Laser hair removal had been on my “someday” list ever since a kid in my A.P. Chemistry class commented on my mustache. (I'm partly Southern Italian with robust hair follicles—what can I say?) Obviously the kid was a jerk and there's nothing wrong with body hair, but the fact remained that as I got older, I still wanted it gone. When I finally got around to it, though, I had a lot of questions. Is laser hair removal painful? How many sessions was I in for? Was my skin—always tans, never burns, year-round medium—too dark for laser hair removal?
The process is more complicated than other in-office procedures, which is why it requires a bit more explanation than, say, your average chemical peel. Here's what you need to know—and everything I certainly wish I'd known—before booking an appointment.
How does laser hair removal work?
Think of laser hair removal as a video game, says Ellen Marmur, M.D., a dermatologist at Marmur Medical in New York City. The laser seeks out pigment in your skin, which is typically found in the base of your hair follicle. Once the laser locates the hair follicle root, which houses your hair stem cells, “the laser then converts from light energy to heat and basically explodes it,” she says. The hair root dies, and the hair falls out.
Because the laser works by seeking out pigment, it's best to time it right—basically, you want to limit the amount of other pigment in your skin, like that from sun exposure. “Patients are less likely to be tanned in winter and spring,” says David Kim, M.D., the dermatologist at Union Square Laser Dermatology in New York City who zapped my upper lip. “If you're tanned, the energy from the laser can be absorbed by your skin in addition to the hair follicles—and cause burns or blisters and leave a disfiguring scar.”
If your skin type is a 3 or higher on the Fitzpatrick scale (which takes into account both skin tone and ethnicity), you may need a special laser. Since I'm a 4, Kim used Candela's GentleYag, which is an ND:Yag laser. “It uses 1064-nanometer wavelength, which is much safer and very effective for patients with darker skin type,” he says. “In contrast, I use GentleLase for patients with lighter skin type, which uses 755-nanometer wavelength.” That shorter wavelength is more powerful, and better suited for skin with less pigment. (For more on this, check out our guide to laser hair removal for dark skin.)
Either way, you'll definitely need multiple sessions, though it depends on a huge variety of factors, including “skin tone, the type of hair and body location, the type of laser, the settings and power that you're using with the laser, and even the time of year,” says Marmur. But expect to need at least three sessions.
How to prepare for laser hair removal
You're going to need your follicle roots intact for the laser to do its job, so avoid waxing, tweezing, threading, or anything else that removes hair at the root before your appointment. Then “shave the areas one to two days prior to the treatment, but not the day of the treatment,” says Kim.
Also, consider the beach off-limits. Two weeks before your appointment, avoid the sun, especially if you're getting hair lasered on sun-exposed areas like your face, neck, chest, back, arms, and legs. No matter your natural skin tone, it'll put you at risk for side effects.
When you arrive at the office, expect to do a test spot, especially if your skin is very fair or naturally medium to dark. “Sometimes we'll do a test spot in a hidden area, like the underarm,” says Marmur. “Then we can see if you're the kind of person who gets really, really red afterward, for example.” Any reactions will be immediate, so the technician can address it on the spot.
What are laser hair removal side effects?
Let's start by clarifying: There are expected side effects, and then there are unwanted side effects of laser hair removal. We'll cover the expected stuff first. A little pinkness and swelling is normal, as are tiny goose-bump-like bumps; those are actually from the swelling of the injured follicles beneath the skin. You also may notice “little black specks that come out of your skin,” says Marmur. “People often misconstrue that as new hair growth, but it's not—it's dead hair shedding.” That's a sign that the laser hair removal worked.
The unwanted side effects include blisters, scabbing, hyperpigmentation, and hypopigmentation. Of some comfort: Pigmentation issues aren't always permanent. “If you get it, let your doctor know right away and use a little cortisone 1% cream on the area,” says Marmur. Keep it out of the sun and heat, and apply a cool compress ASAP.
If you're predisposed to hyperpigmentation, your dermatologist may even make a preemptive strike. “For patients with darker skin types, we apply over-the-counter hydrocortisone 1% cream in the office to minimize inflammation and the risk of darkening of skin, or post-inflammatory hyperpigmentation," says Kim. "We recommend applying the cream twice daily to the affected areas for three to five days.”
Is laser hair removal painful?
It largely varies, since the lasers themselves have gotten better over the years. “I've had patients who were able to tolerate the treatment without any numbing, and patients who experienced some pain even with topical anesthesia,” says Kim. (I, a baby, prefer to spend an hour with numbing cream and have never felt a thing.)
Marmur compares the laser beam to a zinging feeling, similar to a needle prick. She's a fan of contact cooling systems, as they blunt the heat created as the laser beam (which is light energy) converts into heat. Plus, they offer enough cooling to minimize any damage caused to surrounding skin, reducing the risk of hyperpigmentation.
Certain pain-reducing methods, like suctions and contact cooling, are often built into the lasers. “There is a new laser by Lumenis called Splendor that is very effective and significantly more comfortable than other existing lasers, and I have had great success with it,” says Kim. “Because this laser is much more comfortable, I have been able to treat almost all patients without any topical numbing cream which significantly reduces the waiting time for the patients as well.”
Aftercare for laser hair removal
Since laser hair removal heats up your skin as it blasts your hair follicles, it's important to cool it back down afterward to avoid side effects like redness. “We often give people cold gauze in Ziploc bags,” says Marmur. “If you're getting in a car, put on the air conditioning and stay in a cool place for a bit, or take a cool shower afterward.”
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