Body Hair Removal

Posted Thursday, September 13, 2007 to PROCEDURES > Skin

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Jodi Thiessen spoke with Las Vegas cosmetic laser surgeon Edward Zimmerman MD about advances in laser hair removal.

What is the best method for body hair removal? Shaving requires commitment and there is the possibility of razor bumps. Waxing is very painful. Ditto plucking, and it's tedious and only really practical for eyebrows. Electrolysis is painful and expensive. Epilation is messy and can cause irritation.

Lasers are one way body hair can be removed easily, quickly, fairly painlessly and with long lasting results.

Many lasers were originally developed for removing tattoos and skin complaints, such as vascular birthmarks. These lasers are not powerful enough to effectively remove hair. Now there is a range of hair removal lasers including: Ruby (694nm), Alexandrite (755nm), Diode (S00-S10nm)and Nd:YAG (1064nm). As a patient, finding your way among the miriad of hair removal lasers can be a nightmare.

Lasers vary in many ways - wavelength, energy levels and method of delivery. They also differ in the size of "spot" they put out (area being treated with laser light pulse). This relates to the color of hair that can be treated, color of the skin and how many sessions are needed to minimize the hair.

The principle of lasers is based on light absorption. Certain target tissues will absorb certain wavelengths of light more effectively. As the laser light is monochromatic (of the same wavelength/color) the target tissue will take on maximum absorption while the surrounding tissues won't. This allows the target to be isolated and treated.

The target is believed to be the pigment melanin, which gives hair it's color. Blood (hemoglobin) has a similar yet different absorption curve so a laser can target one the hair or the blood - and not damage the other surrounding tissue. The diode laser has one of the higher wavelengths (nanometers, nm relating to wavelength) and is able to determine between the two targets. Las Vegas laser surgeon Dr Edward Zimmerman explained: "Diode is one of the higher wavelengths so there can be penetration without huge amounts of scatter and the necessary energy can reach down to the base of the hair follicle." He continued: 'The hot debate is what we are destroying. Are we heating up the pigment at the base of the hair follicle? Are we destroying the bulb? Are we destroying the tiny blood vessels that feed the hair? We don't know right now."

There are certain aspects of a laser that have been shown to work, pressing down on the skin during application and cooling the skin before the laser hits it. A new diode laser on the market is the MeDioStar (Asclepion-Meditec) and it has both of these functionalities.

"It seems simple, but if you particularly want to go after hair, pressing down on the skin allows the laser to blanch the blood vessels and also narrows the distance between the surface of the epidermis and the base of the hair follicle. So you can get more energy in a shorter distance without putting as much energy in the tissue," explained Dr Zimmerman.

The MeDioStar uses a new cooling mechanism that cools the surface, and only the surface, of the skin to zero degrees. "There is an aluminum foot piece a little bigger than the spot size of the laser," said Dr Zimmerman. "The foot piece is always moving in front of the laser so the epidermis has been cooled to the point where the laser energy goes through it as if it wasn't there and it doesn't cause any noticeable change to the skin except a little redness."

Because only the top layer of the skin is cooled, the base of the hair follicle stays at body temperature. If it was cooled as well the laser wouldn't be able to deliver enough heat energy to damage the follicle.

It also makes the treatment very comfortable. "One patient said it feels like a little hot pin, but most say it feels like a fine scratch," explained Dr Zimmerman.

Hair goes through 3 periods of growth: an active growth (anagen); a stage where it stops growing and prepares to fallout (catagen); and a resting phase (telogen). It is only during the growth phase that hair reacts to light - which is why more than one treatment with any laser will be necessary to disable all hair growth.

As the light is thought to target melanin, blonde hairs are harder to eradicate. The diode is applicable because of it's high wavelength - it is able to treat lighter hair and darker skin. However the ideal candidate is always a person with dark hair and light skin. The lighter the hair and darker the skin the more likely problems will occur such as pigmentation changes in the skin or blistering. People who do not fit the ideal criteria may need more treatments to get their ultimate result.

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