Permanent Hair Reduction FAQ
The most commonly asked questions and answers about this laser treatment.
- Why use the Gentlelase laser for hair removal?
- How does Laser Hair Removal Work?
- How does hair grow?
- How does the Gentlelase work?
- What skin types is GentleYAG made for?
- What are the advantages over electrolysis?
- Why are 4 or 5 sessions needed?
- Should I expect to be "hair free" in the treated area after the series of treatments?
- How much hair will grow back, and how fast will it grow back?
- Is the laser treatment painful?
- What can I expect after the treatment?
- What are Hirsutism and Hypertrichosis?
- How can I get the best value from each treatment?
- What if I have moles, freckles and tattoos in the area to be treated?
- What will happen on the treatment day?
- Is the process the simple?
- What will happen after treatment?
- Why does the hair sometimes look like it's "growing" for 1-3 weeks after laser treatment?
- Are there any restrictions on my activity after treatment?
Why use the Gentlelase laser for hair removal?
Traditional techniques such as shaving, plucking and waxing, provide only temporary relief and may actually stimulate hair growth. Electrolysis, while effective, often requires years of ongoing and frequently painful treatments. Waxing, shaving, and chemicals (such as Nair) commonly result in scarring, allergic reactions, and ingrown hairs. Laser hair removal works by targeting the pigment inside the hair follicle without damaging delicate pores and structures of the skin. Because hair cycles through "growth" and "dormant" phases, and because during the "dormant" phase the follicle has no pigment, at least 4 to 5 treatments will be needed.
Laser hair removal is a non-invasive method of hair removal, which does not require needles or messy chemical creams. Since thousands of hairs can be zapped in a single treatment session, large areas like the back, shoulders, arms and legs can be effectively and efficiently treated. A patented dynamic cooling device reduces pain and maximizes patient protection by delivering a short, targeted burst of non-toxic cryogen onto the top layers of the skin milliseconds before the laser pulse. This evaporative coolant speeds up treatment, without affecting the underlying targeted hair follicles and blood vessels or impeding your visibility. The DCD is unique to Candela lasers eliminates the need for messy cooling gels and expensive anesthesia for most patients. Best of all, it helps decrease treatment times, and allows for quick recovery. Also, with a treatment spot size of up to 18mm, the treatments are very fast. For instance, a full back treatment can be completed in just 30 minutes! This treatment can easily be scheduled into your lunch hour!
How does Laser Hair Removal Work?
To understand how this method works, it helps to know a little more about how hair grows and how laser light vaporizes unwanted tissue.
How does hair grow?
Human hairs are comprised of three distinct parts: the bulb at the base of the hair follicle that produces hair, the shaft, and the hair follicle itself. Both the bulb and the shaft are embedded within the skin, leaving only the hair visible to the naked eye. For long-term hair removal, the hair follicle must be destroyed along with its germinating centers that are in the bulb. The GentleLASE most effectively disables hair that is in the active growth (anagen) phase. Because all the hair in a treated area may not be in the anagen phase, more than one laser treatment may be necessary to remove the hair that subsequently enters the growth phase.
How does the Gentlelase work?
A laser produces a beam of highly concentrated light. Different types of lasers produce different colors of light. The light emitted by the GentleLASE is absorbed by the pigment (melanin) located in hair follicles (melanin pigments give hair its color) and hair shaft. The laser pulses for a fraction of a second, just long enough to vaporize the pigment, disabling several hair follicles one at a time to eliminate or significantly impede the hair's re-growth - but not long enough to damage the surrounding skin. The GentleLASE's special contact-cooling hand piece further protects the epidermis (upper layer of skin). This patented method of epidermal preservation allows delivery of more laser energy deeper into the hair follicle. Although the GentleLASE is FDA approved for all skin types, it is excellent in treating Skin Types I-III. It is delicate enough for a woman's fine, sensitive skin and robust enough for a man's beard, back, or arms. In addition to a patient's skin color, their hair color also influences the success of laser hair removal. As a rule, the pigment in dark hair absorbs more laser energy, making black or brown hair easier to treat. Light hair, such as blonde or red, contains a pigment that absorbs laser energy less readily, and therefore does not respond with permanent hair reduction.
What skin types is GentleYAG made for?
We have a different laser that is made just for these skin types. Previous to the release of Nd:Yag lasers, treating dark skin for hair reduction was risky and sometimes painful. The Candela GentleYAG system safely and effectively treats a wide variety of cosmetic skin problems that before now were difficult or impossible to treat. Our GentleYAG laser technology is known for its ability to provide permanent hair reduction in Skin Types IV-VI and tanned skin. The GentleYAG System, a revolutionary long-pulse high-energy laser emits a gentle beam of light that harmlessly passes through the skin where it is absorbed by the target. The laser energy is transformed into heat, leaving the surrounding skin unaffected. The Dynamic Cooling Device provides the most comfortable treatment available and protects the outer layer of skin. Our Candela GentleYAG system can uniquely remove unwanted body hair on all skin types without damaging the skin or causing hyper-pigmentation.
What are the advantages over electrolysis?
With electrolysis, the operator inserts a needle into the hair shaft with the intention of reaching the follicle, then sends a small electrical charge designed to disable the follicle. The operator then removes that particular hair with a tweezer. Hair removal is much faster with a laser as the laser is pulsed about once per second across the surface of the skin. Each "pulse" of laser light disables a large numbers of hair follicles. Electrolysis operators can only treat those hairs that they can see and which they can reach the follicle through the hair shaft. A laser treats any "active" follicle, even if the hair has not yet reached the surface of the skin, or if the hair shaft is not straight.
Why are 4 or 5 sessions needed?
All lasers work by disabling hairs that are in their active growth cycle at the time of treatment. Hair follicles in their "dormant" phase have no hair shaft in them and so will not be affected by the laser.
Because hair follicles cycle through "active" and "dormant" phases, additional sessions are usually desired once the "dormant" follicles become "active". The other groups of hair follicles that produce dark terminal hair in the future are the fine vellus “peach fuzz" follicles, which have no pigment and so are not affected by laser treatment. If some of these fine little “peach fuzz" follicles mature into terminal hair follicles, they can be treated with laser at that time.
Newer lasers use the longest, most deeply penetrating wavelength, and maximize the number of killed hair follicles and minimize the number that are stunned during each treatment session. At any one time, depending on the location on the body, 30% to 75% of your hair follicles are in the active (anagen) phase. Yet only 1/4 to 1/3 of your hairs have enough of the pigment in their ROOTS to absorb the laser beam which destroys the hair root. The bottom line: About 1/4 (25%) of your hair roots are good targets for the laser beam and can be damaged or destroyed in any single laser session.
Because 1/4 of the actively growing pigmented hair roots are damaged or destroyed in any one session, almost all people will want a minimum of four to five treatments to reach a satisfactory degree of hair reduction. Many people will wish to have more than four treatments, most commonly 5 to 7 treatments; and in some cases another session in six to twelve months to eliminate any terminal hairs that have developed when vellus hair follicles mature into terminal hair follicles. We recommend & sell packages of 5 treatments, with touch ups at a very reduced cost should you desire them.
The number of treatment sessions required will also depend on:
- The desired degree of hair reduction (as the amount of hair declines, some people become very enthusiastic and want even LESS hair than they had originally planned on having removed)
- Hair color (people with naturally light colored hair sometimes need more treatments)
- Ethnic and genetic background (people with dark skin sometimes need more treatments)
- Hormonal status (Polycystic ovarian disease can cause an over-growth of hair and it is impossible to get the same results of someone not suffering from this disease.)
- Area being treated (The upper lip is commonly the most difficult to treat)
- Hair density (Courser hair is easier to treat)
- Weight (obesity can increase hair growth)
- Medication (for example medicines like Dilantin and cyclosporine can increase hair growth)
Should I expect to be "hair free" in the treated area after the series of treatments?
No, most patients experience an 85-90% reduction in the amount of hair in a given area and a reduction in the thickness and color of the remaining hair, but should not expect to be "hair free". It has been suggested that a 6 month follow-up may be sufficient to assess final outcome after the final laser hair removal session, because once re-growth has stabilized (usually within 6 months), there is usually little or no change in hair counts at 6,12, and 24 months.
How much hair will grow back, and how fast will it grow back?
The laser/pulsed light work by destroying hair roots which are active at the time of treatment, and which have enough pigment to absorb sufficient laser energy. The hair shafts in the treated hair follicles will fall out or be "shed" for 1-3 weeks after treatment. After the first treatment, hair re-growth may resume within a few weeks or it may be anywhere from 2-4 months before any true hair growth is observed. Previously dormant hair follicles become active, and hair follicles that were “stunned" but not killed recover and start to produce hair shafts again. Some people find that there is not much extra hair reduction after the second treatment, then they notice a substantial further reduction after the third or more commonly the fourth treatment. After four to five treatments there may be little or no re-growth often for years. In other cases, you may wish to have additional touch up treatments after a period of time. The hair fibers that re-grow after laser treatments are generally finer and lighter in color, and so are much less of a cosmetic concern. Reductions in coarseness and color can occur independently of each other.
Is the laser treatment painful?
While some areas of the body are more sensitive than other areas, most patients report little or no discomfort. As stated above, sensitive areas of the body such as the face and bikini will be anesthetized. Other areas usually do not require this.
What can I expect after the treatment?
A typical laser hair removal patient may experience brief swelling and redness similar to sunburn following the procedure. The majority of the redness will fade in 2-3 hours and the skin will return to normal, although some redness may possibly last as long as 2-7 days. Hairs will visibly shed for up to 3 weeks after treatment, and may be mistaken for "re-growth". Using a loofah sponge or salt scrub will help to exfoliate the loose hairs. Repeat treatments are scheduled between 6-12 weeks apart, depending on the area being treated.
Following laser hair removal, patients can return to their normal activities immediately. As always, patients should avoid any direct sun exposure and use a sunscreen with a minimum Sun Protection Factor (SPF) of 30 with Zinc Oxide since the treated skin will be very sensitive to the sun. As with electrolysis, cases of scarring have been reported in the medical literature, but these are extremely rare. A test spot is the best determinant of how each individual's skin will react.
What are Hirsutism and Hypertrichosis?
- Hirsutism is excessive growth of hair in androgen (testosterone)-dependent areas of a woman's body where terminal hair is not normally found, including the face, neck, chest or medial thighs.
- Hypertrichosis is excessive growth of hair in non-androgen dependent parts of the body (i.e. Areas other than the face, neck, chest and medial thighs).
Patients with these disorders CAN be treated, but should not ever expect to have the same results as someone without these disorders.
How can I get the best value from each treatment?
- Avoid waxing, tweezing, plucking, and electrolysis. Because the laser seeks out and destroys ACTIVELY GROWING hair roots, it is important (if you want to get the best value from your treatment) NOT to wax / pluck / tweeze / use EpiLady-type pluckers or have electrolysis for FOUR to SIX WEEKS before laser treatment. These things temporarily remove the pigmented part of the hair follicle that the laser needs to use as a target when it destroys the hair follicle.
- Shaving or clipping the hair? A good idea… a must idea. Shaving or clipping the area to be treated is not a problem. In fact, we like the areas to be shaved 4-24 hours before treatment. Some people find that the skin is less sensitive if it is shaved at least 4-24 hours before treatment. Another advantage of shaving the area to be treated BEFORE the appointment is that YOU can shape the area to be treated exactly the way YOU want it to be. This is of particular importance in areas like the sideburns, temples, and bikini line/bikini area/pubic area. If our office has to shave the area for preparation there may be a surcharge for this service. The fee structure is based on patients preparing the area by shaving prior to treatments.
- Excess hair should be removed from the treatment area before treatment, because hair ABOVE the surface of the skin will simply absorb and waste laser energy and keep it from getting to the hair root, where it is needed.
- Contrary to popular belief, shaving DOES NOT make hair grow back thicker, faster, darker or more profusely! So go ahead and shave before treatment.
- Timing: It takes 6 to 12 weeks for the next crop of hair roots to become active and develop pigment which is the target for the laser. So, to get the best value from your treatments, you should wait 6-12 weeks between treatments. 8-12 weeks is usually ideal.
There is no harm in having treatments MORE FREQUENTLY than every 6 weeks, or having treatments less than 6 weeks after waxing, plucking, etc. -- but this is less efficient, and could increase the total number of treatments needed to get a good result.
Also, while there is no harm in waiting MORE THAN 6-8 weeks between treatments (for example, if there has not been much re-growth after your last laser treatment), there is usually no extra BENEFIT to waiting longer than 12 weeks between treatments.
- Medications? We are not aware of any mandatory medications that should not be taken while you are getting laser treatments. Anabolic steroids should certainly NOT be taken unless medically necessary, because these can increase male-pattern hair growth in some cases. Women who take injections of (testosterone & estradiol) as part of therapy for menopause and to increase libido often experience unwanted hair growth, which can be treated with laser hair removal. We still prefer the patient to hold tetracycline class medications for several days before treatments if possible, due to sunlight sensitivity issues. Please avoid the use of Accutane™ for at least six months prior to any laser treatment.
Medicines that inhibit hair growth (for example, spironolactone, birth control pills, and Vaniqa cream) might slightly reduce the pigment in hair roots and make laser treatment less efficient, but this seldom interferes with the effectiveness of laser treatment. Laser hair removal can certainly be done WHILE you are on those medicines, if you wish. These "anti-androgenic" medicines produce gradual but temporary effects, and will not remove unwanted hair from areas that are independent of androgen regulation.
Pre-treatment with medicines like Zovirax, Valtrex or Famvir is NOT necessary, unless you have had cold sores in the area to be treated. Please notify us of any incidence of herpes infections so that we can prescribe the proper prophylactic medication.
What if I have moles, freckles and tattoos in the area to be treated?
Small moles and freckles do not require any special precautions. Large, dark moles and freckles which are to be treated may require a reduction in the intensity of the laser light, the same way that the intensity would be reduced when treating a dark-skinned or tanned person. Large areas with tattoos are best left untreated. Be sure to tell the doctor if you have permanent lip liner or permanent eyebrow liner, as these areas require special precautions if the surrounding area is being treated.
What will happen on the treatment day?
Other than your regular skin care routine there is no standard "prep" for this procedure.
- Please do not wear makeup on the areas to be treated, because some kinds of makeup can absorb and waste laser energy, or even heat up to the point where your skin would be irritated. Makeup will need to be removed before treatment, and may be re-applied immediately after treatment if you wish. There are no restrictions on what you may eat or drink prior to your appointment.
- Please shave or clip the areas to be treated before you come in for treatment. Freshly shaved skin is more sensitive, and there is less discomfort if you wait at least 4-24 hours between shaving and having laser treatment. Shaving also allows you to shape the exact area you want treated -- this is sometimes very useful in the bikini area. Excess hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the hair root, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin.
- After all of your last minute questions have been answered and paperwork handled, pre-treatment photos may be taken of the areas you wish to have treated.
- Everyone in the treatment room must wear protective goggles when the laser is turned on. Eye injuries can occur if proper eyewear is not worn while the laser is used.
- The length of the procedure itself can range from a few minutes for the upper lip to an hour (for example, a man's chest or back).
- If you decide before coming in that you would like to have additional areas treated, please call ahead so that we can schedule enough time to accommodate your needs.
Is the process the simple?
Yes! A topical numbing agent will be applied to sensitive areas (face or bikini) for 45 minutes. The cream is removed and the procedure starts with the doctor or nurse applying even pulses to the area treated. The cryogen spray takes care of the discomfort of the laser and the treatment is generally painless. Some people find the FIRST laser treatment more uncomfortable than subsequent treatments. This is due to the fact that there are more hair roots that are being destroyed during the first treatment. Some people find it helpful to simply take two or three plain Tylenol a couple of hours before coming in for treatment. Some women find that they are less sensitive after their monthly menstrual period. Women may prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time.
What will happen after treatment?
Redness often has faded greatly by the time you get home. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favorite moisturizer or an Aloe lotion or cream. The hair follicles may appear slightly more obvious or a bit pink for the next day or two, but this is seldom a cosmetic problem, and generally much less obvious than after waxing, plucking, or tweezing.
Why does the hair sometimes look like it's "growing" for 1-3 weeks after laser treatment?
Lasers destroy hair roots that are active at the time of treatment, but do not remove hair shafts instantly. Hair shafts in the treated hair follicles will fall out, or "shed" in the first week after treatment, with all of the treated hairs falling out within 2-3 weeks. It is normal that some hairs in the treated area may not fall out within 2-3 weeks. These will be treated in the next session. These hairs which are being shed will come out by themselves. For 3-4 days after laser treatment it is best not to shave the treated area or to wash it with anything but a mild soap like Dove, Purpose, or Cetaphil and your bare hand (no Buf-Pufs, or scrubs.) Some people find that their skin feels irritated. Please be very gentle to your skin.
Are there any restrictions on my activity after treatment?
Since the laser does not burn or cut the skin in any way, bandages are necessary. You can return to work the same day and resume all your regular activities. To reduce the chance of uneven tanning in the treated areas, you should minimize sun exposure and tanning for at least a week or two after. It is OK to resume shaving or clipping hair in the treated area after 3-4 days. You should NOT have waxing, plucking, tweezing, or electrolysis, because these things will temporarily remove pigmented hairs from the hair roots and reduce the effectiveness of your next laser treatment. Shaving is the BEST temporary way to remove unwanted hair before laser treatment and between laser treatments.
You can shave as often as you want. It has been shown in scientific studies that:
- Shaving does NOT make hair grow faster.
- Shaving does NOT make hair grow thicker.
- Shaving does NOT make hair grow darker.
- Shaving does NOT make hair grow more profusely.
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