Laser Hair Removal Guide
Temporary hair removal is accomplished with conventional treatments such as shaving, waxing and epilation. Another method is the use of selective photolysis, which is light energy that is produced by the laser, and is targeted at the pigment in hair. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin).
Long lasting hair removal can be achieved with the use of several available lasers. Total temporary hair removal, which lasts for several months, can be done in almost all patients. However, total permanent laser hair removal is not commonly done. Stable permanent hair removal may be possible in some cases and usually requires multiple treatment sessions.
- Is laser hair removal painful?
Laser hair removal can be mild to moderately uncomfortable. Each individual hair follicle is surrounded by nerve endings. While some patients may be able to tolerate the procedure without the use of an anesthetic, others may find the application of an anesthetic cream (such as EMLA) helpful. A generous layer of anesthetic cream is applied for 30-60 minutes before the procedure and can provide adequate relief from discomfort during the procedure.
- How many treatments are necessary?
For satisfactory, long-lasting hair removal most patients require three to six treatments. The interval between treatments varies between 4 and 12 weeks, and will depend on your hair color, the type of laser used, and the location treated.
- What are the complications?
Fortunately, the complications of laser hair removal are rare if it's done by an experienced and skilled physician. You should expect a certain degree of pain, swelling and redness around the hair follicle after each treatment session. These symptoms resolve over the following 24 hours and include:
- Pigment alteration: Postinflammatory hyperpigmentation or darkening of the skin next to the treated area has been reported in 5% of patients and is sometimes seen in darker skinned individuals. Strict sun avoidance is recommended. Hypopigmentation, or lightening of the surrounding skin, has also been reported. These adverse effects are usually temporary. Alteration in underlying pigments is also a risk, especially when Q-switched lasers are used.
- Infection: Bacterial infections are rare and occur when the superficial skin is injured. Antibiotic treatment may be prescribed, but generally good wound care is sufficient to prevent infection. If you have had prior episodes of cold sores or herpes simplex infections, you may develop a recurrent episode after a laser treatment. If you have a history of herpes simplex infections, your doctor should prescribe appropriate antiviral medication prior to laser hair removal to prevent a recurrent herpes episode.
- Scarring may rarely occur and generally follows an infection or superficial skin injury.
Who is a candidate for Laser Hair Removal?
Almost anybody who has undesirable hair is a candidate for laser hair removal. However certain conditions may complicate treatment. Laser hair removal achieves the best results with light-skinned, dark-haired individuals. Lasers with longer wavelengths are generally useful for darker-skinned patients.
Caution must be exercised in certain situations:
- The presence of an active bacterial or viral infection prevents treatment until the condition resolves.
- A history of hypertrophic scarring or keloid formation requires less aggressive laser treatments in order to avoid any complications.
- The presence of a suntan makes laser hair removal less effective and increases the likelihood of scarring or skin injury.
- If you have psoriasis or vitiligo, you should be warned about the possibility of causing more lesions in the treated areas.
- Most dermatologists recommend waiting 1 year after taking isotretinoin (Accutane®) before doing laser hair removal because of atypical scarring that has been associated with use of this drug during treatment.
Laser hair removal can be performed on virtually any hair bearing part of your body including your arms, legs, bikini area, back, etc.
Objectives of Therapy
- The primary objective is safe and effective hair removal.
- Total permanent hair removal, while desirable, is not always possible.
- Total temporary hair removal lasting several months is a reasonable expectation.
- Some permanent hair reduction in treated areas is possible, especially after multiple treatments.
- You should strictly avoid sun tanning and artificial tanning products.
- You should avoid waxing, plucking or electrolysis of any areas to be treated for at least 6 weeks before your laser treatment.
- The use of shaving and depilatory creams is allowed.
- If you have darker skin, you should consider a bleaching cream or skin lightening regimen.
- You should shave the treatment areas within 24 hours prior to treatment.
- Anesthetic cream can be applied 30-60 minutes prior to treatment
- You should remove cosmetics prior to treatment.
- You will see redness and swelling around the treated hair follicles immediately following treatment.
- Blisters and crusting are rare, though more commonly seen in darker skinned individuals.
- Several days after treatment, hair may be extruded from the follicle.
- Immediately following treatment, cold compresses can be applied to the skin surface
- Emollients and/or topical corticosteroid creams can be used to keep areas moist and reduce redness and swelling.
- Blisters and crusting are treated with antibiotic ointment and daily soaks.
- You should strictly avoid the sun in order to prevent pigmentary changes.
Lasers used for Hair Removal
Laser energy, through the principle of selective photothermolysis (a process that involves selective absorption of an intense light pulse at wavelengths that are absorbed by the hair follicles, but not by the surrounding tissue), targets the pigment in the hair follicle. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin). Growing hair is more sensitive to destruction than resting hairs. Many of the lasers listed below utilize epidermal or skin cooling techniques. The effect of cooling the surface of the skin serves to minimize discomfort during treatment while increasing the effectiveness of the laser treatments.
- Ruby Laser (694 nm, normal mode)
- All patients will see a growth delay of their hair. Some patients will see a permanent reduction in hair growth.
- This laser is more effective for dark hair. Blonde and gray hairs are more resistant.
- White hairs do not respond to treatment
- Epilaser® (Palomar) and Epitouch® (Sharplan) are examples of ruby lasers
- Alexandrite Laser (755 nm, normal mode)
- All patients will see a growth delay of their hair. Some will see a permanent reduction in hair growth.
- It is effective for dark hair. Blonde and gray hairs are more resistant.
- White hairs do not respond to treatment
- It is potentially safer for darker skin than the ruby laser
- Rapid repetition rates of the laser will reduce treatment time
- Apogee® (Cynosure) uses a cooling gel on the skin
- Gentlase® (Candela) uses dynamic cooling spray
- Pulsed Diode Laser (800nm)
- Patients with thick or coarse hair will see a delay in hair growth. Some patients will see a permanent reduction in hair growth.
- It is effective for dark hair. It is not effective for fine hair.
- Potentially, it is safer for darker skin types
- LightSheer® (Coherent) uses contact cooling
- Intense Pulsed Light Source (500-1200 nm)
- It is effective for dark hair, both fine and coarse
- It is potentially useful for darker skin types
- Epilight® (ESC) uses cooling gel
- Nd:YAG Laser (1064 nm, Q-switched)
- Permanent hair removal has not been demonstrated
- It can temporarily remove light hairs
- It is potentially safe for all skin types, and causes the least epidermal damage of all treatments.
- Carbon suspension is applied to skin in some treatments
- There is a lower risk of epidermal damage
- Short operative times are required
- It causes the least discomfort of all laser hair removal treatments