I was fortunate to receive the first Halo prototype and have been working with the technology since before it's production release, now almost 3 years. I also did the initial treatments and protocol research for neck and chest. My practice is laser focused with a lot of laser (mostly Halo) and full-field resurfacing. I feel strongly that people get their best aesthetic result when their face, neck and chest match and they have healthy radiant skin throughtout. 70% of my patients do treat their face, neck and chest in the same session and we do these treatments every single day. I believe from personal and my patient's experience that high density/depth Halo or any other light/laser treatment on the neck and chest is uncomfortable and I want my patients to be as comfortable as possible. I will also full resurface face/neck/chest in the same session and for that it is absolutely necessary to use topical over all. I do have patients use topical over face, neck and chest with a few caveats: They must be otherwise healthy with no reason for hepatic compromise (and this involves reviewing their social habits, medications and supplements) I only use lower lidocaine topicals in this area with blends of benzocaine, lower concentration lidocaine compounded. I also always have my compounding pharmacist use a vasoconstrictor - I use phenylephrine, but I know people who are using clobetasol. I also supplement this regimen with Zimmer/cooling, oral analgesia and relaxation (I usually use hydrocodone, atarax, and ativan, although I know many offices do not do this), so the patient is less dependent on topical only for their comfort. The goal is that patients be as comfortable as possible. Hope this helps you and your patients get the best results!