Hair on Face and Body

A few days ago a middle aged married woman, walked into my clinic with complaints of slowly progressive hair growth on her face and legs. I could see the anguish and shame on her face, when she said that she shaved her upper lip weekly and waxed her legs and arms monthly. With tears in her eyes, she confessed that she is losing self confidence and self esteem, which badly affects her family life and profession.

Having too much hair on the face and body can be highly embarrassing and cause great distress especially for women. Hirsutism or too much body and facial hair in women may be hereditary, ethnical or part of underlying medical/hormonal problem or without any obvious reason. Your doctor will be the best person to analyse the cause.

Shaving, bleaching, plucking, waxing, threading, sugaring with lemon and application of depilatories will remove hair temporarily, but can cause irritation and allergy. Electrolysis permanently removes hair, but has become very unpopular now due to its irreversible adverse effects.

What is the best available solution?
Laser-assisted hair reduction is the most efficient method of long-term hair removal currently available. Several hair removal systems have been shown to be effective for this: neodymium:yttrium-aluminium-garnet (Nd:YAG) laser, ruby laser, alexandrite laser, diode laser and the intense pulsed light (IPL) are some of them. The parameters used with each laser system vary considerably.

How does LASER work?
All these lasers work on the principle of selective photothermolysis of the hair, with the melanin pigment in the hair follicles as the target for laser beam. (Selective photothermolysis means the precise targeting of a tissue using a specific wavelength of light with the intention of absorbing light energy into that target area alone, thereby producing sufficient heat to damage the target while the surrounding area remain relatively untouched) It is generally believed that hair follicles are more responsive to treatment while they are in the growing (anagen) phase.

What can you expect during and after the procedure?
Regardless of the type of laser used, multiple treatments are necessary to achieve satisfactory results. Hair clearance, after repeated treatments, of 30 to 80% is generally reported 6 months after the last treatment. Maintenance sessions may be required for some. Patients with dark colored skin can be treated effectively with comparable morbidity to those with lighter colored skin. Although there is no obvious advantage of one laser system over another in terms of treatment outcome, laser parameters may be important when choosing the ideal laser for a patient. Laser hair reduction can be performed on face, body, armpits, bikini area, hands and legs.

Can Laser hair reduction be performed in men?
Of course. Laser hair reduction is of particular value in men, in treating “shave bumps” which commonly occur in the neck area due to incorrect shaving methods. It is also used to remove unwanted hairs from the body and also to shape the beard and moustache.

What are the usual treatment guidelines?
Before treatment starts, all patients must thoroughly understand the procedure and the need to repeatedly treat the affected area, so that their expectations are realistic. A detailed medical history is taken to identify the cause of hirsutism, which may be amenable to medical treatment. Patients who have very tanned skin are advised to wait till their skin color is lighter before treatment starts, Unwanted hair on the proposed treatment area is shaved before treatment. Waxing or plucking of hairs however is not advisable before treatment.

During treatment, both the operator and patient wear protective goggles, and a smoke evacuator is used if available. A test patch is usually performed before full treatment. When treatment is on the face, the test patch is usually selected on the chin area or behind the ears. Cooling gel is applied to the proposed treatment area if a cooling tip is not available. Darker colored hairs respond better to treatment, and lighter colored skin tolerates higher laser energy. After treatment, some charred hair follicles may remain in the follicular canals giving an impression that unsuccessful treatment has been given. These charred hair stumps may eventually fall out. It must be noted that white or grey hairs do not respond to laser treatment.

After each treatment, patients are advised to avoid sun exposure (or to apply sun screens) to the treated area. It is advisable to follow your doctor’s instructions carefully.

Repeat treatment is usually given when the hairs start to regrow (approximately after an interval of one month)

What about pain during the procedure?
Since most patients describe the treatment as less painful than either waxing or electrolysis, topical anesthesia (creams, spray etc) is optional.

What are the possible side effects?
Redness of the skin immediately after treatment is almost universal, and should resolve within a few hours to a few days. Crusting and blistering of the skin may occur and usually heals within a week to 10 days. In case of post-laser colour changes in the treated area, no specific treatment is usually given as they are self-limiting, and usually resolve within 6 to 8 weeks.

How can you minimize the side effects?
Methods to reduce the incidence of adverse effects include lightening of the skin and sun avoidance prior to laser treatment, cooling of the skin during treatment, and sun avoidance and sun protection after treatment. Proper patient selection and tailoring of the laser parameters used to the patient’s skin type remain the most important factors in efficacious and well tolerated laser treatment. Although complications are relatively rare and self-resolving, care has to be taken to ensure proper counseling and treatment is given at the earliest opportunity.

What will it cost for laser hair removal?
Treatment cost varies with the size of the area treated.

Conclusion:
Laser-assisted hair removal is a well tolerated and effective method of long term hair removal if performed with care. It can help you feel and look your very best, no longer questioning how you look when you show off a bit of skin.

Dr. Mathew Thomas M
M.D. (Derm), Dip. In Aesthetic Medicine (Board Certified)
Specialist Dermatology,
G.M.C. Hospital, Fujairah.