Sites of hair growth:

Females commonly have hair on the face, axilla, groin, legs and in males, chest, back, shoulder, neck, and hair above the ears is a concern.

Causes of hair growth/indications of hair removal:

• Hypertrichosis: Hypertrichosis means hairs grow in androgen-independent areas. It can be caused by genetics, drugs like steroids, thyroid disease, malnutrition, anorexia nervosa, and cancer.
• Hirsutism: In this, due to the testosterone hormone in the females, there is hair growth in unwanted areas such as chin, sideburn, chest, thighs, back, and abdomen. This is due to PCOD or tumor of the adrenal glands.
• Cosmetic reasons: There are mainly cosmetic reasons behind the removal of unwanted hair. Females want to remove hair from armpits, legs, upper lips. The reasons for this can range from cultural practices to general awareness. Recently many males undergo laser treatment for beard shaping, neck/legs.
• Medical reason: Sometimes laser hair removal is done due to hair-related diseases like pseudofolliculitis barbae, pilonidal sinus, skin graft, and hairs trapped in keloids sinuses. In pseudofolliculitis barbae, commonly known as razor bumps, hairs are curly or spirally after shaving and they cause inflammation.

What are different hair removal technologies?

The most commonly used temporary methods in hair removal are threading, plucking, shaving, waxing, and chemical depilation. These are easy methods but are quite tedious and inconvenient. They also do not do permanent hair reduction. Their results mostly last for 2 weeks. Permanent hair reduction involves laser hair removal and electrolysis.

Let us see about these techniques.

Electrolysis is considered a gold standard treatment. In this, a small size needle is inserted into the hair root and the hair follicles are destroyed by electric current. It gives results in all types of hair like white, red, blonde, and black hair. Its downside or disadvantage is that it is a very slow process. It is not suitable for treating very large areas. The experience of the doctor is very important in this and it gives variable results as you have to go through to the precise hair follicle depth.

Why laser hair removal is superior to all other technologies?

LHR is a very selective procedure, it does not require any needle insertion like electrolysis. The laser rays target the hair follicle. This is a very fast procedure. A complete facial treatment can be completed in just 5 to 7 minutes. The chances of problems in this are negligible.

How laser works?

Laser hair removal procedure is based on the principle of selective photothermolysis. In this, light energy is converted into heat which selectively damages the hair follicle. Melanin is a natural skin pigment that provides color to the skin and hair. There are two types of melanin, eumelanin which gives brown-black color, and pheomelanin which gives red color. Laser hair removal targets eumelanin, due to which lasers give very good results in hairs of black color and because of which lasers do not work due to the lack of black pigment in red and white hair. In LHR hair melanin absorbs light and its temperature increases. Simultaneously, there is heat diffusion in the stem cells of the hair root. The stem cells that make up the hair get damaged. This process is called selective photothermolysis.

What are different laser or light technologies for hair removal?

In laser and light technology, ruby, alexandrite, diode, nd yag and IPL are the common technologies used.

• Ruby laser: Ruby laser was the first laser that was used for the first time in laser hair removal. Right now we have much better options than that, so not many use Ruby ​​laser.‍
• 755 nm Alexandrite laser: 755 nm Alexandrite laser is not suitable for our Indian skin type as it has chances of having problems.
• Diode, nd yag, and IPL are used in most Indian patients because their safety profile is quite good.‍
• Diode laser: 800,810 nm wavelength diode laser is safe for skin types 1 to 5 and gives very good results. You can expect 75 to 90% results from this laser.‍
• ND-Yag: 1064 nm wavelength nd-yag laser is the best combination of safety and results for dark skin type. You can expect 70 to 90% results from this laser. Due to the long wavelength, it penetrates deeper so that the melanin of the skin absorbs less laser energy and the side effects are much less.‍
• IPL: IPL is a light-based treatment. Usually, the wavelength of 600-1200nm is used in this. Their results are less than Diode and Nd-yag. Their spot size is bigger, due to which they can do very fast treatment. Usually, it is used for arms, legs, and full body hair removal treatment. In Indian skin type diode or Nd-yag give equivalent result but if you talk about side effects or safety profile then Nd-yag is better.

Q-switch lasers are less commonly used.

How do I do the process?

How do we decide the treatment of LHR patients at Arra Aesthetics?

As soon as a client or a patient comes to us, I first assess the history of their hair growth in detail. Where is the hair, how many hairs are there? Do they have symptoms of any disease due to which hairs come in unwanted places like PCOD or thyroid or is there any medication history of which medicines can cause hair growth like steroids, hormones, or menstrual irregularities? I ask the patient about their treatment modalities if they have had other treatments. Which laser was used, what was its power, the date on which the last treatment was done, and how was the patient’s response to treatment? Most of the patients do not know the details of the machine but it is necessary as it can give me an idea as to why the patient did not get good results in laser hair removal. If I suspect any disease that is causing unwanted hair growth like PCOD, thyroid gland, or adrenal gland, then I do a complete biochemical workup and ultrasonography pelvis so that treatment can be started on these diseases. The results of laser hair removal for these patients can be better only if you do disease treatment. I advise the patient to always expect realistic results. Permanent hair reduction is our goal. Also, I explain well to them that lasers will not work on white, red, and blonde hairs. I recommend electrolysis treatment for them.

Why are repeated sessions needed?

There is a question in the mind of every patient that why hairs cannot be destroyed in a single session. Why is there a need for frequent treatment sessions? It would have been good for us doctors too. If we try to understand the answer, why do we have to do this? So it depends on the hair growth cycle. There are three phases of hair growth. Anagen means growth phase, catagen means regression phase, telogen means resting phase. Lasers work only on those hairs which are in the anagen phase. About 70% of the hairs on the face and 50% of the hairs on the arms and legs are in the anagen phase, the rest of the hairs are in the catagen or telogen phase. It takes 4-10 months to get into the anagen phase again. This is a major reason to do repeat sessions. The second main reason is that lasers destroy stem cells by indirect action. The duration of the anagen phase is different for different body parts. Accordingly, we plan treatment sessions.

How to get the best results in laser hair removal?

How do we ensure that you get the best results with laser hair removal?

I follow a process according to which your detailed history is discussed and examination is done. The reasons for hair growth are ascertained and if you have hair growth due to any disease, then medicines are prescribed along with laser treatment for them. Each patient has to use the right amount of laser power and frequency while doing laser hair removal treatment according to their skin type. The most important thing is which laser machine the clinic uses. On this also the results depend. We have the best QOOL-epilation laser hair removal system, due to which we can complete the treatment in a record 50% less time. I will share the details of this technology in another blog.

• Complications: After laser hair removal, it is normal to have redness and slight swelling at the site of the hair. If your doctor has a good quality laser machine, then in the areas of treatment blisters, burns, scars, pigmentation, or darkening are not common complications these days. Most important is for you to understand that paradoxical hypertrichosis is an unusual condition that occurs in 10% of patients in which after laser hair removal, there is hair growth on the side from where the hair is removed. The laser helps in hair growth in this case.

• Ideal number of sessions: It depends on which area of ​​the body the hair removal is being done, what is the growth pattern of the hair, and which laser technology is being used. If you do not have any problem with hormones then 6 sessions are sufficient and if there is a problem then it can take 10-12 sessions. 10 to 15% of patients are resistant to treatment because of this it may take more sessions.

Ideal interval between two sessions:

What should be the time between the two treatment sessions?

There is usually a gap of 4 to 6 weeks between the two treatment recommendations. It depends on which part of the body we are treating. Arra Aesthetics has QOOL-epilation technology, under this, we complete 3 treatment sessions in 1 month, whereas in a normal laser, only one session can be done in 1 month.

What precautions you should take before LHR?

Waxing and plucking should not be done within 2 weeks of the planned laser hair removal. Sun exposure should be avoided.

What to expect after LHR?

You should expect a 15 to 20% hair reduction after each laser hair removal treatment session. If you correctly complete your treatment sessions on time then you get 70-90% results. You should never do one treatment session today and another after 2 months. You will not get results at all. It is a continuous process and it is necessary to have treatment sessions on time.

Safety of LHR:

Laser hair removal is a safe procedure. Thousands of patients do hair removal every day. I give a demo of the ultraselectiveness of QOOL-epilation technology to all the patients who visit us at Arra Aesthetics.

These are the results of some laser hair removal treatments, after seeing which you will probably feel confident about the treatment.

What is meant by permanent word in LHR?

Many patients have misunderstanding about permanent hair reduction. They understand that permanency means hairs will never grow. Fortunately with laser hair removal treatment, the process of hair growth slows down i.e., the amount of hair becomes much less than before. Vellus hairs are usually very thin and golden hairs of small size on our body. So you should expect this and not complete hair removal.

I will give you information about our QOOL-epilation technology in the next blog in detail.