Things to Consider Before Deciding on Laser Hair Removal

Unwanted hair is a common aesthetic concern for both men and women in today’s society. Hair removal can be obtained by shaving, waxing, plucking, chemical depilatories, and electrolysis. While these techniques can be effective, they are often temporary and/or painful. Although electrolysis may permanently remove hair, it is a slow and operator-dependent procedure with variable efficacy.

Laser treatments have emerged as the standard against which others are measured for hair removal. Treatments provide a longer-lasting hair-free period than other methods. There are 3 main types of lasers that can be used in aesthetics to treat unwanted hairs: Neodynium YAG lasers, Alexandrite lasers, and long-pulse diode lasers. (A fourth laser type, the long-pulse ruby laser, is no longer commonly used.). In addition, there is a light device called IPL (“intense pulse light”) which can be used effectively for hair removal, especially if used on smaller areas such as the underarms, bikini and face. This is not a laser but uses light in a way to generate an effect similar to that of a laser.

If you have decided that laser hair removal is something you want to pursue, then the following are factors to consider. I have ranked them in the order that I, personally, would rank them if I were the consumer.

Safety
Efficacy
Cost
Time per session
Number of treatments

Safety

Safety is a factor than often gets overlooked when it comes to laser hair removal. Darker skin colors are at higher risk of side effects than fair skin tones. Risks of laser hair removal include pain, blistering, permanent lightening/darkening of the skin, change in skin sensation/feeling, and rarely scarring. These risks are low if the correct precautions are taken.

What steps can be done to reduce these risks? Choose your location/provider wisely. Is the facility part of a medical clinic? Is it clean? Is there a dermatologist or plastic surgeon present? Typically the cost of a procedure is tied most closely to the benefit/risk ratio of the setting. Having a dermatologist / plastic surgeon or their extender perform the procedure with a state-of-the-art laser in a hospital/clinic based setting is likely to be more costly than going to an aesthetician using an older/preowned model laser in a day-spa or mall. However, the risk of injury is much lower, and the efficacy significantly higher. Just as important, if you are unfortunate enough to have a complication from a treatment session, you need to trust that the provider will know what to do and do it promptly.

Enquire about what type of lasers they have available and what they recommend for you. For individuals that have darker skin tones (people with skin of color or those that tan easily and rarely burn), the safest type of laser to use is the Neodynium Yag (“NdYag”) laser. This laser bypasses the top layer of skin and places the energy directly into the hair follicle. For people with more fair skin, all 4 laser types as well as IPL can be used effectively.
For fair skinned clients deciding on the laser type depends not only on safety but also on the other parameters listed.

Efficacy

The efficacy of all 3 lasers as well as the IPL are all “in the same ballpark”. Depending on the study, each have been shown to have their advantages and disadvantages when compared against each other. No one laser can claim to produce 100% permanent hair removal. For people considering laser hair removal, I have listed each of the 4 laser types along with a few comments about them below.

Alexandrite lasers (755 nm wavelength)
These work great for lighter skin tones. They have a shorter wavelength and are at higher risk of blistering, lightening/darkening of the skin or scarring. (Never use on tanned skin.) These devices can have great results but require more skill and caution than other laser types. Common brands include Gentlelase, EpiTouch and Apogee. Alexandrite lasers are often painful and may require topical numbing creams. They are often used by chain stores specializing in hair removal.

Diode lasers (810 nm wavelength)
Because of the longer wavelength, these lasers can be used in people than have darker skin, when compared to the Alexandrite lasers. These lasers are often chosen because they are often fast and may have a large spot size, so each session can take less time. They are effective lasers. Common diode laser brands are Light Sheer, MeDioStar, and Apex 800.

NdYag (1064 vm wavelength)
The longer wavelength allows these lasers to minimize risk to the skin. It is the safest laser for darker skin tones. Early generation NdYag lasers were known for being less effective and quite painful. New versions have changed that. We selected the latest generation long-pulse NdYag made by Fotona because of its high efficacy in all skin types/tones and because it is painless and requires no topical numbing creams.

IPL
In contrast to lasers which use monochromatic light, intense pulse light uses a xenon flashlamp with filters to generate light beams with variable wavelengths. These devices can produce excellent results but require a qualified provider. There is a higher risk of complications with these devices than with some of the lasers mentioned. These devices are best used in patients with lighter skin tones with no tan. These devices tend to have less pain than many of the lasers used, but similar efficacy.

At Lumen, we use two different devices to optimize hair removal: the Elos Plus IPL device made by Syneron Candela and the Fotona SP long-pulse NdYag laser. Depending on the skin type/hair type of the client, we may use one or both of these.

Cost

According to the American Society of Plastic Surgery, the average cost per session is $235. There is a wide range in cost, however. Factors that affect cost include:
Setting/ Qualifications of provider (eg dermatologist/plastic surgeon vs physician extender vs nurse vs aesthetician; hospital/clinic vs shopping mall)
Size of area ( entire back vs upper lip)
Type of device used
Number of sessions required
Sometimes, the number of sessions required can vary. At Lumen, we offer a package price that includes unlimited sessions for a full calendar year.

Time per Session

Some lasers are faster than others. Some lasers have a larger spot size than others. These factors, along with the size of the treatment area and the experience of the provider, will determine how long each session takes. A small area such as the underarms, usually takes 5 minutes or so. Larger areas such as the back can take 30-45 minutes. Most providers quote prices based on the location, not on the time it takes for each session.

Number of Treatments

Most areas take 6-8 sessions to get full results. Some individuals and locations respond more quickly or slowly. Facial hairs often respond more slowly than hairs on the legs. Likewise, women that have polycystic ovarian syndrome or other hormonal conditions may respond less effectively.

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