Frequently Asked Questions

Some questions that patients have presented are answered below. Please do not hesitate to call us with any questions that you may have. You can reach us at (724) 347-4561 during the day, or you can correspond with our certified cosmetic laser technician by e-mail, michellem@malakmd.net.

General Laser Treatment Questions

What is laser therapy and how does it work?

Laser therapy is a safe, effective, and commonly used treatment, providing optimal results in areas such as the removal of unwanted hair skin rejuvenation, wrinkle reduction, leg veins, or tattoos; and the treatment of acne.

Lasers work by delivering an intense beam of light that is absorbed by the skin. This light is converted to heat and is absorbed by the cells being targeted, while leaving the surrounding tissue unaffected. Candela lasers feature a patented skin-cooling device for even greater patient comfort and safety, as well as better results.

What is light-based therapy (intense pulsed light) and how does it work?

Intense Pulsed Light (IPL) therapy is an effective way to rejuvenate the skin, giving it a more youthful appearance. Light-based treatments use a less-intense, broader spectrum of light than lasers, but are effective in treating rejuvenation of the skin. Candela uses the Ellipse I2PL, which is the only light-based product that is built specifically to dual-filter light as it is absorbed, thereby generating more consistent results.

Are laser and light-based treatments safe?

Yes, laser and light-based treatments have been used for many years for a variety of medical and cosmetic procedures. Candela, the most trusted name in the industry, has pioneered the development of some of the safest and most effective technologies and products available on the market today.

What will my treatment be like?

You and your practitioner will wear safety glasses to protect your eyes during the procedure. The doctor will use a small handpiece that touches your skin to deliver the light. You may feel a light spray of coolant on your skin before each laser pulse.

How long will my treatment take, and how many treatments will I need?

Every treatment, like every patient, is unique. Consult your practitioner to decide what is best for you based on your needs and expectations.

What precautions should I take before or after my treatment?

In general, avoid sun exposure for 4-6 weeks before treatment, and again after treatment until your physician allows it. Care should be taken in the first few days following treatments to avoid scrubbing or rinsing the treated area with abrasive skin cleansers. Consult your practitioner for specific precautions that relate to your individualized treatment plan.

Are there any adverse side-effects to laser or light-based treatments?

In general, most procedures have a low risk of adverse side effects. Some patients experience pigment changes in the skin color. If this occurs, the skin will typically return to normal pigmentation over time. All treatment results are individual.

Is this procedure covered by insurance?

Most insurance companies do not offer reimbursement for cosmetic procedures; however, consult your insurance carrier for more information.

 Hair Removal Questions

What is the laser hair removal system and why is it a safe treatment?

Lasers have been used for many years for a variety of medical procedures, including cosmetic treatment of facial and leg veins, age spots and fine lines on the face. The GentleLASE, an alexandrite laser system, emits a gentle beam of light that passes through the skin, to the hair follicle, where it is absorbed. The laser energy is transformed into heat, which can disable the follicle, leaving the surrounding skin unchanged. The skin is protected during treatment by a process where a coolant is sprayed onto the skin, cooling the outer layers to provide patients increased comfort.

What are the methods of hair removal?

Traditional hair removal techniques, such as shaving, chemical depilatories, plucking and waxing, provide only temporary relief. Until now, the only semi-permanent way to remove hair has been by electrolysis which can be painful, time consuming and is limited to small cosmetic areas. Scarring, allergic reactions and ingrown hairs are common side effects of all these hair removal methods. The laser more safely removes unwanted body hair without damaging the delicate pores and structures of the skin.


Why should I have laser treatment?

This is a procedure to remove unwanted hair. The best results have been achieved on darker, finer hair in people with lighter skin color, but other factors may influence the treatment process and are generally best evaluated and discussed in person.


What does the treatment include?

Depending on the amount of hair treated, the procedure varies from patient to patient. Generally, the treatment will include:

  • -Safety eyewear to protect the patient's eyes during the procedure from the intense laser light.
  • -A small handpiece will be used with a probe that touches the skin to deliver the laser light. A light spray of coolant onto the skin will be felt just before each laser pulse.
  • -Most patients experience mild discomfort at the treatment site because of the dynamic cooling device.
  • -The degree of discomfort varies with each person, depending on his/her pain threshold. Topical anesthesia may be used. Be sure to discuss this with your physician in advance of laser treatment.
  • -The procedure can take as little as 10 minutes or up to an hour, depending on the area treated. All patients can go home immediately following treatment.
  • -The treated area may become pink or red within about 30 minutes of treatment; this may last from a few hours to several days.

What precautions should be taken before and after treatment?

Avoid the sun 4-6 weeks before and after treatment until your physician allows it. You must avoid bleaching, plucking or waxing hair for 6 weeks prior to treatment. If you have a history of facial fever blisters, antiviral therapy may be prescribed before treatment.

If you are tan or have darker skin type, a bleaching cream may be started 4-6 weeks before treatment. If your skin tone is too dark, you may not be a good candidate for this type of treatment. You should discuss with us the improvements you expect to achieve. Together you and the physician can decide if your expectations will be met and if this laser treatment is the best option. 

How many treatments will I need?

Hair grows in cycles. The number of treatments required depends upon your skin, hair coloring and coarseness of the hair. Everyone will require at least 2-3 treatments as the process is only effective on hairs during their growing cycle. Repeated sessions will be necessary to treat these follicles when they re-enter the growth phase.

It is not possible at this time to assure permanent, complete hair removal after a series of treatments. Most patients have at least some long term reduction in hair growth and/or somewhat less coarse hair.

Is this procedure covered by insurance?

Most insurance companies do not offer reimbursement for cosmetic procedures; however, consult your insurance carrier for more information. 

   Extended Database of Common Questions

Is there any downtime after being treated with lasers?

Erythema (redness) and slight edema (swelling) are very normal after having a laser treatment and usually resolve after a day or two. However, patients receiving treatment for benign pigmented lesions and "laser peels" may experience micro crusting or even sloughing of the skin for a week to ten days.

If I've been out in the sun, use a tanning bed, or use sunless tanning products; can I be treated with a laser?

Because many of the lasers made by Candela have absorption by melanin/pigment, we advise that patients avoid ANY sun exposure, tanning beds, and sunless tanning products for at least 2 weeks prior to treatment and 2 weeks after. The only treatment that can be performed on patients with a tan is laser hair reduction and should only be performed using the GentleYAG laser. Still, patients should avoid sun exposure and tanning beds for 1 week prior to treatment and 2 weeks after. The GentleYAG has no absorption of sunless tanning products.

 What causes bruising?

Bruising, or purpura, is typically caused by energy being delivered into the skin too quickly. Particularly with the Vbeam and GentleYAG for vascular anomalies. Also to be considered are medications or herbal supplements such as, ibuprofen, aspirin, vitamin E and fish oils. We also advise that patients avoid being treated soon after exercise. Vascular dilation creates more targets that may bruise.

 What is the difference between fine and coarse hair?

The difference is the diameter. Finer hair has a lesser diameter than coarser hairs. This is important when determining the pulse duration of the treatment parameters. Remember we select our pulse duration dependent on the TRT or thermal relaxation time. The larger the structure, the longer the thermal relaxation time, thus the longer pulse duration required.

 How many treatments are required?

The number of treatments required is dependent on several factors. First, what is the indication being treated? Hair requires more treatments than vascular lesions for example and what body area being treated for hair will also play a factor in number of treatments. Also, every patient responds differently therefore Jane Doe may need more treatments than Jill Doe.

 What causes micro-crusting?

Micro-crusting is a result of heating the epidermis. When treating benign pigmented lesions, the object is to heat the abnormal pigment (dark spot) and as a result the pigment is cooked and turns a darker color. This result is the micro-crusting. Please remember that patients need to keep these areas moist with an ointment and to avoid picking, scratching, or aggressively washing the area.

 Can the DCD cryogen cause cancer?

There are no clinical studies showing that the DCD has ever caused Cancer.

 Can plume from the HR cause viral infections such as HSV, HPV, or HIV?

It is very important to utilize a smoke evacuator when performing laser hair reduction treatments. The plume is a carcinogen that should not be inhaled. There have been no reports of HSV or HIV as a result of laser hair reduction treatments; however HPV can become an aerosol and inhalation should be avoided.

 Does light activate the hair to grow?

There have been studies that have shown that too low of a fluence can stimulate limited hair growth.

 Does shaving activate an anagen cycle?

Shaving does not activate an anagen cycle. The mechanical action of shaving is to remove the hair above the skins surface. It has no effect on the hair follicle or surrounding structures.

 Will the laser be harmful to organs and lymph nodes?

No. Due to the limited depth of penetration neither the organs or lymph nodes should absorb the laser light.

 Photosensitivity and Topical Meds: how long should medications and topicals be avoided prior to and after laser treatments?

It depends on the medication and the topical being used by the patient. Patients should be off of Accutane for at least 6 months prior to laser treatments. Other medications should be examined and a test spot be performed if there is any concern of an adverse reaction. Retinoids should also be ceased 3-5 days prior to laser treatment as they can create excessive redness.

 How close to the eye can be treated?

Practitioners should avoid treating inside the orbital rim.

 Can the laser light flashing trigger migraines?

If light sensitivity is a concern then this should be discussed with the patient.

 Can vessels on the chest and breast be treated?

Yes, but begin with lower fluences and perform a test spot to determine the appropriate energies.

What drugs, other than Accutane, would interfere with laser treatments?

There are a number of medications that are considered photo sensitizing. If light interacts with any of these medications, a test spot should be performed to judge the skin's reaction.

 Is there a limit of the total amount of treatments a patient can receive for a particular indication?

There is no limit of treatments a patient can receive. Patients must understand that there will be a limit on their improvement and this will be discussed during consultation. If the patient and practitioner choose to continue with treatments, Candela is not aware of any contraindications in doing so.

 How long does it take for a hair to shed once it has been treated?

Hair can take up to two weeks to shed after treatment of the GentleLASE and nearly three weeks after treatment with the GentleYAG.

  How deep does the laser penetrate into the skin?

The depth of penetration will be dependant on the laser's wavelength. The longer the wavelength, the deeper the penetration into the skin.

 How long should a patient wait before applying make up, deodorant, etc?

So long as the treatment is non-ablative, 2-3 hours is the recommended period of time.

 When treating legs for hair reduction, do they need to be cleanly shaven?

Yes, all areas being treated for hair reduction should be shaved the day prior to treatment. Any hair that is above the surface of the skin will absorb light that is intended for the hair follicle.

 How long before and after should patients avoid sun exposure or tanning beds?

For treatments with the GentleYAG, patients should avoid sun exposure and tanning bed for 1 week before and 1 week after treatment. For all other Candela devices, patients should avoid the sun for at least two weeks prior and two weeks after.

 What should be applied to the skin post treatment?

There are many different things that can be applied to the skin after a laser treatment. Most common are aloe vera, cold compresses, and most importantly a 30+ spf sun block.

 Is it common for patients having laser hair reduction on the lower legs to encounter itching, swelling, red welts, etc? Is this an allergic reaction to the DCD cryogen?

It is recommended that patients shave their legs the day prior to having laser hair reduction treatments. This is done to alleviate any irritation to the lower legs. Shaving the day of treatment increases the likelihood of itching, swelling and red welts. It is unknown what the mechanism that causes these symptoms. Patients that experience this can apply cool compresses and take an antihistamine to resolve the issues.

 Can patients exercise before or after treatment of leg veins?

Patients should avoid exercise the day of treatment and for 5 days after the treatment of leg veins. Also to be avoided are excessively hot baths and showers, steam rooms or saunas, alcohol, and any medications that may thin the blood.

 When performing hair reduction treatments, why does it sometimes seem like a patient's hair is growing thicker for several weeks after the treatment?

Some patients may experience a phenomenon where all present hair follicles will become "in phase" and grow at the same time.

 How much hair will remain after completing a series of treatment? In other words, is there a guarantee?

Unfortunately there are no guarantees in laser hair reduction. There are clinical studies showing improvement of up to 80-90% but that every patient will respond with this amount of efficacy. Patients will be told during consultation that results will vary from patient to patient.

  What are the potential side effects from using the laser?

While side effects are quire rare, the possibilities are erythema, edema, bruising, welting, hyper or hypo-pigmentation and blisters.

 What happens to the skin after treatment?

Common endpoints are erythema or redness, and edema or swelling.

 Why are some lasers approved for some indications and other lasers approved for others?

Because each laser has their own specific wavelength, they each are attracted to different chromophores or targets.

 What exactly is happening during the treatment? Hair? Vessels? Pigment? Etc?

Hair: The laser light is attracted to the melanin in the hair follicle; particularly in the bulb and bulge. Heat is collected there damaging the cells lining the hair follicle with the potential to also damage the vascular matrix preventing future hair from growing.

Leg Veins/Facial Telangiectasias: Depending on the modality in use the vessel will either be ruptured, coagulated, or luminal stenosis

 Why is there a need for multiple treatments?

Due to the nature of the human body, it may take multiple treatments for improvement. For hair, there are several cycles of hair growth and a certain number of hairs may only be growing at a particular time. For vessels, they may need to be shrunk over a number of treatments. And wrinkle treatments are a result of the laser stimulating the body to produce or reorganize collagen.

 What is the interval between laser treatments?

Typically most treatments are 4-6 weeks apart. However, depending on the indication being treated and where on the body the treatment is being performed. Treatments on the trunk should be done at 8-10 week intervals and extremities at 10-12 weeks.

 There are many medications that may cause photosensitivity; is this important for patients having laser treatments?

Absolutely. During a patient's consultation, it important to obtain information on any medication a patient may be taking.

 If a male patient is taking performance enhancers, will it have an impact on the efficacy of their treatments?

It is possible that performance enhancers might impact hair reduction treatments. If the performance enhancers have components which increase testosterone production, the increase in hormonal activity might interfere with efficacy.

What is the post treatment protocol for leg veins? Can I exercise? Can I drink alcohol? Etc?

In order to optimize leg vein treatments certain activities should be avoided:

  • Abstain from running, jogging, lifting weights for approximately 5 days.

  • Abstain from baths, hot tubs, saunas, long showers, or any activity which will make you sweat.

  • If your physician has recommended use of compression stockings, please follow their instructions for use.

  • Because alcohol can cause vasodilation, abstaining from alcohol is recommended for approximately 5 days.