Question
I had my first Lumenis Lightsheer laser hair treatment on my back and upper arms today. The technician used a setting of 46 joules; I am unsure of pulse duration.
I am Fitzpatrick Skin Type 2 - White, male with mostly dark hair although some hairs are red. I have had no sun exposure pre- or post procedure.
I have developed painful red, circular welts on most of the treatment area. The welts look slightly raised and nasty- like hives.
I have very sensitive skin. Aloe vera gel stings quite badly for about 10 minutes after I apply it.
Are these painful red welts normal? Will they scar? At what point do I know if something will scar or if it's not normal? What are warning signs to look out for? Was 46 joules too high? Thank you.

Answer
I had my first Lumenis Lightsheer laser hair treatment on my back and upper arms today. The technician used a setting of 46 joules; I am unsure of pulse duration.
I am Fitzpatrick Skin Type 2 - White, male with mostly dark hair although some hairs are red. I have had no sun exposure pre- or post procedure.
I have developed painful red, circular welts on most of the treatment area. The welts look slightly raised and nasty- like hives.
I have very sensitive skin. Aloe vera gel stings quite badly for about 10 minutes after I apply it.
Are these painful red welts normal? Will they scar? At what point do I know if something will scar or if it's not normal? What are warning signs to look out for? Was 46 joules too high? Thank you.

Answer
46 joules is pretty high, especially for your first treatment. those areas do need high settings for good results especially if not all hair is dark. but this laser maxes out at 50 joules to give you an idea.
high joules are good, but not at the expense of burns. at those settings, even if you weren't burned, you would probably experience 1-2 days of redness. i would give it 1-2 days and see what happens to the area.
Aloe Vera is good normally for after LHR, so try to use it to help it heal faster.
For your next treatment, I would probably try 30-35 joules and slowly go up from there if you need to.

Answer
Thank you for the reply Blink888.
The technician also pressed the device into the skin to try and make the laser penetrate more deeply. (She told me this as she was doing it).
I don't mind going through pain and welts in the short term, as long as the negative effects aren't permanent. And if I see positive hair results, well that's even better.
I was just concerned, because I kept reading that 30-45 joules was recommended.
I wish I knew what a burn would look like, vs redness and swelling that is normal for this treatment.
It seems like so many terms are thrown around like "bruising", "irritation", "scabs", "burns", "scars", "welts", "hyperpigmentation", etc. and it's very difficult for an everyday guy like me to know what each term means. I don't have any point of reference.
The technician said ahead of time it would hurt very much, and she also said that I would see marks after and they would heal in time. It hasn't even been a full 24 hours yet, so I will hang on, and try not to worry about it.
If anyone else has something they might want to add, I appreciate any input. Thank you.

Answer
30 joules is minimum to achieve results with LightSheer. If your skin can handle 45 joules, it would be great for you. Let us know how the area looks in 2 days. Burns would be scabbing and possibly darker pigmentation areas. Using compression on LightSheer is also good, it makes the treatment more effective. So hang in there, I think you might be ok.

Answer
Ok, I'm 48 hours after my first zapping.
Some of the red marks are fading to pink. The parts that hurt the most were the parts of my back closest to the back of my neck, and that is the area with the nastiest looking marks.
The best way I would describe their appearance, is it looks like I've been shot multiple times by a paint gun. That leaves welts. The next closest analogy I could think of would be chicken pox or fairly nasty back acne.
There is no bubbling, or brown colour. And they are no longer elevated. I took an anti-histamine on day 1 and that seemed to reduce the elevation.
My upper arms and shoulders are not too bad. Little pink, a bit of general redness, and lots of little dried blood marks.
I am optimistic the nastier stuff will fade.
I've had waxing, shaving, Nad-ing, Epi-light, and now laser. I would say the laser has been by far the most dangerous to this point in terms of damage to the skin, and pain (during and after).
What will be interesting will be its efficacy, regarding actual hair removal. I'll keep posting my results.

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Sorry, one correction to my last post. Laser was NOT the most painful "during treatment." The most painful was definitely NAD-ing, and waxing. That pain was pretty close to unbearable.

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Oh, I have also stopped using the aloe vera gel. I found that it burned, and it left a stciky residue that kept sticking to my shirt and bed sheets.
I've switched to a dimethicone based, fragrance free moisturizing cream that I use on my face. It doesn't leave a sticky residue and it's supposed to help dry skin.
Oh, and the welts felt really dry right after treatment. They are beginning to approximate normal feeling skin now. So, again, I am optimistic.
But realistically, I don't see these marks completely fading for at least a month.

Answer
it sounds like a bit of pigmentation and of course the settings were a bit too high for your first time. they should have probably started you out at 30-35 joules. i would definitely report this reacton back to them, so that next time they can drop down to about 35 joules and work up from that. the worst reaction is usually after first treatment since hair is most dense, so 46 joules was a bit too much.
marks will fade, but yes, it will take a month or 2. but eventually, they should go away. keep taking care of your skin and keep us updated. thanks!

Answer
Sounds like a histamine reaction, no permanent damage to the skin. You may want to take an anti-histamine before and after your future treatments. The reason the LightSheer is pressed firmly into the skin is because of it's cooling system, the "Chill Tip." Not enough contact and your skin isn't cooled properly before the laser is fired. Nothing to do with getting it deeper. It's calibrated to go the right depth if it is being properly used. Too deep and you miss the hair completely.

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I know I have a slight allergy to aloe... if I use lotion with aloe after shaving my legs I will get red bumps all over my legs... any other lotion doesn't have this effect... my kids also are sensitive to aloe. I used hydrocortisone after my laser treatment. Just a thought, people are allergic to weird things, it's important to find out b/c the first exposure might be mild skin reactions but the next exposure could cause anaphylaxis.

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Thanks for the reply Kaitlyn, LE, and Blink.
Kaitlyn, careful with the hydrocortisone. Very thin layer, and only for a short period of time, and wash your hands after. That stuff gets right in your skin - changes your skin's natural immune response - makes you more susceptible to warts, thinning, spider veins, rosacea, etc.
But, a small amount for a small period should be fine. Don't apply it like moisturizer.

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warts??! never heard of that... i'll have to look into that. I have to put 1% hydrocortisone on my baby (11mos) for eczema a few days a week so I handle it often. We were never taught that! (nursing school)

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Yes, molluscum contagiosum is the most common when using hydrocortisone, especially in children, but it can affect adults too. They are very superficial and easily treated, but they are highly contagious and can spread like wildfire if you don't catch them in time.

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I'm very sorry to hear about your little one's eczema. I have eczema as well, so I understand. I've really educated myself a lot by talking to others on an eczema forum, so I keep mine mostly in check.
I don't want to get too off topic but I highly recommend Zinc-O. It's a product that contains Zinc oxide which is a really nice physical anti-inflammatory. It also creates a nice protection against Demodex mites, which is often linked to eczema and many other skin conditions. You can order samples off the internet. It's easier to wash off than most zinc oxide formulations.