10 questions on laser epilation
How does a laser work in hair removal?
It works on the principle of selective photothermolysis, eliminating the hair follicle with no damage to neighbouring structures. The laser emits light pulses that are selectively absorbed by the target chromophore or melanin present in each hair. Other chromophores in the skin are water and haemoglobin. The light energy absorbed by melanin is transformed into heat, burning and denaturalising the hair follicle.
What is the best laser to use in hair removal?
Each system affords its unique advantages and drawbacks. To choose the right system, we need to evaluate the type of skin, the type of hair, and the area to be epilated in each patient. Instituto Médico Láser offers the most complete laser and intense pulsed light platform in Europe, making the treatment of most phototypes possible by alternating between the different systems in each patient to optimise treatment.
What are the limitations and drawbacks of a laser system?
There are areas such as the face where hair removal may not be permanent. Moreover, a laser system is not successful in grey hair types, nor can it remove fair and fine hair. Laser cannot be used in high phototypes and is contraindicated in suntanned skins, in pregnant women and in patients treated with isotretinoin or photosensitising drugs. The use of a laser is complex and because of this, operating a laser requires some learning and the supervision of a medical professional.
What are the main advantages of a laser?
It is a fast, comfortable and generally well tolerated method enabling the treatment of large areas, with long lasting results which, in many cases, are permanent. It is an effective method to treat hair-related pathologies such as pseudo folliculitis, hirsutism, hair removal from skin grafts, Necker nevus, etc.
What type of lasers are used in photoepilation?
The most suitable lasers are those that have a wave length between 700 and 1400 nm, as it is in this range where there is a greater absorption of melanin and where there is less interference with other pigments such as haemoglobin. The most frequently used lasers are:
- Ruby laser (694 nm): It is indicated for fair phototypes, from phototype I to III. It has now fallen into disuse.
- Alexandrite laser (755 nm): It treats dark phototypes up to phototype IV, preserving the epidermis.
- Diodo laser (800 nm): It treats dark phototypes up to phototype V, preserving the epidermis.
- Neodymium:YAG laser (1064nm): Its wavelength is not heavily absorbed by pigments, enabling treatment of all skin types but with lesser efficacy.
- Intense pulsed light (590-1200 nm): It allows more combinations depending on the skin and hair type to be treated, being specially useful for facial hair.
What are the most suitable areas for treatment?
The armpit and groin areas and legs are the best areas for treatment, where a significant decrease in hair density is observed from the very first sessions, with a permanent elimination of hair. Hair removal from the beard area, back and thorax in the male, also offers very satisfactory results, though more sessions are required. Lasers can remove hair from any area in the body, excepting the internal part of the eyebrow due to proximity to the eyeball.
What factors should be taken into account?
- Density of melanin in the hair follicle: The higher the concentration of melanin, the greater the pigmentation in the matrix of the hair and the greater efficacy of the laser. White hair does not respond to this treatment.
- Density of melanin in the skin: The more suntanned the skin is, the greater the risk to have side effects. The highest phototypes require the use of lasers with a longer wave length and a long pulse length.
- Hair thickness: The thicker the hair is and the greater the pigmentation, the greater the absorption of energy and the more successful the epilation. Fine hair absorbs less energy and does not respond to treatment as well.
- Depth of the hair follicle: It is important to consider hair depth to choose lasers with a stronger or weaker penetration.
- Growth stage of the hair: It is considered that the anagen phase, when the hair is thicker and more pigmented, is the best to carry out treatment with optimal results.
- Follicular density: The higher the hair population, the lower the dose of energy.
- Age, gender: The presence of androgens (male hormones) makes treatment more difficult, hindering results. Males achieve less satisfactory results and require more sessions. Women with hormonal alterations and body areas that are hormone-dependent (areolas, linea alba and chin) are harder to epilate.
- Topography: Some areas respond better than others to treatment. Armpits, groin area and legs respond much better than the facial area. Hair density in the face is high and hair growth is subject to female hormonal variations during periods such as menopause.
Does it hurt?
During the session it is normal to experience some discomfort in the way of a burning sensation, pricking sensation or mild pain. Once the session is finalised, slight erythema will develop which will fade away the next day. If the hair is too thick there might be some perifollicular oedema in the form of transitory reddening around the hair indicating the treatment has been effective.
A few days after the treatment, some black dots might be noticed corresponding to the dead hair about to fall off. If the patient is prone to develop haematomas, it is likely for them to appear after the treatment. Since photoepilation is a form of aggression to the hair follicle, there might be fistulas caused by the infection of the follicle, or folliculitis. This problem gets resolved with the application of an antibiotic cream for 2 or 3 days.
How many sessions are necessary?
The number of sessions required depends on factors such as skin and hair colour and the area to be treated, the patient’s gender, age and hormonal moment. The time interval between sessions at the beginning is approximately six weeks for facial treatments and two to three weeks for body treatments. The doctor will decide the time interval between sessions according to patient’s characteristics.
Session duration will vary from 10 minutes (upper lip) to several hours for very large areas (legs or back). As an example, let’s take the groin skin in a 20-year old woman in whom her latent hair has become activated. The total number of hair follicles that are activated and that are subject to destruction by this technique corresponds to the total number of hair for that specific body area. It is easy for 80% of the hair to be eliminated in about 6 to 8 sessions, reaching a complete epilation with two or three touch-ups per year.
Is there any incompatibility with regard to sun exposure?
After hair is removed through any method, including laser epilation, there is an irritation that makes sun exposure unadvisable until after 48 hours. The incompatibility of sun tanning with regard to the laser has to do with the next session, as the light emission will be absorbed by the skin surface and not by the hair’s matrix.
If this happens, there will be superficial burning due to the heating of the surface and there will be no real depilatory effect because the light is absorbed by the colour of the epidermis. You can of course sunbathe and suntan, but then you will have to wait at least one month until you can have a new laser session.
Madrid, 1 February 2006
Instituto Médico Láser introduced photoepilation in Spain in April 1977. The ample experience that IML has on this type of treatment, the number of cases treated and its technological platform, have made IML an authority on the subject of photoepilation. Much of IML knowledge is described in the attached document, a 10-page dossier where all the questions in relation to laser hair removal are answered.
We hope this information is of help to you to write news as the spring time approaches. For further information, please do not hesitate to contact Dr. Royo, who will be pleased to answer any of your questions (Tel. 91-3198380).