Dermatology & Cosmetic Surgery

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Dermatology & Cosmetic Surgery
1918 Randolph Road, Charlotte, NC
(704) 333-9113

Laser Hair Removal

Currently there are four laser wavelengths available for the treatment of unwanted body hair. These wavelengths target the pigment in the hair (melanin) in an effort to destroy hair follicle. Thus dark colored hair responds best to laser hair removal because dark hair contains high levels of pigment or melanin. Lighter hair responds less well and white hair does not respond to laser hair removal. The following four laser wavelengths have been shown to be effective in the removal of pigmented hair: 694 nm produced by the Ruby laser, 755 nm produced by the Alexandrite laser, 800 nm produced by the Diode laser, and the 1064 nm neodymium:YAG laser. The pulsed laser energy is absorbed by the pigmented hair shaft and transferred to the surrounding follicle. The heat build-up caused by the absorption of energy by the hair itself is capable of creating follicular damage and retard or prevent future hair production by that follicle.

What results can be expected?

Patients will achieve varying degrees of success. The application of these laser energies to the skin results in almost complete removal of all actively growing hairs. This results in what is called a growth delay where for a varying period of several weeks to months after a laser treatment there is minimal or no hair growth. After this time, the percentage of hairs that regrow following one treatment can vary. Some reports note as much as 50% reduction after one treatment; however, it is probably more realistic to expect a reduction of 20 – 40% after one treatment. With subsequent treatments, the percentage of hair that regrows is further reduced. With a series of treatments (3 – 6), significant permanent reduction of hair may be achieved, so that very little or no hair is growing. Based on large clinical trials, most patients reach 70% reduction after 3 treatments, but at least 4 – 6 treatments are needed to achieve 95% reduction. Even after completing a series of treatments it is likely an additional treatment will be required in 4 – 6 months. Patients with darker skin will require more sessions of laser hair removal. Because the wavelengths commonly used for laser hair removal are also absorbed by pigment in the skin, the laser must be operated with less energy in order to protect the pigmented upper layer of skin. This results in a safer treatment for darker skin, but may require more sessions. Part of the difficulty in eradication unwanted or excess hair lies in the fact that the follicle has tremendous capacity to regenerate. This ability to recover and regenerate is highly variable from individual to individual and from one anatomic site to another. In most instances multiple treatments are necessary in order to achieve permanent hair reduction and in some instances treatment may fail to permanently remove all the hair in a given anatomic site. The efficacy of laser hair removal is closely associated with hair biology and the hair cycle. Hair growth cycles are divided into three phases. The anagen follicle or growing hair is thought to be the major target for laser energy and represents the most vulnerable phase of the hair growth cycle. Telogen or resting hairs are not actively growing and appear to be more resistant to the laser energy. The transitional phase between anagen and telogen phases known as the catagen phase is short but also relatively resistant to laser removal.

How does laser hair removal differ from electrolysis?

Electrolysis is a much slower process. With electrolysis, a needle is actually inserted into each hair follicle, one at a time. Once inserted, an electric shock burns the follicle to retard hair growth. Numerous sessions are required because only a very small area may be treated with each session. With laser hair removal, a large number of hairs are treated with each laser pulse. Thus, very large areas may be treated in a single session Most patients who have had both procedures say that laser hair removal is less painful, faster and more convenient.

What occurs in a laser hair removal treatment session?

Laser hair removal is a gentle three-step process. The area is first shaved and then treated with the laser. The laser energy passes through the skin and is absorbed by the pigment in the hair follicle. In a fraction of a second, the hair follicles are treated. Lastly, after an area is treated ice packs and a topical steroid cream are applied to reduce redness and swelling.

Treatment sessions can last from a few minutes to over an hour depending on the size of the area being treated. After your treatment, you can return to your normal activities. The use of sunscreen is recommended on any treated areas exposed to the sun.

Is laser hair removal painful?

During the treatment, you will feel a tingling or stinging sensation. Different body areas may be more or less sensitive. A topical numbing cream may be prescribed if your first treatment is too uncomfortable.

What does the skin look like after treatment?

Immediately after treatment, it is normal for the skin to appear red and there may be slight swelling around the treated hair follicles. The redness and swelling resolve very quickly – usually within hours. For the next several days to a week laser treated hair may be visible within the follicle. These hairs will fall out over a period of days to weeks. If visible areas are treated (face), do not plan any major social engagements for at least a week after treatment, otherwise you can return to normal activities immediately.

What are the risks associated with laser hair removal?

Laser hair removal has proven to be a very safe procedure. Since laser pulses are a constant energy and there are effective devices to cool and protect the upper layer of skin, there is minimal chance of scarring associated with this process. In certain instances temporary increased or decreased pigmentation will be noted within the laser treated sites, especially in more darkly pigmented patients. In certain cases there may be some degree of crusting during the postoperative period which is treated by the use of bland emollients (Vaseline) or topical antibiotics.