Laser Hair Removal

Laser Hair Removal

Laser Hair Removal is the process of removing unwanted hair by focusing pulses of laser light to destroy the hair follicle. Today, most woman rely on some form of hair removal in their everyday beauty routines. Waxing bars, eyebrow threading studios, and electrolysis centers are at an all time high and continue to rise. New technologies in hair removal have made it one of the most popular beauty services available. Laser Hair Removal technology has also advanced significantly making it extremely safe, reliable, and significantly decreasing the time women need to spend shaving.

History:

The ancient Egyptians are the founders of many beauty rituals. Women of ancient Egypt removed all of their body hair, including that on their heads, with tweezers (made from seashells), pumice stones, early beeswax and sugar based waxes.

During the Roman Empire, the lack of body hair was considered a sign of the upper class. Wealthy women and men used razors made from flints, tweezers, creams, and stones to remove excess hair. Even pubic hair was considered uncivilized. This is why many famous statues and paintings of Grecian women are depicted hairless.

During the Middle Ages, Queen Elizabeth I set the precedence for hair removal by removing it from her face but not her body. The trend of this era was to remove the eyebrows and hair from the forehead to make it appear larger. Women used walnut oil, or bandages soaked in ammonia, which they got from their feline pets, and vinegar to destroy the hair.

In the late 18th century, a more civilized approach to hair removal was developed. Jean Jacques Perret, a French barber, created the first straight razor for men in 1760. It was also used by some women.

In 1844, Dr. Gouraud created one of the first depilatory creams called Poudre Subtile. King Camp Gillette, in 1880, created the first modern day razor for men. A revolution in hair removal was born. It would be another three decades before a razor specifically marketed for women would appear.

In 1915, Gillette created the first razor specifically for woman called the “Milady Decolletee”. Many ads for depilatory creams hit the masses. In 1907, an ad for X-Bazin Depilatory Powder began circulating promising to remove “humilating growth of hair on the face, neck and arms”. A decade later, a leading women’s fashion magazine featured an ad with a woman with her arms raised and her armpits bare. This was the first of it’s kind.

After the success of the male razor, Remington released the first electric women’s razor in 1940. Due to a wartime shortage of nylon, more products and techniques for hair removal hit the market as women were forced to go bare legged more often.

During the 1950s, hair removal became more publicly accepted. Since many depilatory creams were still irritating to the skin, women relied on razors to shave their legs and underarms and tweezers to groom and shape their eyebrows.

Wax strips made their debut in the 1960s and quickly became the method of choice for removing unwanted hair under the arms and on the legs. The first laser hair removal method hit the market in the mid-sixties, but was quickly abandoned because it damaged the skin.

Although electrolysis had been around for nearly a century, it became more reliable and safe in the 1970s with the development of transistorized equipment. The decade also saw a resurgence in the removal of bikini hair as the swimsuit fad of the 1960s took off.

In 1996, Dr. Rox Anderson discovered it was possible to remove hair by targeting the hair follicile. Dr. Anderson was an MIT graduate and a graduate of Harvard Medical School. This method proved to be successful, and was first applied in 1996. In 1997 the United States Food and Drug Administration approved this technique for hair removal. As this technology continued to be researched, laser hair removal became more effective and efficient. It is now a common method in removing hair for long periods of time.

How does laser hair removal work?
Dr. Rox Anderson Laser hair Removal
The principle Dr. Anderson discovered is called selective photothermolysis (SPTL). It is the the matching of a specific wavelength of light to a target tissue. The target tissue then absorbs this light leading to its destruction without harm to the surrounding tissue. Thus, it is specific and selective for only that tissue type. One of these target tissues in the human body is melanin. Melanin is a complex polymer derived from the amino acid tyrosine. It gives us the color and pigment to our skin. Melanin is known as a chromophore because it can selectively absorb certain wavelengths of light. When melanin is targeted by the laser, the laser heats only the melanin and causes it to be destroyed. Since follicles are associated with melanin, the hair follicle is too destroyed while leaving the surrounding skin unaffected.

Melanin is considered the primary chromophore for all hair removal lasers currently on the market. Melanin occurs naturally in the skin and gives skin and hair their color. There are two types of melanin in hair. Eumelanin gives hair brown or black color, while Pheomelanin gives hair blonde or red color. Because of the selective absorption of photons of laser light, only black or brown hair can be removed. Laser works best with dark coarse hair. Light skin and dark hair are an ideal combination, being most effective and producing the best results. But new lasers are now able to target black hair in patients with dark skin with success.

Several wavelengths of laser energy have been used for hair removal. They range from from visible light to near-infrared radiation. These lasers are characterized by their wavelength, measured in nanometers. They include Argon 488nm or 514.5nm (no longer used), Ruby 694.3 nm, Alexandrite 755 nm, Pulse Diode 810 nm and Nd:YAG 1064 nm. Even Intense Pulsed Light (IPL) 650nm has been used with success in hair removal.

Pulse width (or duration) is one of the most important considerations. The length of the heating pulse correlates directly to the damage achieved in the follicle. The main target for destroying hair follicles is the germ cells. They live on the surface of the hair shaft. Light energy is absorbed by the melanin within the hair and heat is generated. The heat then conducts out towards the germ cells. As long as a sufficient temperature is maintained for the required time then these cells will be successfully destroyed. To achieve these conditions the laser or IPL system must be able to generate the required power output. The main reason why hair removal fails is simply because the equipment cannot generate the desired temperature for the correct time.

Spot size, or the width of the laser beam, directly affects the depth of penetration of the light energy due to scattering effects in the dermal layer. Larger beam diameters result in deeper deposition of energy and hence can induce higher temperatures in deeper follicles. Hair removal lasers have a spot size about the size of a fingertip from 3-18 mm.

Fluence or energy density is another important consideration. Fluence is measured in joules per square centimeter (J/cm²). It is important to get treated at high enough settings to heat up the follicles enough to disable them from producing hair.

  • Epidermal cooling has been determined to allow higher fluences and reduce pain and side effects, especially in darker skin. Three types of cooling systems have been developed:
  • Contact Cooling: A window built into the laser hand piece is cooled by circulating water or other internal coolant. This type of cooling is by far the most efficient method of keeping the epidermis protected since it provides a constant heat sink at the skin surface. Sapphire windows are much more conductive than quartz.
  • Cryogen Spray: A cooling spray which is sprayed directly onto the skin immediately before and after the laser pulse.
  • Air Cooling: A second machine blows cold air at -34 degrees C over the treatment area.

The most important output parameter when treating hair (and other skin conditions) is power density. Power density is a combination of energy, spot diameter and pulse duration. These three parameters determine what actually happens when the light energy is absorbed by the tissue chromophore be it melanin, hemoglobin or water, with the amount of tissue damaged being determined by the temperature/time combination.

Hair Growth Cycles:

There are three stages of hair growth: Anagen, Catagen and Telogen.
Hair Growth Cycles Laser Hair Removal
Anagen Phase
The anagen phase is known as the growth phase. It begins in the papilla and can last from two to six years. The span at which the hair remains in this stage of growth is determined by genetics. The longer the hair stays in the anagen phase, the longer it will grow. During this phase, the cells in the papilla divide to produce new hair fibers, and the follicle buries itself into the dermal layer of the skin to nourish the strand. About 85% of the hairs on the head are in the anagen phase at any given time

Catagen Phase
Signals sent out by the body determine when the anagen phase ends and the catagen phase begins. The first sign of catagen is the cessation of melanin production in the hair bulb and breakdown of follicular melanocytes. The catagen phase, also known as the transitional phase, allows the follicle to renew itself. During this time, which lasts about two weeks, the hair follicle shrinks due to disintegration and the papilla detaches and “rests,” cutting the hair strand off from its nourishing blood supply. The follicle becomes 1/6 its original length, causing the hair shaft to be pushed upward. While hair is not growing during this phase, the length of the terminal fibers increase when the follicle pushes them upward.

Telogen phase
During the telogen or resting phase the follicle remains dormant for one to four months. Ten to fifteen percent of the hairs on one’s head are in this phase of growth at any given time. In this phase the epidermal cells lining the follicle channel continue to grow as normal and may accumulate around the base of the hair, temporarily anchoring it in place and preserving the hair for its natural purpose without taxing the body’s resources needed during the growth phase.
At some point, the follicle will begin to grow again, softening the anchor point of the shaft initially. The hair base will break free from the root and the hair will be shed. Within two weeks the new hair shaft will begin to emerge once the telogen phase is complete. The process results in normal hair loss known as shedding.

How The Hair Cycles Effect You:

It can take 6-12 weeks for hair to grow from the papilla to show above the skin during the anagen phase. With this knowledge we know that if you were to pluck your eyebrows you would not see the exact same hair in a week, even if you have hair in the same area. This growing stage, anagen phase, is the perfect time to receive laser hair removal treatments. Because only 85% of the hairs are in this phase, it will take multiple treatments over a period of time to achieve the desired results. On average it takes 5 treatments, separated by 8 weeks to complete a course of treatment. It is very important to keep on your schedule for your treatments. Missing a treatment could allow your hair to enter the catagen phase. If you get treatment during the catagen stage, it will likely not be as effective because the hair is not actively growing. Thus, laser hair removal treatments are scheduled around the Anagen stage of hair growth to work towards a goal of permanent hair removal.

Multiple treatments depending on the type of hair and skin color have been shown to provide long-term reduction of hair. Most patients need a minimum of five treatments. Current parameters differ from device to device but manufacturers and clinicians generally recommend waiting from four to eight weeks between sessions, depending on the area being treated. The number of sessions depends on various parameters, including the area of the body being treated, skin color, coarseness of hair, reason for hirsutism, and sex. Coarse dark hair on light skin is easiest to treat. Certain areas may require considerably more treatments to achieve desired results such as a man’s beard.

Laser does not work well on light-colored hair, red hair, gray hair, white hair, as well as fine hair of any color. For darker skinned patients with black hair, the 810nm Diode laser and the long-pulsed Nd:YAG with a cooling tip can be safe and effective.
Typically the shedding of the treated hairs takes about two to three weeks. These hairs should be allowed to fall out on their own and should not be manipulated to avoid infections. Pulling hairs after a session can be more painful as well as counteract the effects of the treatment.

Side Effects and Risks:

Normal side effects which may occur after laser hair removal treatments include itching, pink skin, redness, and swelling around the treatment area or swelling of the follicles (follicular edema). These side effects rarely last more than two or three days.

The newest 810nm Diode lasers with an internal cooling head are essentially pain free. They do not require the use of numbing creams. Lasers that do not have an internal cooling system or use and external cooling system will have some level of pain. These lasers require the use of a numbing cream. The cream should be applied about 30 minutes before the procedure. Icing the area after the treatment helps relieve any discomfort. Use of strong numbing creams over large skin areas being treated at one time must be avoided, as this can seriously harm or cause death in patients.

Extremely rare side effects include burning the skin, hypopigmentation, hyperpigmentation, acne, scab formation, red or purple discoloration and infection. These risks can be significantly reduced by treatment with an appropriate laser type used at appropriate settings for the individual’s skin type and treatment area.

What To Expect:

Laser hair removal is an in-office procedure. The process takes between 10-30 minutes depending on the number of areas treated.

Prior to your laser hair removal treatment, you should not tweeze, wax, or use any hair treatment that removes hair from it’s root. There must be hair in the follicle for laser hair removal to work. One should avoid sun exposure, spray tans or self tanners 14 days prior and 7 days after your laser hair removal treatment. Tanned skin has extra melanin which attracts laser energy. The day of your laser hair removal treatment, avoid applying any lotion, moisturizer, sunscreen, perfume, or other similar cosmetics to the surface of your skin. Do not apply make-up or wear jewelry to your appointment. You will need to shave 1-2 days before your session. The idea is to have a nice, close shave, so that there is no hair outside the skin. It is best to have just enough hair to be visible so your laser technician knows what is to be treated.

During the procedure a cool gel will be applied. The gel enhances the efficacy of the laser. Depending if the laser has a built in cooling system, one may need to apply an anesthetic gel prior to the treatment. Once the treatment is performed, a moisturizer with sunblock will be applied.

Immediately after the treatment, there may be mild redness and swelling. The swelling may last up to 2 hours and the redness may last for a couple of days. The treated area may feel like a sunburn. One may apply ice for the first few hours after treatment to reduce any discomfort or swelling. Make-up can be applied two hours after the treatment. It is necessary to avoid sun exposure for 7 days after the procedure. There are no restrictions on bathing except to treat the skin gently, as if you had a sunburn for the first 24 hours. One should wash the area gently and pat dry until the skin returns to normal. Avoid picking or scratching the treated skin. Do not use any other hair removal treatment products or services (waxing, electrolysis or tweezing) that will disturb the hair follicle in the treatment area. Anywhere from 3-7 days after the treatment, shedding of the surface hair may occur and this appears as new hair growth. This is not new hair growth, it is the shaft that was below the skin being expelled. It may take 7-10 days for the shafts to be fully expelled.

Dr. DeConti has extensive training and certifications in multiple laser systems including alexandrite, q-switch, diode, KTP:YAG, Nd:YAG, CO2, erbium, argon, krypton, ruby and copper vapor lasers as well as Intense Pulsed Light Systems (IPL). He can treat a wide range of medical and cosmetic conditions including laser hair removal, skin resurfacing, tattoo removal, port-wine stains and hemangioma removal, wrinkle correction and reduction, pigmented spots, lesion destruction, acne reduction, telangiectasia and vein reduction, laser liposuction, laser photocoagulation, endovenous laser therapy and laser scalpel surgery. As a highly credentialed plastic surgeon with the American Board of Plastic Surgery and the American Society of Laser Medicine and Surgery, he is an expert in the intimate details of laser medicine and surgery. This knowledge allows Dr. DeConti and his staff to perform all laser procedures accurately and effectively for the finest and most optimum results with the least amount of risk.

To learn more about the benefits of Laser Hair Removal call 804 673-8000 and schedule a consultation at DeConti Plastic Surgery today.

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