I hope this guide to Laser treatments for hair removal will be helpful to anyone considering undergoing the process.
Having undergone both Laser and Electrolysis for permanent hair reduction and removal, I would say to any one considering the same that thorough research is really important. Understanding the process and being able to select the right clinic and machine will allow one to have the best results possible. Since treatments are quite expensive, I’m sure most people would want to aim for maximum results in as few treatments as possible.
Background
Lasers are optical devices which produce intense coherent, collimated and mono-chromatic beams of light. Lasers designed for permanent hair reduction emit wavelengths of light designed to be absorbed by the pigment in the hair (melanin). If the surrounding skin is relatively light compared to the colour of the hair, then the entire energy of the laser will be concentrated in the hair shaft, effectively destroying it without affecting the skin or follicle. Hair removal lasers target the dark pigment in the hair. Therefore, the best candidates are clients with light skin and dark hair. The body areas that will respond the best are areas with coarse hair (more absorption).
I think it’s important to state the FDA classification of Laser Hair Removal devices. The FDA has approved Laser for “permanent reduction.” They permanently disable hair follicles, however laser hair removal doesn’t work in the same way on everyone and doesn’t remove 100% of the hair in an area. Generally, this means that you shouldn’t expect to remove every single hair from an area, although you can remove the majority of it providing it’s dark and coarse enough to begin with.
Laser hair removal is performed by a trained laser specialist or a doctor. Depending on the clinic, by pointing the laser device at shaved skin where the hair is present. Laser works by disabling hairs. Since various hairs will enter their growth cycle at different times, several treatments are necessary to disable most of the follicles in a given area.
The type of Laser used depends on the skin type of the client.
** Laser Types **
(Laser works best on dark coarse hair. The finer in texture and lighter in colour the hair, and the darker your skin, the less effective the treatments will be no matter which laser you use. Fine and light-coloured hair has very little pigment, so hair removal lasers cannot target it. Lasers with large spot sizes and short pulse widths are most effective)
Alexandrite long pulse lasers have a wavelength of 755nm are the most effective lasers. Their limitation is that they can only be used safely on very light skin types (Fitzpatrick skin types I-III). Just because it is an alexandrite, does not make it the best on the market. Precision cooling of the skin prior to laser application, spot size (the larger, the better), exact delivery of an effective energy beam deep into the tissue, and proper training can make all the difference. Some of the most popular alexandrite lasers include GentleLASE by Candela Corporation (maximum 18mm spot size) and Apogee by Cynosure (maximum 15mm spot size).
Diode long pulse lasers with a wavelength of 810nm work ok on skin types I-IV, and could be a good option for patients with skin type IV when they are too dark for an alexandrite laser, but want a more effective treatment than with an Nd:YAG on finer hair. The most popular on the market is the LightSheer laser by Lumenus. Proper operation of diodes is absolutely necessary for good results, so operator skill is especially important when using this type of laser.
Nd:YAG long pulse lasers have a wavelength of 1064nm and are the only option for darker skin types (IV-VI). The limitation of these machines is that they are made to protect darker skin from burning, and are thus not as effective on finer hair. However, for patients with darker skin, Nd:YAG is the only safe option. If you have darker skin and fine or light-coloured hair, laser hair removal is probably not a good option for you, regardless of the type of laser used. In such cases, electrolysis is the only permanent option.
Popular Nd:Yag Lasers are the Apogee Elite by Cynosure (also has an Alexandrite) and Candela GentleYAG. Newly released is the Apogee Elite MPX which allows simultaneous Alexandrite and Nd:YAG operation and larger spot sizes.
(Intense Pulse Light machines or IPLs). Most light-based applications are not true lasers. These machines use a highly concentrated beam of traditional incoherent light, often in conjunction with a cream or gel, to burn the hair shaft. A serious flaw with these systems is that they lack the laser’s ability to produce a selective bandwidth of light that will only affect the hair shaft (selective photothermolysis). These devices produce a wide bandwidth of light that can heat up all of the surrounding tissue, making it less effective in killing hair and putting the patient at a higher risk for burns, especially on darker skin. IPLs are generally cheaper than true laser devices and are used for various skin procedures first and foremost, with hair removal as an add-on feature. As a rule, true hair removal lasers (i.e. alexandrite, diode, and ND:Yag types) usually achieve better and faster hair removal results.
For a few years, IPL devices gained a lot of popularity in newly opening salons that did not want to invest large amounts in true Lasers. However, more recently they are seeing a downturn in popularity as consumers have not been achieving permanent results after spending a lot of money.
To sum up, it’s important to choose a clinic that has the right kind of Laser for your skin type and also a technician who is experienced and will therefore use the best settings possible. As well as overtreatment, which can result in burns, under-treatment can make the hair finer by weakening the follicle, rather than destroying it. This finer will then not respond to further Laser treatments and the only way to permanently remove it would be with electrolysis.
** The Process**
Multiple treatments spaced anywhere from 8-16 weeks apart (depending on the treatment area and session number) are generally required to achieve substantial hair removal.
This is because hair grows in three phases. During any treatment session, only the follicles in the anagen phase can be destroyed, even though all present and treated hairs should shed.
[Under normal circumstances, hair growth in each hair follicle occurs in a cycle. There are three main phases of the hair growth cycle: anagen, catagen and telogen. Anagen (active) is the growing phase or when the hair fiber is produced. Catagen (club hair) is the period of controlled regression of the hair follicle. This phase is when the lower part of the hair stops growing, but does not shed, and the follicle is reabsorbed. Telogen (tired) is the last of the hair growth cycle. In this resting phase, the old hair falls out in preparation for the development of a new anagen hair.]
Approximately 8-16 weeks after every treatment, the next treatment is needed to eliminate the hairs that have now come out of the dormant phase and are active. After 6-8 treatments or so, patients should experience a considerable hair reduction. Note: On all areas except underarms, I achieved considerable hair reduction (or what I consider maximum results) in less than 6 treatments. I will discuss getting the most out of treatments in the following paragraphs.
You should not be waxing or removing hair with the root with any other method for at least 6 weeks before your first treatment and throughout the course of treatment because the hair needs to be in place to be targeted by laser.
However, it is generally advised (not by the clinics because they want you to have as many treatments as possible) to wax the area you want treated 2-3 months before your first session. This is just a way of synchronising the hair growth so as much as possible is in the growth stage when you go for your first session. I did this for all my treatments areas and I’m sure it contributed to requiring less treatments.
The area should be shaved as closely as possible so that laser can target the most energy towards the hair follicle and not waste energy on the part of the hair that is above the skin’s surface. If you treat an unshaved area, you risk potential skin burns caused by singed hairs. You should shave the area to be treated 1-3 days prior to your treatment. This will leave very slight stubble visible and make it a bit easier on your tech not to miss the spots you want treated if you have hair that cannot be seen at all after it’s shaved.
The laser technician must cover the entire area to be treated, with requires slight overlapping of the laser spot at each zap. At my clinic, the technicians will use a red pencil to first outline the treatment area and then divide this into boxes. This then becomes a number of smaller areas they can treat one at a time to make sure the entire area is covered well. If I have ever had a missed patch, it’s been very small. I assumed this was standard practice but have since found out that many clinics do not do this which generally results in lots of missed patches that do not shed. Do ask if your potential clinic does this when you go for the consultation.
After treatment is completed (both underarms take under 10 minutes, legs can take 1-2hours), you can apply pure aloe vera gel to soothe the skin for a few days. Within 1.5-3.5 weeks, you should experience shedding of all treated hair. At first, hair will look like it’s growing, but it is just coming out to shed. Shedding starts at about 1.5 weeks and can last until 3.5 weeks post-treatment or so. Exfoliating and/or scrubbing gently in the shower with a loofa can help speed up the process. After shedding completes, you might still see little black dots “stuck” in the hair follicles. These are commonly referred to as “pepperspots” and will shed eventually on their own, though it might take a bit longer, or they will be singed off at your next treatment. You can exfoliate to help those out as well.
After the treated hair sheds, you should experience a hair-free period for a few weeks (can be almost 6 weeks for the legs), until the hair in the next growth phase (which was dormant before) starts to come in. Once you see enough grow in to justify another treatment, go in for your next appointment. This usually happens within 8-12 weeks post-treatment. To complete treatments, you should continue treatments spaced at least 8-12 weeks apart until you have reached diminishing returns and the remaining hairs are too fine for laser to target, or until you have reached you desired reduction. This usually involves 2-10 treatments depending on your desired reduction.
Important Note: if you don’t experience shedding or a hair-free period, you should inform your technician. This is an indication that the treatment wasn’t effective and adjustments need to be made (for example, the settings could to be raised). If you feel that a majority of the hair didn’t shed 3-4 weeks post-treatment, the technician might have missed many spots and you may consider asking for a touch-up.
Usually, treatments are spaced 8-12 weeks apart to start, and can gradually move to 10-16 weeks apart after the initial 2-3 treatments. Instead of following an arbitrary schedule, wait until you have experienced shedding of the treated hairs and then see enough hair come in after the hair-free period to justify having another treatment. Spacing also depends on area treated as hair cycles vary on various body parts.
Virtually all clinics will tell you to come back “as soon as you see new hair emerge” or “every 6-8 weeks”. There are two disadvantages to this. Firstly because you are not letting all the growing hair emerge, you cannot assess the level of hair reduction you have so far achieved. Secondly and more importantly, if only some of the hairs are present at the surface, those will be the only hairs treated; waiting another few weeks will allow more growing hairs to emerge and the next treatment will then target all these hairs.
The way I approached LHR treatments was to wait as long as possible before my next treatment. So generally I would book my next session when I felt growth had reached a plateau and no more new hairs were emerging. Therefore each treatment I had targeted the maximum number of hairs. As long as you don’t wait so long so that the hairs are no longer in the anagen phase, treatment will still be effective. If you go back early you will end up having more treatments overall.
A guide to the number of weeks between treatments is:
Underarms and Bikini area: 8-12 weeks
Arms: 10-14 weeks
Legs: 12-16 weeks
Once the desired or maximum level of reduction is achieved, one can stop treatments. Generally, I would advise not buying packages because you just don’t know how many treatments you will need.
How treatments I had depending on self assessment of the area. For example;
Underarms
I had 6 underarm treatments. 12 weeks after my sixth treatment there was still about 10-15% of hair left that was a mixture of fine, medium and some coarse. I could have had a 7th treatment but it would have only treated some of those hairs and even an 8th, 9th and 10th treatment would never remove all the hairs. I decided it would be better worth my money to finish off the all the remaining hairs with electrolysis for complete removal. Initially, it took my electrologist 15mins of electrolysis per underarm to clear all visible hairs every 6 weeks. This reduced over the following months as the number of hairs left reduced.
Legs
I achieved over 90% reduction on my lower legs with 3 and a half Laser treatments (the 4th treatment was just for a patch on the front of each leg – the only place left with hairs thick enough to treat). The remaining hair is sparse and fine. For my thighs, the backs and sides didn’t respond much because most of the hair was too fine (expected). I had 4 treatments in total for about 80% reduction on the front thighs and the remaining hair is finer in texture. I decided to stop because I did not see a great difference between the results after the 3rd treatment and 4th treatment. It has been observed that thigh hairs don’t generally respond as well to Laser even if they are thick and dark enough.
Pain
In one pulse, the laser can remove all the hair on a patch of skin the depending on the specific laser spot size, i.e. the “laser head,” ranging from 9-18mm on average. Everyone’s pain threshold is different and generally laser hair removal is not much more painful than waxing, but the sensation is different. It resembles a rubber band snapping against the skin for a quick second with each pulse. Most people do not require an anaesthetic cream (like EMLA), but one may be used for very sensitive patients/areas (can be provided or prescribed at the clinic). However, if you do not feel any pain at all, it might be an indication that the settings are set too low to actually kill the hair. Please advise your clinic if this is the case.
The possibility exists that some side effects or complications can occur given various variables, including:
Normal
- Itching
- Redness for up to 3 days
- Swelling (around mouth of follicle) for up to 3 days
- Pain, tingling, or feeling of numbness (cold spray)
Rare
- Crusting/scab formation (on ingrown hairs)
- Bruising
- Purpura (purple coloring of the skin) on tanned areas
- Infection
- Temporary pigment change (hypopigmentation or hyperpigmentation)
Another phenomenon experienced by increasing clients (as more people are opting for LHR) is that of induced growth. This is when the treatments actually stimulate dormant follicles to start producing new hairs or existing hairs to become thicker and darker. This is generally in body areas that have excess hair in the first place due to the sensitivity to androgens, such as a woman’s face or man’s shoulders and upper back. And/or when hairs (such as the fine vellus hairs on a woman’s face) that are actually too fine to be effectively treated are done so.
It is the unfortunate case that I whilst I have heard no first hand accounts of pigmentation, I regularly hear from people who have experienced induced growth. Even searching GupShup will bring up a number of cases.
Generally, I would not advise women to opt for LHR on the face. Either the hairs will be fine, vellus hairs (even if dark) so will not respond at all or very well (you may end up having treatments for 2 years, only for much of the hair to come back once you stop). Or, if you do have coarser hairs (due to, for example, PCOS) it is advisable to first get the hormones under control and then go for electrolysis.
You can also search GupShup for previous posts which discuss laser hair removal.
[A lot of the information contained in this post is courtesy of the FAQs on HairTell.]