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A Comprehensive Laser Hair Removal Guide: Expert Insights & Top Tips

Updated on December 17, 2023, by Don Mehrabi

Unwanted body hair can be a cosmetic problem or a sign of an underlying medical disorder. Laser treatments are a quick, safe, and long-lasting solution to this skin issue. Numerous laser hair removal procedures are available to remove unwanted hair, yet the safety and success of the treatment depend on the provider’s skill.

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Laser hair removal is one of many procedures commonly performed at BHSkin Dermatology. However, patients often want more information before scheduling a session. This article discusses how laser removes hair and what you can expect during the treatment process. I also explain here how you can optimize the benefits of your hair treatment.

Laser Hair Removal at a Glance
  • Lasers work by vaporizing melanin-containing hair follicle cells.
  • Laser treatment works best on individuals with dark hair and light skin. However, newer equipment types and technique refinement can make the procedure safe for everyone.
  • Things to do before laser hair removal: sun protection, shaving, cold sore medication intake, topical hydroquinone, avoiding treatments that pull the hair from the root
  • Things to do after laser hair removal: icing the site, gentle cleansing and moisturizing, sun protection, elevating the treated site, topical steroid for inflammation
  • The procedure’s effectiveness depends on the treatment area’s location, hair and skin color, light type used, patient’s hormonal status, and number of sessions.

Understanding the Process: How Laser Treatments Remove Hair

During the process, powerful light beams destroy the hair follicles by vaporizing melanin, the skin and hair’s main pigment. Laser light removes the hair shaft and ingrown hair. Additionally, deep laser penetration prevents new hair growth by damaging immature hair follicle cells. The procedure is highly effective on thick, dark hair, which contains a lot of melanin, but less on white or blonde hair.

Laser hair reduction works only during the active hair growth stage, known as anagen. Melanin is produced in large amounts during the anagen phase. Hair darkening stops in the succeeding stages—catagen and telogen—as melanin production ceases and the hair begins to fall. About 10-15% of your hair is in catagen or telogen. Fallen hair is in the exogen phase, which terminates telogen and signals the beginning of a new cycle.

The hair growth cycle’s effect on the follicles’ laser responsiveness makes multiple treatments necessary. Intense pulsed light (IPL), which uses a less powerful light source, requires more sessions than lasers to treat areas with the same hair density. 

What Are the Common Indications for Laser Hair Removal?

Laser technology can remove hair that causes cosmetic problems and correct inflammatory hair follicle conditions.

For the first group, most individuals consulting for cosmetic hair reduction have no health issues. However, some medical conditions may cause excessive hair growth all over the body (hypertrichosis) or in hormone-sensitive areas like the upper lip (hirsutism).

Meanwhile, hair follicle conditions treated by lasers include pseudofolliculitis barbae and acne keloidalis nuchae. These inflammatory conditions tend to be chronic and disfiguring. Destroying the hair follicles with laser energy reduces inflammation in the affected areas.

What Types of Lasers Are Used for Removing Unwanted Hair?

Hair-reducing lasers penetrate the hair follicles without creating open wounds, making them non-ablative. They differ from ablative lasers like CO2 lasers, which cut the superficial skin layers. Inflammation is less with non-ablative lasers and usually lasts only a few days.

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The laser types used for hair reduction are the following:

  • Ruby laser – emits powerful red light with a wavelength of 694 nanometers. Ruby lasers can easily damage melanin-containing cells called “melanocytes” in the superficial skin layers. This type of laser may cause post-inflammatory hyperpigmentation (PIH) in individuals of color.
  • Alexandrite laser – produces near-infrared light with a wavelength of 755 nanometers. Alexandrite lasers can also easily damage the melanocytes and cause PIH in susceptible people.
  • Diode laser – emits near-infrared light with a wavelength of 810 nanometers. Diode lasers penetrate the hair follicles with little melanocyte damage. Thus, PIH risk to dark skin is less.
  • Neodymium-doped yttrium-aluminum-garnet laser – otherwise known as Nd:YAG laser. These lasers produce near-infrared light with a wavelength of 1064 nanometers. Nd:YAG lasers also penetrate deeply, cause less melanocyte damage, and pose less PIH risk. 

Not all lasers suit every skin type because of the risk of PIH and, sometimes, scarring in darker skin. However, higher-wavelength lasers are usually gentler on skin of color. Reducing the risk of PIH and scarring entails choosing the right laser type, using the appropriate settings, and ensuring skin cooling during the treatment. 

IPL is the fifth light-based hair removal option. IPL devices are technically not laser devices. These instruments emit a less energetic, broader light spectrum (500-1200 nanometers) that can be filtered to suit various skin types. IPL devices also have large spot sizes, enabling them to cover large areas at a time. 

Choosing the Right Laser Treatment for Hair Removal

No single dermatologic laser type is best in every situation. Choosing a light-based hair removal device must be based on factors like problem severity, hair color, skin tone, vulnerability to side effects, cost, and treatment availability.

For example, the Alexandrite laser has been shown to be more effective for short-term hair removal than IPL, but both can reach 90% hair reduction when performed repeatedly. Meanwhile, using diode lasers on patients of color helps avoid PIH and scarring, which can worsen the problem rather than solve it.

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Cost and equipment availability can impact accessibility to laser treatment. The best light-based hair removal procedure to choose is the one that is effective, safe, and not impossible for the patient to get in their geographic location.

No matter the equipment employed for hair removal, opting for a laser specialist to conduct the procedure is crucial. Inexperienced providers, who may misuse equipment settings or employ subpar techniques, are frequently responsible for undesirable outcomes in hair removal treatments.

What Are the Advantages of Light-Based Therapy Over Other Hair Removal Methods?

Laser treatment’s advantages over other hair removal methods include the following:

  • Hair reduction can be permanent.
  • Results are immediate.
  • Light-based devices can treat large areas at once.

IPL can also yield fast results and treat sizable areas. Additionally, IPL treatments are less expensive. However, some individuals treated with IPL may observe unwanted hair regrowth afterward.

Is Laser Hair Treatment Right for You? Ideal Candidates Explained

That depends on the type of light-based technology used. Generally, patients with light skin and darker hair are the best candidates for ruby and Alexandrite lasers, as they have less PIH and scarring risk. On the other hand, IPL and diode and Nd:YAG lasers can be used on various skin types as long as the provider operates the equipment with the correct settings.

Who May Not Be a Good Candidate for Laser Hair Treatment?

The following are contraindications to light-based hair removal treatment:

  • Active or recurrent cold sores
  • Autoimmune disorders that make the skin photosensitive, such as psoriasis
  • Intake of light-sensitizing medications, such as the antibiotics minocycline and doxycycline
  • Using skin-sensitizing treatments like isotretinoin and chemical peels

Laser treatments have not been proven unsafe during pregnancy or lactation, although I recommend delaying the procedure at a later time to ensure the mother and baby’s safety. Similarly, patients on isotretinoin must postpone the treatment until 6-12 months after their last dose.

Preparing for Your Session: Important Steps

At our clinic, the therapeutic journey starts when you come in for your initial appointment. I examine every patient thoroughly to ensure that laser hair removal is suitable for them. I will recommend an alternative treatment if it is not. If you are a good candidate for the procedure, I will set your first laser treatment appointment as soon as possible. I will take a photo of the treatment area for documentation and monitoring your therapeutic response.

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Good pretreatment preparation helps avoid complications. Thus, I recommend the following measures before patients come in for a laser hair reduction session:

  • Avoid pulling out the hair in the treatment area, as in threading, tweezing, or waxing, starting 6 weeks before your appointment. These methods remove the laser’s melanin-filled follicular targets, rendering light treatments ineffective.
  • Start using sun protection 4-6 weeks before your session. Sun exposure increases PIH risk.
  • You may shave the area a few days before your appointment, leaving only a stubble, to enhance laser follicle penetration and avoid burns from hair singeing.
  • I will prescribe an antiviral if you have a history of recurrent cold sores.
  • I recommend topical hydroquinone use starting a few weeks before treatment to PIH-prone patients. I may also perform a spot test to assess your PIH vulnerability.

Make sure the treatment area is cleansed and cosmetic-free before coming in for your appointment.

What to Expect During Your Laser Hair Removal Session

Our staff will provide you with a medical gown and protective eyewear to start the session. Once you’re settled comfortably in the treatment room, I  will begin cleaning the target area before applying numbing medication to your skin.

Skin cooling reduces heat damage and the risk of complications after treatment. Lasers cool your skin by spraying a cold mist on the treatment area. IPL devices require cooling gels to reduce heat damage to the skin. 

The numbing medication and cooling gel take about 30 minutes to take effect. Once the treatment area is numb, I shall apply the device in pulses. This part of the treatment may last several minutes to an hour, depending on how much hair is removed.

Once done, I will clean up the treated area and explain how to care for your skin after your session. Our staff will furnish you with a copy of the posttreatment care instructions before sending you home.

What to Expect After Your Laser Hair Removal Session

Recovery after hair removal is a straightforward process. Here, I shall explain what you can expect after your procedure.

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When Will You Notice Results After Your Hair Removal Laser Session?

You may see hair growth starting to decrease in the first few days after therapy. However, you may not see the full effect of a single treatment for up to 12 weeks after your session. Monthly treatments can speed up the hair reduction process.

Is There Recovery Time After Laser Hair Treatment?

The procedure causes little inflammation, so downtime is minimal to none. Patients may return to their usual routines after their session. However, avoiding strenuous activities and protecting the area from trauma for a few days can reduce the risk of complications.

How to Care for Your Skin Post Laser Hair Removal

Like good pretreatment preparation, adherence to the recommended aftercare regimen also helps patients avoid complications. The following measures can help speed up your skin’s recovery after laser hair treatment:

  • Ice the treated area to reduce inflammation and pain.
  • Use cool water and a mild cleanser to wash the skin the first night after your procedure. Apply a moisturizer in areas prone to drying. Cleanse and moisturize your face twice daily onward.
  • Protect the skin from the sun and activities that cause skin flushing during the first few days after treatment. Heat exposure can result in skin irritation and recovery delays.
  • Elevate the area in the first few days to minimize swelling.
  • Protect the treated skin from cosmetics and other potential irritants while inflamed.
  • You may use a topical steroid cream for redness and swelling.

Contact our office right away if you develop unusual symptoms after your session.

Understanding Potential Side Effects of Hair Removal with Lasers

The most frequent side effects of laser hair removal are mild pain, redness, and swelling. These are normal inflammatory symptoms after a dermatologic procedure and resolve spontaneously in a few days. Icing the area or taking acetaminophen may help reduce the discomfort.

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The procedure has a low complication risk, but the procedure potentially causes the following:

  • Blistering
  • Burning
  • PIH
  • Crusting
  • Bruising
  • Scarring
  • Hair follicle inflammation (folliculitis)
  • Acne
  • Rosacea-like rash
  • Premature hair graying
  • Hypersensitivity to medical supplies used during the procedure
  • Accidental eye injury
  • Abnormal hair regrowth in some patients after IPL

However, these complications often arise when inexperienced providers mishandle the procedure. That is why choosing a board-certified dermatologist to perform your treatment hair removal is crucial to optimizing the treatment’s benefits.

Evaluating the Effectiveness of Laser Treatment for Hair

The procedure’s outcomes vary based on several factors, which include the following:

  • Location – areas where the hairs have thicker shafts respond better than those with thinner hair shafts. For example, the procedure is more effective on the armpits than the limbs.
  • Hair and skin color – patients with dark hair and a fair complexion respond best to the treatment.
  • Light-based treatment type – Alexandrite and diode demonstrate the best short-term efficacy.
  • Hormonal status – high blood levels of male hormones reduce the treatment’s efficacy.
  • Number of treatments – increasing the number of sessions improves effectiveness.

Light-based treatments typically reduce 10-40% of unwanted hair after a single treatment. Multiple sessions can cause about 90% hair reduction.

How Many Sessions Does It Take to Permanently Remove Hair?

Permanent hair removal is not always achievable. The hair-free period varies from patient to patient. Some may not see unwanted hair regrowth until 6 months. For others, it may take a year or more.

A minimum of 4-6 sessions scheduled 4-6 weeks apart are required in the initial stages of therapy. Most patients need maintenance treatments every 6-12 months. IPL generally requires more sessions than laser treatment.

Why Should You Choose a Board-Certified Dermatologist to Perform Your Laser Hair Removal Procedure?

Results depend on your provider’s skill. Laser-trained medical professionals like board-certified dermatologists are the best providers of this treatment for the following reasons:

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  • Safety – Board-certified dermatologists’ long experience performing light treatments enables them to screen the right candidates and avoid complications from equipment-use errors.
  • Excellent cosmetic results – Board-certified dermatologists are skin anatomy experts. We know which spots to treat and what techniques to use for the best cosmetic outcomes.
  • Keen eye for medical conditions affecting the skin – Excessive hair growth may be a manifestation of an underlying disorder needing medical management. Dermatologists can identify those conditions and work with your primary care physician to determine a more comprehensive therapeutic plan that can control all your symptoms.

Entrusting your light treatments to a board-certified dermatologist guarantees the best possible outcomes while keeping your overall healthcare costs manageable.

Key Considerations

In summary, laser treatment is effective in removing unwanted body hair. The results are immediate and long-lasting and cover vast areas at once. Various types are available to make it safe for all skin types. Good pretreatment preparation and aftercare help avoid complications and speed up recovery. Most importantly, trusting a board-certified dermatologist to perform your procedure ensures the best outcomes.

Best Providers in LA

Hair growth in odd places can be distressing. Shaving and waxing can help, but their results don’t last long. Laser treatment is a safe and long-lasting way to remove unwanted hair growth. 

At BHSkin Dermatology, our skin specialists are some of the best laser providers in LA. Visit us at our Encino or Glendale office or use our telederm platform for your initial consultation.

Book your appointment today!

 

Sources:

  1. Bhat, Y. et al. (2020). Laser Treatment in Hirsutism: An Update. Dermatology Practical and Conceptual. 10(2). https://doi.org/10.5826/dpc.1002a48
  2. Hogan, S. et al. (2023, November 1). Who Is Holding the Syringe? A Survey of Truth in Advertising Among Medical Spas. Dermatologic Surgery. 49(11), 1001-1005. https://doi.org/10.1097/dss.0000000000003929
  3. Kang, C. N. et al. (2021, September 10). Hair Removal Practices: Literature Review. Skin Therapy Letter. 26(5). https://www.skintherapyletter.com/dermatology/hair-removal-practices/
  4. Krasniqi, A. et al. (2022, July 4). Efficacy of lasers and light sources in long-term hair reduction: a systematic review. Journal of Cosmetic and Laser Therapy. 24(1-5), 1-8. https://www.tandfonline.com/doi/full/10.1080/14764172.2022.2075899
  5. Ormiga, P. and Aguinaga, F. (2018). Laser for Hair Removal. In M. C. A. Issa and B. Tamura (Eds.) Lasers, Lights and Other Technologies (pp. 223-232). Springer. http://dx.doi.org/10.1007/978-3-319-16799-2_16
  6. Orringer, J. S. (2019). Chapter 210: Nonablative Laser and Light-Based Therapy: Cosmetic and Medical Indications. Fitzpatrick’s Dermatology, 9th ed. McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210446830 
  7. Thomas, M. M. and Houreld, N. N. (2019, April 24). The “ins and outs” of laser hair removal: a mini review. Journal of Cosmetic and Laser Therapy. 21(6), 316-322. https://doi.org/10.1080/14764172.2019.1605449
  8. Vaidya, T, et al. (2023, July 25). Laser Hair Removal. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK507861/ 
Don-Mehrabi

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online

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