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Laser Wars
Erasing Unwanted Hair

By David V. Poole, M.D.

Originally published in Massage Bodywork magazine, April/May 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.


I have hair that must be the best hair in the world, because nothing gets rid of it for more than a short time. I probably have tried every depilatory cream made... Most all have a foul smell and leave me with a painful rash that lasts for days. By the time the rash goes away, the hair is returning. Shaving gives me razor burns, irritates my skin and seems to make the hair grow back thicker and faster than ever. Plucking, waxing and electrolysis were, I'm sure, designed as some sort of medieval way to torture people. For me they have been expensive and painful. I recently saw a show on how hair is surgically moved from one area of the body and added to another, where it is wanted. It seems that with all the miracle drugs and treatments available today that modern medicine should have found a better, more permanent, less painful way to get rid of the hair I don't want.


The Hair Industry
Throughout history, hair has had a tremendous significance -- cosmetically, socially and sexually -- for both men and women. As cultures, ages and times have changed, so has the importance of hair, the length of it, the color and consistency of it, and often the location of it. Enormous sums of money are spent each year on hair -- cutting it, coloring it, straightening or curling it, adding to it or removing it. It is estimated that $3 to $7 billion is spent annually on hair removal alone. Hair is very big business; it is a multi-billion dollar a year industry. You only have to go as far as your radio or television to realize how enormous this hair-raising industry really is. It seems that every day there is a new miracle hair product being advertised to revitalize damaged hair, add bounce and body, or whatever they are assuring you their products will do for your hair, on that given day.

Studies have shown that the "right hair," color, style and length can add confidence to the person who has it and a somewhat magical appeal to those around them. Likewise, the "wrong hair" can reduce self-confidence and the subconscious attraction that a person with the "right hair" seems to have on those around them. But what seems to be even worse is the lack of hair in the desired locations or unwanted hair in undesirable locations. Historically, it has been much easier to add hair to an area than to permanently remove hair from the undesirable locations. Not so any more. Today, it is significantly easier to remove unwanted hair than it is to add or transplant hair.


Unwanted Hair
In many cases, unwanted hair can be divided into two categories: Hirsutism and Hypertrichosis. Hirsutism is an increase in hair on the female body in androgen-dependent (typical male) sites. This can be caused by an increase in male hormones known as androgens. Increased androgens can be from hormone-producing tissues within the body or from medications that can mimic androgen hormones or stimulate their production. Hypertrichosis is an increase in hair all over the body that may be congenital, acquired, hereditary or caused by medications. Whatever the reasons, the physical and emotional consequences of excess hair are often devastating and far-reaching. It is for this reason that enormous amounts of time, energy and money have gone into research on how to control hair -- both its growth and its permanent removal.


Laser Hair Removal
Various types of laser hair removal systems have been around for several years. Some of them are not actually lasers, but are intense light sources which can heat the hair shaft and thus damage or destroy the hair. The new generation of lasers has had significantly more success in treating unwanted hair. While there are many to choose from, the Ruby Laser and the Alexandrite Laser have emerged as systems of choice. In general terms, lasers are able to permanently remove hair by destroying the growing part of the root of the hair. Lasers are "tuned" for a specific color range, in this case the color of the hair shaft. The goal is to have the laser light pass safely through the skin and as it comes close to the darker pigments in the root of the hair to release its energy heating and kill the hair. This is most easily accomplished in a person with light complexion and dark hair; it is much more difficult in those with darker complexions and lighter hair.

The laser has a difficult time telling the difference between brown skin and a brown hair root. When this happens, the laser session tends to be more uncomfortable, often described as having a rubber band repeatedly snapped on the skin. Because the laser can't tell the difference between the brown colors, some of the laser's energy is released on the skin's surface before it can reach the hair shaft. In this case, it not only doesn't kill as many hairs, but it hurts and can cause skin irritation or even burns. The basic idea behind the Alexandrite-type laser is to un-focus the laser energy so it is less sensitive to a specific color. Even though it may have a slightly lower hair-killing ability than the Ruby laser, it has less chance of causing skin irritation or burns. With the Alexandrite laser systems, a much wider range of complexions and hair colors can potentially be treated safely and effectively.


Cool Lasers
The latest addition to the market is the cool laser. The idea behind this is simple; like your mother telling you to put ice on a burn to help make it feel better. If the skin being treated by the laser can be cooled before, during or after the laser hair removal session, the discomfort will be less and the risk of irritation or burns is less. In my practice this has dramatically improved patient satisfaction with the procedure. Most of my patients now either lay quietly or carry on a relaxed conversation during their laser hair removal session, even when treating potentially sensitive areas. The machine I use has a "dynamic cooling" system built into it. When the laser is fired, a blast of cryogen cools the skin before the laser fires in the same spot. It is quick and essentially painless.


Combination Therapies
Many combination therapies can safely be performed on the same day as laser hair removal. Facials, massage, endermologie, and many of the wraps, soaks and/or scrubs. What's safe and what is not?

Any therapy being performed at a site that is separate from the area being treated for hair removal is probably safe. For example, giving a facial while laser hair removal is being performed on the legs or bikini line is not only safe but may help to relax the apprehensive client. Giving a simple moisturizing facial may also help to give a value-added appreciation for the services you are offering. We often perform a quick cleansing facial and then apply a moisture wrap to the client's face while they receive their laser hair removal. Massage is another safe therapy which can be performed before or after laser hair removal.

There are two good rules of thumb: In general, you can safely perform any of your usual treatments at a site that is different from the laser hair removal site. And if what you're doing seems to hurt or to be more uncomfortable than usual to the client, then it is probably best performed at a separate session.

Because laser hair removal is typically a pricey service, I offer it as a package with other services, ultimately improving the client's satisfaction. Word of mouth is the best referral source and to have clients enthusiastically talking about the service they received will more than make up for the "free" facial or massage you have given.


Advice To Live By
Knowledge provides you with the power to make safe and effective choices. Laser centers are popping up everywhere, in shopping malls, spas, salons and doctor's offices. Be sure the person performing your laser hair removal is knowledgeable, experienced and well-trained. Ask for this information and speak with other patients who have had similar treatments by the person who will be performing your laser hair removal. Find out if a physician will be supervising your treatment or will be available should questions arise. Ask for the name, address and telephone number of their physician in case you have questions or concerns. Find out about the fees they charge, what is included in the fee, how many sessions you will receive, the fee for "touch-ups" and over what period of time will these "touch-ups" be performed. The knowledge you gain by asking questions can help to protect you, physically, emotionally and financially.

You can receive a complimentary information package on any of our cosmetic plastic surgery procedures by writing to Ask the Doctor, c/o David V. Poole, M.D., at 773 Douglas Avenue, Altamonte Springs, Florida 32714 or by calling the Cosmetic Plastic Surgery Information Center Hotline at 407/788-8080 and ask for our patient care coordinator.

David V. Poole, M.D., is a Board Certified Plastic Surgeon specializing in plastic surgery.




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