laser hair removal

Hair. Those who have it don’t want it. Those who don’t have it want it. Some time in the 1990s hair became ugly. I’m not talking about hair on the top of your head. I’m talking about the rest of the hair on your body. Certainly, unwanted hair has plagued women for centuries. More recently, men too seem bothered by it.

Hair shows up in the usual places: the underarms and the groin. But it also appears in places we don’t expect it: the nipples, the upper lip, even the chin in women; inside the ears and nose in men. Techniques of hair removal include plucking, waxing, bleaching, shaving, and electrolysis. In the 1990s, lasers that destroyed hair were invented. The early versions were not too powerful and resulted in only temporary hair removal. Newer, more powerful lasers chill the skin and kill the hair permanently.


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These lasers were breakthrough products. Some of the most satisfied patients I have are women who have had beards removed, or who are rid of chronic ingrown hairs in the bikini area. Over 1.5 million people underwent laser hair removal in 2005.

How Lasers Work
Lasers split light into one precise color. Think of light coming in your window, hitting your chandelier, and causing a rainbow of colors to be projected onto the wall. Now capture just one of those colors and intensify it millions of times. That is basically a laser. The laser light passes through substances that are not the correct color and is completely absorbed by one specific color. Scientists and doctors call this substance a chromophore—the target for a specific laser.

QUIZ: What’s Your Skin Type?

When intensified light, specifically tuned for, say, dark brown color, hits the hair, it superheats and vaporizes it. The hair acts as a fuse, leading all the way to the hair follicle. When the heat absorbed by the hair hits the follicle, it fries and permanently destroys it. If you think about it, laser hair removal is strikingly like electrolysis. In that process, a metal electrode is placed down the hair shaft until the follicle is reached. Electric current is then passed along the wire, frying the follicle.

Laser hair removal is much more efficient than electrolysis. In a half second, a 9 × 9 millimeter square of skin is treated. All the growing hairs within this square are destroyed. The process is relatively independent of the skills of the practitioner; the laser finds the hairs. 

At any given time, only a portion of the hair grows. Other hairs are resting. Laser hair removal kills only the actively growing hairs. And it kills only follicles that have actively growing hairs. That is why techniques that remove the hair, such as waxing or plucking, decrease the efficiency of laser hair removal. These techniques should be avoided for months before the laser procedure. You don’t have to be hairy, though; you can shave the hair or use a depilatory cream such as Nair.

The laser destroys any brown it encounters. It doesn’t know the difference between hair and tanned skin. The darker the skin, therefore, the more the blistering. When the skin is hit by the laser, it responds by making pigment. This can be a big problem. It turns out that people with olive complexions have the most severe problems with hyperpigmentation after laser hair removal. Southern Asians, Puerto Ricans, and southern Italians all have problems with hyper-pigmentation. People with darker skin should use the lightening cream hydroquinone for at least two weeks prior to laser treatment to decrease the chance of this troublesome side effect.

Today’s Lasers Really Do Work
Early hair removal lasers did not kill hair: they heated up the follicles and ‘‘stunned’’ the hair. It fell out but returned in a few weeks. I always wondered why someone would pay for temporary hair removal when they could wax at a fraction of the cost. When the stronger lasers were made, we saw the first permanent results.

The lasers available now can kill black and dark brown hair, but still have a hard time with light brown hair. None can kill blond or white hair. If white hair persists after a course of laser hair removal, electrolysis can be used.

In the average patient, each laser treatment kills between 20 and 40 percent of the hair. After three treatments, about 80 percent of the hair is destroyed. After four treatments, about 90 percent of the hair is gone. The darker your skin, the lower the power that must be used in order not to cause burns. But the lower the power, the less hair is killed. It can take a dozen or more treatments to decrease the hair on dark-skinned or tanned people.

Hormonal Problems Can Cause Hair Growth
In women who have hormonal problems, many laser treatments will be necessary unless the problems are brought under control. Polycystic ovary disease (Stein-Leventhal syndrome) is one of the more common conditions that cause facial hair growth. Under the influence of hormones, each little blond hair of the face has the potential to become a large black hair. It’s kind of like weeding a garden. Even though you pull all the weeds, the seeds are already in place for a new crop in a few weeks. The blond hairs are the seeds of larger hairs. 

There Are Different Types of Laser Hair Removal Systems
Laser hair removal systems use various wavelengths of light to kill hair, and each system is a little different. Before beginning a laser hair removal program, be sure you know what kind of laser is being used. Find out the percentage of hair destroyed with each treatment. Make sure the hair removal is permanent. Determine the chance of complications such as blistering, bruising, and increased or decreased skin pigmentation with your doctor’s particular system.

Alternative Methods of Hair Removal
Techniques such as plucking or waxing the hair are temporary, but they do work. Depilatories such as Nair contain chemicals that dissolve hair. Shaving works, but creates stubble.

Electrolysis uses electric current to fry the hair follicles. It is painful and tedious, with weekly treatments that sometimes stretch on for years. The effectiveness is only as good as the electrologist. There are competent electrologists and there are those who go through the motions, plucking the hairs at the end of the treatment. Electrology cannot treat ingrown hairs, and it can result in dreadful scarring if not performed correctly. I believe that this technique will be relegated to the removal of blond and white hairs, since laser hair removal is so much more efficient on darker hairs.

The drug Vaniqua (eflornithine) slows the production of hair and causes it to form improperly. The result is an early breaking off of hair shafts. Again, with the advent of laser hair removal my opinion is that this drug is best used on blond or white hairs.

The Cost
The average cost for laser removal is $350 per treatment. Areas such as the upper lip might cost $200 per session, the entire back or thighs about $2,000 per session.

Want more? Check out these 17 at-home hair-removal revelations.