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Top 10 issues

1- Laser Hair Removal is not for everyone.

2- Laser Hair Removal is efficacious, fast and expensive.

3- Laser Hair Removal is an Aesthetic Medicine procedure.

4- La couleur de la peau et des poils a une influence sur l’épilation laser.

5- Skin and hair colors have an impact on Laser Hair removal.

6- Laser Hair Removal may be performed on any body area except the eye.

7- Laser yields to very long term, or even permanent hair removal.

8- Intense Pulsed Light aka Flash Lamp is not equivalent to LASER for hair removal.

9- Sun tan and Laser Hair Removal do not mix.

10- Precautions need to be followed.


Issue #1 : Laser Hair Removal is not for everyone.

Key success factor #1: the hair has to be darker than the skin on which it resides. Very pigmented skins (dark and black) will absorb too much energy (light) in the skin rather than in the hair, consequently they will not be appropriate candidates for Alexandrite laser treatment. Some laser centers dedicated to hair removal (such as Advanced Medical Laser, LLC) have invested in new lasers capable of treating dark and black skins (phototypes V and VI). When selecting your laser center, you should call ahead to make sure the appropriate equipment is available for your skin type.

Issue #2: Laser Hair Removal is efficacious, fast and expensive.

A treatment cost depends on the area treated. Prices per session in Laser Hair Removal Centers of Excellence are usually within a similar range and tend to be more affordable than in stand-alone offices. It’s all about volume and experience. On average, an upper lip should not cost more than $60 (6 minutes) per session. A man’s back should not cost more than $300 (45-60 minutes) and finally, a woman’s ½ leg should not cost more than $200. The main reason for these high costs is due to the expensive laser equipment needed to provide superior results: between $85,000 and $120,000 per laser. Some large centers, such as Advanced Medical Laser, have between 3 and 7 lasers to process all skin types and various indications.

Issue #3: Laser Hair Removal is an Aesthetics Medicine procedure

In a Laser Center of Excellence, a laser physician should operate the laser and be directly involved in your treatment. Setting the laser parameters is a very important medical step in your laser program and consequently delegating this phase to a technician or a nurse is not appropriate. Your laser physician should be properly trained, having followed a formal post-graduate course or degree in Laser Medicine. His/her degree should be displayed in the laser center. The so called training provided by a laser equipment manufacturer is not appropriate in a Laser Center of Excellence. If a laser technician performs your treatment, please make sure that it’s under the direct supervision of your laser physician, after he or she established the laser settings. It’s a safety issue and a question of professionalism.
Aesthetics Medicine is usually not covered under any Medical Insurance Plan.

Issue #4: Skin and Hair color has an impact on Laser Hair Removal.

LFair skin makes it easy to remove hair with an Alexandrite laser. The total number of sessions is lower and results better and faster than in cases where the skin is pigmented. People with darker skins may contemplate a Laser Hair Removal Program but only in a center where the appropriate lasers are available and where experienced laser physicians are performing treatments. The total number of sessions will probably be higher and results more difficult to reach. Each individual requires a specific attention and a customized treatment.

Dark hair absorbs more laser energy than light hair. Thick hair is easier to destroy than thin hair. Blond hair (yellow) and red hair (real one) are almost impossible to treat. Many sessions are necessary, sometimes too many. Blond hair contains pheomelanin, a low absorbing pigment while dark hair contains eumelanin, the ideal laser target.

Issue#5: Laser Hair Removal requires several sessions.

Although, you will notice significant results after your first session, the simple fact that our hair lives according to a life cycle called the hair cycle means that in order to be efficacious, we need to catch hairs at the right time. That time is the Anagen Phase, the growth phase. Since all our hair is not in that phase at the same time, we need to repeat the treatment until all hairs in the Anagen phase have been caught and destroyed on the desired area.

Issue #6: Laser Hair Removal may be performed anywhere on the body except on the eye.

Eyes and lasers don’t mix. They MUST be protected at ALL times during a laser session. Your laser physician will cover your eyes either with wavelength specific eyeglasses or with a pair of goggles. They will prevent a direct hit to your eyes and protect your eyes from laser light refraction.

The most frequently treated areas are:

a) women: the face (upper lip and chin), underarms, bikini, legs (1/2 and full) , neck, nipples and tummy line.

b) men: chest, abdomen, back and shoulders.

Issue #7: Laser yields to very long term and even permanent hair removal.

Shaving, waxing, depilatory creaming and even tweezing are all short-term hair removal techniques. The FDA and EEC Health Ministries have approved new lasers for the permanent hair removal indication. New clinical trials are frequently published on this subject. Nevertheless, depending on the laser settings used by your laser physician, your results will be either long term or permanent. According to the most recent articles, only the higher settings yield to permanent hair removal. In this approach, high performance skin cooling and pain management are obstacles to many laser centers not equipped with the appropriate lasers and where professional staff may be inattentive to pain minimization.

Le refroidissement de la peau doit être particulièrement étudié. C’est pourquoi une unité spéciale de refroidissement doit accompagner le laser et être disponible pour chaque impulsion. L’idéal est un système d’air froid « gelé », en sub-zéro, pulsé, sur la zone à épiler. Ainsi, avant chaque impulsion la peau a le temps de refroidir et ensuite, être maintenue froide pendant chaque impulsion et tout au long de la séance.

Skin cooling is a key part of a hair removal program. This is why a special cooling unit must be associated to a laser to deliver refrigerated air or gas during each pulse. The ideal system is the constant refrigerated sub-zero pulsed air. This system delivers cooling on the treated area at all times, before, during and after a laser pulse. This way the skin is kept cool during each laser pulse and so for the entire laser procedure.

Pain tolerance varies amongst people. Since a cosmetic procedure is rarely appreciated if it’s painful, a standard (or mediocre) laser operator tends to provide low energy pulses to keep his/her client comfortable. The problem is: the more painful is the pulse, the better are the results. Efficacy is proportional to pain!

Finally, results after each session are cumulative. The more you treat, the better are the results in terms of hair reduction and permanency. Nevertheless, each patient is different so results are neither expected nor predictable. They vary from one person to another even with the best lasers.

Issue #8: Intense Pulsed Light (IPL) or Flash Lamps and Lasers are not equivalent for Hair Removal.

On a technology basis and on pure physics these machines are totally different. The light produced by a laser is stimulated, coherent and monochromatic (just one wavelength, specific to its target: melanin). The IPL machine produces a beam of light in several wavelengths thus non-specific. At the end of the fiber optic, at the hand piece level, a color filter is inserted to select the desired wavelength. The other wavelengths are kept, supposedly, aside. Although a thermolysis is obtained leading to some hair removal, published clinical data suggest that final results are different from those obtained with lasers and tend to be just long term and not permanent. In addition, the number of sessions tends to be greater with a Flash Lamp compared to a laser.

Finally, a Flash Lamp is a bit more complicated than a laser and yields to a higher risk of settings errors. It requires a great deal of expertise from the operator, preferably a physician, since hair is not the only target reached by this equipment. A word of caution: since a Flash Lamp is 1/3rd the cost of a laser, a Flash Lamp session should not cost you what a laser session would.

Issue #9: Sun Tan and Laser Hair Removal do NOT mix.

A tanned skin will “cook” under a laser. It must be said high and clear. Since we all lose our tan sooner rather than later, patience pays. Your laser physician will be quite glad to see you anyway, but with a lighter or fairer skin, he/she will be delighted. Those who treat pigmented skins with Alexandrite or Diode lasers, take serious risks or don’t tell people that they minimize their laser settings. In that case, results will be slow and poor. Many more sessions will be needed; your wallet will consequently suffer.

Issue #10: Precautions must be followed.

a) A diet won’t impact your laser treatment. If you take beta-carotene, a diet supplement, supposed to facilitate UV exposure, you should stop it 2 months prior to your laser hair removal program.

b) Teens may undergo a successful laser program. Nevertheless, if their growth is not finalized, new hair may appear on a treated area. The impact of laser hair removal on a child or a teenager’s skin has not been studied; there are no published data on this subject. Finally, teens comply usually well with this type of program but children under 12 may not accept it. In any case, a minor needs to sign an Informed Consent Form and get one parent or legal guardian to sign it as well. It is recommended to come and support your teen for his/her first session.
c) People with dark skin (dark brown and black) may undergo a successful laser hair removal program only with a NdYAG long pulse laser. Session times are longer than those observed with Alexandrite lasers (spot size is smaller). Also, program duration usually takes from one to two additional sessions since this laser is slower to remove thin hair. Only this type of laser will lead to tangible results on photo types V and VI.

d) Who should stay away from a laser? People who just got a superb sun burn or sun tan; blond or red hair people, people who would be overwhelmed with the relatively high cost of a laser hair removal program (5 to 9 sessions on average).

e) An adequate evaluation of the laser center where you plan on going is key. You should check your physician competences and expertise (years of experience in laser medicine, specific laser medicine training, post-graduate degrees in laser medicine), memberships to professional societies. Also, a thorough evaluation of his/her laser technician is very important. Make sure that your laser physician sets the laser before each session.

Evaluate the center itself. Is it clean, comfortable, professional looking, quality oriented? Are people working there welcoming, attentive to your needs or questions, are they available for you and willing to help you? Your physician will cover the more detailed scientific information. Bring the same care to your laser center selection as if you were selecting your brain, plastic or heart surgeon.