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DONALD J. CAPUANO, M.D.
Plastic Surgeon

Update 2008
Laser hair removal has progressed in acceptance to the point where many other forms of hair removal are becoming obsolete.

TOPICS

ANATOMY OF THE HAIR AND ITS GROWTH CYCLE
TREATMENT OPTIONS
'NEWER' METHODS - LASER TREATMENTS
OFFICE TREATMENTS
AMOUNT OF DISCOMFORT - DOES IT HURT
TREATMENT TIMES - HOW LONG DOES IT TAKE
SIDE EFFECTS
AFTER TREATMENT CARE AND ACTIVITIES
COST OF SERVICES
WHAT AREA(S) CAN BE TREATED
CAN A CHILD BE TREATED

There are many options for hair reduction and removal. It is best to learn about the nature of hair itself in order the make an informed decision.

ANATOMY OF THE HAIR AND ITS GROWTH CYCLE

Human hairs are made up of three distinct parts: the BULB (base) of the hair follicle produces the hair; the SHAFT; and the HAIR itself. The bulb and shaft are embedded within the skin, leaving only the hair visible to the naked eye. To remove unwanted hair on a permanent basis, it is necessary to destroy the hair follicle and the bulb. Reaching the bulb is the most difficult task in hair removal. This is made even more difficult by the fact that different types of hair are embedded at different depths of the skin. For example, the hair on a person's upper lip is embedded less deeply than hair in the bikini line.

The hair removal process is further complicated because long-term destruction of unwanted hair is only possible if the hair is treated and the follicle is destroyed during the GROWING stage of the hair cycle.

This cycle is comprised of three phases: growth, dormant and dying. Only hair in the GROWTH phase can be removed on a long-term basis, and at any given time the body's hair follicles are in different stages of the growth cycle. Because of the changing growth cycles, more than one treatments are needed for long-term hair removal. Mathematically it is impossible to remove all the hair. If there were 100 hairs in an area after the first treatment about 66 would remain. After the second, about 40-45 would be left. After another treatment about 28, then 19 then 12, etc.

TREATMENT OPTIONS

For eons humans have devised many methods of removal of hair.

Shaving - is the most common form of hair removal. The primary benefit of this method is convenience. This method, however, is not intended to be a long-term hair removal treatment, as it does not impair hair re-growth. Shaving merely removes hair that is already dead, and contrary to popular belief, this method of hair removal does not affect hair growth or thickness. Additionally, shaving can cause skin irritation, ingrown hairs and cuts from the razor blade.

Depilatory Cream - This is another common treatment for unwanted hair, and again, its popularity stems from its privacy and convenience. This method is extremely time consuming, as the cream must remain applied until the hair is fully dissolved. Many people find that the cream has an unpleasant odor and that the process is very messy. Because the creams can be costly, this is not the most cost-effective or time- efficient method to treat large areas of the body for hair removal. Lastly, the strength of the chemicals necessary to dissolve unwanted hair may cause rashes, allergic reactions or police.

Waxing - This method of treatment is popular because it affords a longer-term solution to hair removal. Lasting up to 6 or 8 weeks, this method removes hair from the follicle bed, but does not destroy the follicle itself. Therefore the hair does re-grow. Some find this method painful and it can cause skin irritation and pimples. Additionally, waxing may also distort the hair follicles and make other hair removal techniques more difficult.

Electrolysis - By passing an electric current through the follicle, this hair removal technique does damage some follicle beds. However, it can be painful, time consuming and expensive as each hair follicle must be treated separately. Multiple treatments lasting months to years are necessary because true damage can only be inflicted to the hair follicles during the growth phase of their life cycle. Fifty percent of hairs treated re-grow after each treatment. Adverse side effects from this treatment technique include holes and redness at treatment sites. Lastly, because the electrode must be inserted subcutaneously into each follicle, there is the risk of infection.

 

'NEWER' METHODS - LASER TREATMENTS

During the past few years, lasers have gained attention as a hair removal tool. The procedure typically begins with shaving the area requiring hair removal. This should be done at the time of the treatment by the office staff. A beam of light is then aimed at the treatment area. The laser is then 'fired'. The laser light seeks a target.

When the laser light hits the hair target, light is converted into heat and the heat is absorbed in the follicle, shaft or bulb. It raises their temperature. Once the temperature reaches a high enough level during active growth, the hair structures are critically damaged, preventing hair re-growth.

Because any pigment (brown coloration) will absorb the laser light, tanned skin, pigmented skin, moles, freckles, 'old age spots', etc. may loose pigment and may decrease the amount of light absorbed by the hair follicle.

Not all hair is damaged equally. The darker the hair, the lighter the skin, the greater the amount of energy is absorbed by the dark hair and thus the greater the damage. Lighter hair and darker (pigmented skin) do not provide the best contrast and thus the laser is not as effective as energy is absorbed by both the hair and the skin. In some cases tanned skin can absorb too much energy and become temporarily blistered or injured.

After an examination, Dr. Capuano will advise you as to how much contrast is necessary in your particular case to achieve an acceptable result.

OFFICE TREATMENTS

When you arrive at the office the hair in the area to be treated is examined. It is then clipped or shaved by the staff. The doctor then applies the laser treatment unit to your skin. A short pulse of laser light penetrates the skin, (like a flash bulb), destroying hundreds of hair follicles in a single flash. There are no needles or injections needed.

For larger areas the laser has a scanner. The scanner moves the beam using a computer chip. This happens much more rapidly than a human could possibly move the beam. This scanner allows large areas to be treated in a shorter period of time.

AMOUNT OF DISCOMFORT - DOES IT HURT

The laser pulse may feel like a rubber band. A frequent comment is that it was 'nothing'. Some will feel the pulse more than others. The test area (one or more pulses) will be an indicator of the amount of discomfort. No medication or anesthesia is usually required. If after the first treatment you feel that you do need medication, we will make a recommendation.

TREATMENT TIMES - HOW LONG DOES IT TAKE

The laser used in our office besides having the scanning device, has the ability to shoot several pulses each second. This allows a larger area to be treated in a shorter length of time. A lip or chin may take just a few minutes to treat. Legs, backs and chests about one-half to one hour. The average man's beard can be treated in less than 45 minutes. This is about equal to 200 hours of electrolysis. The bikini area hair is treated in about 10 minutes, (about 8 hours of electrolysis). NOTE - that just like electrolysis - more than one treatment will be needed because of the hair growth cycle.

SIDE EFFECTS

Slight irritation and redness, rather like mild sunburn, may occur immediately after treatment and can last for a few days. It goes away within a few days. A very small minority of people may experience slight blistering which will clear up in 2 - 3 days. Rarely, there may be areas of increased pigment (hyperpigmentation). These areas if they occur almost invariably fade and blend in. If areas of decreased coloration (hypopigmentation) should occur, again quite a rare appearance, there may be some residual effect. There is a remote risk of infection or scarring.

Direct exposure to strong sunlight should be avoided and a high protection sun cream should be used for a week after treatment. You should not consider laser epilation if you are hypersensitive to light. At your consultation and unless agreed upon otherwise, the doctor will give you a test on a small area of skin which will be checked one week later before your treatment. During the treatments you will be asked to wear goggles. We ask you to keep your goggles on when the laser is being fired. The staff also wears goggles during your treatment.

AFTER TREATMENT CARE AND ACTIVITIES

- Care should be taken to prevent injury to the treated area for the first 4 or 5 days following treatment. Rough Shaving should be avoided after treatment until the skin feels normal'. This may be a few days to a week or more. - Sun block (not sunscreen) should be used and avoid exposure to the sun light during the treatment period. Sun tanning increases the concentration of melanin, which competes with the target for the absorption of the energy from the LASER and increases the risk of redness, etc. - If the skin is broken or a blister appears apply an antibiotic and notify the office so that we can follow your treatment course. - Cold packs or preparations such as Aloe Vera may be used to ease after treatment stinging if any. - Makeup can be applied gently as long as the skin is not blistered and the makeup does not irritate the skin. Makeup can be used as an additional sun block. - Any questions or concerns please do not hesitate to call our office. - You can resume any routine daily activities that does not irritate or bother the treatment area. You will be the best judge of what bothers the treated area. Activities that are associated with exposure to the sun should be carefully monitored, e.g.. golfing, fishing, boating, sun bathing, etc. Avoid hot showers or hot tubs, harsh soaps, new creams or cosmetics, etc., until your skin feels quite normal (a day perhaps more)

COST OF SERVICES

This medical procedure is available at a very reasonable cost considering the complicated technology that is provided, the cost of the laser, the maintenance and the personnel required. The total treatment cost is much less than electrolysis with fewer chances of complications. Large areas such as the back or legs can not reasonably be treated by electrolysis are able to be treated using the laser.

Because areas of treatment differ in size, location, number of treatment, male and female the cost of services must be individualized. Costs given by phone are approximate.

Payment for services by periodic payments is available by credit card otherwise payment at the time of service is required.

October 2008 Subject to update/change- PRICING LISTED ARE ESTIMATES ONLY

Four to Eight Treatments may be needed
If more treatments are needed - cost will be reduced
Maximum treatment area, per amount quoted
is about 5 " in diameter (12 cm about the size of a CD)
WOMEN MEN
Between eyebrows 125-175
Upper lip 110-375
Chin/Neck 125-150
Chest 85-400
Abdomen/Linea Nigra 200-400
Forearms 175-245
Upper arms 150
Hands 65-225
Bikini 200
Upper legs 220
Lower Legs 230

WHAT AREA(S) CAN BE TREATED

All parts of the body, including upper lip, chin, beard, legs, arms, hands, underarms, back, bikini line, torso, ETC., can be treated.

CAN CHILDREN BE TREATED

At the present time (2008) there is no age limitation for the use of the hair removal laser. The patient's ability to tolerate the procedure may be a concern. It should also be noted that with puberty or other hormone changes there can be hair regrowth.

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INFORMATION ABOUT LASER REMOVAL OF HAIR

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