Electrolysis was the only form of long-term hair removal available before Intense Pulse Light (IPL) and laser devices entered the market. Electrolysis is still used today even though it is painful to the patient. It can also be invasive to the skin which allows for risk of infection. During the electrolysis procedure, a fine needle is inserted into the hair follicle, delivering a galvanic current to destruct the stem cells in the follicle. Unfortunately, this painstaking process is performed one hair follicle at a time. Maintenance procedures are often needed for years after the first treatment.

In contrast, with laser and pulsed light technology, hundreds of hair follicles are treated at a time and vary upon the spot size (the size of the tip of the device delivering energy). These hair removal procedures are non-invasive and take only minutes to perform instead of the many hours with electrolysis.

What is Melanin?

A patient’s skin type and hair color can be the most important consideration prior to hair removal treatment. Laser hair removal is based on selective photothermolysis (using light and heat for destruction of a hair follicle) with melanin being the target chromophore (chemical grouping that produces color). The difference between the absorption of laser or light energy by melanin in the hair follicle and melanin in the epidermis determines the amount of energy that can be safely used without harming the skin.

Light skinned patients with dark hair are considered to be the ideal patients for hair removal On the other hand, a patient with very dark skin and gray or white hair, would have little if any response. Since melanin in the hair shaft and follicle are the target source for laser and IPL hair removal procedures, it is important for patients during their initial consultation not to tweeze, wax or use any depilatory device prior to hair removal. The patient can, however, shave the area to be treated (which preserves the chromophore in the follicle), or can use hair removal creams. Hair which is protruding from the skin can singe during a laser or light treatment which causes an unpleasant smell and possible flares.

Procedure

Most devices technically operate the same way when performing a hair removal procedure. The parameters on the device (joules, milliseconds, pulse, etc.) should be set according to the skin analysis and history performed on the patient. It is important to for patients not to wear dark clothing near the area to be treated as the pigment in the clothing could potentially be absorbed by the laser or light and can result in a burn. The patient should be instructed to refrain from using any body washes, lotions, cosmetics, or any skin medications the day of treatment. Some patients may prefer to have a topical anesthetic applied prior to the procedure. If any residue of the anesthetic remains, it should be wiped clean from the skin. A spot test, or patch test, should be performed on the intended treatment area. Several treatments are required at monthly intervals for an optimal outcome and a yearly maintenance procedure is recommended.

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