about ten minutes for an upper lip to an hour or more for a full back or both legs.
The usual description is a cold flick followed by a hot snap, like an elastic band against the skin. The cryogen makes the surface briefly, sharply cold, which both protects the epidermis and takes the edge off the sting. The 1064 nm Nd:YAG at hair removal settings feels deeper and hotter than the 755 nm alexandrite, more of a dull hot pinch than a sharp one. Most people manage without any numbing cream. Bony areas, the upper lip and the bikini line are the ones people find sharpest.
Hair removal usually takes six to eight sessions, spaced four to six weeks apart on the face and six to eight weeks apart on the body, because only follicles in the active growth phase can be destroyed and only a fraction are in that phase at any moment. Vascular and pigmented lesions often respond in one to three sessions. Rejuvenation is generally a series of three to five. Maintenance sessions are common after a hair removal course finishes, particularly on hormonally driven facial hair.
Afterwards and risks
There is no meaningful downtime from a correctly performed treatment. Most people go back to work the same day. The honest part of this page is the section below it.
Questions
Next step
The consultation is where your skin gets typed, your history gets taken, the right wavelength gets chosen and a test patch gets booked. Bring a list of your medications and tell us about any previous laser treatment, including anything that did not go well.
Dr. Paul Kuzel, MD FRCPCBook a consultation Call (403) 286-6888
Related pages: laser hair removal, vascular and pigmented lesions, PicoWay, cryotherapy, RF microneedling.
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