Updated: Jun 3, 2020
Body hair…not a fan. Shaving…not a fan. Waxing, also, Not. A. Fan. When I was about 23 years old, laser hair removal was becoming more and more of a popular option for reducing unwanted hair. In its infancy, it was considered a luxury treatment, and was quite expensive. Laser treatment chains like American Laser Centers (my very first job as a laser tech. BTW) started popping up across the US offering packages with payment options so that everyone could take advantage of permanent hair reduction via laser light therapy.
Originally developed in the 1960’s, laser hair removal has revolutionized the way we remove hair. Lasers are differentiated by the wavelength of light used to accomplish their goals. The first laser for hair follicle destruction was a ruby laser (wavelength of 694.3nm). It was slow and could only treat a small number of follicles at once, but most concerning was that it was dangerous leaving burns and tissue damage in its wake. Next, came the YAG (1064nm) laser in 1964 which was very safe, but unable to produce permanent results. Then the first alexandrite laser came into play in the 1970’s. The alexandrite (755nm), which is the optimal wavelength for treating hair, was safer but wasn’t immensely powerful, so it required too many treatments to be considered a great option. After time and experimentation though, scientists learned that laser power was tunable, and the Alexandrite became the gold standard for hair reduction. As treatment continued, it became apparent that skin color and genetics also played a part in successful treatment of unwanted hair via laser. A dermatologist by the name of Dr. Thomas B. Fitzpatrick developed a system for phototyping human skin that is still used today. We use the Fitzpatrick skin typing method to determine wavelength, power, and pulse duration settings to treat unwanted hair safely and effectively with laser.
What is commonly referred to as laser hair removal should actually be called laser hair reduction because there is no way to guarantee the total and complete destruction of every hair follicle within an area. Follicles can begin producing hairs at any point throughout your life even after laser treatment, but follicles that have previously been destroyed will not regrow a hair. Laser hair reduction works on the principle of selective photothermolysis. That is the conversion of light energy into heat when it finds the correct target chromophore. In the case of hair reduction, the target chromophore is melanin or pigment. You may have heard that blonde, gray, white and red hair can not be treated with lasers. That’s because there isn’t enough target chromophore to attract the amount of energy required to disable the follicle. Unfortunately, if you have any of these hair colors, you are stuck with shaving, waxing, tweezing, threading, electrology, or making peace with your inner feminist hippie.
When the correct amount of laser energy is applied, in the proper pulse duration (measured in milliseconds,) to the target chromophore, during the anagen phase of growth, the follicle has been disabled. In other words, laser hair removal is hard. All the stars have to be aligned in order for it to work. A lot of it is trial and error. While education and experience give us guidelines for treatment, every body is different. Every hair growth cycle is different. Therefore, every treatment could also be different! Successful hair reduction happens when patients are consistent with treatments. For areas from the shoulders up, treatment should happen every 4-6 weeks. For treatment of areas from the shoulders to the groin, every 6-8 weeks, and the legs are every 10 weeks. The number of treatments will vary from person to person based on, Fitzpatrick skin type, scheduling compliance, hormonal activity, certain medications, pain tolerance, and sun exposure avoidance (or lack thereof). When someone gets tan the melanin in the skin becomes the target chromophore and can result in burns, scarring and long-term or even permanent pigmentation issues. Many of my patients will tell me they aren’t tan, even when it's obvious that they are. Now, I’m not saying they are lying, but maybe they just forget that visible tan lines mean they are, in fact tan. I will deny you treatment if this is the case. I won’t negotiate. If you are ok with looking like a zebra, then I’m sure there is a laser center that will ignore this contraindication. I will not.
Still not entirely sure you understand? That’s because we haven’t gone over the mechanics. Hair grows in phases. The anagen phase of growth is the period of time that a hair is attached to and feeding off of the small capillaries at the base of the follicle. Cells rapidly divide and multiply to add to the hair shaft. There is a concentration of melanin at the root or bulb of the hair that attracts laser energy. That energy converts to heat and cauterizes the capillaries. With no nutrition source, the follicle is incapable of producing new hairs. The existing hair pushes through the remaining phases of growth, falls out and no new hairs can grow in its place. At any given time, only about 15-20% of body hair is in its anagen phase of growth, so we have to treat multiple times to get the results we are looking for. If you are taking hormones of any kind, it can affect our ability to treat. If you are on antibiotics it is not safe to treat you until you’ve finished them and been off of them for three days. Most antibiotics cause skin to become extremely sensitive to photo stimulation meaning that skin can easily burn if the medication is not out of your system. Darker skin will require lower power levels and longer pulse durations, to ensure that the targeted melanin is in the hair, and not the skin. This unfortunately equates to more treatments.
If you want to have laser treatment to enjoy smooth hair-free skin during bathing suit season, you need to plan ahead. You should expect at least six treatments (no guarantees that it won’t be more, and sometimes it is less). Each treatment will be between 4 and 10 weeks apart depending on the location (see paragraph 4) of the hair. If you do the math, you may need to start in October or November. Be sure that you don’t wax or tweeze prior to your appointments. If you do, there is no hair there to target. Please do shave before you come to your appointment. Laser energy does no good above the surface of the skin. We need all of the energy to concentrate at the base of the follicle, so clean shaven is best. This includes facial hair. Your hair will not come back darker and thicker if you shave it. That is an old wives’ tale. If we need to see where your hair growth remains, we’ll ask you not to shave, and we’ll supply you with a razor to shave after we’ve seen what still needs to be treated. Some areas are extra sensitive and can be numbed prior to treatment, but plan on an extra 40 minutes to an hour for numbing time. Being that its May, you’re out of luck for this summer, but we’ll see you in the fall after your tan fades.
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