If you’re not happy with shaving, twee-zing, or waxing to remove unwanted hair, laser hair removal may be an option worth considering.
Laser hair removal is one of the most commonly done cosmetic procedures in the U.S. It beams highly concentrated light into hair follicles. Pigment in the follicles absorb the light. That destroys the hair.
How to Prepare for Laser Hair Removal
Laser hair removal is more than just ”zapping” unwanted hair. It is a medical procedure that requires training to perform and carries potential risks. Before getting laser hair removal, you should thoroughly check the credentials of the doctor or technician performing the procedure.
If you are planning on undergoing laser hair removal, you should limit plucking, waxing, and electrolysis for six weeks before treatment. That’s because the laser targets the hairs’ roots, which are temporarily removed by waxing or plucking.
You should also avoid sun exposure for six weeks before and after treatment. Sun exposure makes laser hair removal less effective and makes complications after treatment more likely.
Comparison with electrolysis and IPL
Electrolysis is another hair removal method that has been used for over 135 years. At this time, it is the only permanent option for removal of very fine and light-colored hair. The FDA currently allows the term “permanent hair removal” for electrolysis only. Unlike laser epilation, electrolysis can be used to remove 100% of the hair from an area and is effective on hair of all colors, if used at an adequate power level with proper technique. Hair may re-grow however, based upon specific hormone levels or changes therein, and your genetic predisposition to grow new hair.
A study conducted in 2000 at the ASVAK Laser Center in Ankara, Turkey comparing alexandrite laser and electrolysis for hair removal on 12 patients concluded that laser hair removal was 60 times faster, less painful and more reliable than electrolysis.
Intense pulsed light (IPL) epilators, though technically not containing a laser, use xenon flash lamps that emit full spectrum light. IPL-based methods, sometimes called “AFT”, “phototricholysis” or “photoepilation”, are now commonly (but incorrectly) referred to as “laser hair removal”.
Multiple treatments depending on the type of hair and skin color have been shown to provide long-term reduction of hair. Most patients need a minimum of seven treatments. Current parameters differ from device to device but manufacturers and clinicians generally recommend waiting from three to eight weeks depending on the area being treated. The number of sessions depends on various parameters, including the area of the body being treated, skin color, coarseness of hair, reason for hirsutism, and sex. Coarse dark hair on light skin is easiest to treat. Certain areas (notably men’s faces) may require considerably more treatments to achieve desired results. Hair grows in several phases (anagen, telogen, catagen) and a laser can only affect the currently active growing hair follicles (early anagen). Hence, several sessions are needed to kill hair in all phases of growth. This problem is countered by spacing appointments sufficiently so that inactive follicles will start to grow again. Laser does not work well on light-colored hair, red hair, grey hair, white hair, as well as fine hair of any color, such as vellus. For darker skin patients with black hair, the long-pulsed Nd:YAG laser with a cooling tip can be safe and effective when used by an experienced practitioner.
Intervals between sessions
Usually treatments are spaced three to eight weeks apart depending on the body area and the hair cycle length for that area. The face usually requires more frequent treatments three to four weeks apart, whereas legs require less frequent treatments and patients should be advised to wait at least six weeks. Typically the shedding of the treated hairs takes about two to three weeks. These hairs should be allowed to fall out on their own and should not be manipulated by the patient.
Benefits of Laser Hair Removal
Lasers are useful for removing unwanted hair from the face, leg, arm, underarm, bikini line, and other areas.
Benefits of laser hair removal include:
Precision. Lasers can selectively target dark, coarse hairs while leaving the surrounding skin undamaged.
Speed. Each pulse of the laser takes a fraction of a second and can treat many hairs at the same time. The laser can treat an area approximately the size of a quarter every second. Small areas such as the upper lip can be treated in less than a minute, and large areas, such as the back or legs, may take up to an hour.
Predictability. Ninety percent of patients have permanent hair loss after an average of three to five sessions.
Side effects and risks
Some normal side effects may occur after laser hair removal treatments, including itching, pink skin, redness, and swelling around the treatment area or swelling of the follicles (follicular edema). These side effects rarely last more than two or three days. The two most common serious side effects are acne and skin discoloration.
Some level of pain should also be expected during treatments. Numbing creams are available at most clinics, sometimes for an additional cost. Some numbing creams are available over the counter. Use of strong numbing creams over large skin areas being treated at one time must be avoided, as this has seriously harmed, and even killed, patients. Typically, the cream should be applied about 30 minutes before the procedure. Icing the area after the treatment helps relieve the side effects faster. Ibrahimi and Kilmer reported a study of a novel device of diode handpiece with a large spot size which used vacuum-assisted suction to reduce the level of pain associated with laser treatment. 
Unwanted side effects such as hypo- or hyper-pigmentation or, in extreme cases, burning of the skin call for an adjustment in laser selection or settings. Risks include the chance of burning the skin or discoloration of the skin, hypopigmentation (white spots), flare of acne, swelling around the hair follicle (considered a normal reaction), scab formation, purpura, and infection. These risks can be reduced by treatment with an appropriate laser type used at appropriate settings for the individual’s skin type and treatment area.
Some patients may show side effects from an allergy to either the hair removal gel used with certain laser types or to a numbing cream, or to simply shaving the area too soon in relation to the treatment.
Rare side effects include blistering, scarring and skin texture changes.
What to Expect During Laser Hair Removal
Just before the procedure, your hair that will be undergoing treatment will be trimmed to a few millimeters above the skin surface. The laser equipment will be adjusted according to the color, thickness, and location of your hair being treated as well as your skin color.
Depending on the laser or light source used, you and the technician will need to wear appropriate eye protection. It will also be necessary to protect the outer layers of your skin with a cold gel or special cooling device. This will help the laser light penetrate the skin.
Next, the technician will give a pulse of light to the treatment area and watch the area for several minutes to make sure the best settings were used and to check for bad reactions.
When the procedure is completed, you may be given ice packs, anti-inflammatory creams or lotions, or cold water to ease any discomfort. You may schedule your next treatment four to six weeks later. You’ll get treatments until hair stops growing.