Laser Hair Removal

Laser Hair Removal How does laser remove hair?

Highly controlled flashes of laser beams are selectively absorbed by hair follicles lying below the surface of the skin. The absorbed light heats the hair, which damages and destroys the regrowth potential of the follicle- all without damaging surrounding tissue. Hair follicles are usually in different growth cycles at different times in relation to one another. Since the follicle must in active growth in order to be affected by the laser, several treatments spread over several months are required to assure the destruction of all hair follicles.

Contact with Us

[contact-form-7 id=”519″ title=”Laser Hair Removal”]

What happens during a treatment?

It begins by trimming away the hair above the skin. You may be asked to wear dark glasses to protect your eyes from the bright light. Next, a cold gel is spread over the treatment area. The laser handpiece is then applied to your skin and pulses of laser begin disabling your unwanted hair. When the gel is removed, much of the hair is wiped off with it. The remaining hair in the treated area falls out over the next week or two.

What does the treatment feel like?

Each pulse of laser feels like a slight sting or pinch, similar to the snap of a rubber band. Topical anesthetics may be used but most people don’t require it.

Can all hair be treated?

Our state of the art lasers offer you customized treatment according to your hair color, texture and body location. Any hair with at least some pigment in it ( black, brown ) can be treated effectively.

Is laser hair removal safe for all skin types?

Newlook skin & hair clinic uses the most advanced laser systems which are FDA approved for permanent reduction of hair in all skin types, including dark skinned African Americans and Hispanics.

Are there any possible side effects?
Side effects are rare. You may experience some slight reddening or local swelling at the treatment site, but this typically goes away within hours. On rare occasions, some blistering or bruising may occur, but typically resolves quickly. The skin may also become lighter or darker following treatment, but will generally return to normal within a few weeks. Limiting sun exposure before and after treatments will minimize risk of complications.
What kind of results should I expect?

Our lasers are FDA approved for permanent hair reduction. The number of treatments required depends on several factors related to your specific kind of hair and skin. Usually five to six treatments spread out 8 weeks apart are required to achieve satisfactory results. Following each treatment, you can generally return to work and resume all regular activities.

What type of laser do you use?

We carry the latest models of the Light Sheer laser (Diode laser, top XC Model) and the Epilight (Intense Pulsed Light). Both of these lasers are FDA approved for permanent hair reduction and have been shown to provide excellent results with all types of hair and skin colors.

Which laser is right for me?

Depending on your skin tone and color, and the coarsness and darkness of your hair, the doctor will decide which laser would be best for your specific needs. However, we prefer to use the Light Sheer on most of our patients because it is faster, and provides extra skin cooling protection via it’s chill tip.

Skin Contact Cooling / Chill Tip.

It is very important to protect the top layers of the skin from becoming too hot during a laser treatment. Many lasers have different cooling mechanisms to protect the top skin, however, none of them can match the cooling protection which is provided by the Light Sheer’s contact cooling Chill Tip. The tip of the Light Sheer is made of saphire which conducts heat very quickly. This saphire tip is constantly cooled to 5 degrees by the control of the laser’s computer. When the tip of the laser is placed on the skin, it cools down the upper layer of the skin and protects it from getting too hot. This allows us to use higher energies at a safe level, and thus obtain better results.

About Hair

Hair is a dermal appendage found almost everywhere on the human body except the palms, soles, and lips. Vellus hairs are fine, colorless hairs (“peachfuzz”) covering most of the body, except those areas covered with Terminal hairs, which are coarse pigmented hairs found on the scalp and eyebrows. Vellus hairs can transform into terminal hairs when stimulated by androgens (male sex hormones), especially those on the face, back, chest, abdomen, axillae (armpits) and genitalia at puberty. Vellus hairs can tranform into terminal hairs with aging. The number of hair follicles present in the skin is fixed at birth.

The hair shaft is composed of the protein keratin and is produced in the lower part of the follicle, or bulb. The middle part of the follicle contains the opening for a sebaceous gland, the attachment of the arrector pilii muscle, and a thickened area in the root sheath called the “bulge”, which is believed to contain stem cells important for regeneration of the hair follicle. Melanin is produced in the bulb and possibly in the bulge, and concentrated in the hair shaft and upper part of the bulb. Depending on the thickness of the skin, the bulb may be as deep as 7mm, below the skin in the subcutaneous tissue. Actively growing, or anagen hair follicles are longest and deepest, while follicles just coming out of dormancy, the bulb is much more superficial (see hair cycle, below)

Melanin is the pigment which gives both hair and skin its color. Much more melanin is present in hair than in skin, and this property allows relatively more absorption of laser light energy in hair than in skin (see below). Hair color is determined not only by the absolute amount of melanin, but by the relative amounts of black-brown eumelanin and reddish brown pheomelanin, and refraction of light within the layers of the hair shaft itself.

Hair growth cycle

Hair growth occurs in cycles throughout an individual’s lifetime. Active hair growth is called Anagen, and the length of the anagen phase determines the length of the hair. Scalp hairs may remain in the anagen for up to 3 years. Hair follicles then enter Catagen, a phase of regression which lasts a few weeks. The Telogen, or resting phase, can last for months, depending inversely on the number of actively growing hairs in the area, ie. the scalp has a shorter telogen phase than the chest. As anagen resumes, the hair follicle lengthens, the bulb descends deeper into the skin, and the old hair shaft is gradually shed. In humans, individual hair follicles are more or less independent, with most hairs in anagen at any given time. In animals which shed their hair, the follicles cycle more or less simultaneously.

Body Site % Anagen (growing) hairs %Telogen (resting) hairs Duration of Telogen Follicle Density Depth of Follicle
Scalp 85% 15% 3 months 350/sq.cm 5-7 mm
Beard 70% 30% 10 weeks 500/sq.cm. 2-4 mm
Upper Lip 65% 35% 6 weeks 500/sq.cm. 1-2.5 mm
Axilla (armpit) 30% 70% 3 months 65/sq.cm. 4-5mm
Chest/Back 30% 70% 3 months 70/sq.cm. 2-5mm
Breasts 30% 70% 4 months 70/sq.cm. 2-4mm
Arms 20% 80% 5 months 80/sq.cm 2-4mm
Legs 20% 80% 6 months 60/sq.cm 2-4.5 mm
Bikini/Pubic 30% 70% 3 months 70/sq.cm. 4-5 mm

Physical Basis for Laser Hair Removal: Laser Hair Removal is based on the principle of selective photothermolysis, in which energy is delivered to the treatment area in such a manner as to maximize tissue damage to the hair follicle while sparing the skin and surrounding tissue. Melanin pigment makes a logical target chromophore, because it’s most abundant in the hair bulb, which is believed to be the most important target for hair removal, much less abundant in epidermis, even in dark-skinned patients, and it absorbs well in the skin’s “optical window” between 600-900nm.

Wavelengths under 600nm are strongly absorbed by hemoglobin and protein (scatter), and wavelengths above 900nm are strongly absorbed by water in tissue. Skin is relatively “transparent” in the 600-900nm range, with melanin-bearing structures as the most attractive target for laser energy. Melanin absorption decreases with increasing wavelength. Ruby laser light at 694nm is strongly absorbed by melanin, not only in hair but in epidermis, so epidermal melanin content limits the depth of penetration and energy fluence that can be used without unacceptable thermal injury to the skin. Nd:YAG laser light at 1064nm is much less strongly absorbed by melanin as well as other chromophores present in skin, and therefore penetrates much more deeply and with minimal epidermal reaction and collateral heating. These properties can be exploited clinically, as outlined below.

Diode Laser: Solid state 800nm diode lasers feature a longer wavelength and pulsewidth, theoretically offering an advantage in treating darker skinned patients. The Aesculap-Meditec MeDioStar has obtained the USFDA approved for Permananent hair reduction.

Q-Switched Nd:YAG: With a wavelength of 1064nm, relatively low melanin absorption, and skin penetration up to 5mm, the Nd:YAG laser is an excellent choice for laser hair removal, at least in theory. However, the nanosecond-range pulse width of the Q-Switched YAG is thousands of times too short to cause complete disruption of the hair follicle, resulting in prompt hair regrowth. In order to enhance absorption of energy, a suspension of carbon particles can applied before treatment, usually after hair removal by waxing, allowing the carbon suspension to penetrate into the follicle and conduct absorbed laser energy to the follicular structures, as in theThermolase SoftLight system. Although safe for darker-skinned patients and effective for short term hair reduction, the Q-Switched Nd:YAG is generally considered the least effective laser for long-term hair reduction.

Photodynamic Therapy: In photodynamic therapy a photosensitizing compound is applied topically to hair-bearing skin after waxing, to allow the compound to enter the now-empty hair follicle. The area is then irradiated with laser light to activate the photosensitizer, which releases toxic oxygen radicals that damage the hair follicles. Currently in the investigational stage, preliminary studies have demonstrated up to 40% hair loss at 6 months after a single treatment. Photodynamic therapy has been used with limited success for certain malignant tumors, but the lack of safe, effective, selective photosensitizers have limited its use.

Practical Aspects of Laser Hair Removal:

Preoperative evaluation: The most important consideration with Laser Hair Removal is the patient’s skin type and hair color. The differential absorption of melanin in the hair follicle and melanin in the epidermis determines the amount of energy that can be safely used. The Ideal Patient has light (type I) skin with black hair, and a patient with very dark (type VI) skin with white or grey hair would have little if any response. Presumably because of the absence of melanin, no currently available device works well in patients with canites, or grey hair.

Skin Type Skin Color Tanning History Skin Color Tanning History
I very fair, “transparent” Always burns, never tans
II fair Always burns, tans with difficulty
III fair to light olive Burns mildly,tans slowly
IV olive to brown Rarely burns, tans with ease
V dark brown Very rarely burns, tans very easily
VI black Never burns, tans very easily

 

An underlying cause for the excess hair, if present, should be corrected. These causes may include endocrine abnormalities and medication effect, including minoxidil, steroids, oral contraceptives, and some immunosuppressive agents.

Contraindications to Laser Hair Removal include patients who have healed poorly after other types of laser treatments, patients prone to skin discoloration, patients with grey or white hair, and patients who are pregnant. There’s no scientific evidence to suggest that laser light used in hair removal can injure a fetus, but the question of injury will not arise should any fetal problems occur. Patients who are tanned should wait for the tan to fade for best results, and patients using photosensitizing medication such as Accutane, tetracycline, or Retin-A should discontinue the medication weeks, and for Accutane, months before treatment. Herpes Simplex Labialis (fever blisters) can be activated by Laser Hair Removal, especially on the upper lip, and patients with a tendency for fever blistering can be started on antiviral medication before treatment.

Preoperative preparation: Hair should not be plucked or waxed before treatment. This removes the hair shaft from the follicle, thus removing most of the melanin chromophore. Hair may be shaved, which preserves the chromophore in the follicle, and prevent dispersion of energy by external hair. Lotions, cosmetics, and other skin preparations should be avoided on the day of treatment.

Postoperative care: In most cases, little specific postoperative care is necessary. Mild burning sensations and redness can be treated with ice packs and oral pain medication. In cases where blistering occurs, topical antibiotic cream and a non-adherent dressing can be applied. Sun exposure should be avoided, and an SPF 15 or greater sunblock should be used. Moisturizing lotions and makeup may be applied the next day. During the weeks after treatment, damaged hair follicles and hair shafts are extruded or shed, and may be misinterpreted as early regrowth of hair. This is especially noticeable in areas with thick, coarse hair.

Efficacy of Laser Hair Removal: The “permanence” of Laser Hair Removal is often called into question. In practice, no laser destroys all of the hair follicles. Some follicles are destroyed, others are miniaturized into vellus hairs, and some are shocked into prolonged dormancy. Multiple treatments are needed for best results, and the best interval for treatment is when new hair regrowth is observed, usually 6 to 12 weeks after the first treatment, and 3 to 6 months after the second treatment. In most cases there will be visible improvement within a week after the first treatment. Repeat treatments can be performed at suitable intervals.

It’s possible that with a sufficient number of treatments, true “permanent hair removal” can be ultimately achieved, but not for every single hair present in a given area. As an example, only 30% of hair follicles on the back are in anagen (active growth) at a given time-70% of the hair follicles are in telogen (dormant), even though they may contain visible hairs. Assuming a single laser treatment permanently eliminates every actively growing follicle (the actual figure may be closer to half), 70% of the hair follicles originally present may eventually sprout visible hair. After 3 months (the average length of dormancy on the back), 30% of the remaing follicles will enter anagen, and if a second laser treatment eliminates every actively growing follicle (30% of the 70% remaining after the first treatment), then only an additional 21% of the original hair follicles will be destroyed, leaving 49% of the original hair follicles able to regrow visible hair. A third treatment will leave 34% of the orginal follicles, a fourth 24%, and so on. In actual practice, some of the follicles are shocked into prolonged dormancy, or converted to vellus hairs, so the visible effect is greater than suggested by the percentages. Experience to date with laser hair reduction suggests that the hair reduction achieved is “permanent”.

Efficacy of Laser Hair Removal: The “permanence” of Laser Hair Removal is often called into question. In practice, no laser destroys all of the hair follicles. Some follicles are destroyed, others are miniaturized into vellus hairs, and some are shocked into prolonged dormancy. Multiple treatments are needed for best results, and the best interval for treatment is when new hair regrowth is observed, usually 6 to 12 weeks after the first treatment, and 3 to 6 months after the second treatment. In most cases there will be visible improvement within a week after the first treatment. Repeat treatments can be performed at suitable intervals.

It’s possible that with a sufficient number of treatments, true “permanent hair removal” can be ultimately achieved, but not for every single hair present in a given area. As an example, only 30% of hair follicles on the back are in anagen (active growth) at a given time-70% of the hair follicles are in telogen (dormant), even though they may contain visible hairs. Assuming a single laser treatment permanently eliminates every actively growing follicle (the actual figure may be closer to half), 70% of the hair follicles originally present may eventually sprout visible hair. After 3 months (the average length of dormancy on the back), 30% of the remaing follicles will enter anagen, and if a second laser treatment eliminates every actively growing follicle (30% of the 70% remaining after the first treatment), then only an additional 21% of the original hair follicles will be destroyed, leaving 49% of the original hair follicles able to regrow visible hair. A third treatment will leave 34% of the orginal follicles, a fourth 24%, and so on. In actual practice, some of the follicles are shocked into prolonged dormancy, or converted to vellus hairs, so the visible effect is greater than suggested by the percentages. Experience to date with laser hair reduction suggests that the hair reduction achieved is “permanent”.