Laser Hair Removal

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	D G C © 2008 Updated May 08

W.J. CLAYTON M.B.B.S.

Lasers have revolutionised the management of unwanted hair, but they are not suitable for everyone nor are they without unwanted effects.

Who is suitable?

As a general guide laser treatment suits anyone with dark unwanted hair. White, blonde and grey hairs will not respond.

Ginger and pale brown hairs respond poorly. Dark brown and black hairs do best. Men and women can be treated, as can all body parts, and all skin colours. Do not have treatment if you have even a faint sun tan or are about to get one. LaserLasertreatment does not mix well with sunny holidays.

Is it permanent?

No, although the improvement is often long lasting. Permanence is not a useful description of laser treatment except when trying to sell it. Hair follicles have great regenerative powers. The brighter the laser light the greater the effect on the hair but the greater the risk of unwanted effects. Regular treatment also improves results. It is difficult to predict individual responses as many factors are involved such as: the thickness of the hairs, different body sites, hormonal differences, how dark the hairs are and how strong a laser light can be tolerated. However, in general, the hair free intervals gradually lengthen and regrowth gets sparser and finer. Most people will have long lasting benefits.

How does it compare?

Laser treatment will generally give you longer hair free intervals than waxing, shaving, plucking, or depilatory creams. It can treat more hairs more rapidly than electrolysis due to the large size of the laser beams.

Is it safe?

The laser makes an extremely powerful beam of red light. This can blind you or burn you if used wrongly. Care must be taken to protect eyes by limiting the number of people in the treatment room and wearing protective goggles during treatments. The strength of the laser must be carefully adjusted to avoid burns. It helps to keep the skin surface chilled during treatment. It is not thought to cause cancer.

How does it work?

The bright laser light will heat up anything that is dark. The hair follicles are damaged by heating up the black hairs within them. Remember that6 most of the follicles on your body are resting and hairless at any one time. These resting follicles will not be affected by the laser light. However, by repeating the treatment with each new crop of hairs eventually most follicles will be lasered. A lasered follicle takes a long time to recover, depending on how hot it has got. The technique depends on there being more dark pigment in your hair than there is in your skin, so that the hair follicles can be heated whilst your skin is kept cool. This is why most unwanted effects occur in darker skin types. Recently suntanned skin is particularly vulnerable to unwanted pigment changes in the skin caused by the laser light.

Which laser?

Most lasers and intense pulsed light sources will give good hair reduction in suitable patients when used correctly. Different lasers suit different skin colours. For example an Alexandrite is suitable for white to pale brown skins, and a long pulsed Nd: YAG on dark brown to black skins. Sun tanned skins cannot be treated. There have been several imaginative ideas to improve the response of white and blonde hairs to laser treatment, but it is still not very successful.

What are the unwanted effects?

There is some discomfort which is brief and can be relieved by chilling the treated area. There may be redness or goose bumps for an hour or so. The skin may feel sensitive for a day or two. Some peeling or scabbing may occur with temporary changes in skin colour, usually in the form of dark marks. Under-powered treatment may stimulate hair growth in susceptible individuals. This is a possibility when being very cautious with brown skin types. Rare unwanted effects include scarring, patchy loss of skin pigment, loosening of dental veneers and thrombosis of small veins.

How strong?

The stronger you have the treatment the better the results on the hair but the greater the risk of unwanted effects on the skin. On darker skin types dark circles may form for a week or two. These occasionally fade to leave pale marks that last for many months. For the longest hair free intervals in the least number of treatments you should have treatment at the limit of your skin’s tolerance, but this will mean risking a few of these unwanted effects.

What preparation is required?

It is very important to stop plucking and waxing for many weeks before starting treatment. You can trim or shave. This is difficult, but it is important for good results. You must also resist plucking hairs between treatments.

What aftercare is needed?

A plain moisturiser such as Aqueous Cream should be applied gently to prevent peeling. You should also get into the habit of wearing a strong sun block on exposed areas. This applies to all skin colours and is very important. If your skin darkens a little in the summer or while on holiday, then you will be more likely to get burnt on your next treatment.

What results can I expect?

It is difficult to predict exactly how well you will do. There are wide variations depending on body area, skin colour, hair colour and strength of treatment. As a guide:

Women with white skin and black hair treating underarm, bikini and legs should have hair free intervals of about 8 – 12 weeks initially, then very scanty regrowth after 4 – 6 treatments.

Women with black facial hair and white skin should achieve good control, with hair free periods of 6 – 8 weeks, with finer and sparser regrowth by 6 treatments. You will probably want occasional maintenance treatments. Brown and ginger hair will do less well. White and blonde hairs do not respond.

Women with brown skin should achieve hair free periods of 4 weeks on the face and 8 weeks elsewhere. Regrowth will be finer but is likely to be persistent.

After 6 treatments women with black skin and African type hair should be hair free on the face for about 8 weeks. Elsewhere on the body the hair free period will be about 12 weeks or more. Regrowth should be fine and scanty. Only occasional maintenance treatments will be required.

Men’s backs will become hair free for about 8 weeks with the regrowth getting finer after 6 treatments. You are unlikely to become completely hair free.

Men’s beards take many treatments and hair in the goatee area can be very persistent. Shaving rash and ingrown hairs respond well to just a few treatments, especially in Afro-Caribbean skin types, although the beard may look patchy.