AUCTORES
Chat with usEditorial Note | DOI: https://doi.org/10.31579/2578-8949/056
*Corresponding Author: Rahul Pillai, Kkris skin care center & laser clinic, Kerala
Citation: Rahul Pillai (2019) Laser Hair Removal on Skin of Colour JDermatol Dermatit 4(3); DOI:10.31579/2578-8949/056
Copyright: © 2019. Rahul Pillai This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 30 July 2019 | Accepted: 17 August 2019 | Published: 27 August 2019
Keywords: Keywords
When it comes to laser hair removal in ethnic skin, there’s a very narrow spectrum of treatment options and it has always been challenging due to the the higher competing epidermal melanocyte.The Aesthetic industry has been constantly trying to develop an ideal platform to treat all skin types(Fitzpatrick 1-6),however we are yet to find that ideal laser that would treat a a skin type 1 and 6 with same efficiency,also irrespective of thick or thin hair.
When it comes to laser hair removal in ethnic skin, there’s a very narrow spectrum of treatment options and it has always been challenging due to the the higher competing epidermal melanocyte.The Aesthetic industry has been constantly trying to develop an ideal platform to treat all skin types(Fitzpatrick 1-6),however we are yet to find that ideal laser that would treat a a skin type 1 and 6 with same efficiency,also irrespective of thick or thin hair.The technologies to offer remains the same for the last two decades,however there has been modifications on existing technology to suite various skin types,faster treatment and lesser complication and definitely better results,making it truly a swift lunch time procedure.
The principle behind hair removal is selective photothermolysis(heat is being absorbed by melanin, which eventually heats up the hair shaft, the hair follicle, the surrounding area and the germinating layers in such a way that the melanin helps in destroying the hair.The chromophore here is melanin, which is competing with other chromophores that are oxyhemoglobin and water[1,5].
The spectrum of 600 nm to 1,100 nm wavelength is useful in destroying the hair follicle, but the more specific we are, the lesser chance of complications. This brings us down to a few technologies utilising different wavelength, such as Pulsed Diode,Nd-Yag,Alexandrite,Ruby, which are a little more specific when it comes to heating the melanin which helps in destroying the hair.
The latest statistics on population from the US show that by 2020 ethnic skin will become a far more significant demographic proportion. (http://nationalequityatlas.org/data-summaries,PERE-Policy Link). European trends are similar –the ethnic skin majority is increasing in number – and that’s one reason why understanding how to treat an ethnic skin will become important if you want to maintain a good practice.
The US FDA definition of permanent hair reduction matches with the results that are currently being achieved. Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs re-growing after a treatment regime, which may include several sessions. The number of hairs redrawing must be stable over time greater than the duration of the complete growth cycle of hair follicles, which varies from four to twelve months according to body location. Permanent hair reduction does not necessarily imply the elimination of all hairs in the treatment area. In practical experience once a patient has completed about 9-13 sittings, usually there is very minimal or no significant hair growth for about 3-10 years unless there are some hair growth stimulating factors involved like hormone variations,certains drugs,etc.(Source: http://www.fda.gov/Radiation-EmittingProducts/ResourcesforYouRadiationEmittingProducts).
Different areas of the body respond differently to lasers. A place like upper lip requires multiple numbers of sittings. Promising that you’ll be able to do a permanent hair reduction in six to nine sittings is risky – you’ll probably require more.The rest of the cheeks, or the arms or legs respond better and the back of the body also responds differently.
Ideally, when we look at ethnic skin, we are looking at a patient who comes with realistic expectations, somebody who’s got normal endocrine activities – so not with polycystic ovarian syndrome, hirsutism or hyperandrogenism. This factors are very important because that will influence the number of sittings that we are going to do, no matter what technology we are going to use.
An ideal patient has thick, dark hair, but light skin ton [4,8].However, this is challenging when it comes to Indian skin because there are huge variations between different people across the states. .
The differences from one Indian state to another are probably greater than between Czech and Slovak – yet India is one country. You may have a patient who’s fair in skin, with dark hair and light-brown eyes and expect that using a high energy will be safe, but she gets a burn. On the other hand you might have to treat a darker skin tone, which doesn’t respond the same. It’s challenging because you can’t judge an Indian patient or a darker skin Indian simply by looking at them.Its with experience repeatedly treating such patients the we get an idea of how a such skin tones react.Offcourse we have the option of doing a test dose and deciding our fluence and pulse width or to be on safer side always start with a higher pulse width and lesser fluence.
Three important parameters to consider when treating are pulse width, the spot size, and fluence.
We all talk about thermal relaxation time, although this may not be the appropriate term to be used.Thermal containment time is more relevant and more important thermal destruction time, because a specific amount of energy is needed within the hair shaft so that it heats up the tissue,and the melanin gets heated up, in such a way that the hair gets destroyed. That should be ideally something with the pulse width not less than 10. A 10 ms could actually burn the patient, but something about 100ms won’t give good results, so we’re looking for something between 10 to 90 ms pulse width,optimally between 15-30 ms .
Thermal destruction time should give a heat sufficient to destroy the primary as well as the secondary germinating layers. The main reason hair returns,is not because the primary germinating layer is not getting destroyed – the secondary germinating layer is not getting destroyed, and which is located near the arrector pili muscle.Besides not all hair are in the same phase.So ideally enough energy should be present to heat up and destroy this layer too, this is why different variations of same technology work, such diode laser which produces single shots of high energy or in motion technology which gradually heats up the tissue. No particular technology can be called the best technology as all of them work provided you know to make them work .
So this is how technologies provided from Alma(Alma Lasers Ltd.Caesarea,Israel) and Lumenis(Lumenis Inc.Medical,Santa Clara,California,USA) work. These are contrasting machines, but they both work and give differing explanations for their efficacy, but as a doctor, the physics is an important consideration.Both machines gradually create heat within the hair shaft, which increases and destroys the primary and secondary germinating layers. So, it doesn’t matter what technology you use, if you understand the physics, you can make it work[1,10].
A larger the spot size creates more dispersion or scattering of energy. A large hand-piece, for example from LightSheer Dezire which is (22mmX35mm),can do an entire back in 15 minutes, or the entire body in one hour, without any complications and give good results. It is because a large spot size requires smaller fluence, and hence lesser complications ,also it gives the same results because the dispersion is more than a small spot size.
Understanding the implications of this isn’t entirely simple. One should not confuse the terms of fluence, energy, power, or peak intensity of a laser – they’re all different terms.
Using them as synonyms should be corrected.Fluence is the amount of energy that we are delivering per treated area, in joules per square cm. So fluence is the same as Energy Density.
A burn happens when the dermal-epidermal junction is being destroyed – so epidermal cooling is important.A burn will never occur if the dermal-epidermal junction remains intact. There are cooling devices but most lasers have inbuilt cooling system in the hand piece itself , so that theoretically, if you are cooling the area well enough, using any energy level is safe. That’s true in theory, but must be implemented practically.
IPL
IPL’s broad spectrum Intense Pulse Light which is very useful when it comes to fine vellus hair.Since it targets a broad spectrum between 600 -1100nm it is not very specific for hair reduction and never the first go to machine but an optional one to have, as IPL has high versatility although not much specificity[11].
Ruby ,694 nm,was the first such laser for hair reduction. It was quite effective, but had many complications such as burns and pigmentary changes, hence its not favoured in treating ethnic skin[12,14].
Alexandrite was initially very popular because it gave great results, but because of the complications the diode took over, however now the alexandrite is back in fashion again. Although having a single handpiece of Alex alone is definitely not the right laser for treating skin of colour. You rather see a patient for a few more sittings rather than having less with alexandrite and expecting some kind of complications such as pigmentations or burns.Because laser is a voluntary procedure, if it burns, patients simply aren’t going to come back to you.One has to note companies which promote Alexandrite laser is not actually selling an Alexandrite laser but a Diode laser with a wavelength of Alexandrite ,755nm [13-14].
The Nd:YAG has got the longest wavelength, but the melanin absorption is less, making it very safe on darker skin types. Low melanin absorption means it can be used safely with high energy and the penetration is comparatively less, but more energy can be used.It is safer, but we require more number of sittings and still Diode is preffered as Gold standard for Laser hair removal and also for ethnic skin [12-14].
The diode absorption is probably not as good as alexandrite, the penetration is not as much as an Nd:YAG, but somewhere in between, and that makes it ideal for treating ethnic skin. Somewhere between 800 nm to 810 nm would be ideal for treating, and the various lasers that have come into the market right now are modifications of a Diode laser , because that’s what is ideal in darker skin type and selling more in the emerging Asian aesthetic market[1,2,3,4,5,8].
The use of local anaesthesia is not widely accepted as you want your patient to react to avoid burns.That way onecan either decrease the fluence or increase the pulse width
Cooling is a must.For example Lumenis lasers are have Sapphire Chilltip which cools the skin adequately before firing. Even the temperature of a room is very important when it comes to treating ethnic skin and also for the maintenance of a laser equiptment. Lower energy can be used if patients are feeling any pain, or pulse width can be increased so that the patient feels more comfort, however this may lead to a higher number of sittings being required[8,15,16,17].1
Vacuum suction technology is unique . It’s pretty effective because the skin is pulled closer to the hand-piece, in such a way that lesser energy is going to give better results hence less painfull. Using a 5.5 or 6 fluence larger hand piece (22x35 mm)will give the same results as something like 20 or 30 fluence in a smaller hand-piece(9x9 mm) . When vacuum technology pulls the skin up, the competing chromophores and the oxyhemoglobin move apart. Even the chromophores on the skin are reduced. Also the unique vacuum mechanism activates tactile and pressure skin receptors to inhibit the transmission of pain sensation,hence is less painfull. It’s also a mechanism that creates pain in one area to reduce pain in another.
It’s ideal for a patient who thinks they can’t bear even minimal pain.
For treating thin hair there’s no particular solution, except repeated number of sittings. An IPL is a good option if you have the finest, thin-haired patients or lighter-haired patients. It’s inexpensive, and but low-efficiency or you can use a Diode laser with very short Pulse Width and high energy which has its own risk of burning but is effective.Here an Alexandrite like wavelength maybe usefull and many users feel its pretty safe,although risk of burning a darker skin type exists[18,23].
When it comes to the hand-pieces, the large hand-piece can be used for greater body surface areas with low fluence and smaller areas like upper lip with small hand piece and higher fluence.
Its been observed that patients generally don’t see the results in the first or the second sitting with a large handpiece as compared to small hand piece but by the third or the fourth sitting they find that the results are the same . Hence it doesn’t matter if you are using large piece for larger for larger body areas and small hand piece for lets say facial hair,eventually on a whole body treatments results are the same if you combine both for 6-9 sittings. So, this is one option you can look into when you’re treating ethnic skin.
Lumenis had sometime back launched the INFINITYdevice which is a diode laser with a 805 and 1060 wavelength handpiece making it safe for use in even very dark skin yet get the benefit of a Diode laser. This is a good option as there are various wavelength and handpiece options making it truly versatile,so for very dark skin a 1060nm wavelength can be used and after a couple of sittings,once we understand how the skin reacts, shift to a diode laser, 805nm wavelength.Although it looked promising in the beginning with the introduction of multiwavelenghth platform with a single handpiece firing 3 wavelengths,the Infinity laser fell out of favour.
Using a Diode laser with a Nd-YAG like wavelength(1060nm) the results are not the same as a Nd-YAG laser (1064 nm) but after a follow-up of six months, 75% reduction was noted in most of the studies as an average.
Alma IN-Motion technology gives good results. Both these companies Lumenis and Alma are good, and again, these are both what sell maximally in Asian countries.We get the same results whether we use in motion technology or single stamping method because the idea is the destroy the Bulb,Bulge and Papilla and eventually enough heat to destroy the primary and secondary germinative layer.So it really doesn’t matter if we give maximum fluence at one shot or by repeated motion to generate enough heat to destroy the hair follicle.[1-5,8.23-29].
The alexandrite has been reintroduced by the new Alma company in a new platform called Soprano platinum Ice which combines 3 wavelengths( 755nm,810nm & 1064nm) Combination of 3 different wavelengths in single handpiece was developed to target different tissue depth & anatomical structures within the hair follicle.This blend of Alexandrite 755nm, Diode 810nm & Nd:YAG 1064nm provides better results in fine hair reduction compared to conventional Diode laser. But needs to be used carefully in dark skin type patients.
One has to however keep in mind thats its coming from the same Diode platform form.They come with the option to buy 755,810,1064 nm wavelength separate handpiece or a single hand piece firing 3 wavelengths at varying proportion.Example a single shot will contain 50% 810nm wavelength,25 % each of 755 & 1064 nm wavelengths.The latest introduction recently launched called Soprano Titanium has 4cm2 sized handpiece to treat fast and effectively type 1-6 Fitzpatrick Skin tones. It’s effective when it comes to thin-hairs which last at the end, so you treat them with the diode laser, and finally when it comes to the last thin hair, you can treat that with the alexandrite if you have a separate handpiece,if not also since there is 25% of 755nm wavelength being fired,its quite effective to give faster results that 805 or 810 nm alone.These are additional luxuries you can have in your clinic if you have the financial capacity and the right kind of patients walking in.
Another FDA approved laser for hair removal is from Cocoon Medical which has their flagship system Primelase HR (Cocoon Medical,Barcelona,Spain).Besides being a powerful laser ,it has advantages of handpieces of 755nm,810nm,1060nm in different spot size along with a hand piece in combined diode mode of 810nm,940nm and 1060nm.Since 755 Alex and 810 Diode has almost similar penetration depth and Nd:YAG penetrates very deep,there was a need to cover the large part of deep seated hair follicle.Hence amalgamation of 810, 940 & 1060 is better and covers entire length of follicle homogeneously.This was the idea for introducing this new wavelength and users are giving a positive feedback with this handpiece.However the catch in this laser is its Ultra short Pulse of 3ms which can be increased uptp 400ms and high peak power of 4800watts.The shorter the pulse and higher the fluence definitely better the result,however more the chances of damage to the skin besides the hair follicle alone,especially if darker skin type.Although Pulse width of 400ms is safe to use when starting of treatment on skin type 4,5 and 6,it doesn’t give results beyond a point unless the pulse width is reduced to first 100 and than to 30ms.Eventually when its fine thin hair the lesser the pulse(especially if below 10ms) ,the better but more the chance of burns also.Hence while treating fine thin hair their 810nm diode wavelength handpiece is very efficient as the pulse width can be brought down to 3ms
And the most recent introduction in the field of laser hair removal,its Lumenis Splendor X.SPLENDOR X, lets you customize hair removal and skin treatments across an infinite spectrum of skin tones blending Alexandrite (755nm) and Nd:Yag (1064nm) wavelengths.Here unlike other laser system which was a diode laser with wavelengths similar to Alexandrite or Nd:YAG,there are two laser system Alexandrite 755nm and Nd:YAG 1064nm,the wavelengths can be synchronized to fired independently or simultaneously, with varying proportions to tailor treatment, according to the individual’s skin type, hair color and thickness allowing safe and effective treatment. 3.5KV power supply from each handpiece ,amounting to 7KV power makes it’s the most powerful laser in the market as of now.It also has the options of various sizes of handpieces making LHR even more faster and efficient.Its introduction doesn’t neccesorily mean Diode doesn’t give the desired results,as mentioned earlier these are luxuries that one can have at their center based the ethinicity treated,footfalls in the center and financial capacity of the patients.
When it comes to speed now treating a whole body takes less than 30 minutes with any of the latest systems in the market with handpieces of varying sizes.
You can make any technology work as long as you understand the physics behind it. No technology is a bad technology. But understanding the skin is more important and also understanding the technology behind a laser, because you know how this skin is going to react, and you know what to do with the laser .Offcourse it would be a priviledge to have all types of lasers in your clinic if its financially viable and that would make any practise versatile. When it comes to treating darker skin types,Diode laser still has the edge when you consider the result-safety profile and it has been the gold standard and it still remains to be.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner