Objective :
- Introduction
- Purpose
- Principle
- Lasers for hair removal
- Indication
- Contraindications
- Prerequisites
- Post procedure care
- Results
- Complications
Introduction :
Laser hair removal (LHR) is the most commonly requested cosmetic procedure worldwide.
Laser is an acronym for light amplification by the stimulated emission of radiation.
Stimulated emission is a process by which one photon can stimulate the creation of another photon by interacting with an excited atom or molecule.
Lasers work by pumping many atoms into the excited state from which a very large amount of stimulated emission can occur.
Purpose :
To improve skin appearance by removing unwanted hairs.
Principle :
Laser for skin work on the theory of “Selective photothermolysis”.
This term implies a site specific, thermally mediated injury of microscopic tissue targets by the selective absorption of pulses of radiation by the targets and chromophores.
The natural or artificial chromosomes absorbs monochromatic and broadband electromagnetic radiation of specific wavelength.
The chromophore for laser hair removal is melanin. Melanin absorbs light which damage the hair follicle, effectively results in hair reduction.
During laser hair removal, a laser emits a light that is absorbed by the pigment (melanin) in the hair. The laser goes through the skin surface to reach the root of hair follicles, light can be absorbed and converted into heat and damaged hair follicles that produces hairs. This damage inhibits or delays future hair growth.
Lasers for Hair Removal :
- Nd:YAG laser (neodymium-doped yttrium aluminum garnet)
- Wavelength: 1064 nm
- Alexandrite Laser :
- Wavelength: 755nm
- Diode laser :
- Wavelength: 800-810nm
Indication :
Permanent hair removal or Removal of excessive hair growth.
Contraindications :
Absolute:
- Pregnancy and Brest feeding
- Photosensitivity or sun tan
- Skin cancer
- Recurrent infection like herpes and cold sores
- Skin disorder like psoriasis, Bleeding disorders
- Active or recurrent infection and Previous surgery of the site
- Presences of Tattoos on the site of treatment area
Relative:
- Epilepsy
- Wound or ulcer near the site
- History of sensitizing medication like retinoids
- History of delayed or poor wound healing
- History of post inflammatory hyperpigmentation
Prerequisites :
- Stop waxing, tweezing, plucking for at least 3 weeks before coming for the laser session because it will pulls out the hair shaft.
- Do not expose the skin to sunlight or apply any self-tanning product at least 7 days before treatment to reduce chances of burn.
- Patients should not wear any makeup ,lotion, ointment on the area where laser is to be done. The area to be treated should always be free of any topicals.
- Stop using any chemical depilation at least 7 days before treatment.
- Stop any sensitizing medication such as isotretinoin at least 3 to 7 days before treatment.
- Stop using blood thinner for at least 3 days before and after treatment.
- Topical anesthesia can be used at least 45 min before treatment.
- Mark the area of the patient where treatment is to be done and trim the hair in the area to be treated.
- Retina contains melanin that can be damaged by wavelengths in the red and near-IR range, proper eye protection is absolutely critical for both the patient and physician.
Post procedure care :
- Advise the patient to don’t use facewash or soap for 12 hours as it can cause irritation and increase erythema.Can wash with simple tap water if necessary.
- Apply moisturizer that must be hypoallergenic because skin is too much sensitive after treatment.
- Apply the ice packs/cooling towels after treatment to alleviate the burning sensation.
- Don’t rub, pick or scratch the treated area.
- Do not wear any make-up for at least 24 hours.
- Avoid aggressive exercise or any type of physical activity that cause sweating for at least 48 hours.
- Do not use chemical peels for at least 1 week as it can cause irritation.
- Avoid sun exposure and apply a thick layer of sunscreen or sunblock when going outdoors or staying indoors.
- Avoid bleaching in the treatment area.
- Use of isotretinoin and other topical medication at least 3 to 7 days after the treatment.
Results:
While laser hair removal can significantly reduce the hair growth, it’s not always permanent.
Maintenance sessions may be needed to maintain smooth skin.
Side effects or complications :
There may be possible adverse reactions immediately after the treatment such as
- Mild or excessive pain
- Mild or excessive persistent erythema
- Superficial burn
- Cold or heat urticaria
There may be further adverse reactions between 4 and 12 hours after the treatment such as
- The treatment skin will be sensitive and fragile and therefore could tear when rubbed
- Hyper/Hypopigmentation
- Flare up of acne
- Reactivation of herpes simplex