Laser hair removal is described as a medical procedure that can reduce unwanted hair on various parts of the body, including the face, arms, armpits, legs, bikini area, hands, feet, and back. This process involves the use of lasers that damage a person’s hair follicles in an effort to reduce the growth of hair in these areas.
This article takes a comprehensive look at laser hair removal, with input from several experts, so you can learn everything you need to know before moving forward with this procedure. We’ve addressed numerous subtopics, including the pain factor, how much it costs, best candidates and how to find the right provider.
Potential side effects can include burns, blistering or scarring; and ocular damage can potentially result if improper eye shields are used when treating the face. Before you proceed with laser hair removal, talk to your medical provider, or a Board Certified Dermatologist, first.
What Is Laser Hair Removal?
Laser hair removal is the process of using laser or light-based energy to damage hair follicles under the skin to reduce hair growth in the treated area, said Dr. Deanne Mraz Robinson, president and co-founder of Modern Dermatology in Westport, Connecticut, who completed a fellowship in Cosmetic & Laser Surgery following her residency in dermatology at Yale.
“It is actually best to refer to it as laser hair reduction as it will not result in removal of 100 percent of the treated hair in the area,” said Dr. Robinson, who is also an Assistant Clinical Professor of Dermatology at Yale New Haven Hospital.
This medical procedure uses a laser to remove unwanted hair by targeting the pigment (melanin) in the hair follicle, further explained Dr. Rhonda Q. Klein, a Board Certified Dermatologist at Modern Dermatology.
“The light that the laser emits is converted to heat which damages the hair follicle, thereby inhibiting further hair growth,” Dr. Klein said.
During this process, the laser will be aimed at the hair follicles and a small pulse will be delivered to follicle, added Dr. Lauren L. Levy, a Board Certified Dermatologist at Loucas Dermatology in New York City.
Laser hair removal can be used for unwanted excessive hair on any part of the body, such as the face, arms, legs, trunk and bikini area, said Dr. Paul Yamauchi, Ph.D, a dermatologist in private practice at the Dermatology Institute and Skin Care Center in California, where he has been performing laser hair removal for nearly two decades. He has also conducted laser hair removal clinical trials in the past.
The scientific principle behind laser hair removal is through a phenomena called photothermolysis, where the laser targets and heats the pigment called melanin in the hair follicle below the skin based on a selective wavelength, Dr. Yamauchi explained.
“The energy from heating the pigment is transferred to the hair follicle thereby destroying it,” said Dr. Yamauchi, who is also the founder of the Clinical Science Institute in Southern California.
How Does Laser Hair Removal Compare to Waxing or Shaving?
While all methods of hair removal are popular, Dr. Matthew Elias, a Board Certified Dermatologist at Elias Dermatology in Florida, noted that laser hair removal “can have the most profound effect” on large areas of hair in the shortest amount of time, leading to long-term reduction in hair; whereas other treatments like shaving and waxing will require constant frequent treatments.
Dr. Yamauchi agreed that “all methods are popular;” adding that laser hair removal “is a more permanent solution in removing unwanted hair, but is more expensive.”
Because laser hair removal is more permanent than waxing or shaving, it is increasingly popular, Dr. Klein said, “Though it should be noted that no method of hair removal is completely permanent, as there are stem cells in the hair follicle. It does delay hair growth for long periods of time after a series of treatments are performed.”
Additionally, many patients with sensitive skin cannot tolerate waxing due to irritation, Dr. Levy noted: “Shaving can cause infections, ingrown hairs, and folliculitis (the infection of hair follicles) so laser hair removal is an excellent alternative for anyone having any of these complications from shaving.”
Does Laser Hair Removal Work?
“That’s a big yes,” said Dr. Elias. When laser hair removal is performed in an expert Board Certified Dermatologist’s office, “it most definitely works” with a multitude of different lasers to provide a wide range of treatments based on the location of the body being treated, ethnicity, hair type, tanned or non-tanned skin.
Laser hair removal works with the majority of people, Dr. Yamauchi noted, with treatments performed every 5 to 8 weeks. “Several sessions are necessary to achieve the desired results.”
The laser's wavelength specifically targets the pigment deep within the hair follicle bulb called melanin; this results in damaging the hair follicle, and with several treatments, the follicle is further destroyed with the goal of producing finer, lighter, and slower growing hair, Dr. Robinson further explained.
Several treatments are required, generally 6 to 8 spaced 4 to 6 weeks apart, as the procedure is only effective on the actively growing follicles, which is in rotation as hair has a “growing” and “resting” phase, Dr. Robinson said.
“Most times, this series of treatments will reduce hair growth by approximately 80%,” Dr. Robinson noted. “There will always be some hairs that continue to grow and patients require touch up treatments 1 to 2 times per year.”
Laser hair removal is most effective for people with dark coarse hairs, Dr. Klein said, adding that it does not work on blonde, white, or gray hairs, as the laser is unable to target those follicles.
“It is most effective to undergo laser hair removal when you don't have a tan and will be avoiding the sun, and can do the entire series at once,” said Dr. Klein, adding that there are some ultrasound devices that can be used for lighter hairs, “but this technology is still evolving.”
It works, but some hair types respond better to lasers than others, Dr. Levy noted. “The best outcomes are with those who have light skin and dark thick hair (a large contrast between the hair color and skin color) because the laser picks up the melanin in the hair better.”
Is Laser Hair Removal Permanent?
No, according to Dr. Elias, adding that there is a long-term reduction, but you will require touch-up treatments every so often.
Dr. Yamauchi said laser hair removal is permanent “to a certain extent,” and the more sessions that are done, “the more permanent is the removal.”
You will also notice the hair grows back slower because of injury to the hair follicle, said Dr. Yamauchi, adding that treatments are performed every 5 to 8 weeks, and several sessions are necessary to achieve the desired results. “However, sometimes the hair may grow back because not all the hair follicles are permanently destroyed or they slowly recover. In that instance, touch-up sessions are done.”
Usually, 6 to 8 treatments will be required, Dr. Robinson noted; and while results are considered permanent, some patients like to come in 1 to 2 times a year for a touch-up.
Dr. Klein explained that “no hair removal is absolutely permanent,” because there are stem cells in the hair follicle. “But usually after 4 to 6 treatments, little to no hair remains for an extended period of time (years usually) then occasional touchups may be needed.”
According to Dr. Levy, laser hair removal is not considered permanent but does drastically reduce the amount of hair as the follicle is stunted. “Additionally, when the hair grows back it is often finer and lighter. Patients may need to have some maintenance treatments if they want to totally eliminate shaving or waxing.”
Is Laser Hair Removal Safe?
Yes, laser hair removal is safe, Dr. Elias said, especially when performed in a Board Certified Dermatologist’s office, where “you can be assured of the highest safety profile and lowest risk for complications.”
As long as laser hair removal is performed properly, it is safe, Dr. Yamauchi noted, adding that “it is critical” that the correct energy settings are chosen, and the proper cooling is performed. “At our center, we perform test spots with different energy settings in a small area to ensure correct settings before we treat the whole area.”
It is not safe if being performed by an unqualified individual, Dr. Robinson warned. Additionally, “there are specific wavelengths and devices that are not safe for certain skin types, so it is best to consult with your Board Certified Dermatologist to discuss the most appropriate treatment for you.”
Dr. Klein agreed that laser hair removal “is very safe” when performed by a Board Certified Dermatologist with proper technology.
“There are many devices – such as IPL, which is not a laser but a light device – that may be used for laser hair removal that are not as effective,” Dr. Klein noted. “Further, in darker pigmented individuals, only longer wavelength lasers can be used…as otherwise burns or post inflammatory hyperpigmentation may occur. When performed properly by a core physician, the risk of burns, dyspigmentation, and scars are very exceedingly rare.”
Just like with any procedure, there may be complications including skin irritation, burns on the skin, and scaring (hypo- or hyper-pigmentation) if the settings are not correct, Dr. Levy warned. “Additionally, if the procedure is done on tanned skin, the risk of scarring is greater. If the wrong laser or setting is used then these complications are more likely to occur.”
Does Laser Hair Removal Hurt?
As far as the pain factor is concerned, laser hair removal can hurt, Dr. Elias said, and this is dependent on the body area and type of laser used. “The newest hair removal lasers, like the Lumenis Splendour X, are incredibly well tolerated on all body parts.”
According to Dr. Yamauchi, there is some pain and discomfort associated with laser hair removal, and that’s why a cooling system is used during the procedure to minimize pain as well as avoid side effects.
“Often times, numbing cream is applied at the office to minimize discomfort,” Dr. Yamauchi added. “In general, the thicker the hair, the more it hurts. This is especially true on the back. Other more sensitive areas are the armpits and bikini area.”
Dr. Robinson noted that the pain is relative to the person's individual pain threshold and the area being treated, and in general, she finds patients experience more pain with the underarms and bikini area.
“We offer topical numbing for more sensitive areas or can pre-treat with ProNox (aka laughing gas) to help our patients relax and take the edge off,” Dr. Robinson added. “But really it's not bad and is a pretty quick treatment.”
Dr. Klein said that it can be “mild to moderately uncomfortable,” and usually a Zimmer (cooling system) is all that is required for comfort with the newer laser devices.”
The procedure overall feels like a small electrical pulse or burning sensation that lasts for several minutes, Dr. Levy added, and using ice prior to the procedure is helpful.
Marilyn Stotts, an Advanced Practice Nurse Practitioner who has provided laser hair removal for 16 years and works at the Dermatique Medical Center in Southern California, said most patients describe “a snapping sensation, similar to snapping a rubber band on the skin.”
Possible Side Effects of Laser Hair Removal
When performed by inexperienced operators without the supervision of a Board Certified Dermatologist, there may be higher incidences of side effects like burns and scarring, Dr. Elias warned.
Regardless of any kind of laser treatment, whether it’s laser hair removal, skin resurfacing or skin tightening, the potential side effects are burns, blistering, scarring, and skin discoloration, Dr. Yamauchi noted. These side effects are minimized if the procedure is properly done, he said, and further recommended that patients who undergo laser hair removal must avoid the sun before and after the procedure.
According to Dr. Robinson, if the inappropriate wavelength, device, or cooling is used, burns, blisters and subsequent dyspigmentation can occur; and that this is more common in darker skin types, or if treating in areas of an active tan.
Dr. Klein said that skin irritation is common, as is redness and swelling, though all disappear usually within a couple of hours. Post inflammation hyper- or hypo-pigmentation can also occur, as can blistering, crusting and scarring “when improperly treated.” She added that avoiding the sun, waxing, and irritating skin products can be helpful prior to treatment, “but discuss with your dermatologist your products and shaving prior to treatment.”
Additionally, “some patients will notice charring of hair that will fall out,” Stotts noted.
In other potential side effects, Dr. Levy warned if improper eye shields are used when treating the face, “then ocular damage can occur.”
Parts of the Body that Respond Best to Laser Hair Removal
In general, all areas of the body respond equally to laser hair removal, according to Dr. Yamauchi.
Dr. Robinson said because the laser is attracted to melanin in the follicle, “areas with dark, coarse hair will respond best to the treatment, so underarms and bikini are usually the top performers for most people.”
Arms, legs, bikini, axillae, and trunk are great areas for laser hair removal, said Dr. Klein, adding that the face “is also a wonderful area, not around the eyes, though.” She noted that facial hair is more hormonally mediated, and may require extra sessions in individuals with hormonally mediated conditions (such as polycystic ovary syndrome) and may require touchups after hormonal changes, such as pregnancy.
In Dr. Levy’s experience, the legs, arms, and armpits have the best response; and facial hair that is coarse and thick also has an excellent response. The bikini area also works well, she added, “but it is more painful, so many patients cannot tolerate the several needed treatments.”
The Cost of Laser Hair Removal
The cost of laser hair removal varies depending on the office of the Board Certified Dermatologist, as well as the area being treated. For instance, at Dr. Yamauchi’s private practice, “we charge $300 for every 15 minutes of treatment.” This breaks down to the following:
- 15 minutes: Face, bikini, axilla (armpit)
- 15 to 30 minutes: Face, bikini, axilla, arms
- 30 minutes: Legs
- 30 to 45 minutes: Back
- 45 to 60 minutes: Back and legs
- 75 minutes: Whole body
At Dr. Robinson’s practice, Modern Dermatology, “this ranges from amount of area treated and whether purchased as a single treatment or series. Prices begin at $250.” Dr. Klein, who also works at Modern Dermatology, noted that the treatment can cost up to $1,000 for larger areas (legs, back); adding that most places will offer a discount if a package of 6 is purchased, which can equate to 20% off or one free treatment.
At Dr. Levy’s private practice in New York City, the breakdown is the following:
- Face: $300 to $350
- Axilla (armpit): $250 to $300
- Arms $350 to $450
- Legs: $400 to $500
- Lip: $200
- Bikini: $250 to $350
In Stotts’ experience, the price breakdown is the following:
- Underarms: $200
- Back: $700
- Forearms: $250
- Upper lip: $125
- Neck: $250
- Full leg: $700
- Upper thigh: $300
- Bikini: $200
- Chin: $125
- Hands or feet: $125
Best Way to Prepare for Laser Hair Removal
If you’re getting ready for laser hair removal, Dr. Elias advises to shave the day before your hair removal procedure and show up with no products on your skin. Also, “for the safest and best results, don't attempt hair removal when tan.”
According to Dr. Yamauchi, a person should not wax for at least a month prior to treatment. “This is because waxing temporarily removes the hair follicle, and there is nothing for the laser to target,” he warned. “In addition, avoiding the sun and tanning prior to laser hair removal is necessary to avoid skin discoloration.”
Dr. Robinson said you’ll need to stop waxing or tweezing during your treatments because these processes remove the hair bulb, “and that is the target for laser.” Instead, “I ask my patients to shave or trim the areas they want treated the night prior.”
In further details, Dr. Klein advises stopping waxing, tweezing or using depilatories 4 to 8 weeks prior to treatment. “I usually advise patients to shave for 2 months prior to treatment, then 1 to 2 days prior to laser.” Additionally, “avoid the sun for at least 2 weeks after treatment.”
Dr. Levy emphasized to make sure the skin is not tanned. Also, avoid waxing, plucking or other hair removal practices prior to the procedure. She agreed to shave the treatment area 1 to 2 days prior to treatment, because “there should be some stubble present.” In other advice “if you have a history of cold sores (herpes labialis) and are getting the lip area lasered, you may want to take anti-virals prior to the procedure.”
Laser Hair Removal After Care
After undergoing laser hair removal, it is normal for your skin to turn red and bumpy, like goose bumps, because of the heat that has been transferred to the hair follicle, Dr. Yamauchi explained.
“This can last for a few hours to a couple of days,” Dr. Yamauchi said. Additionally, “sometimes your skin can become itchy. Applying a mild steroid cream can help with that.” He further emphasized that one needs to avoid the sun before and after laser hair removal treatment.
According to Dr. Robinson, some redness, swelling and bumpiness “is normal,” and generally subsides on its own within 24 hours. She advised avoiding lotions, especially those with fragrance, as well as self-tanner for 72 hours. Also, “avoid sun exposure to the area for two weeks.”
Dr. Klein said gentle products after treatment, sunscreen, and sun avoidance are critical; adding that ice after treatment can help with swelling and pain.
If the skin becomes red or irritated, the use of a topical steroid can help, Dr. Levy advised; also, ice and over-the-counter pain medicine can help with swelling and pain. She agreed it’s important to stay out of the sun after the procedure and between treatments.
Best and Worst Candidates for Laser Hair Removal
According to Dr. Elias, fair skin with dark hair is always the optimal candidate; “however, with the newer lasers almost all skin types and types of hair can be treated.”
Dr. Yamauchi said someone with a very low pain tolerance, or a person who refuses to avoid sun exposure before and after treatment, “is not any ideal candidate for laser hair removal,” adding that light hair, including white, blonde and gray, will not work with laser hair removal. “Otherwise, most people will be good candidates.”
In Dr. Robinson’s experience, “light skin, dark hair is the ideal candidate.” She added that “today we are fortunate to have a variety of laser devices, some with highly customizable settings, so that the treatment is effective on all skin colors and types. Currently, however, we do not have a device to target white or light hairs.”
Dr. Klein agreed that light-skinned individuals with dark coarse hairs are best for laser hair removal; “however, all patients can be treated depending on laser selection.”
Dr. Levy added that for patients with darker skin types, there is more risk of pigmentary alteration or scarring after the procedure if the right laser is not used (such as a longer pulsed laser), “so be sure your practitioner is qualified.”
Stotts added that the following people should completely avoid laser hair removal:
- Patients who are on medications that induce light sensitivity
- Individuals who are tan or sunburned
- Individuals with seizure disorders (they might need to avoid treatment due to light flashes)
Finding the Right Laser Hair Removal Provider
Stotts advised inquiring about who will provide the service, and how much experience the provider has. Also, “ask the provider to discuss contraindications to treatment.”
Dr. Elias recommends looking for a Board Certified Dermatologist, which can be found at Find a Dermatologist.
Dr. Yamauchi noted that “a center where there is a Board Certified Dermatologist trained in laser hair removal is the best place.”
In other recommendations, Dr. Robinson advised looking for a Board Certified Dermatologist “who has experience and training with lasers specifically.” Additionally, “be wary of Groupon deals and medi-spas who may not even have a physician onsite should you need one.”
You can also check the American Academy of Dermatology, American Society for Dermatologic Surgery or the American Society for Laser Medicine & Surgery to identify a properly trained physician in your area, Dr. Klein said.
“A Board Certified Dermatologist will have the most experience,” Dr. Klein explained. “You can also ask your prospective provider what kind of laser they use. For example, the Gentlemax laser by Candela is one of the best for laser hair removal, as it has both Alex and Nd:YAG wavelengths…so very effective and minimal pain.”
Dr. Levy added to talk to your dermatologist about the procedure to see if they offer it, or recommend someone to perform the procedure.
Laser hair removal is ideal for people who experience hair follicle irritation and bumps from shaving, Stotts said. Also, “you will save time and money because you will not need to shave.” She added that laser hair removal promotes a positive body image, especially for the many women who have facial hair “that is troubling for them.”
It’s important to remember that laser hair removal “is not comfort-free,” said Dr. Yamauchi, noting that numbing cream can help minimize the pain, “but you will still feel some discomfort.” He added that the majority of people will benefit, “but there are some that laser hair removal will not help, and there will not be hair reduction.”
Before you decide to undergo laser hair removal, “be committed to the process,” Dr. Robinson advised. “Remember that optimal results come with repeated treatments spaced 4 to 6 weeks apart.”
Laser hair removal is an excellent treatment that delivers both convenience and aesthetic benefit, Dr. Robinson added. “Medically it is also a fantastic option for patients with chronically ingrown hairs and folliculitis. It's safe, effective and with permanent results – a procedure nearly everyone agrees is worth it.”
It’s also important to make sure the person performing the procedure is qualified, Dr. Levy emphasized. And remember, “it will take several treatments to get a result and it is not permanent, but the hair will be thinner and more manageable.” She added that laser hair removal, overall, is “a safe and well-tolerated procedure to reduce hair growth if done by the correct professional with the right device.”
In other advice, Dr. Klein recommended to “pick a time of year that works for you for multiple sessions. I generally advise starting in the fall so you are finished by spring.”
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