The Evolution of Laser Hair Removal
By Richard H. Tholen, MD, FACS
Published on July 19, 2010
Laser hair removal is the third most common non-surgical cosmetic procedure performed in the United States, surpassed only by BOTOX® Cosmetic and filler injections, according to statistics provided by the American Society for Aesthetic Plastic Surgery. Over 1.4 million laser hair removal treatments were performed in 2007, an increase of 230 percent since 1997. Even in a down economy, in 2009, nearly 1.3 million laser hair removal treatments were performed, at an average national cost of $331 per treatment.
Ever since the first ruby laser was developed in 1960, medical practitioners have sought to use virtually every laser wavelength on most anything within zapping distance of their lasers: birthmarks, tattoos, skin conditions, tumors, and unwanted hair. The first medical lasers were bulky, low-power, and often had no specific improvement or real benefit over traditional techniques. Non-laser photo epilators were first developed in 1969, but proved to be ineffective, and prompted lawsuits (settled out of court by the manufacturer), as well as removal from the market in 1972.
By the 1980's, specific lasers were being designed and built to treat specific conditions, and by the mid-1990s, lasers were being used for "permanent hair removal." By 1997, several different kinds of laser (different wavelengths, power density, spot size, pulse duration, and manufacturer) were FDA-approved, but advertisements that promised "permanent and painless" treatment were found to be untrue. At least one lawsuit was settled out of court; meanwhile, the public still clamored for laser hair removal. FDA approval was given for some lasers, but laser manufacturers are still striving to develop better technology and more selective laser parameters to achieve the Holy Grail of Hair Removal: "Complete, Permanent, and Painless." At present, the best lasers achieve significant hair reduction, mostly permanent removal, and minimal discomfort.
Laser hair removal utilizes beams of highly concentrated light (at a precise wavelength, power, and pulse duration) to be absorbed by the pigment or hair-producing areas within the follicle) at the proper time in the hair growth cycle to permanently destroy the hair. Since different hairs are at different phases of their growth cycle, multiple treatments are necessary for maximum removal. Most patients achieve 60-95 percent hair removal if they complete the recommended number of treatments. Some regrowth is seen by most patients, but regrowth may be finer or lighter in color.
Today, there are at least seven types of laser or IPL (intense pulsed light) technology utilized by over 24 manufacturers, with over 40 different machines, just for hair removal. But here are the facts:
- The best results are still seen in patients with dark hair and light skin
- Multiple treatments are necessary to target as many hair follicles as possible in the appropriate phase of hair growth
- Complete removal of unwanted hair is unrealistic, but permanent reduction can be achieved
- Cooling or anesthetizing the surface of the skin reduces pain and side effects
- Ultraviolet avoidance before and after treatment is advisable
- Results vary with machine, operator, and patient
- Not everyone gets great results, but many do
- There are very few peer-reviewed medical reports in the literature regarding specific lasers, long-term results, or comparison between lasers, hair colors, or skin types
- "Newer" lasers or IPLs are capable of treating lighter hairs and/or darker skin types, but results are usually less dramatic than the marketing
- There is a risk of side effects such as blisters, scars, skin color change, and other problems
- Not every spa with a laser is appropriately physician-supervised, and the actual laser technician may have little on no medical training.
Since laser hair removal is offered by so many spas, clinics, and medical practitioners, don't hesitate to ask what laser is used, who actually does the treatment, the training and safety measures used, and which physician is responsible for supervision. Any reputable provider will be happy to share their information.