Considering Laser Hair Removal? Read This First
The thought of a life without constant shaving, waxing, or sugaring sounds amazing. Just imagine all the free time you'll have without having to make monthly wax visits to your favorite esthetician. Plus, you could kiss red bumps and ingrown hairs goodbye.
Thankfully, laser hair removal has never been safer or more effective for all skin and hair types — but, that doesn’t mean it’s easy or painless.
So before you book your first appointment, there are a few details dermatologists would like you to consider.
That's why we tapped three of the best in biz to lay down the laws of laser hair removal to ensure you have the safest, and most effective, experience possible.
How Does Hair Removal Work?
“Any type of laser treatment is basically the use of a fancy light,” explains Dr. Paul Jarrod Frank, a NYC-based cosmetic dermatologist. “When we want to target the hair, we use wavelengths of laser light that targets the pigment that's found in hair, without hurting the surrounding normal tissue.”
Thanks to major advancements in technology, there are now many different types of lasers with various wavelengths to hone in more precisely on the pigment deep in the skin, where the hair root and follicle live, to damage the follicle and slow down future hair growth.
Is Laser Hair Removal Safe for Everyone?
Although the newest lasers are able to more accurately distinguish deep hair follicle pigments from superficial skin pigments, those with deeper skin tones should still take extra precautions when researching practitioners and the lasers they use.
“People with skin of color have larger and more numerous melanosomes, which package melanin,” explains Dr. Hope Mitchell, founder of Mitchell Dermatology in Ohio and Chair of the NMA Derm Research Committee, which represents African American physicians and their patients. “In patients with darker skin types, melanin is dispersed throughout the upper layers of the skin and it will compete with melanin in the hair to absorb the laser energy.”
This can be avoided by ensuring that the right laser with the correct wavelength is used for your skin color.
Dr. Eva Simmons-O’Brien, a board certified dermatologist and assistant professor at Johns Hopkins University, recommends the Nd:YAG lasers for all skin types, and especially for those with darker skin tones.
“They have the ideal wavelength for darker skin types, types 4 to 6, because they bypass the melanin in the skin and target hair follicles or collagen below in the mid to deep dermis,” says Dr. Simmons-O’Brien. She also adds that patients of color should not only confirm ahead of time that their desired dermatologist has the modern laser, but should ask their dermatologist to perform a spot treatment first to see how their skin reacts and heals.
“This is not the time to coupon shop,” reminds Dr. Mitchell, who suggests researching the practice prior to the appointment. “Don’t be afraid to ask, ‘How many people with skin of color have you treated?’ or ‘Why do you believe this laser is safe for my skin type?’ Ask if there have been side effects from the laser treatment and how were they handled.”
And above all, advises Dr. Mitchell, “Never be afraid to get a second opinion before making your final decision.”
How Should I Prepare for My Appointment?
Most dermatologists will ask you to shave the area you’re going to have treated 24 to 48 hours before the session to ensure no hair is visible, which minimizes the likelihood of inflammation. It’s important to also avoid exfoliation and tanning prior to sessions, which can make skin more sensitive.
Additionally, those with darker skin tones should stop all acid-based cleansers, peel pads, and topical retinoids four to five days before their treatment. Vitamin C or any other brightening products should also be avoided two days before treatment, according to Dr. Simmons-O’Brien.
“Patients of color should make sure to tell their dermatologist if they have a history of fever blisters (HSV), so that they can be prescribed prophylactic antiviral treatment,” she also recommends.
How Painful Is Laser Hair Removal?
"Most of the time, no gels or topical anesthesia are required,” says Dr. Frank. "[It's] a relatively routine, painless procedure.” However, the sensation from the laser on the skin can range from a suction to a snapping rubber band, while others have an air conditioning-like effect to cool the skin and balance the laser’s heat.
However, for people of color, this can vary. "Even on appropriate settings with the laser, darker skin will retain more heat than lighter skin [tones],”says Dr. Simmons-O’Brien. She advises that immediately after the procedure, a topical steroid should be applied to the treated area followed by an ice compress for 10 to 15 minutes to cool down the skin.
Simmons-O’Brien also suggests that patients with darker skin tones apply “a liberal application of sunblock after the procedure and reapplied throughout the day.”
But regardless of your pain tolerance, the good news is that depending on the body area, the appointment is typically quick, with underarms and bikini averaging about ten minutes, while legs and back require about thirty, according to Dr. Frank.
How Long Does it Take to See Results?
You’ll see a noticeable difference in hair regrowth after the first session. But keep in mind that this isn't a one-and-done deal. A good rule of thumb is to expect one session per month for five or six months, depending on your hair type, with hair becoming fewer and finer after each subsequent session. However, it is important to keep your own expectations in check, as the process is FDA-approved only as permanent hair reduction.
“Hair grows in cycles and hair follicles don't grow at the same time. I would say for most people, a realistic expectation is a 90% removal at completion,” explains Dr. Frank. “You can expect people with darker skin tones to be more like closer to six [sessions] and people with fair skin closer to four.”
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Are There Any Risks Associated with Laser Hair Removal?
“Laser is heat and any laser procedure comes with the risk of burn, blistering, changes in color of the skin,” says Dr. Frank. “Using the right laser for the right skin type, as well as the right person performing it is the most important thing. Older school lasers are still uncomfortable and that's when people need numbing gels and topical anesthesia.”
Darker skin tones are especially sensitive with a greater risk for adverse side effects.
“If the incorrect laser or laser settings are used, the energy beam may additionally be absorbed by melanin in darker skin, putting you at risk for side effects such as hyper or hypopigmentation,” says Dr. Mitchell, who stresses the importance of choosing a practitioner with experience treating patients of color. “Persistent post-treatment redness, swelling, blistering, pain or open sores would be concerning when treating people with darker skin types.”
What Do I Need to Know About Aftercare?
With laser hair removal, timing is everything. The procedure’s only post-procedure golden rule is to avoid the sun, at least for two weeks, but preferably until the entire months-long process is completed.
“It’s in your own best interest to avoid the sun throughout the whole process, because it limits the efficacy of the treatment,” explains Dr. Frank. He typically advises patients to begin treatments in the cooler autumn months.
Dr. Mitchell tells her patients with darker skin tones to use a gentle cleanser and moisturizer for five to seven days post-procedure until their skin has calmed down, then it is safe to reintroduce any active skincare.