Unwanted or excess hair growth may appear on face as well as many areas of the body in both females and males. In case of females it can be on the upper and lower lips, sideburns, cheeks, chin, neck and both upper and lower extremities. In case of males it can be on ears, high on the cheeks, low on the neck, chest and back. Both males and females may desire hair free and clean armpits (axillae) and bikini areas for their personal reasons.

The common ways to remove unwanted hair including shaving, waxing, threading, plucking, tweezing or use ofdepilatory creams. However, all these methods are temporary. Electrolysis is permanent but is painful, time consuming and needs many lengthy sessions. There are many side effects including infection and pigmentation.In contrast to above, laser hair removal (LHR) is the only method, which is quick, relatively painless and effective for permanent hair reduction. A large area of the skin can be treated at one time making LHR faster and cost-effective than other methods.

Hair removal lasers have been in use since 1997 and have been approved for "Permanent Hair Reduction" in the United States by the FDA.Under the FDA's definition, "Permanent Hair Reduction" is the long-term, stable reduction in the number of hairs re-growing after a treatment regime.A treatment regime in case of LHR consists of a series of treatment sessions carried out at an appropriate interval for a recommended number of sessions. Here one must remember, that both the interval between treatments as well as the total number of sessions required differ from patient to patient and from one body area to another. Just in two decades LHR has become most popular because of its speed and efficacy. Efficacy mainly depends upon the choice of the laser technology and the quality of the laser system (machine). Nonetheless, the person behind the machine with his skill and experience can add significantly to the ultimate results.

The primary principle behind laser hair removal is selective photothermolysis (SPTL). In the simplest words, it is the matching of a specific wavelength of light and pulse duration to obtain optimal effect on a targeted tissue with minimal effect on surrounding tissue.[Chromophore is a material, either endogenous, present in the tissues, or exogenous, that is, introduces from outside, which absorbs particular wavelengths of light depending on its absorption coefficient.] Melanin occurs naturally in the skin and gives skin and hair their color.Melanin is the primary chromophore for all hair removal lasers currently on the market.Basal stem cells in the bulge portion of the hair follicle i.e. hair root are responsible for continued growth of the hair. Melanin of hair root absorbs laser, heats up and causes localized damage of follicular epithelium. There is no melanin in white hair; therefore they cannot be destroyed with laser. Pulse width is the duration for which the laser beam falls on the skin. It is one of the most important factor in laser treatment. The length of the laser pulse relates directly to the damage achieved in the follicle. Inthe hair follicleitself the main target zone is that of germ cells which surround the hair shaft. Light energy is absorbed in the melanin and the hair bulb gets heated. The heat then conducts out towards the germ cells. As long as sufficient temperature is maintained for the required time then the germ cells will be successfully destroyed. Only attaining the required temperature is not sufficient unless it is maintained for the corresponding time. To achieve these conditions the laser system must be able to generate the required power output. The main reason why hair removal fails is simply because the equipment cannot generate the desired temperature for the correct time.

There are three phases of hair growth: anagen, telogen and catagen. Anagen is active growth phase, telogen is resting phase and catagen is transition between anagen to telogen. Lasers can only affect the activelygrowing hair follicles in early anagen phase. Follicles in telogen or catagen phasecan be destroyed when enter into anagen phase, only then they. Hence, several sessions are needed to damage all the hair in an area of skin. Most patients need a minimum of six to nine treatments. The exact number of treatments depend on several factors on both, patient’s and operator’s side. Ethnicity or genetics, hormonal influence, area of the body, skin color, coarseness and color of hair,pain tolerance during treatment and body response to treatment are the factors from patient’s side. Laser technology which is best suitable for the type of skin being treated, topnotch laser system from amongst the plethora of machines available, perfect parameters selected and a technique honed over the years of experience when executed as per protocol gives the best possible results in the minimum number of sessions.Coarse and dark hairs on light skin are easiest to treat.

Some minor side effects may occur after LHR treatment, including redness and swelling; which usually disappears within a few hours. Mosquito bite like swelling of the follicles is considered as a normal reaction. This peri-follicular edema is a sought after treatment end point which indicates delivery of the most appropriate energy. Superficial burns can occur if the skin doesn’t tolerate the energy and which is more likely to occur in darker skin types or in tanned skin. Though bothersome to the patient, these dry brown marks peel off in a few days.Hypo or hyper-pigmentation occurring after this is extremely rare, correctible and does not leave any permanent marks. Folliculitis i.e. bacterial infection of the hair follicles can occur if post treatment care is not adequate. This is likely in patients who have regularly plucked their hair.

1.What care should I take if I am planning for LHR treatment ?

Before treatment, patients are advised to avoid undue sun exposure and tanning. It is preferable to use a broad-spectrum sunscreen with SPF 30+ or higher regularly till all treatment sessions are complete. Plucking, tweezing, waxing, or threading should not be done for at least 3 weeks before treatment. We prefer to see your hair growth pattern; therefore it is better to come for first consultation with the growth on. Females having irregular menstrual cycles or suspected to have PCOS (Poly Cystic Ovarian Syndrome) should get hormonal assay, abdominal ultrasound, and a gynecologist’s or endocrinologist’s consultation done preferably prior to laser consultation.

2. Any precaution on the day of laser treatment ?

On the day of treatment, the area should be clean and free of cosmetics including the sun bloc. If you haven’t used sunscreen, had unprotected sun exposure or tanned your skin then please inform the doctor. If you are used to get herpes eruptions (peri-oral blisters) then better to start Tab. Acyclovir. Lightening of moles in the treatment area may occur, therefore; you should inform the doctor beforehand so that your wanted mole can be protected.

3. What should I expect during the laser treatment ?

After examining, the area will be marked and clean shaved. It is necessary, because even the shortest of hair stub, protruding above the skin surface, can literally melt with the laser energy and burn the skin. The area being treated will be pre cooled with the ice packs. The diode laser system, LightSheer Desire (Lumenis, USA) also has a sapphire chill tip which keeps the skin cool before, during and after the laser pulse.The laser pulses feel like warm micro pricks entering the skin. You are supposed to give realistic feedback to the doctor regarding the intensity of the laser pulse received. Undue tolerance can lead to side effects.After the treatment you may continue to apply ice packfor some more time to sooth the burning sensation.

4. How long will my treatment last ?

A typical LHR procedure on face will last 15-45 minutes, and greatly depends on the area, or areas being treated. For treating body areas such as chest, abdomen, back, arms or legs, our system has a separate fast hand piece. It has a larger spot sizeof ?? mm X ?? mmwhich uses vacuum-assisted suction on the skin just before delivery of the pulse. This unique patented technology needs much lesser energy that increases patient comfort.

5. Can I go back to myjob ?

Patients can schedule an appointment early on in the day, or during the lunch hour and return to normal activities immediately after.

6. Can my ‘beard bumps’ be treated by LHR ?

The procedure is also an effective option for the removal of persistent, ingrown hairs that cause unsightly red bumps and skin irritations.

7. What care should I take in between treatment sessions ?

You should avoid sun-exposure and regularly use a broad-spectrum (UVA/UVB) sunscreen with SPF 30+ or more till your last treatment. You can continue to use cosmetics.

8. Will I never get hair growth after completing the treatment sessions ?

It depends on whether the area treated is influenced by latter hormone changes or not. Areas un influenced by hormonal changes like underarms and bikini areas in both the sexes and male hair distributed areas usually completely clear after required number of sessions. But, many females experience some regrowth of hair on their treated areas in the years following their last treatment. This means that although laser treatments will permanently reduce the total number of body hairs, they will not result in a permanent removal of all hair, as hormonal influence continues albeit intermittently. Some will need touch-up treatments, especially on large areas, after the initial set of 6-9 treatments.