Interest in permanent hair removal using laser light energy has exploded over the past few years. Dermatique introduced laser hair removal to this area in September 1997, and since then, we have performed hundreds of treatment sessions with good early results and no significant complications. This article will answer several of the most common questions we encounter concerning this promising new technique. Next month we will continue our series on skin care, with a review of topical vitamin C and other skin antioxidants.

How does laser hair removal work?

The hair removal laser emits laser light with a specific wavelength that selectively targets the melanin pigment in the root of the hair follicle. This allows the laser to destroy the hair follicle without damaging the overlying skin, a principle known as "selective photothermolysis." Because melanin is the target, obviously the laser will work best on brown or black hair, and not at all on gray or white hair.

What are the advantages over other types of hair removal?

Laser hair removal is much quicker, more efficient and less painful than electrolysis. Other hair removal techniques such as waxing, shaving, plucking and the use of epilating devices frequently cause irritation, folliculitis and sometimes scarring, all of which can be avoided with the hair removal laser.

Are there any disadvantages to this type of treatment?

There are no disadvantages to laser hair removal, except perhaps the cost. It is more expensive than shaving or waxing, but since the results are long-lasting, it will pay for itself over time. Electrolysis is the only other potentially permanent method of hair removal, but it treats hairs one by one, so multiple treatment sessions, sometimes over many years, are required. Over the long term, the cost of electrolysis adds up, and can often be much more than the cost of treatment with the laser.

Is laser hair removal for everyone? If not, for whom is it not suitable?

Laser hair removal is not quite for everyone. Since the target for the laser is melanin pigment, obviously the technique works best on brown or black hair. It does not work at all on white or gray hair. The results on red and blonde hair fall somewhere in between. Also, since the laser targets melanin, and since it cannot distinguish melanin in the skin from melanin in the hair follicle, people with dark skin or a deep tan are not good candidates.

Will it work on any area of the body?

Laser hair removal will theoretically work on any area of the body. However, the most common areas treated in women are the underarms, the bikini area and the face. In men, treatment of the back and shoulders is most common. Since the current generation of the laser has a 7 millimeter spot size (about 1/2 inch), treatment of large areas such as the entire back or both legs is not practical because it would take too long. In the next few months, our laser will be equipped with a scanner, which will allow treatment of a much larger area with each laser pulse. We will then be able to treat the legs, arms and back in a reasonable amount of time.

How much does it cost?

The cost of laser hair removal varies depending on the specific area or areas treated. Remember that the complete treatment program for any area will entail three to five sessions over a six to twelve month period. The total cost for complete treatment of an area will range from several hundred to two thousand dollars. We welcome you to come by Dermatique for a more accurate cost estimate for treatment of the specific areas that are of concern to you.

Is there any down time after laser hair removal? If so, how long?

Down time after laser hair removal is minimal. Most people experience mild redness of the skin in the area treated which subsides in a few minutes to a few hours. Occasionally the redness lasts overnight. In people with slightly darker skin or a mild tan, the skin reaction is greater, and may include blistering or a purple discoloration which takes several days to resolve. In rare instances, there can be temporary lightening of the skin (hypopigmentation) or darkening of the skin (hyperpigmentation) in the area treated, but so far this has not been permanent. Theoretically, there is a small risk of permanent scarring, but to date this has not been reported with this particular laser. Let me emphasize that the darker your skin the greater the skin reaction because the laser energy is absorbed by the melanin in the skin. The ideal candidate has lily white skin and black hair. Blacks and people with dark skin or a deep tan are not good candidates and can not be treated.

Will it take more than one treatment?

The laser works best on actively growing hair. The normal hair growth cycle includes an active growth phase, a dormant phase and a transitional or in between phase. All of the hair follicles in a given body area exist in one of these phases, but they are never all in the same phase at the same time. This asynchronous cycling of the hair follicles makes it impossible for the laser to wipe out all of the hair with a single treatment, since not all of the hairs are in their active growth phase at any given time. We generally wait two to three months between treatments to allow dormant hair follicles to enter their active growth phase so they can be effectively treated. Three to five treatments are usually necessary to adequately treat any given area. Different body areas have different percentages of actively growing and dormant hair, and the hair in different body areas cycles at different rates. As we learn more about hair follicle biology, treatment parameters are being constantly refined to increase effectiveness.

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