1. What is Laser Hair Removal?
Laser hair removal is a procedure, which removes hair from the body utilizing a long pulse laser. Laser hair removal lasers have been in use since 1997. The treatment is performed by a specially-trained laser specialist or a doctor (depending on the clinic and state regulations) by pointing the laser device at shaved skin. Laser heat disables follicles from producing hair. Hair grows in cycles. Since various hairs will enter their growth cycle at different times, about 6-8 treatments at intervals of 4-6 weeks are necessary to disable most of the follicles in a given area.
2. Am I a Candidate for Laser Hair Removal?
Both men and women seek laser hair removal to remove unwanted hair. Hair removal is commonly done on underarm, pubic area, legs, abdomen, lip, chin, back, buttocks, thighs, face, neck, chest, arms, fingers and toes. Laser technology works by targeting dark pigment. Therefore, it works best on pale skin and dark coarse hair. The lighter the skin and the darker and more coarse the hair, the better are the results. That being said, people with light brown hair or darker skin tones can still be successful with laser hair removal, however the number of treatments may need to be increased as you will be damaging the hair follicle at a slower rate because it cannot hold as much heat as a dark, coarse hair. (Purchase a Laser Package of 8 treatments to save!)
3. Which Type of Hair Removal Laser will Work for Me?
Currently, there are three popular types of hair removal lasers made by various manufacturers: Alexandrite, Diode, and Nd:YAG. Intense Pulse Light systems (IPLs) are also used for hair removal. Some of the more popular brands of devices currently on the market are:
- Alexandrite: GentleLASE, Apogee(this is the type we use here at Bare!)
- Diode: LightSheer, F1 Diode, MeDioStar, Palomar SLP 1000, Comet (w/RF technology)
- Nd:YAG: CoolGlide, GentleYAG, Lyra-i, Sciton
- Alexandrite/ND:Yag Combination Devices: GentleMAX, Apogee Elite, Apogee MPX
- IPL: Palomar Starlux and EsteLux, Harmony, EpiLight, Aculight, Vasculigh, Aurora
In order to determine the best device to use, patients/laser technicians need to figure out their skin type using the Fitzpatrick Skin Chart*. In 1975, Thomas B Fitzpatrick, MD, PhD, of Harvard Medical School, developed a classification system for skin typing. This system was based on a person's response to sun exposure in terms of the degree of burning and tanning the individual experienced.
(*This tool is approximate)
- TYPE I: Highly sensitive, always burns, never tans.
- Example: Red hair with freckles or Albino
- TYPE II: Very sun sensitive, burns easily, tans minimally.
- Example: Fair-skinned, fair-haired Caucasians
- TYPE III: Sun sensitive skin, sometimes burns, slowly tans to light brown.
- Example: Darker Caucasians, European mix
- TYPE IV: Minimally sun sensitive, burns minimally, always tans to moderate brown.
- Example: Mediterranean, European, Asian, Hispanic, American Indian
- TYPE V: Sun-insensitive skin, rarely burns, tans well.
- Example: Hispanics, Afro-American, Middle Eastern
- TYPE VI: Sun-insensitive, never burns, deeply pigmented.
- Example: Afro-American, African, Middle Eastern
- Alexandrite lasers are best for skin types I-IV (This is the type of laser we use at Bare!)
- Diode lasers work well for skin types I-IV
- Nd:YAG lasers are best for skin types IV and darker
- ND:YAG lasers were specifically created to cater to dark-skinned patients. This is the only type of laser that should be used on skin types V and darker. Using any other types of lasers on this type of skin can result in burns if they are used at settings that disable the hair permanently. (We are hoping to purchase a YAG laser to use at Bare very soon for our Type V skin types so check in with us periodically!)
4. How Does Laser Hair Removal Work?
Lasers designed for permanent hair reduction emit wavelengths of light that are absorbed by the pigment in the hair (melanin). If the surrounding skin is lighter than the color of the hair, the energy of the laser is concentrated in the hair shaft, effectively destroying it without affecting the skin or the follicle.
Since lasers target pigment, treatments are most effective on coarse hair because it has a lot of pigment and can absorb a lot of heat. Fine hair cannot absorb as much heat and therefore may require additional treatments.
The ability of the laser device to produce a very narrow bandwidth on a consistent basis is the key to a safe, efficient treatment. While the laser emits a beam that only heats the hair shaft, heat is transmitted from the hair shaft to the surrounding tissue for several milliseconds after the laser pulse. Several lasers possess cooling attachments, which cool the surrounding skin to fully absorb any heat transmitted from the destroyed hair shafts. (We use this cooling agent on our laser at Bare!)
Intense Pulse Light (IPL) machines are not 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). IPLs produce a wide bandwidth of light that can heat up all of the surrounding tissue, making it less effective in disabling hair and putting the patient at a higher risk for burns, especially on darker skin.
IPL devices are generally cheaper than laser devices, which is why many clinics choose to use them. (We do NOT use IPL devices at Bare!)
Generally, true hair removal lasers (i.e. alexandrite, diode, and ND:Yag types) tend to achieve better and faster results than IPLs.
5. How Many Laser Treatments Will I Need and How Far Apart are They Scheduled?
Most patients need at least 6-8 effective treatments spaced 4-6 weeks apart. Because hair grows in cycles, several sessions are necessary in order to affect all hair on any given area. Due to length of hair growth cycles, treatments are usually needed once every 4-6 weeks. Hair cycle length varies depending on body part. Face usually requires more frequent treatments (about 4 weeks apart) whereas legs and back need less frequent treatments (closer to 6 weeks apart). Shedding of all treated hair should be expected within 2 weeks of each treatment. Once the hair sheds, patients should experience a hair-free period of several weeks. Once new hair comes in again, patients should come in for their next session.
6. Is Laser Hair Removal Permanent?
Laser hair removal lasers have been in use since 1997 and the Food and Drug Administration approved them for ?permanent reduction.? They disable hair permanently as long as the right type of hair is treated with an appropriate type of laser at effective settings.
However, it is called a ?reduction? because, no matter what some clinics may claim, hair removal lasers cannot always remove 100% of the hair in an area. With proper treatments, laser can remove the majority of the coarse hair on a body area, but they cannot remove finer hairs all of the time. Generally, a patient can tell how much reduction was achieved from a course of treatments after waiting 6-12 months from their last treatment. Any hair that grows in after the 12-month period is new hair that the body can develop due to numerous factors such as age, diet, hormonal changes, and medical conditions such as PCOS. Patients who experience new growth later in life can get touchup treatments.
Some experts believe a small percentage of people are non-responders to laser hair removal treatments. This has not been confirmed or proven, and reasons are not known. At the same time, it's difficult to judge whether a patient?s lack of results is, in fact, due to being a non-responder. Lack of results could be due to an undetected underlying medical condition or improperly performed treatments.
7. How Much Does Laser Hair Removal Cost?
Prices vary widely from clinic to clinic. It?s a good idea to get quotes from several clinics in the area to compare prices and other factors.
Some clinics offer discounts if paying for a package of multiple treatments upfront. (Bare offers a 50% off deal for all prepaid packages!)
However, buying a package also prevents an unhappy patient from switching providers. Since laser operator skill is very important in achieving results, it is recommended to start with one small area and investing in treatment packages only once satisfied. It?s a good idea to compare types of lasers used, treatment prices, and most importantly the technicians? skill and experiences!
8. Is Laser Hair Removal Painful?
In one pulse, laser removes all the hair on a patch of skin the size of a nickel or a quarter. Generally, laser hair removal is not much more painful than waxing, though the sensation is different. With each pulse, the feeling resembles a rubber band snapping against the skin for a quick second. Pain is only felt while the laser is hitting the skin and doesn?t last. Most people do not require an anesthetic cream, though one can be prescribed to more sensitive patients. EMLA is one popular option.
Using anesthetic creams is safest on small areas. It?s also important to obtain a cream that is properly compounded. Using an inappropriately compounded numbing cream on large areas can result in adverse side effects or even death. Patients should consult with their doctor. (EMLA cream is available for purchase at Bare, however we very seldom have a client who actually feels that they need it so we always recommend trying laser without the anesthetic cream?it doesn?t hurt very bad at all!)
9. Are They any Laser Hair Removal Risks or Side Effects?
Some people may experience the following potential temporary side effects:
- Redness for up to 3 days (highly unlikely though ? usually area is red for about an hour at most)
- Swelling around mouth of follicle for up to 3 days (again, unlikely ? inflammation usually is gone relatively fast)
- Tingling or feeling of numbness
The following rare side effects are indicative of inappropriate laser type and/or settings:
- Crusting/scab formation
- Purpura (purple coloring of the skin)
- Temporary pigment change (hypopigmentation or hyperpigmentation)
10. What if I Merely Want to Reduce Hair Density in a Certain Area?
Yes. This can be achieved with 3-4 treatments instead of the full course of 6-8 treatments. To achieve an even reduction without patchiness, it is imperative to find an experienced laser operator who overlaps properly while covering the area and doesn?t miss spots. (Laser Technicians at Bare are trained on this procedure and are able to achieve this desired effect!)
It?s also a good idea to wait at least 12 weeks between sessions in order to correctly assess the amount of reduction achieved at any point during the course of treatments.
11. How Do I Choose the Right Laser Clinic for My Needs?
THE LASER: Choose a clinic with the best laser for your skin type*. Do not fall for marketing hype. Every laser can technically be applied to any skin type without adverse side effects by manipulating the settings, but only the right laser at appropriate settings will result in permanent hair reduction.
*Patients who are in between skin types on the Fitzpatrick skin chart should get test spots done with various laser types to determine whether their skin can handle aggressive settings on the more powerful devices.
THE CLINIC: Choose a clinic whose main priority is your results. Be an informed consumer and ask questions to assess the clinic?s knowledge of laser hair removal. Avoid clinics with high-pressure tactics. Prices can vary by as much as 100-300%, and are often negotiable.
THE LASER OPERATOR: The person operating the laser device should have extensive experience specifically in laser hair removal. The best technicians are those who have the most hands-on experience, not those with the most education on paper. It?s a good idea to find out whether the same person will be performing each session.(Bare prides themself on being the best option out there for your laser hair removal needs and will continue to do so!)
12. What Should I Expect Before and After a Laser Treatment?
Patients should not wax, epilate, or remove hair with the root using any other hair removal method for at least 4 weeks prior to their first session and throughout their course of treatments. The hair needs to be in place in order to be targeted by laser as laser devices targets the pigment in the hair.
The area to be treated should be shaved 1-2 days prior to treatments so that the energy is targeted towards the hair follicle and not wasted it on the hair above the skin?s surface. Treating unshaved skin can result in burning of the skin by singed hairs.
Treatments are relatively quick. Both underarms take about 2 minutes total. Full legs can take about 45 minutes- 1 hour. After the treatment, applying ice packs and cooled pure aloe vera gel help soothe the skin.
All hair should shed within 2 weeks* following the treatment. Sometimes, shedding doesn?t start until about 10 days after the session. During the shedding phase, hair may look like it?s growing, but it is actually coming out to shed. Exfoliating and/or scrubbing gently in the shower with a loofa can help speed up the shedding process.
After 2 weeks, some patients may see small black dots remain in the hair follicles on some areas. These are commonly referred to as ?pepperspots?, which eventually shed on their own. Exfoliating may help speed up the process. Regardless, they will be singed off in the following session.
Once the hair sheds, patients should experience a hair-free period for several weeks. Once new hair grows in, patients should come in for their next session. For most people and on most body areas, this happens about 4-6 weeks after the previous treatment.
Patients should continue treatments until remaining hairs are too fine for laser to target, or until they?ve reached their desired reduction.
*Shedding of all treated hair should be expected within 2 weeks of each treatment. The hair which doesn?t shed and is growing as usual after 2 weeks has been either missed or not affected due to inappropriate settings. If this is the case, a touchup treatment is necessary at that time. All 6-8 treatments should be good effective treatments at aggressive settings in order to achieve permanent results.
13. What Are the Hair Growth Cycles?
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. Normally this cycle of hair production will continue for the duration of the individual's life. However, various factors can influence, promote and inhibit hair production.
Laser affects hairs when it?s in its anagen phase of growth. Thus, patients need multiple treatments in order to disable each batch of hair as it enters the anagen phase of growth. Hair cycle length varies depending on body part. Face usually requires more frequent treatments (about 4 weeks apart) whereas legs and back need less frequent treatments (closer to 6 weeks apart). Spacing treatments 4-6 weeks apart allows adequate time to target hair on most body areas.
14. What are the Causes of Excessive Hair Growth and How Can They Affect My Treatments?
The causes of excessive hair growth are many and varied, including:
- Glandular and/or hormonal imbalances, including diseases causing these effects (i.e. PCOS condition in women)
- Insulin resistance issues
- Thyroid problems
- Reactions to certain medications
- Normal aging processes
- Excessive temporary hair removal methods that impact the root (like waxing and tweezing)
Before starting laser treatments, patients with excessive hair growth on uncommon areas should explore possible underlying medical reasons for it. Hair removal methods can only impact hair that?s currently growing. They cannot prevent the body from developing new hair after treatments are completed.
Women with facial male-pattern growth are advised to see an endocrinologist to explore the possibility of PCOS or elevated testosterone levels. Men experiencing excessive growth can get tested for insulin resistance.
15. Is it True that Laser Hair Removal Can Actually Stimulate Hair Growth in Some Areas?
Some patients report that finer hairs treated with laser become more prominent and more numerous. Related discussions have begun at industry conferences. It is an extremely rare occurrence which happens only when treating fine hair, especially on women?s faces and men?s upper arms, shoulders and upper backs. It is also a concern when treating sparse hairs of any kind on any body area. Darker skin types (type IV and darker) are more susceptible to experiencing laser-induced growth.