Laser hair removal has become one of the most common cosmetic procedures performed in the United States, ranked second among cosmetic procedures behind neurotoxin injections in frequency of procedures performed. Laser hair removal utilizes beams of highly concentrated light designed to selectively penetrate into the hair follicles, to be absorbed by the pigment in the hair follicles and to destroy the hair within that hair follicle. A variety of lasers and light sources have been developed that may be employed in laser hair removal. The procedure was originally described to be performed on dark hairs on light skin; newer technologies have made the procedure safer for patients with darker skin and those of color. Various types of lasers are utilized with laser hair removal – the most common of which are alexandrite, diode, Neodymium YAG and intense pulsed light sources.
WHAT IT CAN HELP/CURE
Laser hair removal can remove unwanted hair in those individuals who have disease states in which unwanted hair growth can occur, or it can be performed on those individuals who have no active disease states and just want removal of unwanted hair. Most individuals will require a series of treatments over time which will result in the removal of the unwanted hair. Most of the lasers and light sources are FDA cleared for permanent hair reduction, which means reduction over time. Some individuals will see very long term hair removal which may last for many years. Others may require maintenance treatments over time to maintain their degree of hair loss. It is truly impossible to determine in advance who will require how many treatments and how long the hair will remain gone. As stated above, laser hair removal works best in those with dark hairs on lighter skin, however newer technologies and newer lasers and light sources have made the procedure safe and effective in those with darker skin and those individuals of color.
WHAT TO EXPECT BEFORE, DURING AND AFTER THE PROCEDURE
Prior to having laser hair removal, thoroughly check the credentials of the physician or technician performing the procedure. Although laser hair removal is the second most common cosmetic procedure, many clinics promise results that are just not realistic. Once you have the proper comfort level with the clinic where you are going to have the procedure performed, you will schedule an appointment.
Most patients will have the hair trimmed with a scissor to just a few millimeters above the skin surface. The laser and light source will be set with parameters which take into consideration your skin color, the hair color, the thickness of the hair, the location of the hair and the amount of energy needed for the treatment to be performed. Depending on the laser or light source used, both the patient and the technician will wear appropriate eye protection, to prevent the laser light from penetrating into the eyes, which in itself can be a significant danger. The area to be treated should be clean and dry. Again, depending on the laser or light source, either a cold gel or a special cooling device will be used to protect the outer layers of the skin. This also helps the laser light penetrate further into the skin. Many of these cooling devices are now part of the laser itself, and you will feel the cold when the laser is applied to the skin. The operator will then give a pulse of light to the treatment area and should then observe the area for several minutes to determine if the optimal parameters were used. They will also look to see that there are no adverse effects prior to continuing the procedure. When the procedure is finished, it is common for the area treated to have some redness and some accentuation of the hair follicles themselves. This is “normal,” and should disappear over the next 12-24 hours, in most cases. At the conclusion of the procedure, most will have ice applied to the area treated, and some may use some special aloe gels or anti-inflammatory creams, lotions, or water to relieve any discomfort to the area.
Most individuals will be scheduled for another treatment 4-6 weeks later and the procedure will be repeated until hair growth has been eliminated. At each successive laser hair removal procedure, less hair should be found in the treatment area. Treatments will be resumed at a point in the future when, and if, hair growth occurs again necessitating further therapy.
COMPLICATIONS THAT CAN OCCUR
As with any laser treatment, complications can occur with laser hair removal. Both the physician and the patient must be aware that they may occur and be able to identify them and treat them appropriately. With laser hair removal, redness and swelling of the hair follicle, known medically as erythema and perifollicular edema, are “normal” events seen with most laser hair removal procedures. On occasion, pain and discomfort will occur with laser hair removal – most of this can be easily treated with over-the-counter pain medicines. Excessive pain during the procedure, especially during successive laser hair removal procedures, should be brought to the laser technician’s attention immediately, so laser settings may be adjusted. Other adverse events, although rare, are seen and should be reported immediately to the physician in charge. These include blisters and burns, which can occur with every one of the devices on the market, and especially if there is a recent history of sun exposure or if one goes into the sun immediately after the procedure. Patients should be advised to avoid direct sun exposure for at least one week following all laser hair removal procedures. Blisters and burns, although rare, do occur, and on occasion, will lead to either too much or too little pigment remaining in the skin, conditions known as hyperpigmentation or hypopigmentation. And even rarer, true scarring results, with raised red scars known as hypertrophic scars and keloids.
All patients should be warned of these risks prior to laser hair removal procedures and all facilities should be well versed in how to handle these complications. Dermatologic surgeons are well versed in handling any of these complications, making these highly trained physicians and their facilities ideal locations for laser hair removal procedures.
QUESTIONS TO ASK YOUR DERMATOLOGIC SURGEON
As with any cosmetic procedure, ask your dermatologic surgeon questions regarding their experience and training, including the training of any of the technicians who may perform the procedure. You should be able to get some degree of expectations from your dermatologic surgeon, as to how many treatments he or she may think you may require and learn about the follow-up and how you go about speaking with the physician’s office if you have any questions. Dermatologic surgeons are skilled in this and many cosmetic laser treatments.
FOR MORE INFORMATION AND REFERRALS
For more information on skin conditions and treatments, along with a list of ASDS members in your state, please visit the Find a Dermatologic Surgeon section of our Web site.
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