The hairy truth about laser treatments

For the last several years women have been allured by the promise of “permanent hair removal” with laser treatments. Never shave or wax again? Sounds like a dream come true, … and a dream it may be.

The US cosmetic industry is a multibillion dollar market that is ever-expanding and evolving. Laser treatments for unwanted body hair have become a must-have for 60 percent of women. According to the American Academy for Aesthetic Plastic Surgery, laser hair removal was among the most popular nonsurgical aesthetic procedures (after Botox and hyaluronic acid fillers) in 2012, totaling more than 1.2 million treatments and nearly $500 million dollars. But what are we really getting for our money?

The laser is a concentrated beam of light and is aimed at the hair. The light from the laser is absorbed by pigment (melanin), which we have in our skin and hair. Ideally, the light follows the dark, pigmented hair to the follicle. The hair follicle is then damaged by the intensity of the laser and thus reduces future growth. Because of the interplay of the laser and pigment, treatments work optimally on people who have very light skin and very dark body hair. In theory, this sounds simple. However, hair follicles have various phases, and lasers most effectively damage the follicles in the growth phase (anagen phase). The problem is that we have thousands of hair follicles all at different phases and these growth phases vary unpredictably in duration sometimes four to 12 months according to body location. This makes scheduling and accurately determining how many treatments are needed for desired results merely a guesstimate. Surveys show the average number of treatment needed for satisfactory results is four (and sometimes more). Additionally, while we desire and are paying for permanent damage to the hair follicles, lest we never shave again, our bodies have amazing healing powers. Our skin (which includes hair follicles) is super important as it is the first line of defense to the outside world, and it is particularly unique in that it has stem cells within its layers. Stem cells, as you may have heard, have life-giving properties. And in this case, may give new life to those annoying hairs you spent so much time and money trying to get rid of.

Laser hair removal is often advertised as permanent hair removal. But beware, given the regenerative properties of our skin and hair this can be misleading. Lasers may remove hair for anywhere from months to years, but results vary widely from person to person. Often, repeat treatment (aka “touch ups”) are required every six to 12 months to maintain results. This is why the FDA has given several manufacturers permission to claim, “permanent reduction,” but not “permanent removal” for their lasers. This means that although laser treatments with these devices will permanently reduce the total number of body hairs, they will not result in a permanent removal of all hair. Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs re-growing after a treatment regime. Permanent hair reduction does not necessarily imply the elimination of all hairs in the treatment area. To date, the FDA has not granted any laser or manufacturer the right to claim permanent hair removal. There are different lasers, all with their own specs, uses, and nuances (you can do your own research on approved lasers and their treatments through the FDA here).

According to the American Academy of Dermatology, here are the results you can expect:

  • The percentage of hairs removed per session varies by location on the body, with thinner-skinned areas (e.g., armpits and bikini area) generally responding better than thick-skinned areas (e.g., back and chin).
  • About 10 percent to 25 percent reduction in hair growth can be expected with each treatment.
  • Three or more treatments are usually needed.
  • Treatments are repeated every four to eight weeks.
  • The hair that regrows following treatment tends to be lighter and finer in texture.

Currently, clinical research shows there is no evidence for a complete and persistent hair removal treatment. However, laser hair reduction does have an efficacy that is superior to conventional treatments like shaving, waxing, and electrolysis. Cost would certainly be a consideration for most. And like all procedures there are risks to laser treatments (pain!, for one), but the occurrence of postoperative side-effects is reported low for all the laser systems.

Laser hair reduction (or temporary removal) treatments are not for everyone. Be sure to ask lots of questions, particularly regarding your skin color versus body hair pigment. “Results” (or lack there of) are in the eye of the beholder, and know they may vary, considerably.

 

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