What is a LASER? A laser is a medical device that uses a focused beam of light to target specific structures in the skin. By definition a laser has a single wavelength of light. The wavelength we use is a 1064nm NdYag laser – called the Cutera Xeo Cool Glide. Why is this important? The higher the number (up to about 1300nm), the longer the wavelength and the deeper the laser light penetrates in the skin. Only a 1064nm laser effectively penetrates to the deeper layers of the skin where the root of the hair lies. In contrast, an intense pulsed light device (which we also have in the office but we do not use for hair removal very often) contains many wavelengths of light between 560nm and 1200nm. This type of device is generally less effective for permanent hair removal. Many things are marketed as a “laser”. It is important to understand the above information to evaluate laser hair removal options in an educated manner. It is also important to note that in the state of WV, use of a laser is allowed for physicians and those under direct on site supervision of a physician.
How does Laser Hair Removal Work? In laser hair removal, the laser light targets the pigment in the hair. In the skin, hairs are generated by and sit in hair follicles. The interaction between the laser and the pigment in the hair generates energy in the hair, best described as heat. This energy is transferred from the hair to the hair follicle. By damaging the hair follicle, we prevent that hair follicle from generating new hairs in the future. Over a few weeks after the laser treatment, the old hair is pushed out of the hair follicle (this can make it seem like the hair is actually growing). Once the old hair falls out, no new one grows back. Because the laser targets the actual hair, the hairs need to be present for the laser to work. You can shave prior to treatment, but we recommend no waxing or plucking for at least six weeks prior to treatment.
Sound great! What’s the catch? Because the laser works by targeting the pigment in the hair, it is most effective on thick, dark hair. It does not work on blond, gray or white hair. The laser simply has no target if there is no pigment. Fine blond hairs that normally occur on the skin also will not respond.
Why does it take multiple treatments? All hairs on the body progress through three major stages of growth – Anagen, catagen and telogen. Anagen phase is the active growing phase, catagen is a short transition phase and telogen is the resting phase. The length of hair is determined by the length of the anagen phase. Different regions of the body have different anagen lengths, causing scalp hair to be longer than eyelash hair, etc. Different regions also have a greater percentage of hairs in the anagen phase at any given point in time. Only the anagen, actively growing hairs, are anchored well enough to the hair follicle to allow effective transfer of the laser energy. Therefore, the laser is only effective on the anagen hairs. If in a given body area 50% of the hairs are actively growing, then the first treatment would target 50%, the second 50% of the 50% that remain and so on. This is why it takes multiple treatments. Treatments are scheduled 6-10 weeks apart, enough time to allow a new group of anagen hairs to grow. Many factors influence hair growth cycle, such as age, weight, ethnicity, hormones, diet, medications, metabolism and stress. Each area can require 6 treatments to effectively remove the hairs.
Is it really permanent? Yes., but treatment results may vary among patients. The FDA approves the Xeo Cutera 1064 NdYag CoolGlide Laser ® for Permanent Hair Reduction. The FDA defines permanent hair reduction as the long term, stable reduction in the number of hairs re-growing after a treatment regimen. In clinical studies patients were followed for one year after completing two treatments. The reduction in hair growth proved to be stable for that period of time. However, this is new technology, and we have less than 15 years of long term data, so we can’t say 100% that the results will last forever. However, this does appear to be the case.
How does the CoolGlide® laser treatment compare with other hair removal methods? Shaving, waxing, plucking and depilatory creams provide temporary results. These treatments must be repeated frequently. Electrolysis is tedious, invasive, and often painful. It can result in scarring. It involves inserting a needle into each hair follicle and delivering an electrical charge to destroy them one a time. Electrolysis often requires years of treatments at regular intervals and treats one hair at a time. Laser treatment delivers non-invasive laser light energy to hundreds of hair follicles at one time. In just a few minutes laser can effectively treat an area that would take over an hour with electrolysis.
Are laser treatment safe? Lasers have been in existence for more than 40 years and are used by a wide range of medical specialists. Since only light is used to remove hair, it is totally non-invasive. Therefore, it does not cause some of the irritations typically found with other hair removal methods.
What do the laser treatments feel like? Our laser Xeo CoolGlide® handpiece, as the name implies, cools and soothes the skin as it glides along the treatment area. When the light pulse is delivered, some patients experience a mild stinging or pinching sensation for a fraction of a second. No local anesthetic or pain medication is usually required. Because the CoolGlide® incorporates a large spot size and a high rate of energy delivery, treatments are extremely fast and effective.
What is it important for Dr Rosenberger to know prior to any laser treatments? Inform Dr. Rosenberger if you have a history of sun/fever blisters, cold sores or facial herpes. A history of keloids, hypertrophic scarring, vitiligo, gold therapy, tattoos in the targeted area, and darkening of the skin after procedures are all relative contraindications to laser hair removal.
Are there side effects? Short-term side effects include slight reddening of the skin or local hive like swelling. Rarely a pimple like lesion can develop at the site of an ingrown hair. Blisters are unexpected, but do rarely occur. Most side effects are typically transient, lasting from 15 minutes to two hours. Most patients can go right back to work or social activities on the day of treatment. Rarely, discoloration can occur at the laser site.
How long do the treatments take? An upper lip, chin ,underarms or bikini often only takes 10 minutes. Legs and backs take longer. Very often, follow-up treatments are shorter because there is much less hair to treat. Hair density, area treated and phase of hair growth can affect length of treatments.
What happens after the treatments? Following the treatment you can return to normal activities immediately. SPF 30 sunscreen is recommended for the entire treatment period on any areas exposed to the sun. We can treat tan skin and dark skin, but not sunburned or recently tanned skin. In the next two weeks you may experience what seems to be regrowth of hair. Most of these hairs are being shed as a result of your treatment and are not regrowing. In between treatments you should not wax or pluck the hair. Shaving is OK as it will not hinder your end results. There is often no immediate change. Don’t worry if you do not see an obvious change immediately after your first treatment.
Can all skin types and colors be treated safely with the CoolGlide® system? The CoolGlide® laser has an advantage over other laser hair removal systems because it allows treatment of all skin types, including lightly tanned and dark-skinned patients.