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Laser Hair Removal Technology
There are currently four types of lasers in use for laser
hair removal: ruby, alexandrite, diode, and Nd:YAG. These lasers deliver
an intense beam of light which is made up of a single wavelength
or color. The light energy is absorbed by the pigment or melanin
in the hair follicle. The follicle is thereby heated and injured,
resulting in less hair growth. In addition, there are a variety
of intense pulsed light systems (non-laser) in use for laser
hair removal. These systems deliver light which is made up of multiple
wavelengths or colors.
Ruby Lasers (eg Epilaser, E2000)
The ruby laser was one of the earliest lasers to be approved for
hair removal. Ruby lasers work well for treatment of dark hair in
fair-skinned patients. However, they are very limited in their ability
to safely treat patients with darker or tanned skin. Use of a ruby
laser on a darker-skinned person carries an unacceptably high risk
of side effects such as crusting, blistering, pigmentary change
(lightening or darkening of the skin), or scarring. For this reason,
other lasers have largely supplanted the ruby laser for laser
hair removal.
Alexandrite Lasers (eg GentleLase, Apogee)
Alexandrite lasers have been very popular in the past for laser
hair removal. Like the ruby, alexandrite lasers work best for dark
hair in fair-skinned patients. The alexandrite laser is somewhat
safer than the ruby for treatment of darker skinned patients. However,
it still carries the risks of skin burning and pigmentary change
in darker patients. Use of the alexandrite laser is best reserved
for patients with light skin.
Diode Lasers (eg Lightsheer, SLP 1000, MeDioStar, Apex 800)
Worldwide, the Lightsheer diode laser has achieved the most widespread
use for laser hair removal. This laser works well in fair-skinned
patients, but has the added versatility to safely treat many darker
or tanned patients. By extending the pulse duration to 100 milliseconds
or beyond, diode lasers can effectively treat tanned or dark-skinned
patients. Diode lasers appear to fall into the "sweet spot" in laser
hair removal, allowing safe and effective treatment of the widest
range of hair type and patient.
Nd:YAG Lasers (Lyra, Coolglide)
The original Nd:YAG laser (Softlight) which was approved for laser
hair removal only provided temporary results. More recently, long-pulsed
Nd:YAG lasers have been developed which can achieve long-lasting
hair removal. These lasers can be used to safely treat patients
of all skin colors. The Nd:YAG laser is the treatment of choice
for patients with dark, coarse hair and dark skin, such as African-Americans.
Compared to other lasers, the Nd:YAG laser may have reduced efficacy
for treatment of finer, lighter hair, as there is less melanin absorption
at the Nd:YAG wavelength.
Intense pulsed light (e.g. Epilight, Quantum, Estelux, Aurora)
Intense pulsed light systems represent an alternative to lasers
for treatment of excessive hair. These systems are effective in
experienced hands, but can have a higher risk of side effects when
used improperly. Unlike lasers, these systems deliver multi-wavelength
light to the skin, which can have both advantages and disadvantages.
The treatment handpiece tends to be large and rectangular in shape,
which makes treatment of smaller areas such as the upper lip more
difficult. The Aurora device represents new (unproven) technology
which utilizes pulsed light in combination with radiofrequency energy.
Although the company maintains that this device can treat white
or light hair, credible evidence to support this is lacking.
Cooling
A crucial point to understand is that all of the above devices need
to be used together with some type of cooling to protect the skin.
Some devices (e.g. Lightsheer) have a built-in cooling tip which
very reliably protects the skin when good contact is maintained.
Other devices (e.g. GentleLase) use a brief spurt of cryogen just
before the laser pulse to cool the skin. Another cooling option
is a strong flow of ice-cold air which is blown onto the skin. One
type of cooling which may not be as reliable uses a built-in cold
handpiece to pre-cool the skin (e.g. Altus CoolGlide). The problem
is that if the operator does not move the handpiece in the correct
direction, the laser may fire on skin which has not been cooled
at all.
If you are considering laser hair removal, click on our
directory of laser hair removal specialists to find an experienced
laser hair removal specialist near you.
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