Laser hair removal has become popular in last 20 years. Because laser technology offers the fast, safe, and effective treatment of unsightly hair. Even published studies have confirmed the long-term efficacy of laser treatment in commercials you come across the claim that laser hair removal has severe side effects.
Removal of hair by light can be accomplished, in theory, by 3 mechanisms: photothermal destruction through local heating, photomechanical destruction through the generation of shock waves, or photochemical destruction through the creation of toxic mediators such as singlet oxygen or free radicals. Light sources that destroy hair photothermally include the long-pulsed ruby (694 nm), long-pulsed alexandrite (755 nm), long-pulsed diode (810 nm), long-pulsed Nd:YAG (1064 nm), and intense-pulsed light. Radiofrequency also injures hair photothermally. A Q-switched Nd:YAG laser (1064 nm), with or without the addition of a topical carbon suspension, destroys hair mechanically.
Using the theory of selective photothermolysis, laser hair removal will be more effective in those patients with light skin and dark hair. Those with darker skin are more difficult to treat, although it is possible. For treatment of light hair, combination radiofrequency and optical devices as well as photodynamic therapy, is under investigation.
Complications can occur after laser hair removal, but can be reduced through an understanding of the fundamentals of laser treatment. The goal of laser hair removal is to damage the stem cells in the bulge of the hair follicle by targeting melanin, the endogenous chromophore used by laser and light devices to remove hair. The competing chromophores in the skin and hair—oxyhemoglobin and water—have a decreased absorption of between 690 nm and 1000 nm, thus making this an ideal range for laser and light sources. Typical complications include scarring and pigmentary changes; less obvious ones include reticulate erythema and ocular complications . Periorbital epilation should be performed with caution until further studies have been undertaken regarding the potential damage to the intraocular structures with this procedure. Until then, patients need to be informed of the rare but potentially serious side effects of this particular laser cosmetic procedure.
Laser hair removal is now widely accepted as a safe technique to remove unwanted hair in both men and women. Although overall incidence of adverse effects after laser hair removal appears to be low and transient, these side effects can be more common when laser hair removal is carried out by untrained personnel. There is a misleading advertisement that hair act as a deterrent to prevent bacteria on the skin which result in acne. However, after a successful laser session pores get smaller and skin becomes smoother.
Light absorption of the pigmented hair shaft and surrounding follicle is an important factor in hair removal; therefore, the patient should avoid plucking, waxing, or electrolysis before laser therapy. Shaving and bleaching the hair, which preserve the hair shaft, are allowed. Depilatory creams, which are less likely to disturb the follicle than plucking, waxing, or electrolysis, can also be used, as the hair shaft is not absolutely necessary for laser hair removal.
The abundance of melanin in the epidermis of patients with dark skin colour has been regarded as hazardous because of the increased incidence of side effects in this patient population. Similarly, sun avoidance should be emphasized, as a patient with tanned skin is at a higher risk of epidermal damage.
After therapy, patients should be given ice to decrease pain and reduce swelling. Topical corticosteroid creams help to minimize posttreatment erythema and edema; they also decrease the duration of hyperpigmentation. Antibiotic ointment is recommended if epidermal injury is noted. Patients should be advised to continue avoiding sun exposure. If epidermal injury has not occurred, makeup can be applied the day after treatment.
Family physicians are increasingly involved in supervising laser hair removal. The knowledge about the cutaneous side effects of this technique and its clinical presentation is important for prevention and patient counseling, as well as correct diagnosis and treatment of complications.