Laser Hair Removal FAQ

Frequently Asked Questions:

1. What is laser hair removal?
2. Is laser hair removal permanent?
3. What are the causes of excessive hair growth and how will this affect laser hair removal treatments?
4. Can anyone have laser hair removal?
5. How do I determine my skin type?
6. How many laser hair removal treatments will I need, and at what frequency?
7. How does hair growth work?
8. I've heard that laser hair removal can cause more hair growth. Is this true?
9. Can laser hair removal be used to simply reduce hair density in a particular area?
10. How does laser hair removal work?
11. Is laser hair removal painful?
12. What are the possible risks pf laser hair removal?
13. What should I do to prepare for laser hair removal treatment?
14. How should I go about choosing a laser hair removal center?
15. What are some laser hair removal brands?
16. How much does laser hair removal cost?
17. How do I locate suitable laser hair removal centers in my area?

Q1. What is laser hair removal?
Laser hair removal involves the use of a long pulse laser to inhibit hair growth. The anatomy of the hair follicle is carefully analyzed. Calculations are then made to match the laser light and pulse duration to the follicle size, depth and location to reduce hair re-growth.

During treatment, the light of a long pulse laser is directed at the skin. The laser works to disable hairs that are in their active growth cycle at the time of treatment. Hairs enter their growth cycle at different times, hence several treatments are necessary to disable all of the follicles in a given area.

Lasers can damage skin tissue, so laser hair removal should be performed by a specially-trained laser specialist or doctor. Besides results, your main priorities should always be your safety and health.

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Q2. Is laser hair removal permanent?
Available information on laser hair removal makes it plain that the term 'permanent laser hair removal' is controversial because any laser light beam intended for topical use can only penetrate skin tissue two millimeters deep.

Wikipedia's information on lazer hair removal explains that "the dermal papilla is the only appropriate target of destruction, as it is the only substructure of the hair shaft which can reproduce a new root system, and therefore a new hair shaft. The dermal papilla is located at a depth of 7-8 millimeters for coarse hair, and so is beyond the reach of laser.

At most, 5% of hair in a given area can be removed, which adheres to the common usage of the word "permanent", usually because the hair root has no pigment, or is not very deep or thick in diameter and is therefore within the two millimeter range of the laser. This is why laser technicians are required by law to use the term "reduction". The Food and Drug Administration has approved laser hair removal as "permanent reduction"."

Laser hair removal treatment generally cannot remove every single hair from an area. Follow-up electrolysis treatments for any remaining hairs are normally required as hair becomes too fine for lasers to target, resulting in diminishing returns. Annual or bi-annual touch-up treatments for any new hair growth may also be advised.

Laser hair removal does not seem to work on some people. This can be due to many reasons, such as peculiar genetic or medical conditions which causes excessive hair growth. Of course, whether the laser hair removal treatment was administered correctly also plays a part

Several lasar hair removal treatment sessions, at specified intervals, are usually required to achieve substantial hair removal. Factors which determine the length of treatment include the location of the area to be treated, hair color, hair texture, and the candidate's history of other hair removal measures (eg. depilatories, tweezing, waxing, shaving) etc.

To completely clear an area of hair, a cost-effective approach is starting with laser to remove the bulk of the hair and finishing with electrolysis to remove the remaining finer sparse hair. Electrolysis has been around for decades and it is regarded as a permanant hair removal method. It can take a considerably long time to complete a large area as hairs are treated one at a time., so it is generally recommended for small areas (eg. eyebrows, chin, upper lip), as well as for fine and light-colored hair.

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Q3. What are the causes of excessive hair growth and how will this affect laser hair removal treatments?
There are many reasons for excessive hair growth, such as:

• Genes
• Glandular and/or hormonal imbalances (possible PCOS condition for women), including diseases causing these effects
• Pregnancy
• Insulin resistance issues
• Reactions to certain medications
• Aging
• Excessive temporary hair removal practices like waxing, tweezing, creams and depilatories, etc

Before starting lazor hair removal, talk to your doctor if you suspect you might have an underlying medical condition resulting in excessive hair growth. Women with PCOS hair growth patterns (upper lip, chin, cheeks, etc) should see an endocrinologist and have hormonal tests. You may also want to consider testing for insulin resistance etc.

Laser hair removal may be performed once the condition is brought under control by medication or some other suitable treatment.

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Q4. Can anyone have laser hair removal?
Both men and women can seek laser hair removal. However, it does not work equally well for all people. Those with pale skin and dark coarse hair tend to make the best candidates.

Not all laser hair removal systems perform the same on all skin and hair types. Alexandrite long pulse and diode types of lasers work best on light-colored skin, while Nd:YAG long pulse lasers are better and safer on darker skin (skin types IV and darker). Using an alexandrite or a diode laser on darker skin can result in skin burning or loss of skin pigment (hypo-pigmentation) as laser works by being attracted to and targeting the dark pigment. Long pulse Nd:YAG lasers were created for dark-skinned patients, so they are safer on the skin at settings that actually affect the hair than alexandrite and diode lasers. Please note that tanned skin is also considered darker skin.

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Q5. How do I determine my skin type?
The successful use of laser technology to remove hair, sun spots, scars, wrinkles and veins requires the correct determination of skin type.

A classification system for skin typing was developed in 1975 by Thomas B Fitzpatrick, MD, PhD, of Harvard Medical School. This system was based on a person's response to sun exposure in terms of the degree of burning and tanning experienced by the individual.

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: Mediterranian, 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

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Q6. How many laser hair removal treatments will I need, and at what frequency?
In order to target all hair in the active growth phase, several treatments are needed. Hair grows in three phases and is killed in the first "anagen" active growing phase. Therefore, most people need at least six to eight initial treatments spaced six to ten weeks apart. Additional treatment is required to eliminate the hairs that came out of the dormant phase and are now active.

After several treatment sessions, patients should see considerable hair reduction. Some people may require additional treatments beyond these initial treatments. Of course, the treatments may show no results at all even after several sessions. There are many possible underlying reasons for this, such as genetic or medical conditions, or even incorrect laser settings.

You should see some shedding of the treated hairs within the first few weeks. If not, further sessions may be questionable.

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Q7. How does hair growth work?
The normal hair growth cycle involves three main phases:

Anagen (active) is the growing phase, when the hair fiber is produced. During this stage, hair is rich in melanin, the pigment which gives hair its color. Laser hair removal treatment is most effective during this period.

Catagen (club hair) is the period of controlled regression of the hair follicle. The lower part of the hair stops growing, but does not shed, and the follicle is reabsorbed. At this stage, permenent hair removal is difficult to achieve.

Telogen (tired) is the last stage. The old hair falls out in preparation for the development of a new anagen hair. Permanence cannot be achieved when the hair is in this resting stage.

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Q8. I've heard that laser hair removal can cause more hair growth. Is this true?
This is a rare occurrence and usually seems to happen when treating sparse individual hairs or fine vellus hairs, and at lower settings. The affected areas are generally woman's faces or men's back/shoulders/upper arms. Laser hair removal works best on coarse dark hair. The technician should avoid sparse or vellus hairs, which are more effectively removed with electrolysis.

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Q9. Can laser hair removal be used to simply reduce hair density in a particular area?
This can be achieved by having only a few treatments, and with the help of an experienced technician.

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Q10. How does laser hair removal work?
Lasers are optical devices which produce intense beams of light. A laser consists of an active medium such as a crystal, gas or liquid that amplifies light when stimulated by an external energy source (such as a flash amp or electric discharge). The laser can be fine-tuned to generate a very narrow band of light wavelengths. In one pulse, the laser can remove all the hair on a patch of skin ranging from 9-18mm in size on average.

Lasers designed for permanent hair reduction emit wavelengths of light designed to be absorbed by melanin, which is the pigment which gives hair and skin color. If the skin is relatively light compared to the color of the hair, then the entire energy of the laser will be concentrated in the hair shaft, destroying it without affecting the skin or follicle. Hair removal lasers target the dark pigment in the hair. That's why laser hair removal works best on light skin (the laser passes right through) and dark coarse hair (this has the most pigment).

The key to safe efficient lazer hair removal treatment rests in the ability of the laser to produce a very narrow bandwidth consistently.

Although the laser beam only heats the hair shaft, heat is transmitted from the hair shaft to the surrounding tissue for several milliseconds after the laser pulse. Most modern laser systems have cooling attachments which cool the surrounding skin to fully absorb any heat transmitted from the destroyed hair shafts.

True lazer hair removal systems use lasers. Treatments using light-based epilation devices are commonly referred to as laser hair removal methods, although no lasers are involved. In such methods, a xenon flash lamp is used, which emits intense pulsed light (IPL). These devices use a highly concentrated beam of traditional incoherent light, often in conjunction with a cream or gel, to burn the hair shaft.

One shortcoming of IPL systems is that they lack the laser's ability to produce a selective bandwidth of light that will only affect the hair shaft. These devices produce a wide bandwidth of light that can heat up all of the surrounding tissue. IPLs are generally cheaper devices, used for a variety of skin procedures. Feedback supports the view that true lasers achieve better and faster hair removal results.

Q11. Is laser hair removal painful?
Laser hair removal is usually not much more painful than waxing. It feels like a rubber band snapping against the skin for a quick second with each pulse. Most people do not require an anesthetic cream (like EMLA), but very sensitive patients may request it. The use of anesthetic creams is only safe on small areas (like the upper lip, bikini line, or underarms) and in small quantities. Using it on large areas like the back can cause serious side-effects and even death. Always consult medical advice before using such creams.

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Q12. What are the possible risks pf laser hair removal?
There can be some side effects or complications, such as:

• Itching during treatment
• Redness for up to 3 days
• Swelling (around mouth of follicle) for up to 3 days
• Pain, tingling, or sensation of numbness

• Crusting/scab formation (on ingrown hairs)
• Bruising
• Purpura (purple coloring of the skin) on tanned areas
• Infection
• Temporary pigment change (hypo-pigmentation or hyper-pigmentation)

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Q13. What should I do to prepare for laser hair removal treatment?
Keep out of the sun in the weeks leading up to a laser hair removal session, as tanned skin will compromise the laser treatment. It is advisable to use sunscreen lotion or cream when you are exposed to sunlight. Because the laser's light energy is absorbed by the pigment melanin, in the skin, people with greater contrast respond best. For this reason, some people find it more convenient to schedule their laser hair removal treatment during the winter. Let your doctor know if you are under any medication as some drugs can cause a reaction to light, which might necessitate postponement of the laser treatment.

One to three days in advance, shave the area to be treated. Some clinics will offer to do this for you. Four to six weeks before and during the course of treatment, no waxing or other methods of removing hair with the root is allowed. Hair needs to be intact for laser to target it. Shave as closely as possible so that the laser can focus the most energy on the hair follicle and not waste energy on the part of the hair above the skin.s surface. Shaving just one to three days before treatment ensures that the hair outline or stubble is visible to the technician.

How long treatment will last varies. For instance, back treatment can take an hour or so, while underarms can take under 10 minutes,

Upon completion of each session, apply a hydrating cream or lotion, or even aloe vera, for several days to soothe the skin. Continue to stay away from the sun, and remember to protect yourself with sunscreen lotion or cream whenever you're outdoors in daylight.

Within two to no more than four weeks, shedding of all treated hair should occur. Shedding starts at about one-and-a-half weeks and can last until three-and-a-half weeks after each treatment. Hair pushing through the skin to shed may look like it's growing back. Exfoliating and/or scrubbing gently in the shower or in the bath can help speed up the process.

You might notice little black dots lingering in the skin after shedding. These "pepperspots" will shed eventually. Exfoliation helps speed up their removal.

Upon completion of shedding, you should experience a hair-free period for a few weeks, until the next set of hair that was dormant starts appearing. Schedule another laser hair removal session once there's sufficient hair to justify it. This is normally 6-10 weeks after the last treatment. Continue this process until you experience diminishing returns where the remaining hairs are too fine for lasers to target, or until you have reached you desired level of hair-reduction.

What if you don't experience shedding? Inform your laser hair removal technician. The settings used might have been too low, or the technician might have missed a lot of areas. You may ask for a free touch-up. This should be done no later than four weeks after treatment as by then shedding will be complete, and any unaffected hairs will be apparent. Certain clinics offer these touch-ups free of charge as their standard practice.

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Q14. How should I go about choosing a laser hair removal center?
Check out the center. All of them offer free consultations. Are you satisfied with how the clinic looks and feels? Is it clean and hygienic (nip into the restroom for closer scrutiny)? Is the centre up-to-date and informative)? Is the consultant more interested in your needs and wishes, or is he/she just eager to have you sign up?

Don't be pressured by sales staff to sign up on the spot. Check out several laser hair removal centers before making a decision. Prices can fluctuate widely.

Get information on the laser technician. He/she should have extensive experience of hair removal and should know how best to destroy the hair. You might get a different technician every time at a chain clinic, so ask a lot of questions. Be an informed consumer! The laser hair removal specialist may have a medical degree, but this may have no reflection on their laser hair removal skills. Doctors do not learn hair removal treatments in medical schools, so look for specific knowledge of and experience in hair removal.

Find out about the laser used. The laser used should be appropriate for your skin and hair type. Technically, all laser hair removal systems can be used on any skin type, but you must be satisfied that it will do the job properly for you.

Alexandrite long pulse and diode lasers are very effective when the skin type is light (Type I-II) and the hair is dark enough to attract the laser within the follicle. Other relevant factors are precision cooling of the skin prior to laser application, exact delivery of an effective energy beam deep into the tissue, and proper training. These can make all the difference between maintenance or permanence. Some of popular alexandrite lasers include GentleLASE by Candela Corporation and Apogee by Cynosure.

Diode lasers work best on skin types I-IV. The most popular on the market is the LightSheer laser by Lumenus.

Nd:YAG long pulse lasers are best for treating darker skin types (IV-VI) or patients of color such as African, Afro-American, Indian, Middle Eastern, Asian, Hispanic, Mediterranean, and even some Europeans.

Alexandrites and diodes have higher settings than Yag lasers so they are generally more effective on finer hair. If your skin type falls into types III-IV and the hair is finer, an Alexandrite or a diode is preferred. If you have fine hair and your skin is darker than a type V, the hair might not have enough pigment for successful laser hair removal, so spot testing might be necessary before committing to treatment.

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Q15. What are some laser hair removal brands?

• Alexandrite: GentleLASE, Apogee, EpiTouch Plus
• Diode: LightSheer, SLP 1000, F1 Diode, MeDioStar, LaserLite, Epistar, Apex 800, Comet (w/RF technology), Palomar SLP 1000
• Nd:Yag: CoolGlide, GentleYAG, Lyra-i, Sciton, Apogee Elite, Medlite IV, Varia, Athos
• IPL: Aurora (w/RF technology), Harmony, EpiLight, PhotoDerm, Quantum, Aculight, Vasculight, Palomar Starlux and EsteLux
• Ruby: RubyStar, E2000

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Q16. How much does laser hair removal cost?
Prices can vary as much as 100% to 200% from clinic to clinic. Some centers offer discounts for paying up front for multiple treatments. This may be tempting, but bear in mind that you may not be able to get any refunds in case something goes wrong or you are unhappy with the services.

Remember that lazor hair removal treatment doesn't work on everyone. Always do your legwork before you commit yourself to a program.

Just below is a list of average prices charged in the U.S for commonly treated areas. Always check with the laser hair removal centers for current prices, as well as their definition of the area to be treated. Prices listed here are per treatment session:

Full face - $150-300
Upper lip - $50-150
Chin - $50-150
Underarms (both) - $50-150
Half arms (both) - $200-400
Half legs (both) - $200-400
Butt - $150-300
Regular bikini - $100-200
Brazilian bikini - $200-300
Back - $200-500
Chest - $100-300
Abdomen - $100-300

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Q17. How do I locate suitable laser hair removal centers in my area?
Check out the website for the American Society of Dermatological Surgery at www.asds.net/find.htm

Run a search on any of the laser hair removal forums using the search box for your city name or state. Then read about experiences of previous consumers at the clinics in your area. Don't believe everything you read, though. Some participants in these forums have vested interests. Still, you'll find lots of useful information here. To find forums, use any of the search engines and key in "forum + your location laser hair removal" (without the quote marks).

You can also try running a provider search on the laser manufacturer websites:

Lumenis LightSheer Diode: www.skinandhealth.com/details/practitioner

Candela GentleLASE Alexandrite or GentleYag Yag: www.candelalaser.com/patients/index.cfm?task=practSearch

Cutera Coolglide Yag: www.cutera.com/locator/main.asp

Of course, you can also just check the Yellow Pages or www.citysearch.com for listings.

Laser hair removal treatment is available in all cities and large towns. The Windy City, for instance, is BIG for laser hair removal. Read on for more on laser hair removal in Chicago.

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