She Did Four Sessions Elsewhere: Taking Over Mid-Course

She books lower legs, sits down, and hands you a story instead of a record. Four sessions at a place across town. Now she wants you to pick up where they left off. Reasonable request. It's also the booking that quietly produces most takeover burns and most refund arguments, because the obvious move — carry on near their settings — is the wrong one.

Here's how to run that appointment so it ends in a course you can defend.

What "four sessions" actually tells you

Almost nothing. A session is a booking, not a dose.

Counted visits, not delivered energy

Four visits could mean four low-fluence in-motion passes on a fast salon protocol, or four full-fluence stamped treatments with a proper endpoint. It could mean a 12-minute slot for both lower legs, which is a speed run, or a 35-minute slot, which is a treatment. Ask what she paid per session and how long she was in the room. Cheap and quick usually means gentle, and gentle usually means the follicles were warmed rather than damaged. That single fact reframes the whole consultation: you may not be taking over a half-finished course at all. You may be taking over an unstarted one.

The calendar matters more than the number

Get dates, even rough ones. Four sessions squeezed into eight weeks tells you the other clinic was chasing the booking sheet rather than the growth cycle. Four sessions spread across fourteen months tells you she kept cancelling, and every anagen window they hit was a different crop of hairs. And if her last session was three weeks ago, her skin still carries recent thermal history — you are not treating naive skin, whatever the settings said.

Work out what treated her, without asking for a brand

Brand answers come back useless. She'll name whatever was on the salon poster, or say "the painless one." Ask about the experience instead. Technicians can reconstruct a lot from it.

• Did the head touch your skin and feel cold? Was cold air blowing on you? Did they spread gel first?
• Did they hold it still and click, or slide it back and forth over the same strip for a minute?
• Did it snap like an elastic band, or build up as heat that got uncomfortable and then faded?
• Did you shave beforehand, or did they wax you at the same visit?
• How long did the redness and the little raised bumps last — an hour, an evening, the next day?
• Were you patch tested, and did you come back on a separate day before your first full treatment?

Gliding, contact cooling, repeated fast passes points toward an in-motion diode protocol. Gel plus a stamped head plus a broad snap points toward IPL or an e-light platform. Slower single shots with cold air, especially on deeper skin tones, points toward long-pulse 1064 nm. Treat that as a bracket, not a diagnosis. What each platform does differently, and which one suits which room, is covered in our laser hair removal operating guide.

One answer above is worth more than the rest. If she never saw redness or bumps after any of the four sessions, nobody ever reached a follicular endpoint on her. That's your explanation for "it didn't work," and it's good news for the conversation you're about to have.

Rebuild the baseline. Never inherit it.

Occasionally a client does arrive with a printed record card. Lovely. The numbers on it still don't transfer to your machine.

Fluence through one optic and cooling arrangement is not comparable to the same number on your screen. Pulse structure differs. Spot geometry differs. Skin contact and pre-cooling differ, and cooling is what sets how much energy the epidermis will tolerate.

Her skin has changed too. If those sessions did land, the hair left behind is finer and sparser than what they started on. Less pigment in the shaft means less absorbed energy, so the fluence that felt right on coarse terminal hair may now do very little — or, if you push it blind to compensate, rather too much to the skin around it.

Two test squares, not one

Put down a conservative square and one step above it, in the area you'll actually treat, and read them at 24 to 72 hours. This is not a formality you can skip because she's "experienced." She's experienced on someone else's device. Our patch test protocol covers placement, what counts as a pass, and why nothing happening is not a pass.

Step up the way you would with a new client

Our diode operating documentation is blunt about this: raise energy in small increments — on the order of a few percent of the power scale, and one pulse-width step at a time — and ask and observe between every change rather than after them all. The endpoint you're steering to is warmth with a slight tug at the roots and mild redness around the follicles, not pain. The same manuals note that darker skin wants lower energy and lower repetition rate, paler skin tolerates more. Treat the reaction. The number is just where the reaction happened to live today.

Photograph before your first pulse

You're inheriting whatever the other clinic left on her legs, including any faint post-inflammatory pigmentation. If you don't have a dated photo from before you touched her, that mark becomes yours the moment she notices it. Start her file properly — parameters, responses, photos, every visit — the way our treatment records guide lays out.

Re-screen everything she's already "passed"

People change between clinics. Someone starts doxycycline for acne, begins an anticoagulant, gets pregnant, grows a new lesion nobody has looked at. Her old clearance was true in March. It isn't evidence about August.

Run your own screen from scratch. The contraindication list in our device manuals is the usual one and it hasn't got shorter: photosensitising medication such as tetracyclines, anticoagulant use within the past two weeks, pacemakers and similar implanted devices, poorly controlled diabetes, hypertension, heart disease or epilepsy, pregnancy, a tendency to keloid scarring, any lesion without a firm diagnosis, and recent sun exposure or tanning — those manuals ask for roughly ten clear days before treatment. An undiagnosed lesion in the treatment field is a referral, not a shot to work around.

One takeover-specific item: numbing cream. If her previous clinic told her to slather anaesthetic over both legs at home before arriving, that habit ends here. The FDA has warned consumers about high-concentration topical pain relief products used before cosmetic procedures including laser hair removal, because absorption across large areas has been linked to irregular heartbeat, seizures and breathing difficulty. The full history-taking script sits in our consultation guide. None of this is medical advice; where a client's history is unclear, send her to a physician before you treat.

Reset the count, then reset the promise

In her head she's four of eight. Halfway. That belief is where the argument at session six comes from, so retire it on day one, kindly and out loud.

Wording that works: "I'm starting your course at one on my records. Not because the earlier sessions did nothing — they may well have helped — but because I can't verify what was delivered, and I only plan and price what I can verify."

Then set the outcome honestly. The controlled-trial evidence, summarised in Haedersdal and Wulf's evidence-based review in the Journal of the European Academy of Dermatology and Venereology (2006), is that efficacy improves when treatments are repeated, that partial long-term reduction beyond six months is supported for repeated diode and alexandrite treatment, and that there is no evidence for complete and permanent removal. Reduction, then maintenance. Say it before you take her money, not after.

Sometimes the takeover is a technology problem as well as a technique one. Gan and Graber's review in Dermatologic Surgery (2013) concludes that Nd:YAG, with its longer wavelength, is the best option for pigmented skin. So for a darker-skinned client treated timidly for four sessions, the platform may be as much of the problem as the technique. Moving her to a long-pulse 1064 nm platform, or onto a properly run diode system with real cooling, is often part of the fix — the other part is still reaching a real follicular endpoint, which is what was missing before. Count the cost of the switch as well: 1064 nm is poorly absorbed by epidermal melanin, which is why it is safer on deeper skin, and poorly absorbed by hair melanin too, so expect lower clearance per session, more sessions and more discomfort. Price the course accordingly, and read treating tanned and darker skin before you quote her.

Pricing a client somebody else half-treated

Don't match their package price. Their price bought their protocol and their risk, and you're absorbing an extra visit for the patch test, a longer consultation, and a photo set.

Three rules keep this profitable and calm:

1. Charge the assessment. Patch test plus consult is a paid appointment, creditable against her first session if she books. Free assessments attract shoppers who want a second opinion on the other clinic, not treatment.
2. Sell a short block, never a big one. Three sessions with a formal review at the third, priced per area. You don't yet know how she responds on your device, and an eight-pack sold before your first treatment is a refund you've pre-agreed to. Your standard terms and deposit rules still apply — see the package and booking policy.
3. Write the takeover into consent. One paragraph: the clinic cannot verify treatments performed elsewhere, the course restarts at session one, prior results are not attributable to this clinic, and existing pigmentation or scarring is documented photographically today.

Two things you never do: honour another clinic's unused sessions, and comment on the competence of the previous provider. The first is unpriced liability. The second turns you into a witness if she goes after them.

When to send her away, or wait

Turn the booking into a later date if she has a fresh tan, active crusting or blistering from her last treatment anywhere in the field, or new pigmentation that hasn't settled. Postpone if her medication list has changed and she's not sure of the details.

Decline outright if she wants you to finish in two sessions because she's "already done four," and won't hear otherwise. Losing her at session five costs you a chargeback and a review.

She brought her old record card with the settings. Can I just start there?

No. Fluence on another platform isn't comparable to yours — different optics, pulse structure and cooling change what that number does to skin. Read the card for useful history instead: how often she was treated, what area, whether reactions were recorded, whether anyone patch tested her. Then set your own baseline from your own test squares.

Do I really need a patch test if she's had four sessions already?

Yes, and it's the single thing you'll be glad you did. She's proven tolerant of someone else's device at someone else's settings. Your machine, your cooling, your technician. It also creates the dated record showing what her skin looked like before you touched it, which matters more with a takeover than with anyone else.

She says the other clinic achieved nothing. Should I take her on?

Usually, yes — but find out why first. If she never had redness or follicular bumps after any session, she was under-treated, and that's fixable. If she has deeper skin and was treated on a platform poorly suited to it, changing technology is part of the fix. If she's had genuinely aggressive treatment with good endpoints and still sees no change, look harder at hormonal drivers and lower her expectations before, not after, she pays.

How do I count her sessions for the guarantee I offer?

From one, on your file, with the review point at three. Any promise you make attaches to treatments you delivered and recorded. Say that plainly at the desk and write it into consent — a takeover client who thinks she's inherited a guarantee is the most expensive booking in the diary.

What should the front desk say when someone calls asking to continue a course?

Something like: "We can absolutely take that on. Because it was a different machine, we start with a paid assessment and patch test, then plan your course from there — it's how we keep you safe and make sure you actually get results this time." Book the assessment, not the treatment. Never quote a session count on the phone.

1. Haedersdal M, Wulf HC. Evidence-based review of hair removal using lasers and light sources. J Eur Acad Dermatol Venereol, 2006 Jan;20(1):9-20
2. Gan SD, Graber EM. Laser hair removal: a review. Dermatol Surg, 2013 Jun;39(6):823-38
3. FDA warns consumers to avoid certain topical pain relief products due to potential for dangerous health effects (use before cosmetic procedures such as laser hair removal)