The demand for laser hair removal is increasing rapidly. Some people are afraid to do it, as they think lasers may damage their skin. Others prefer Intense Pulsed Light (IPL) as a more affordable option, especially when they are told that it is safer as well. High expectations commonly lead to disappointments, especially as commercials give the impression that permanent removal can be achieved in a single session. What is the truth about laser hair treatment? Is permanent removal achievable? How many sessions does it take to achieve the desirable effect? And what are the different types of lasers used? Dr. Mahmoud Abdallah, Lecturer of Dermatology, Venereology and Andrology sheds light on the techniques and risks involved. Al-Masry Al-Youm: How does laser hair reduction work? Dr. Mahmoud Abdallah: Laser is a type of light emitted in a single wavelength to selectively destroy a specific target. In the case of laser hair removal, the target is melanin (pigment particles). Melanin absorbs the laser beam and delivers heat energy to destroy hair follicles present in the skin. As white hair contains no melanin, the laser does not affect it. Melanin is present in the skin as well. New technologies can now destroy melanin in the hair, without affecting that in the skin. Adjusting the proper duration at which the laser pulse is delivered saves the skin from being affected by laser. Cooling the skin before laser treatment not only saves the skin, but also reduces the pain felt during the laser session. There are different methods of cooling: applying a cooling gel before the session, using a spray derived from the laser machine, contact cooling through the laser probe itself, or, the most preferable way nowadays, air cooling (delivering cold air to the treated area before the laser beam is shot). Laser hair removal is safest when used on dark hair and fair-colored skin. Al-Masry: How is the laser beam delivered? Dr. Abdallah: The laser beam is delivered with a hand piece that projects a circular spot on to the skin. The spot size varies between 6 to 18 mm, depending on the machine. All the hairs inside the spot are burned simultaneously. The doctor then moves the hand piece over the area being treated, delivering pulses to the skin. For all types of lasers, except diode, the hand piece does not touch the skin Al-Masry: How long does it take? Dr. Abdallah: This depends on the size of the area being treated. A full face takes around ten minutes, while two legs (from knee to heel) take around 45 minutes. Al-Masry: What are the types of lasers used for laser hair removal? Dr. Abdallah: Four types of lasers are currently used: Ruby lasers, Alexandrite lasers, diode lasers, and Nd-Yag lasers. Nd-Yag lasers are safest for dark-skinned patients, but more painful than the other types. Alexandrite and diode lasers are used mainly on fair-skinned people and are a better choice for thin hair. Al-Masry: How is laser different from IPL? Dr. Abdallah: Laser is far more effective and safe than IPL. However, IPL is cheaper by the session. But since many IPL sessions are required to achieve good results, the total cost of IPL appears to be more than laser. Al-Masry: How does the hair thickness affect the results? Dr. Abdallah: Thick hair contains a bigger target (of melanin pigment) and responds better to laser sessions. As a rule the thicker the hair, the better the result. Al-Masry: How many sessions does one need? Dr. Abdallah: On average four to six sessions, four weeks apart are needed to achieve the desired effect. After four sessions, 80 to 90 percent of hairs are permanently removed while the remaining hairs become thin and grow slowly. Thereafter, some people might need a single session every six months to maintain the results. It is essential to realize that people respond differently to laser sessions. Some require only three sessions while others may need up to eight. In the case of female facial hair, it is essential to determine in advance that there is no hormonal imbalance which may affect the results. If there is an imbalance then medical treatment should go hand in hand with the laser sessions. Al-Masry: How can one remove hair in between sessions? Dr. Abdallah: Most people do not grow much hair in between sessions. If they do, epilation and waxing are not recommended as they may affect the results of laser treatment. Shaving or applying depilatory creams are safer options. Al-Masry: Which areas can be treated by laser? Dr. Abdallah: Almost any area can be treated, except eyelashes. Some people ask for facial laser hair removal, others ask for hair removal on the armpits, bikini line and legs. Armpit hairs respond very well to treatment. Only two to three sessions are needed to get rid of armpit hairs. Men frequently ask for removal of hair on their backs. Men and women frequently develop small pimples on hairy sites due to hair growth under the skin. This is commonly seen in men at the lower end of the moustache or in women on the legs or bikini area. The only solution for these small pimples is laser hair removal. Al-Masry: Does it hurt? Dr. Abdallah: Laser hair removal may be somewhat uncomfortable. Like anything else, it is more painful for those who have not undergone the procedure before. That said, many people tolerate laser hair removal very well. Most people feel a stinging pain comparable to being hit by a rubber band. Pain can be significantly reduced by applying a numbing cream and/or using the proper cooling devices before treatment. Al-Masry: What are the side effects of laser hair removal? Dr. Abdallah: If the treatment is done by an expert, there should be no side effects. The proper type of laser should be chosen according to skin and hair types. Change of laser type may be needed after a few sessions to achieve proper results. Skin redness usually appears after sessions and remains for few hours. It is very rare for skin color to turn dark after the session, and if so it is reversible within a few weeks. It should not happen if the proper type of laser is used and the machine is well adjusted. Dark-skinned individuals should use sunscreen to avoid direct sun exposure for a week after the session. Absence from work is not needed. Laser hair removal is also safe during pregnancy as the laser beam does not penetrate the skin. This has been approved by the FDA (Food and Drug Administration). Furthermore, there not a single report of laser treatment causing cancer. In use for over 50 years, it appears that laser hair removal is safe.
