Overview of Laser Hair Removal
More and more people are looking for safe, long-lasting, and effective methods to reduce hair for cosmetic or medical reasons. There are several ways to remove hair such as plucking, waxing, shaving, using hair removal creams, electrolysis, eflornithine cream, and advanced technologies like laser and intense pulsed light (IPL) systems.
Laser and IPL systems are considered some of the best options for long-term hair reduction. These systems work by targeting a pigment in our hair called melanin. The laser or light emitted has a wavelength of 600 to 1200 nanometers (nm), a measure of light waves, which is mostly absorbed by melanin. This destroys the hair shaft, follicular epithelium (the outer layer of the hair follicle), and hair matrix (the cells from which hair grows), reducing hair growth over time.
Anatomy and Physiology of Laser Hair Removal
The job of lasers that are used for skin treatment, primarily operates on the idea of ‘selective photothermolysis.’ In simple terms, this means that lasers can precisely target and heat specific tiny portions of tissue, which can then be injured or destroyed. The laser does this by focusing on certain components in your skin tissue, called chromophores. Either naturally found or artificially introduced, these chromophores absorb light of certain wavelengths.
An important chromophore when it comes to laser hair removal is melanin, which absorbs light within 300 to 1200 nm. So lasers that emit wavelengths in this range can be effectively employed for removing unwanted hair.
Sometimes, the absorption in the target areas is inconsistent. In such situations, the less efficiently absorbing parts might need to be destroyed by heat spreading from parts that are absorbing more. This concept has been given the term ‘the extended theory of selective photothermolysis’.
This process is especially used in laser photoablation, which is used to remove abnormal tissues. In things like our hair, the content of melanin is much higher, particularly in areas like the hair shaft and matrix cells. So, when the laser is used, the melanin captures the energy and spreads it to the surrounding hair follicle structures. Eventually, this leads to the eradication of the hair matrix and stem cells, thereby removing the hair altogether.
Why do People Need Laser Hair Removal
1. Too much body hair (Hirsutism and hypertrichosis)
2. Wanting to improve one’s appearance (Aesthetic purposes)
3. Specific medical conditions that could benefit from hair removal. These include:
– Pseudofolliculitis barbae: A condition causing red, bumpy skin due to ingrown hairs, often seen in the beard area in men.
– Pilonidal sinus: A small hole or ‘tunnel’ in the skin at the top of the buttocks, which may become painful and infected due to trapped hairs.
– Acne keloidalis nuchae: a type of scarring inflammation typically occurring at the back of the neck, often affecting people with thick, curly hair.
Equipment used for Laser Hair Removal
There are several types of lasers used for removing unwanted hair, and these include:
1. Ruby Laser: This laser emits red light through artificial ruby crystals. It’s often best for people with light skin and dark hair (commonly referred to as skin types I-III).
2. Alexandrite Laser: This laser goes a bit deeper into the skin and is great for removing lighter hair. It’s usually recommended for people with skin type I-III.
3. Diode Laser: With its ability to penetrate deeper into the skin, this laser delivers better power and causes less damage to the outer layer of your skin. It is considered safe for darker skin types (I-V).
4. Neodymium-doped Yttrium-Aluminium-Garnet (or Nd: YAG) Laser: This laser ensures better penetration and less damage to the outer layer of the skin. It’s particularly beneficial for darker skin types (I-VI), as it absorbs less melanin, the pigment that gives skin its color.
In addition to lasers, Intense Pulse Light (IPL) or Broadband Light (BBL) are also used. These treatments use high-intensity pulses of varied light, delivered by a flash-lamp. By using various filters, the wavelength band can be narrowed down. They can be used on darker skin and can cover larger areas due to their larger spot size. It’s less expensive than actual lasers but might not be as effective.
The skin types mentioned above are referred to as Fitzpatrick Skin Types:
Type I: Pale white skin, blue/green eyes, blonde/red hair; the skin always burns and doesn’t tan.
Type II: Fair skin, blue eyes; burns easily, tans poorly.
Type III: Darker white skin; typically tans after the initial burn.
Type IV: Light brown skin; burns minimally, tans easily.
Type V: Brown skin; rarely burns, tans darkly easily.
Type VI: Dark brown or black skin; never burns, always tans darkly.
Preparing for Laser Hair Removal
Before undergoing laser hair removal, it’s important to take several preparatory steps. First, your medical history is checked to make sure you’re not currently dealing with an infection or taking any specific drugs that might interfere with the treatment. If you have a lot of body hair, your doctor might need to check your hormone levels to understand why this is happening.
It’s important to note that laser hair removal reduces the amount of hair you have, rather than removing it completely. Your doctor will want to discuss this with you before you proceed, so you understand what results to expect. Your skin and hair type are also evaluated to determine the best type of laser and treatment settings to use for your procedure.
Before your laser hair removal, there are a couple of things you should avoid. You should not pluck or wax your hair for six weeks before the procedure. If the procedure is carried out on areas of the body typically exposed to the sun, you might be asked to use a sunscreen for 4 to 6 weeks prior to the procedure.
Before the procedure starts, your doctor will take photographs of the target area, with your permission, to track how well the treatment works. You’ll also need to make sure the area is freshly shaven, but not too close to the time of your treatment so that tiny stubble can regrow. This makes the laser treatment more effective, as it targets the hair without absorbing too much energy and potentially damaging your skin.
Lastly, before starting the treatment, the doctor will provide all the necessary information and side effects associated with the procedure, and you will be asked to sign a consent form. If you’re worried about potential discomfort during the procedure, a cream to numb the area may be applied about thirty minutes to one hour before the laser hair removal starts.
How is Laser Hair Removal performed
Firstly, the doctor will cleanse your skin to remove any oils. You’ll be made comfortable and both you and the doctor will wear eye protection. Special precautions will be taken to avoid any reflective surfaces or metal objects that could interfere with the laser. The laser settings will be customized to your skin and hair type.
The laser device will be held upright against your skin, pressed gently but firmly, to bring the hair follicles closer to the surface and slow down the blood flow to the area for the duration of the treatment. You might notice some redness and swelling around each hair follicles which is a normal reaction and you’ll be made aware of beforehand.
After the procedure, the skin may be cooled down with ice packs or cooling agents to ease discomfort and reduce swelling. If the skin gets injured during the process, you may need to use a topical antibiotic. It’s very important to keep the treated area away from the sun and use sunscreens after the procedure. To help with the redness and swelling, a topical steroid cream might be prescribed.
The laser only targets hairs in the growth phase of their cycle. So, the whole process will have to be repeated multiple times to catch all the hairs in their growth phase. Generally, 4 to 6 sessions, scheduled 4 to 6 weeks apart are needed to see proper results. After that, you might need additional treatments every 6 to 12 months as some thin hair might grow back.
The results may vary based on where the hair is located on your body, the color contrast between your skin and hair, and what stage of growth your hair is in when treated. The type of laser being used, your hormonal status, and the overall treatment plan can also affect the outcome.
Possible Complications of Laser Hair Removal
When receiving laser or IPL (Intense Pulsed Light) treatment for hair removal, there can be competition for the absorbed laser energy between the pigment in your hair and other skin structures. This can lower the treatment’s effectiveness and cause harm to nearby skin cells by directing energy towards them.
Common side effects of these hair removal methods include skin redness, pain, and a burning sensation following the treatment.
More serious side effects can include blistering, a crusty skin covering, changes in skin color, purplish spots on the skin, and in rare instances, scars. Accidents during the procedure might cause eye-related complications. An unusual situation where the procedure stimulates excessive hair growth could occur, especially in specific skin types and with the use of IPL systems.
What Else Should I Know About Laser Hair Removal?
Choosing the right laser and settings for each patient is crucial, especially for those with naturally dark skin. Most problems can be avoided by carefully adjusting factors such as the energy level of the laser, the size of the area being treated, the color of the laser, and using the right cooling measures. That’s why it’s important these procedures are done by trained professionals who understand how the laser works, how to use it, and what problems may occur.
