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Alma: Accent XL, Harmony XL, Pixel C02 > SHR by Alma Lasers

Any opinions / experience on the SHR by Alma lasers, Is it better than the conventional diode?

I have been using the Soprano for almost 4 years now. It's not the type of laser (diode), it is how the energy is delivered, that makes this laser more effective. The SHR mode allows you to fine tune the amount of energy you are putting in to the hair follicle by the number of passes. Because the skin is allowed to cool off each time you move away from the area, you are able to safely deliver more energy to the follicle than with a single, big pulse. I think, in order to get the best results, you need to do about 15- 20 passes which makes device more labor intensive and time consuming than some of the other lasers. This machine helped me differentiate my practice from my competition because I was able to build a reputation for having a less painful laser that treats all skin types and more importantly, I am getting better results than everyone around me.

06.23 | Unregistered CommenterSong, MD

SHR is one of the methods that Alma uses in their devices. They initially came out with the Soprano (diode) and a Harmony like (IPL) that both use the SHR. SHR with the IPL is a complete fail, doesn't have enough power to give any results, at some point the people from Alma told me it's like waxing, the hair will sleep for a month or two and come back like before.
The Soprano on the other hand is very good, the SHR is useful for large areas where you have black and coarse hair, it's not ideal for smaller areas.
It takes alot of experience to deliver good results with the Soprano and it takes alot more energy (passes) than what Alma says and i would usually add in regular pulses just to make sure i have enough energy in every spot.
Overall i'm very happy with the Soprano, i wouldn't go with a Harmony for laser hair removal.
By the way, i had the Soprano for about 5 years now.

06.29 | Registered Commenterflafson

Thank you for your comments. The main problem I have with the laser is the lack of duplication of results . It's good in some and not so good in others. The comment on the passes is interesting because I was looking at it in terms of total joules for the area to be lased. I deal predominantly with type 4 and 5 skin. Though the results are better than the Nd:yag, I feel there's still a bit to go before I would say optimal results. Definitely superior when it comes to pain

Actually the results are pretty consistent. As long as you treat areas that have dark and coarse hair, you will see good consistent results.
Areas like facial hair for women, it can improve some but don't expect too much, little bit similar with upper shoulders for guys, those are tough places hormonal areas to treat.
Also keep in mind that you will see ideal results on skin types 1-4, while 5 is still treatable, it will take more sessions to get results.
You need to get a feeling for passes/joules you put in each area and you keep going until you see the skin turn pink. As i said before, i also add single shots to the same area after i do SHR just to make sure.
You should also talk with the patient and ask them if they feel the pinch feeling (not heat) after you go single shots, that will give you an indication that there is still hair that can be killed.
Even though Alma released this laser as the easiest/simplest in the world, in reality it takes quite a bit of experience with that specific machine to get good results.
I'm sure many places who offer group type deals will just do 1-2 pass, say "i'm done" and save both on money and never give any results to the patient. There are so many different ways you can "treat" people with the Soprano.

07.1 | Registered Commenterflafson

I'm looking to put about 15-18 joules into an 8x10 area. After doing it for a while, it's easier to count the passes than to constantly stare at the screen. I'm also watching for a skin reaction. After about 15 Joules, I usually continue for a few more passes if I don't see erythema. If you are doing type 4 and 5 skin, watching the joules would be better, since you may not see a skin erythema occurring. Although this laser can be safely used on darker skin, we have to be careful because you can still burn if too much energy is delivered, and you can stimulate hair growth if not enough is delivered.

07.20 | Unregistered CommenterSong, MD

If I may ask how fast are you looking to move the hand piece when delivering the passes, do you do it slowly in a sequential order or it more random and fast irregular movement

07.24 | Unregistered CommenterAlessandra

It shouldn't really matter that much as long as you're fairly consistent. If you go too slow, the patient will feel it so you don't want that and if you're moving in a very irregular motion, you will have areas in the center where are red and areas at the edges which are not, meaning you will see results/pain in the center but nothing on the edges.
Pick a fairly large area, run passes either left/right or up/down depending on what feels better for you and keep going making sure all the areas become pick.
As i said before, i also overlap the area afterwards with single pulse shots just to make sure they all got enough energy.
As long as you teach your patients the difference between heat pain and pinch pain, they should be able to direct you to spots that could use a little more single pulses.

Keep in mind that you should probably move pretty fast with your passes just because you're treating alot of dark skin types.

08.4 | Registered Commenterflafson

There is a tendency to start moving faster so I have to keep correcting myself. The slower you move, the closer the pulses are to each other. This is where being mindful of the total Kjoules is helpful so that you can stay consistent. If you move too slow, it becomes more painful, if you move too fast, you will need to do more passes. If you have the Soprano XLi, it goes up to 20 J/cm2 I usually stay between 12 and 16. The higher the J/cm2, the slower it fires, so it doesn't help cut down on the treatment time. For darker skin 9 or 10 is fine.

08.22 | Unregistered CommenterSong, MD

I also treat in a manner consistent with that which Song, MD mentioned. I was skeptical with the SHR method until I tried it on my own leg. I was told to only treat up to about 10j per area, but have been using about 15-18 also. I have had great results. By trying it on your own skin, you can tell better how fast to go. I go in a pace that is pretty quick. It is important to keep the hand piece flush with the skin though, so not so fast that this cannot be accomplished. If you move slow, it will be really uncomfortable. I plan on doing the rest of my legs with the SHR...much more tolerable.

08.29 | Unregistered Commentermaria b

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