MELBOURNE: Unwanted facial and body hair can affect the way we feel, our social interactions, what we wear and what we do.
Options to camouflage or remove unwanted hair include plucking, shaving, bleaching, using creams and epilation (using a device that pulls out multiple hairs at once).
Longer-term options include electrolysis, which uses an electrical current to destroy individual hair follicles, and laser therapy.
Lasers emit a wavelength of light with a specific single colour. When targeted to the skin, the energy from the light is transferred to the skin and hair pigment melanin. This heats up and damages the surrounding tissue.
But to remove hair permanently and to minimise damage to the surrounding tissue, the laser needs to be targeted to specific cells. These are the hair follicle stem cells, which sit in part of the hair known as the hair bulge.
As the skin surface also contains melanin, which we want to avoid damaging, people are carefully shaved before treatment.
Laser treatment can either permanently reduce the density of the hair or permanently remove unwanted hair.
Permanent reduction in hair density means some hairs will regrow after a single course of therapy and patients will need ongoing laser treatment.
Permanent hair removal means none of the hairs in the treated area will regrow after a single course of therapy and no ongoing laser therapy is needed.
Whether hair is removed permanently or just reduced in density is influenced by: The colour and thickness of the hairs being treated, the colour of the patient’s skin, the type and quality of the laser used, and the competence and training of the person operating the laser.
However, if you have grey hairs, which have no melanin pigmentation, currently available lasers don’t work.
WHAT IT DEPENDS ON
The number of treatments you’ll need depends on your Fitzpatrick skin type. This classifies your skin by a number of characteristics, including its sun sensitivity and its likelihood to tan.
For instance, those with dark hair and pale skin can usually achieve permanent hair removal with four to six treatments every four to six weeks.
Others with darker skin and dark hair may need six to ten treatments every four to six weeks.
Re-treatments must be long enough apart to allow new hair growth to reach the level of the bulge.
SIDE EFFECTS AND COMPLICATIONS TO BE AWARE OF
You will be advised to wear goggles during the treatment to prevent eye injury.
You will also experience some pain during treatment, especially the first few. This is mainly due to not removing all hair in the area to be treated before the procedure.
Hairs missed while shaving absorbs laser energy and heat the skin surface. There is less pain with repeat treatments at regular intervals.
Your skin will feel hot for 15 to 30 minutes after laser treatment. There may be redness and swelling for up to 24 hours.
More serious side effects include blisters, too much or too little skin pigmentation, or permanent scarring.
These generally occur in people with a recent suntan and the laser settings have not been adjusted. Alternatively, these side-effects can occur when patients are taking medications that affect their skin’s response to sunlight.
DOES THE TYPE OF LASER MATTER?
The type of laser not only influences how well it works, it influences your chance of side-effects.
Intense pulsed light (IPL) devices are not laser devices but flash lamps that emits multiple wavebands of light simultaneously. They work in a similar way to lasers, albeit less effectively and they are much less likely to permanently remove hair.
To minimise the risk of damage to melanin-producing cells on the skin surface, the choice of laser and how it’s used should be matched to your skin type.
To control the spread of heat and unwanted tissue damage, short laser pulses are used. The energy of the laser is also adjusted: it needs to be high enough to damage the bulge cells but not so high to cause discomfort or burns.
BE CAUTIOUS WHEN USING HOME LASER DEVICE
While home laser devices and IPL home devices are available, they don’t tend to work as well and you need to use them repeatedly to maintain hair reduction.
Most set parameters for people with fair skin and dark hair. For safety, energy settings are capped.
And in inexperienced hands, complications may still arise. This includes burns, pain, blistering and changes to skin pigmentation.
By contrast, medical-grade lasers are usually required to be registered with regulators. There are also regulations about the facility where the laser is used, compulsory laser safety training requirements and state-based qualifications and licensing for laser operators in many countries.
So, a safe and regulated laser in the hands of a skilled professional is recommended.
Not all excess hair is cause for concern. But severe, excess growth of dark and coarse hair over areas of the body where it ordinarily wouldn’t grow or excess hair growth for someone’s age or sex can be clues to an underlying illness. Your GP can investigate these.
Rodney Sinclair is professor of dermatology at the University of Melbourne. Consultant dermatologist Nekma Meah co-authored this article. This commentary first appeared on The Conversation. Read it here.