How to Talk to Patients about Pain Management in Aesthetics

The popularity of medical aesthetic treatments is growing, as the stigma surrounding cosmetics is slowly being chipped away and more patients discuss their experiences with friends, family, and even their online followers. The introduction of advanced and proven technology that offers effective minimally invasive and non-invasive alternatives to what was previously only possible through cosmetic surgery is one factor supporting industry growth as the promise of little to no pain and downtime appeal to a wider audience.

Of course, this growth has led to a wider variety of patients opting for treatments and among them, a larger number of anxious patients whose top concern is often pain and a lack of control. To ensure a more positive experience for these patients, communication is key. But how do you go about discussing pain management during aesthetic treatments without causing increased anxiety?

First, Know How to Spot Anxiety in New Patients

Anxiousness is often a patient’s expression of worries regarding pain. Your initial consultation with a patient offers the perfect opportunity to get to dig into their past experiences, note any recurring concerns they bring up, and get to know how they might personally approach pain (do they opt for medication for a headache, for example, or reach for alternative treatment methods prior to painkillers). Knowing some signs of anxiety and how you can spot it in new prospective patients can help you better address their concerns and ensure an enjoyable treatment.

According to the American Psychology Association (APA), anxiety is defined as “an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure.” In other words, anxiety is a state of apprehension that can bring about mental and physical changes in a patient. Simply because a patient opts for a medical aesthetics treatment does not mean that they will be comfortable, as anxiety can ebb and flow or be triggered by very specific situations.

The following are some common signs of anxiety and anxiousness:

• Nervousness and restlessness, particularly when discussing aspects of a treatment that may cause pain or discomfort
• A focus on fears of the future that may border on panic or impending danger
• Increasingly rapid breathing (may be to the point of hyperventilation)
• Increased heart rate, sweating, and trembling
• Difficulty keeping on topic or concentrating on the question at hand; appears entirely distracted or returns to a previous topic without prompt
• Attempts to avoid discussing what worries them
• Troubles discussing future outcomes or thinking about anything other than what they are worried about
• Fixation on a specific topic, even after you’ve answered their questions

For patients who show multiple signs of anxiousness during the initial consult or who note a history of an anxiety disorder, encouraging a mental health consult with a trusted provider recommended by your clinic prior to treatment can help to ensure the patient has all the support they need from a collaborative team of qualified professionals. Once the appropriate steps are taken or a patient’s concerns are determined to be an expression of everyday anxiousness and not an anxiety disorder, the following steps can help to address the topic of pain and pain management without exasperating the patient’s anxiety.

Be Descriptive of What to Expect Before Treatment

In many cases, first-time patients may be experiencing anxiousness simply as a result of their fear of the unknown. This may be especially true amongst younger patients, who may be less mature in their understanding of what is involved in a medical aesthetics procedure. While some patients may be less comfortable discussing pain, addressing this aspect of the treatment process is mandatory to fulfill the requirements for informed consent.

While you will want to avoid creating any undue anxiety by offering too much information, you also need to ensure that you are not being overly cautious in offering up too little detail. Patients need to be prepared for what to expect. If you don’t mention a specific step or potential sensation they may feel during the treatment, they might perceive that pain or sensation to be a sign that something has gone wrong, triggering further anxiety and a potentially slippery slope of patient dissatisfaction.

Instead, have a pamphlet on hand that ensures the patient is aware of what occurs during each step of the treatment (before, during, and after) in simpler terms they may easily understand. Review this pamphlet with them to ensure nothing is missed and send it home, so an anxious patient may refer to it often and feel mentally prepared. Having a handful of analogies on hand can also help to better describe more subjective sensations to patients, such as the fact that following some treatments, it’s perfectly normal for the skin to feel warm to the touch, similar to a sunburn. Easily accessible comparisons can help to better describe levels of discomfort that may otherwise vary greatly by patient.

Finally, don’t downplay discomfort but be intentional with your word choices. For example, “slight pain” can seem more daunting than “minimal discomfort,” as the emphasis tends to fall on pain. Sentence structure can also alter where the emphasis lands. Generally speaking, anything that comes after “but” in a sentence garners more attention than what preceded it. For this reason, it might work better to say, “You may experience slight discomfort, but it will resolve quickly,” as compared to, “It will resolve quickly, but you may experience some pain.” While the meaning is generally the same, the perceived importance of facts implied by sentence structure and word choice can be a significant trigger for an anxious patient.

Offer Distractions During the Treatment

If discomfort is expected throughout the treatment, encourage communication from your patients. Ask them to identify if discomfort crosses over into pain. Let the patient know when discomfort may be experienced so they do not misinterpret it as a negative sign. Having said that, focusing too much on discussing discomfort can make matters worse for some patients. Allowing the patient to have a little control can relieve stress and improve comfort. For example, letting the patient make the call of when they may need a break offers patients some control, while also showing an increased level of trust in your patient. Letting a patient choose the music they get to listen to during treatment or, if appropriate, letting them choose what plays on the television in a treatment room can also boost a patient’s sense of control over the situation while providing a further calming effect.

Some additional distraction techniques may be to have a supportive assistant who can easily keep conversation with patients. Asking about their weekend plans, what television show they’re currently watching, or how the family is doing are some easy topics of conversation. Throughout the treatment plan, as you learn more about the patient, you can make a note of what you discussed and ask follow-up questions during the next session, building rapport with that patient, establishing their trust, and offering a calming distraction all at once.

Finally, if pharmaceutical pain management is needed, ensure there is a plan in place prior to treatment, as the need to use additional therapies that were not planned pre-treatment may cause unnecessary worry in an anxious patient. Generally speaking, start with mild therapies, such as a topical numbing cream and work your way up only as needed. Err on the conservative side but ensure you don’t risk a patient’s comfort or minimize their pain if they are expressing it’s too much. Each patient has a different threshold, so it’s important to discuss a personalized approach that meets their unique needs and adapt as needed.

Keep the Communication Lines Open Post-Treatment

For some treatments, minor discomfort may continue post-treatment. In these instances, it is ideal to ensure a patient is well-informed of all potential reactions post-treatment, so they may be able to determine what is within the range of normal reactions and what may be cause for concern. Offering contact information for your clinic’s patient care coordinator—or the assistant who has already formed a connection with the patient in those cases where no care coordinator is on staff—can also help your clinic to effectively address a patient’s fears and concerns before they may escalate.

The Bottom Line for Pain Management in Aesthetics

Throughout every stage of the consultation, treatment, and patient retention process, managing pain is ultimately linked to managing anxiety. A prepared patient is more likely to be a cool, calm, and relaxed patient who experiences minimal discomfort.

Having said that, an experienced professional will know how to adapt treatments to improve patient comfort. For example, a shorter pulse width in laser hair removal can offer more comfortable treatments for patients by keeping heat to a minimum. Further, some advanced laser aesthetic devices offer built-in cooling features to protect the epidermis while reducing the risk of pain, erythema, post-inflammatory hyperpigmentation (PIH), and more. Because the main objective of any laser aesthetic treatment is to maximize thermal damage in the targeted chromophores while ensuring safety and minimizing injury to healthy surrounding skin, cooling systems are essential for patient comfort. Devices with built-in cooling systems that deliver a cooling effect in sync with thermal energy delivery, such as that found in the Venus Velocity™ diode laser hair removal system, can help to more accurately deliver focused thermal therapy to targeted pigment while protecting superficial tissue in the process for improved results and patient comfort.

Interested in learning more about Venus Concept’s lineup of non-invasive and minimally invasive medical aesthetic devices featuring built-in patient safety features? Contact an expert for more details and to find the right device for your clinic’s needs.