Laser hair removal can be an effective approach to treat hirsutism

Information on hirsutism and hair removal treatments
Cosmetic hair removal
Laser hair removal
Oral contraceptives
Cyproterone acetate
GRH analogs

Laser Hair Removal for Hirsutism

Excess and unwanted hair growth is a problem that many women face worldwide. This condition is clinically diagnosed as either hirsutism or hypertrichosis and their associated underlying ailments. These two disorders of hair production cause significant social and psychological trauma among patients. Most women hence take recourse to therapy.

Treatment must be a combination of medical and non-medical procedures

While medical treatment (like with oral contraceptives, antiandrogens etc.) decreases or at least slows down the excess hair growth, it cannot get rid of the existing unwanted hair. Hence, mechanical hair removal techniques must be undertaken simultaneously for effective treatment.

Mechanical processes include tweezing, waxing, shaving, epilation, intense pulsed light (IPL), depilatories, electrolysis, topical creams and laser treatment. Laser therapy has become highly popular in the last few years for its advanced, relatively safe, comparatively lasting and speedy outcome.

The laser procedure

Hair removal by lasers began in 1995. Laser treatment employs a method called selective photothermolysis in order to destroy the hair follicle selectively. The laser is passed through the skin and specifically targets a chromophore called melanin, a natural pigment present in the hair follicle. Melanin absorbs the laser light at a specific wavelength and converts the laser into heat energy for destroying the hair tissue. Since melanin is located in the hair follicle but not the adjoining dermis, targeting it ensures selective damage of the follicle without harming neighboring tissues. However, melanin is present in the epidermis. Hence, laser methods must ensure that the skin is cooled off to prevent thermal damage of the epidermis.

Types of laser treatment

Despite the development of various laser methods, no single type has been adjudged better in terms of safety and effectiveness on all skin types. Latest laser technology has come up with various red and infrared lasers and light sources for removal of unwanted hair.

Some major laser types and therapies are:

  • Ruby lasers (694 nm) that cause lesser epidermal damage.
  • The more recent long-pulsed alexandrite lasers that too safeguard the epidermis better
  • The strong 800-nm diode lasers are safer for dark skinned people, since the epidermis does not absorb the longer wavelength light that easily.
  • Photodynamic therapy is another method that uses laser light and a chemical photosensitizer to damage the hair follicle permanently.
  • There are combination packages as well, that are being developed every other day. The topical use of aminolevulinic acid (ALA) is one such additional therapy being considered and studied for use in combination with laser technology. Though in its developmental stage, ALA’s advantages have been identified in its capacity to target larger areas rapidly and its use on more skin types.

Effectiveness of lasers

The lasers target area of activity is the stem cell group, where the cells multiply very fast in the growing stage (anagen) of the hair production cycle. Hence, laser therapy is most effective in the anagen stage. Though hair production is gradually slowed down after each laser session, permanent hair removal is not possible. Lasers actually ensure a temporary complete hair removal. Generally, there is re-growth after 6 months (though it is sparser than the initial growth) and one must undergo additional therapy.

Research has also shown that despite the laser type employed, significant clinical result is possible after at least 1 month of the second laser session. More noticeable hair reduction is generally occurs 6 months after the third and last laser application.

Effectiveness of the laser depends on the kind of laser used and the patient’s skin biology. Generally, laser hair removal works best on fairer cases with dark-pigmented hair. Estimates suggest that around 80 percent of cases benefit from laser hair removal, though some require multiple sessions.

Side effects of laser hair removal

If the laser pulse administered is too long, it can cause thermal (heat) destruction of the adjoining structures. This can cause scarring. Experts advise that longer wavelength lasers are safer for darker skinned people. Actually, the ideal patient for treatment with laser hair removal, are patients with fair skin and dark hair. Dark skin or tanned patients are more at risk of epidermal harm like scarring and permanent pigmentary changes. Hence, they must take suitable safety measures such as in the form of a preoperative sunscreen or bleaching product.

Before you go for a laser hair-removal method, it is important to be aware of its risks like scarring, dyspigmentation, itching and pain. Remember there will be some degree of discomfort during and right after the laser session. Conditions such as perifollicular edema and erythema occur in most cases and may last up to 3 days. The more serious epidermal damage resulting in bacterial or herpes simplex virus infection or pigmentary changes are rare if the process is correctly performed by experienced laser technicians.

If you are in the hands of trained and expert therapists there should be no need to worry.