What should my doctor do to minimize pain during laser treatment?

Depending on the laser treatment performed, we employ one or all of the following methods to minimize discomfort:

1. Pre-procedure oral anxiolytic (anti-anxiety pill such as valium).
2. Topical anesthetic applied in the office at least 30 minutes prior to the procedure.
3. Facial block - inject lidocaine into region of facial nerves to block pain sensations.
4. Zimmer cooler (blows cold air) can also be used but can affect contraction of skin and final results if trying to decrease wrinkles.
5. Decrease the Hz (Hertz hurts!) while maintaining the same treatment levels.
6. Slow down the repeat rate.
7. Apply ice as needed pre and/or post procedure (many lasers have a built in cooling device).
8. Make sure patient is comfortable and relaxed (all questions answered, aware of all steps in procedure, relaxing environment and calm demeanor of provider and staff).

Every procedure, laser and patient is unique. Some patients never need anything, others need everything! Be empathetic and work with each patient so they have a positive experience. Pain medications are generally not needed if the above measures are followed.

How do I decrease pain? That depends on the type of laser being used and your medical history. Here are options I use regularly:

• For hair removal in sensitive areas and laser skin resurfacing, I normally use a numbing gel (usually containing lidocaine) for 30 minutes or longer. If you have a lidocaine allergy, other options are available.

• Using a chilled air machine during the treatment (such as the Zimmer Cryo 6) can make your skin numb- kind of like putting your bare hands in a snowbank for a minute!

• If needed, I’ll prescribe medication in a pill form to decrease pain and relax patients, provided they have not had bad reactions to pain medications or sedatives. Usually patients take the medicine an hour before the procedure. If you take medicine by mouth, make sure someone drives you to and from your appointment so you don’t get in a car accident.

Everyone is different. Discuss your options with your doctor!

Complaint of discomfort/pain are very common when it comes to laser hair reduction. Keep in mind that, to some degree, a certain level of discomfort is expected when the concept is to destroy the hair follicle. If there is no discomfort, I would question the efficacy of the treatment. Although there is a manufacturer selling a hair reduction laser with claims of being "virtually pain free", we would question long-term results. The FDA requires that the manufacturer support this claim via clinical trials before they are able to market this laser as being pain-free for hair reduction. This has not been done thus far.

Every patient has a different pain threshold, and a good practitioner will be very aware and concerned with this. I would encourage you to be pro-active in reporting your concerns and your previous experience as there are several ways to address pain or even the anticipation of pain. Keep in mind that anxiety heightens the pain experience as well. Without getting into all of the reasons that cause the pain, here are some tips you may be able to ask your practitioner about. If they don't utilize these or are not concerned with your discomfort - find another facility.

• A Zimmer cold air machine is very helpful in chilling the epidermis

• Topical numbing creams are available but must be used exactly as directed

• Keeping the body warm during treatment will help you to relax which will also help manage discomfort

• Discuss with your practitioner the possibility of changing laser settings to minimize discomfort but maintain efficacy of treatments

• Consider not shaving the day of the treatment as this may cause more irritation of the hair follicles

• Take an over the counter analgesic 1 hour prior to your treatment if not contraindicated

• Personally, I always encourage my patient to report and describe discomfort so that they feel in control, heard, and involved in methods to minimize this