Wooden Spatula for Pain Reduction in Upper Lip Laser Hair Removal

Laser hair removal is one of the most common procedures practiced in aesthetic dermatology, with the most common area of hair removal being the upper lip. Laser hair removal especially on the upper lip is associated with discomfort and pain. The in-motion technology and pneumatic skin flattening are popular methods for reducing laser-induced pain.[1] But most laser machines in India do not have this technology. Many laser centers tend to prefer the use of topical anesthetic cream to minimize pain/discomfort, but this often requires about 60min of occlusion time.[2] Many patients, however, do not like to sit for nearly an hour and with a tape on the upper lip. The chill tip in some laser machines also helps in reducing the discomfort. Wooden candy stick has been recommended for use to avoid the development of the Chinese moustache.[1] We describe the usage of a disposable wooden spatula stick to alleviate the discomfort in upper lip laser hair reduction.

A simple wooden spatula stick is wrapped with a gauze piece to create extra layers [Figures 1, 2]. This is then moistened with normal saline. The patient is then asked to keep this gauze-covered wooden spatula in between the upper lip and the gums. The dermatologist, nurse, or patient is instructed to move the spatula in the direction of the laser probe. Care is to be taken to give the laser shot only after the spatula is held in position. Significant reduction in pain was reported by most patients using this technique. The wooden spatula with gauze wrapped around it helps in increasing the distance between the upper lip and the gums, thus preventing the tingling sensation and pain in the gums from the laser shot. In addition, the stretching of skin from gently lifting the spatula tends to cause lesser hair follicles in each laser aperture shot which further reduces the pain. The use of the gauze also helps to create additional distance between the gums and the skin thereby reducing the tingling sensation. Moistening the gauze helps in preventing friction and trauma to the gums and mucosa. Thus the wooden spatula covered with moistened gauze can serve as an economical and time-sparing alternative to topical anesthetic cream in upper lip laser hair reduction. Instructing the patient to move the spatula will also help in pain reduction as it will serve to preoccupy the patient attention and divert from thinking about pain and discomfort which will be useful in anxious patients.

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Figure 1

Disposable wooden spatula and gauze

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Figure 2

Wooden spatula covered with moistened gauze piece

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Five learning points:

• Wooden spatula with moistened gauze is a novel method.

• It is an effective method of pain reduction.

• It is a time-saving procedure in comparison to topical anesthetics.

• Economical method in comparison to topical anesthetics.

• Easily available items are used.