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Laser epilation

It is well-known that removal of unwanted hair e.g. with waxing or tweezers has a temporary result, the hair regrows, because the hair matrix, responsible of hair growth has not been compromised. As already mentioned, hair is produced by the follicle matrix cells. After hair removals always remain intact cells that produce new sound hair and the hair growth cycle continues. Laser epilation is a revolutionary change in the hair removal. Permanent result can be achieved in a relatively painless way. Lasers selectively destroy the follicle; the procedure is based on the principle of selective photothermolysis. The theory of the procedure was originally elaborated to treat venous disorders, its suitability for hair removal has later been revealed. Absorbing light into the target area to destroy the target, without damaging the surrounding tissues - this is the principle of selective photothermolysis. The mechanism of this action is that the target tissue contains pigment (chromophore) what absorbs the light. Melanin pigment of the hair absorbs the laser light, what in the follicle transforms into heat energy. At the appropriate temperature causes irreversible damages in the matrix cells, without harming surrounding tissues.

This is valid only for the growth (anagen) phase because the hair contacts the matrix cells. Laser epilation cannot be performed in the resting (telogen) phase, because hair doesn’t contact the matrix cells, so cannot transfer the heat energy to matrix cells. The matrix cells remain untouched and will produce sound hair in the next cycle. A set of 4-7 treatments is necessary to achieve the expected result. The colour of the hair must be darker than that of the skin; it is a precondition to the laser epilation. Laser light affects the follicle in a selective way, because the light is mainly absorbed in the hair not in the surrounding tissues. Fluffy, light and grey hairs are not responsive to laser epilation.


The treatment
  • Thorough dermatologic screening and medical history taking to exclude conditions and risk factors contraindicating laser hair removal. 
  • Skin type is to be defined, according to Fitzpatrick skin-type chart (see: chart). 
  • The patient is to be informed about the side effects and outcome to be expected 
  • Answering patient’s questions. 
  • Consultation, filling and signing consent to medical treatment. 
What are the contraindications? 

                  • During pregnancy 
                  • Diabetes 
                  • Active dermatologic and other tumours. 
                  • Active autoimmune disease. 
                  • Proneness to hypertrophic or keloid wound healing 
                  • Menstruation: 2-3 days before and after and during menstruation, due to the the increased sensitivity and reactivity of the skin. 
                  • Light sensitivity (photoallergy) or photosensitizing medication (e.g. Roacutan). 
                  • White or grey hair. 
                  • Tanned skin: exposure to sun and solarium is to be avoided for at least six weeks before and after the therapy, to protect the skin and to avoid side effects. 

Testing

If the patient is eligible for laser epilation, a trial treatment (generally only some pulses) is to be made at the treatment site to assess the side effects, the individual reactions and efficient energy threshold. The tested site will be checked 24 hours later. If no pathologic reaction occurred, the treatment can be started.

During the treatment
  • The treatment site is to be cleaned carefully and to be left free of deodorant, cosmetics. 
  • Hair is to be shaved carefully. 
  • Laser setting. 
  • Ultrasound gel will be applied onto the treatment site. 
  • The handpiece is put on the treatment site and the laser device will be activated. This is to be repeated as much times as the whole area will be treated. 
  • The treatment site is continuously iced. 
  • After finishing the procedure, soothing and anti-inflammatory cream will be applied over the treated 
    site. 
  • The therapy is to be repeated every 6-8 weeks. 

Skin reactions to be expected following the treatment


Redness of the treated skin.
Rash-like sweellings (oedema) may develop around the hairs; it is similar to the symptoms following waxing.
Mild burning sensation may occur after the treatment.
All the above symptoms are mild; they disappear in some hours or days without trace.

Side effects

Side effects occur mainly following the treatment of tanned skin. Those are temporary bruise like skin conditions, sun damage like inflammatory symptoms or mild itching. Those symptoms may disappear in some days without trace.
Exposure to sun or solarium before the treatment may cause whitening of the skin; the same after the treatment may result in brownish discoloration, pigmentation of the skin. Both disorders are temporary but may persist during months. Laser epilation is actually the only available procedure with long lasting result. The method is safe, however it requires great caution.