selection of a photoderm practitioner

[Guest guest]

Hazel,

Concerning your internal debate on whether to proceed with photoderm,

let me mention a couple of other, relatively minor, points to

consider.

My background: I did 3 photoderm treatments earlier this year with

well-known photoderm practitioner in New York City. Net result was

that I was quite disappointed. Just recently, I started a series of 5

treatments with a Bitter Sr -trained derm (Dr Zenda -Lat) in

New Jersey. To date, I have done 2 treatments, and I am encouraged,

but want to wait until I finish the 5 to comment definitively.

What I have learned? First, I do believe that going to a

Bitter-trained derm, if not essential, is highly recommended.

Principal reason is that these practitioners tend to continue to

remain in contact with their peers, and share experiences. The NYC

person I saw had been doing photoderm since FDA approval, but I got

the sense that he was not in regular contact with other

practitioners.

I am told that Bitter Sr is more aggressive, and targets rosaceans,

while Bitter Jr's practice is built more towards treating wrinkles,

so I would favor a Sr-trained vs Jr-trained derm. However, this is

just hearsay, so I would not place a lot of weight on this comment.

Second, it is really useful if the practitioner uses a digital camera

so that photographs taken at the start of the current session can

immediately be compared with photos from prior session. My NYC

practitioner took very high-quality conventional photos, but problem

was that each session would begin with me comparing photos from a

previous session with what I would see in a hand-held mirror, all the

while arguing with the nurse about which vein was smaller and so on.

Third, and this is more important, inquire about the number of pulses

to be put down during each session. In NYC, I essentially paid $10

per pulse, and over the 3 sessions, received a grand total of 141

pulses (BTW, a triple pulse counts as one pulse in this accounting

....). In my first two sessions with Dr -Lat, I received

180 and 204 pulses, respectively, which figures out to a cost of less

than $2.25 per pulse. My second treatment also included second pass

with different filter, ala Bitter Sr's latest protocol. Make sure

you ask how long it takes the machine to recharge between pulses.

Conventional photoderm machines require 10 seconds, so you can

obviously get no more than 6 pulses per minute, and realistically you

get no more than 5 per minute since practitioner typically counts

3-2-1 to warn you when its coming. However, the Epilight machine

(used in my current treatment) recharges every 3 seconds, and I know

the pulse is coming once I hear the buzz that recharge is complete.

Hence, I can get close to 20 pulses per minute at full tilt. It is

my (very) strong opinion that full-face treatments should only be

done with practitioners using machines with the fast (3-second)

recharge.

Hope this helps.

Rick

> Deirdre had treatment from Dr two weeks ago and said that

all she

> had been given afterwards was an ice pack so maybe he has changed

the

> procedure he uses

>

> I have not decided at present which clinic to use but I'm thinking

(only

> thinking) about using Nuala Briggs in Harley Street. I'm still not

100%

> convinced though. For me to go ahead with something like this, it

will have

> to feel just right. I am not just using my rational judgment here

but also

> I'm relying on my instincts. At the moment we are having a lot of

work done

> on our property so I can't really concentrate on photoderm, etc,

but

when

> things settle down I am going to get in touch with Nuala Briggs

again with a

> whole load of questions for her to answer and, when/if I get her

responses,

> I will e-mail them to the group. I have already spoken to her on

the phone

> and there were several things that put me off a bit. Wanting quite

a lot of

> money up front (2,500-£3,500) and not doing test patches were

two of

them.

> On the plus side, it seems that a lot of the clinics offering

photoderm in

> the UK haven't much experience in using the parameters suitable for

rosacea

> whereas N Briggs is the only person in the UK who has been trained

by Dr

> Bitter (albeit Dr Bitter Jr).

>

> Once you've paid your £2,500 to £3,500 she says she will give

you as

many

> treatments as it takes to stabilise the condition so that you are

in

a

> position to then only require top ups. After telling me on the

phone that

> I could only be treated if I would commit to the full program, she

then rang

> me back to say that she would be willing to do one treatment for

£250 to

> £350 but, after that, if I wanted to continue, I would still

have to

pay the

> full £2,500 to £3,500 so, in effect, because she doesn't do a

test

patch, if

> you don't want to take a risk of going ahead without one, it seems

you need

> to pay £250 to £350 for the privilege or that's one way of

looking

at it!

> Also, if you think about it, if each treatment costs £250 to

£350

and most

> clinics say that the average person will need five treatments, by

charging

> £2,500 to £3,500 for the full program, with most people, she

is

going to be

> quids in!

>

> Hazel