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Dr. Barry Eppley

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Archive for the ‘laser hair removal’ Category

Plastic Surgery’s Did You Know? Laser Hair Treatments

Sunday, June 17th, 2012

Your hair is not in your skin…technically. The dead hair shaft which we see comes through the skin but the hair follicle or bulb, the live part of hair, sits below the deepest part of the skin. This bulb is what laser hair treatments target. Specific wavelengths of laser light are geared towards the dark color of the hair bulb to heat it up and destroy it. The darker the hair color, the better attraction for the laser light. Lighter hair colors attract less of the laser light, decreasing its effectiveness. In addition, the laser light must pass through the skin to get to the hair bulb, which is why all laser hair treatments pose some risk for skin burns. Lasers are designed to try and get the most energy deep down to the hair bulb which not injuring the skin along the way. This is why darker pigments in the skin, either from natural skin pigments or having a tan, pose both challenges and increased risk of skin burns. For these reasons, the best laser hair treatment results occur in those with dark hair and light colored skin.

Common Questions about Laser Treatments in Plastic Surgery

Monday, January 25th, 2010

1.      What  can lasers do in plastic surgery that a scalpel can’t?


While many think of lasers like a ‘Star Wars’ saber that cuts through tissue, that is not how it is used in plastic surgery. Lasers are not used to cut tissue. While this sounds theoretically appealing, the effects of such heat on the skin cause exactly the opposite of any benefit…tissue burn and delayed healing. Such an effect is of limited use in cosmetic surgery.


The benefits of lasers in plastic surgery are focused on skin-related problems that are not readily treated by any form of conventional surgery. Cosmetic problems of the skin that can not be cut out without severe and undesireable scarring These include facial wrinkles and scars, excessive hair, unwanted tattoos, visible blood vessels, and brown discoloration.


Because of the greater attraction of heat to darker colors, extreme caution must be used in any type of laser treatment in patients of olive, suntanned, or black skin.


2.      How can lasers make my skin look better?


Laser skin resurfacing, commonly called a laser peel, removes the outer damaged layer of skin leaving the way for new cells to appear.  This removal and replacement of top surface skin cells can remove benign growths, reduce the appearance of wrinkles and minimize surface scars. The heat from the laser also has a contraction effect on the deeper collagen layers of the skin which can create some degree of skin tightening.


 The effectiveness of laser skin resurfacing is a function of its depth. Lasers today can be tuned to the depth of penetration or the amount of skin removal desired. From lighter laser skin peels (often call Erbium or microlaser peels) to deeper CO2 laser peels, the results and amount of recovery can be adjusted to each individual patient’s needs and desires. Because of the extended amount of recovery needed for deeper laser peels, a microlaser peeling approach has become popular. The tradeoff of this approach (healing in a week or less) is that a series of treatments are needed to create the best skin smoothing result.


The newest concept in laser skin resurfacing is that of a fractional approach. (e.g., Fraxel)Fractional means that only a fraction of the surface of our skin is actually treated by the laser. The laser burns less skin surface but goes deeper in the areas that are treated. By leaving small areas of untouched skin, healing is much quicker than it would be otherwise. Whether fractional laser resurfacing is better than non-fractional is a matter of debate. The newest lasers are incorporating both approaches in a single treatment.


Any method of laser skin resurfacing requires a good skin regimen for long-term maintenance of the results. This includes a combination of daily topical skin products combined with intermittent microdermabrasions and light chemical peels.


3.      How does laser hair removal work?

      Hair growth can be disabled or destroyed by specific long wavelengths of pulsed laser light. The laser is pulsed for only a fraction of a second so that the energy will be absorbed by the hair follicle but not long enough that too much heat is absorbed by the skin. The result is hair reduction or removal without burning the skin. This creates immediate results that will last far longer than shaving, tweezing, waxing, or chemical depilation, all of which are only very temporary.


One of the most important concepts in laser hair removal is that it requires multiple treatment sessions. This is because the laser works only on hairs that are in their active growth cycle. Since other hairs will enter their growth cycles at different times, additional treatments are needed. The number of sessions may be five to eight, spaced four to six weeks apart.

Because the laser treats many hairs at a time, facial areas (e.g., chin, lip, cheek) can be treated in ten to fifteen minutes. Small body areas (e.g., underarms, bikini line) take about  half an hour. Larger body areas (e.g., full back, chest, full legs, both arms) usually an hour or more, depending upon the size
of the area and the density of the hair. No matter how it is marketed, laser hair removal is uncomfortable and topical anesthetics are always needed.


4.      How do lasers remove tattoos? How effective are they?

      The principle of all laser treatments is based on the absorption of light. The target is the metal oxide pigments which have been implanted in the skin. As the tattoo pigment absorbs the light, the heat causes the metal pigments to shatter into smaller pieces. This ‘smashing of the boulder with a hammer’ creates smaller metal fragments which can then be dispersed through the skin and carried away by scavenger cells.

Because of differential color absorption, some tattoos are easier to remove than others. For example, black and blue pigments clear the easiest followed by red and greens. Light colors such as pink, orange, yellow and white are often very resistant.

It usually takes six or more treatments to remove a tattoo or reduce it to a shadow or smear. Complete removal cannot be guaranteed or predicted for any tattoo. There is definitely some discomfort associated with laser tattoo treatments and there is often some blistering that develops after a treatment. There is some risk of scarring due to the loss of skin pigment from the absorbed heat.


5.      Can I get rid of those tiny blood vessels on my nose and cheeks?


The laser wavelengths needed to treat red colors has been known for decades and served as the color basis for the initial introduction of the concept of laser photothermolysis. (treating color-specific targets) Red spots (angiomas) and small superficial blood vessels are ideal for laser treatments.

Angiomas are quick and easy to treat. The laser turns them initially black (coagulated) and the body simply absorbs them away after a few weeks. Telangectasias are different in that they have flow (you only see them because they have blood flow in them)and are located at different levels in the skin. They are more difficult to treat as it is a delicate balance between enough heat to clot the vessel off but not enough to burn the skin and create a scar. If they are not adequately coagulated, the clot breaks down later and they reappear as the flow returns. Facial telangectasias often require more than one treatment to get the best result.


6.      Will laser treatments help scars?


Scars from acne and injury are frequent patient requests for improvements. In some cases, laser treatments can provide scar improvement but it is highly dependent on the type of scar. Laser treatments are frequently given more credit for scar improvements than they often produce.


Deeper laser resurfacing can reduce the appearance of fine superficial acne scars but not deeper ice-pick or saucer-shaped acne scars. More superficial depth laser treatments rarely produce  any improvement. More than one laser treatment is usually needed.


Incisional and traumatic scars can be improved with laser resurfacing but only if the problem is one of irregular texture. Excisional treatments are more frequently used and are more effective for the problems of wide, depressed, or raised scars. Scars that are noticeable because of their persistent red color can be improved with red wavelength laser treatments.


7.      What’s the difference between laser and light treatments?


While both use light as the treatment method, the type of light used is quite different…which also makes what they are effective for quite different also. A laser is high-energy focused light of a single wavelength. Light, or pulsed light treatments, are lower energy, non-focused light treatments. Known as IPL, BBL, and photofacials, they are very effective for brown spots on the face and hands and generalized redness and rosace. When used with other skin treatments, it can also provide for some minor skin texture improvement and tightening.

Dr. Barry Eppley

Indianapolis, Indiana    

Laser Hair Removal in Men

Sunday, March 8th, 2009

While women commonly seek laser hair removal of the bikini line, underarms, and face, men are good candidates for this procedure as well. For most men, however, the areas where they want to have hair removed are much larger ones, usually the back and shoulders. Such large areas pose problems for conventional hair removal methods such as waxing and electrolysis. While shaving is a low cost approach, it must be done at least every several days and the back area is a hard one to do by yourself. With laser hair removal, these large areas can be done quickly and easily with good long-term hair reduction.

The concept to grasp about laser hair removal is that it can only affect the hairs that are in the active growing phase, known as anagen. On the back and shoulders, only about 50% or so of the hairs are actively growing at any one time. The growth cycle for back hairs is about three to six months. What this tells you is that it will require a series of laser hair treatments to get significant growth reduction. Mathematically, one can calculate the point at which less than 10% of the hairs will be present by taking a 50% reduction at every 4 to 6 week treatment interval. (1st treatment 50% left, 2nd treatment 25% left, third treatment 12.5% left, 4th treatment 6.25% left, 5th treatment 3% left, etc) That is why laser hair treatments are sold in packages of 5 at Ology medspa, it takes that many to see really good results. Long-term, occasional maintenance treatments may be needed as well, maybe once a year for a few years after the initial series.

The biggest issue with treating large areas with laser hair removal is pain control. Because the lasers work with attached cooling mechanisms, treatments are less painful and uncomfortable than they would be otherwise. However, further pain control efforts are helpful and the use of a topical pain relieving cream to be applied before the hair removal begins providing even more relief.

While women have a long history of understanding the cost of beauty, men are often more logical and scrutinizing of such costs. Because areas like the back are bigger than say the bikini line, the cost for a package series of back treatments will be higher. While the cost may seem initially high, it is a long-term investment that will save time and money considering the alternative methods of hair removal.

Perhaps one of the most attractive selling points of laser hair removal for men is that their skin will require very little care afterwards. The area that has been treated will be slightly red and feel like a sunburn. This goes away in a day or two. One can apply moisturizers or aloe for comfort and dryness. One should not get direct sunlight or tan on the area treated for two weeks after treatment.

Dr. Barry Eppley

Indianapolis, Indiana

Laser Hair Removal on Doc Chat Radio Show Indianapolis

Saturday, March 7th, 2009

On this week’s Doc Chat Radio show on WXNT 1430AM in Indianapolis from 1:00 – 2:00PM, hosted by Dr. Barry Eppley, the topic of unwanted hair removal will be discussed. How to get rid of unwanted hair for both women and men will be the theme of the show. Specifically, how laser hair removal works will be covered in detail with his guests. How does it work, who is a good candidate, and what one can expect from the treatments will be reviewed. How does laser hair removal compare to electrolysis or waxing? Which is better? Everything you wanted to know about how to get rid of that hair you don’t want!

Laser Hair Removal -Separating Facts from Fiction

Wednesday, February 25th, 2009

While we are now quite yet into spring, it is but just a month or so away. With the onset of spring, many people will be thinking about getting ready for the summer. Particularly for the younger age groups, outside activities with greater exposure of body parts is high on their minds. As part of some get ready lists, removing unwanted body and facial hair works its way up that list. With the now standard method of laser hair removal widely available, many will seek out these treatments.

While laser hair removal is a good treatment method for many, the marketing and advertising claims frequently do not give an accurate reflection of the facts and the science behind it.

Laser hair removal should be best thought of as a hair reduction method. While some patients do get a high percentage of permanent hair reduction, the concept of permanent and complete elimination of hair is false. The biology of hair growth and the way the laser light works makes this very difficult to achieve. When laser hair removal first came onto the scene in the early 2000s, this was naively widely touted. We now know better. If you can live with 50% to 90% reduction in hair, then laser hair removal may be for you.

Not all hair responds well to the laser. Like a black colored car that attracts sunlight and gets very hot, it is all about driving heat down to the growing hair bulb. For this reason, dark colored hair with fair colored skin always works the best. Blonde, gray, white, and red colored hair is not reduced as much because it is a ‘poor’ target. Expect less hair reduction if this is your hair color. Conversely, dark colored skin picks off some of the laser light before it can get to the hair bulb. (which actually is below the skin) Because higher energies of laser light is needed to get past the pigment in the skin, there is a slightly higher risk of skin burns and irritation.

Laser hair reduction requires a series of treatments to be effective. Because the laser will only knock out hairs in an area that are actually growing (less than 10% of your hair in any area is actually active at any one time), a series of treatments over time is needed. A general rule is that it will take 5 or 6 treatments over a 6 month period to get the best result. So while spring may bring hair removal to mind, you ideally should have started last fall!

Lair hair treatments are not painless…no matter what the advertisements say. The laser light is a hot treatment and it is not like having a massage or manicure. If your laser treatment is or was painless, I can also guarantee you that it will not work. While todays lasers have chilled methods to cool the skin during treatment, topical anesthetics are still necessary. For this reason, a laser hair appointment may require an hour or so with the first half being the application of a numbing cream and then time to let it work.

Long-term maintenance treatments may be needed in many cases. Hair that was initially suppressed by laser treatments can get activated later in life with hormonal changes or medications that one may be taking. While this seems to be contradictary to the way most people think lasers on hair works (frying the hair bulb so that it is ‘killed’), the reality is that the laser changes the hair growth cycle and teaches it to grow differently. Often times, it changes a thick dark hair to a fine and clear vellus hair. But certain changes in life can reactivate its original growth cycle making you see hair ‘coming back’.

Laser hair treatment is commonly done for both women and men. (men and back hair make up about half of the patients that we see) While it can be very effective for the right person, proper knowledge and education will determine if laser hair treatments are a good or better value over traditional waxing methods.

Dr. Barry Eppley

Indianapolis, Indiana

Dr Barry Eppley of Indianapolis and Indy Laser Hair Removal

Friday, March 21st, 2008

Dr. Barry Eppley, plastic surgeon of Indianapolis has reached an agreement with Indy Laser Hair Removal to serve as their Medical Director. Indy Laser Hair Removal is a free-standing facility located on the westside of Indianapolis in Avon. They have been in business since 2004, mainly providing laser hair removal services to the Indianapolis area from their 1,800 square foot facility at the junction of Raceway Road and US Highway 36.

Laser Hair Removal – Understanding How It Works

Monday, November 5th, 2007


The fundamentals of our treatment program is based on scientific evidence and research on the nature of the hair growth cycle.


Growth Phase

ANAGEN Active hair growth phase. It is during this stage that the hair follicle is

directly connected to the blood vessels. It is ONLY during this stage that
we can permanently disable hair growth. The life of the hair is in the
blood. If we cut off the blood supply, we can prevent re-growth.

Dormant Phase

CATAGEN The hair has stooped growing. While we can still see the hair, it is no
Longer connected to the blood supply. Thus, while the hair can be
destroyed during this phase, it cannot be permanently disabled. The hair
will grow back in time.

Shedding Phase

TELOGEN During this phase, the hair is completely dormant. It is no longer connected
to anything and it is preparing to fall out. This hair will shed once a new
Anagen hair begins to form below.

Because of the hair growth cycle, this is why there are 5 treatments spread out over the natural hair growth cycle of the specific body part. Not all hairs are in Anagen at the same time.

Understanding the nature of the way hair grows is the foundation of our laser treatments. Since medical science has determined that the only time hair can be permanently disabled is during the Anagen growth phase, it remains only to determine the length of the growth cycle.


Medical research has conclusively shown that hair growth cycles differ on various parts of the body. This means that different areas must be treated differently. Not all body hair is alike. For example, any any given time, 85% of the hair on your scalp is in the Anagen phase and lasts between two to six years. So, most of the hair on your head is actively growing at any given time. Conversely, your eyebrows have only about 10% of the hair in the Anagen phase at any one time and the phase lasts between three to nine weeks. Have you ever wondered why the hair on your head can grow long while your eyebrows remains fairly uniform in length?

Since the hair growth cycle varies so dramatically on different parts of the body, it is important to know these cycles in order to effectively treat the hair. The lip and chin have different cycles than the legs and underarms. You must treat the hair on each part of the body at the right time!


Treating hair at the right time is important, but that is not the complete picture. To be successful, we must also treat hair in the right way. This is where laser technology plays a role.

The hair follicle is three to five millimeters below the surface. The laser target is in the melanin of the hair. Melanin is the pigment that gives hair and skin color. The darker the hair, the more melanin it contains. Essentially, the hair follicle acts as a conduit, conducting the laser energy (heat) to the hair bulb (where the blood vessels are). As the hair is heated, the connection to the blood vessels are cauterized. As a result, blood can no longer supply the necessary nutrients and hair growth is no longer possible. All the hair in the target area will be affected during the laser procedure but only the hair follicles in the Anagen phase will be permanently disabled

The important issue is how to deliver enough power to destroy the hair follicle while leaving the surrounding skin unharmed. This is done through the long-pulse 1064nm Alexandrite laser or high-intensity broad band light. (BBL) The laser energy is delivered in such a way that enough heat is delivered to the hair follicle to disable it but allows the skin cells to shed the energy and not be harmed.

With this understanding of hair growth science and laser technology, it is now possible to understand that laser hair treatments change how the hair follicles grows and may destroy some but not all of the treated hair.

Dr Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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