Many diode lasers and IPL systems come with ‘ice cold’ cooling tips these days. They tell us that these will chill the skin to give us ‘pain free’ treatments.
The fact is, it’s not true!
The cooling systems inside handpieces (usually water cooling and Peltier elements) are designed, by engineers, to keep the handpiece cooled. In particular, they want to protect the diodes or the flashlamp from thermal damage. These parts are easily damaged when they are hot.
So, the engineers ensure a good cooling regime to protect those parts. But, in the vast majority of systems, that is it!! The cooling power inside the handpieces is nowhere near sufficient to cool the lasers/lamps, AND the skin.
To do that effectively, the cooling system would need to be powerful enough for both jobs – that would likely require an external cooling/chiller system which circulates very cold water.
If you apply a ‘cold’ tip to the skin for treatments, you will find that the temperature of that tip quickly rises after a few shots. Whereas it might have been ‘frozen’ before you started, you will find it has warmed up. After a few more shots, it can even be hotter than the skin surface! In such a situation, the tip is actually having a negative effect on the skin.
What is the answer?
Do NOT rely on your laser/IPL’s cold tips to cool the skin – they will not work after a relatively small number of shots, and in fact, may make the process even more painful.
You need to use something far more efficient – ice cooling. Using ice on the skin for at least two minutes prior to treatments, is by far the most efficient way to cool the skin – far better than air-cooling or cryogens. Air is a poor conductor of heat compared with ice water. And both air and cryogens only cool the skin for a very short period of time, compared with ice packs.
I have tested all of these methods. Ice cooling is easily the best option for long-term and deeper skin cooling. It’s simple thermodynamics!!
And good skin-cooling minimises thermal damage in the tissues, significantly reduces pain and allows for higher fluences to be used, which leads to more successful outcomes.
Stay frosty,
Mike.
PS I recommend the Koolpak ice packs. We’ve used them for years and they are excellent. And no, I don’t get paid anything from them!! Not even free samples!
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Hi Mike,
Great informative post! I know you prefer ice packs to Cryo – I’d be interested to know how you feel an ice pack (which you have to put on and take off the skin during breaks in treatment) compares to a device (like the Zimmer cryo) that you can use continuously throughout treatment as you work?
My view has always been that cooling is helpful to reduce adverse effects by taking the heat out of the skin post treatment but as a pain relief method, is a bit of a placebo. Although of course the placebo effect is valid too! That said, clients seem to enjoy holding/ directing the cryo cooler nozzle themselves – perhaps as it gives them a sense of control in a situation where they don’t have much?
Sarah
Hi Sarah,
While cryo systems can certainly help with pain control, they are too short term to be very effectvie. Applying ice packs for two minutes before treatment means that the top layers of the skin will be very cold – down to 2 degrees Celsius. Cryo cooling cannot generate such cold skin to the same depth!
The issue is that cryo and air cooling only really cool the skin for a relatviely short time compared with ice. It is the time that makes such a difference. As for post-cooling, more than 90% of the light energy we fire into the skin does not do the intended job. It is ‘swimming’ around in the tissues looking to cook something. If we don’t actively remove it, with cooling, then it will remain stuck in the skin and induce more unwanted damage!
Hope this helps,
Mike.
Hi Mike
I love your blogs.
Please give me your opinion on the DEKA laser Moveo treatment/technology. Their sapphire tip is cooled and definitely appears to help with pain.
Hi Kanika,
While some tips can certainly help with pain control, they are too short term to be very effectvie. Applying ice packs for two minutes before tratment means that the top layers of the skin will be very cold – down to 2 degrees Celsius. A sapphire tip cannot generate wsuch cold skin to the same depth!
Best wishes,
Mike.
Hi Mike,
I had laser hair removal and the practitioner used Koolpak ice packs on my skin for 2 minutes prior to the treatment and I was left with severe ice burns. I complained to her about this and she told me she had been trained by you and told this method was beneficial as you have talked about here in this blog post.
However, how do you justify leaving clients with ice burns and ignoring the common guideline when using ice packs that you should not put them straight onto the skin without a barrier because of the risk of ice burns?
She said she was told by those associated with your training that to have ice burns and manage the healing of them for 4 weeks as I had to do is normal. Which I find disturbing as it was severely painful and uncomfortable. This is was not something I was expecting to happen or told would happen after having the treatment.
I have now been left with hyperpigmentation dark spots where the ice burns were which is really unfortunate.
Thanks.
Lou
Hello Lou,
I am sorry to hear of this. It should not have occurred. We do train people to place ice-packs on the skin surface for at least two minutes prior to laser or IPL treatments. This is to minimise any possibility of burning the skin and to reduce the pain. However, we always recommend that any ice-packs are left to melt slightly, for a few minutes, prior to application to the skin. We learned, a few years ago, that this reduces the chances of “ice burns’ to virtually zero because of the water-ice barrier between the skin and the ice. We also recommend wrapping the ice-packs in clingfilm for hygiene reasons.
It sounds like your ice-packs had not melted sufficiently before being placed on your skin. We do not say that “to have ice burns and manage the healing of them for 4 weeks as I had to do is normal.” On the rare occassions that we have seen ice-burns, we noted that they resolved within 24 hours. I don’t understand why anyone would suggest they take four weeks to resolve!
Perhaps you could ask your therapist to contact me so I can discuss this with her and ensure she follows our guidelines.
I hope this helps,
Mike.