There Goes The Fuzz

Laser and light therapies have revolutionised hair reduction.

The permanent hair reduction market in Australia has boomed over the past decade with a variety of lasers and light-based technologies offering safe and effective solutions to excess and unwanted hair.

`Being hair-free no longer appears to be a “trend” but the norm,’ says Dr Susan Austin from the Cosmetic Physicians Society of Australasia (CPSA). “Our doctors have seen a steady increase in the number of patients requesting permanent hair reduction, with the “Brazilian” still among the most popular treatments for female patients.

A new survey by the CPSA shows that almost one in four people who have undergone a non-surgical cosmetic procedure have opted for laser or Intense Pulsed Light (IPL) treatments for permanent hair removal. A further 31.5% of respondents to the survey said they are considering having laser or IPL hair reduction treatments in the future.

An earlier survey by the CPSA found a significant number of women who opted for a permanent Brazilian reported “feeling sexier’ (63%) and “enhanced sexual pleasure” (60%) as reasons for going hair-free.

`Evidently, permanent hair reduction is not just be for aesthetic reasons, it also has an impact on our sex lives,’ says Dr Austin.

But it’s not just women who are looking to go bare says the CPSA, whose members report an increase in the number of men seeking permanent hair reduction.

`For men the most popular areas for laser and IPL hair removal are the back, the chest and interestingly, the beard around the neck and cheeks. We find the key motivation for most many is to look and feel good, as well as a desire to please their partners,’ says Dr Austin.

`Another motivation for men is to avoid shaving, not only to save time on grooming but also because shaving can cause skin irritation for some men.’

Permanent hair reduction, when performed by a fully trained operator, offers clients several benefits compared with other hair removal options such as shaving and waxing.

Clients generally notice the hair grows back less quickly and also finer with the added bonus that there are rarely spots, ingrown hairs or itchiness.

YOUR PERMANENT HAIR REDUCTION OPTIONS

Laser

Laser light is different to normal light for many reasons: it travels in a synchronised fashion; retains its intensity over a long distance; it is monochromatic (of the same wavelength or colour); and it can be pulsed.

The principle behind lasers is light absorption by targets that selectively absorb pulses of radiation. Selective absorption means hair follicles are destroyed but the skin is left undamaged. The same as a black car will be hotter than a white car because it absorbs more wavelengths of light, certain target tissues will absorb certain wavelengths of light more effectively. In the case of hair removal, the target is the pigment, or melanin, in the hair follicle that colours the hair.

Effectiveness is limited if there is no pigment – for example light blonde, white or grey hair. Second, in the telogen growth phase, the hair bulbs are un-pigmented and therefore do not absorb light. The early anagen phase is the best stage to maximise responsiveness to laser and light treatment. Two or three days before treatment you need to either shave or use hair removal cream over the area to be treated. No sun, solarium or fake tan should be used two weeks before your treatment or superficial burning or pigmentation may occur.

Laser hair removal has been described as being similar to a small rubber band being flicked against your skin and any discomfort is typically soothed by a cooling device used simultaneously to take the hair out of the skin. Efficacy depends on the area being treated and can be influenced by sex, age and hormones. However, studies show an average hair loss of approximately 80 percent after six to eight treatments, conducted six to eight weeks apart.

Treatments are spaced to take the hair growth cycle into consideration:

• Anagen (active growth phase).
• Catagen (transitional period).
• Telogen (resting phase).

There is variation in the duration of anagen and telogen phases in different body sites. There is also seasonal variation, which means in summer there’s a higher rate of growth and slower growth during winter.

The Ruby laser (694nm), Alexandrite laser (755nm), Diode laser (810nm), Nd:YAG laser (1064nm) as well as IPL have been commonly used for hair removal. The Ruby and Alexandrite lasers are recommended for hair removal in patients with Fitzpatrick fairer skin types of 1 to 3.

The Diode laser can be used in the range of Fitzpatrick skin types (1 to 5) – from fair with red hair to very dark skin. The long-pulsed Nd:YAG laser, functioning at a wavelength of 1064nm, can be used on all skin types and is the safest device for hair removal in very dark-skinned patients due to its long wavelength and the reduced risks of hypo-pigmentation.

Intense Pulsed Light (IPL)

This non-laser technology uses light wavelengths that safely target either melanin or haemoglobin in the skin. While it was developed for skin concerns, a side effect of the treatment recognised and harnessed is the reduction of hair growth.

IPL sources have been used primarily for hair removal in patients with Fitzpatrick skin type 1 to 4 and light hairs (blonde, grey and white) tend only to be treatable if they are coarse in nature. Unlike lasers, IPL devices produce a broad spectrum of light in a range of wavelengths. This versatility allows the characteristics of the light energy to be adjusted according to each patient’s skin type, specific condition and location of the condition.

During the procedure, pulses of intense light are fired at the skin through varying filters, which isolate specific wavelengths of light. Similarly to laser, the pigment is targeted and preferentially absorbed, heated and selectively destroyed by certain light wavelengths without damaging surrounding tissues.

A minimum of four to six treatments are likely to be required to see results and ongoing treatment is recommended. Darker skin colour and lighter coloured hair will require more treatments, as there is less melanin in the hair roots and the machine cannot be operated at full capacity.

A disadvantage of IPL systems is that most devices use large rectangular spots, creating difficulty in the treatment of convex or concave hair-bearing areas. It has been suggested the efficacy of IPL is increased when combined with radiofrequency (RF) energy, producing results similar to that of laser. The device delivers intense pulse light first to heat the hair follicles and RF supplies thermal injury to the treated area.

The usual downtime with IPL modalities is minimal to none. Straight after IPL a slight burning sensation can occur for a few hours. Temporary discolouration can occur for around three to four days after the procedure and will flake off slowly. Short-term side effects include reddening of the skin (erythema), temporary bruising and oedema (swelling). Reactions such as scabbing and blistering are possible though rare. It’s important to protect skin from UV light with daily sunscreen application.

Photodynamic Therapy

Photodynamic therapy relies on a chemical reaction activated by light energy to selectively destroy specific tissues. When skin is exposed to a light source of an appropriate wavelength, its photosensitiser molecules are activated to produce oxygen intermediates that destroy the targeted cells. There has been evidence of photodynamic therapy working wonders for hair removal regardless of the hair colour or cycle, however more research is needed as it’s the newest kid on the block.

TIPS AND TRICKS

Dr Austin offers the following advice to patients considering laser or IPL:

• Avoid tanning before and after treatment – you cannot have a laser or IPL hair reduction treatment if you have a tan (fake or from sun-exposure or the solarium) because it can interfere with the absorption of laser light and may result in pigment changes in the skin.
• Patients should also avoid sun-exposure after a treatment as their skin will be sensitive and may burn more easily, which may also result in pigmentation changes. `We recommend that patients undergo treatments in the cooler months when they’re less likely to spend time in the sun, or to be meticulous in applying sunscreen if the treatments are performed in the warmer months,’ says Dr Austin.
• Laser and IPL work best on patients with dark hair and fair skin – laser and IPL machines work by using a light which penetrates the skin and is absorbed by the melanin (the dark colour) in the hair shaft, which then causes heat to transmit to the nearby germinal cells thereby destroying the hair follicle. Lighter hairs don’t tend to carry the heat from the laser or IPL as well because they contain less melanin and therefore these types of hair removal are usually less effective on light coloured hairs (eg. blonde, grey and white hairs).
• Check the credentials of the operator – it is important that patients receive a treatment from an operator that has been appropriately trained. `As lasers are medical-grade equipment I’d strongly recommend visiting a medically trained doctor who specialises in cosmetic treatments, as they can also keep an eye out for skin damage, such as pre-cancerous skin lesions or skin cancers’, says Dr Austin. During the process, the practitioner should also ask for a medical history (including any allergies or medications you are taking), cosmetic routine and potential sun-exposure. To check the credentials of the operator, patients should simply ask the operator about what training they‰Ûªve received or check their credentials online (ideally they will have received more than just the standard training from the company that sells the laser or IPL machine).
• Different results for different people – the results of laser and IPL treatments will vary amongst individuals so it’s important to have a realistic expectation of what the outcome will be before you undergo treatment.
• It is best to consider laser and IPL as hair reduction (rather than removal) treatments and when in doubt speak to the operator or your doctor about what you can expect.

BEWARE!

Consumers need to be aware that lasers and IPL machines are medical equipment. Patients considering permanent hair removal should visit a qualified and skilled operator who knows what they are doing.

`Anyone can now buy an IPL or laser device and set themselves up without requiring training or insurance – this situation really puts patients at risk,’ said Dr Gabrielle Caswell, President of the CPSA.The CPSA is calling for regulation of the procedures because consumers are currently at risk of being burned or injured when receiving a laser or IPL treatment from an unqualified operator.

Those interested in finding a qualified doctor who specialises in laser and IPL hair removal can visit www.cosmeticphysicians.org.au.