PHILIPPE ABIMELEC M.D
DERMATOLOGIST
Former Consultant at Saint-Louis Hospital
Hair and Nail Specialist
Fellow of the American Academy of Dermatology
129 rue Caulaincourt 75018 Paris
Phone: 00 33 (0)1 42 64 83 15 - Fax: 00 33(0)1 42 64 31 09
email: dermatologue@orange.fr

The laser emits an invisible light which penetrates the skin without damaging it; it is then absorbed by the pigments of the pilous follicle. The laser light selectively absorbed by the follicle damages its functions and impairs its ability to fabricate hair. At the level of the pilous follicle, the laser light absorbed by the pigments is then transformed into heat which damages the hair but not the surrounding skin.

Laser hair removal is an effective and proven method. Laser can be used as a medical device since it can be exactly tuned according to each patient's type of skin, guaranteeing an effective treatment. Observance of instructions and precautions are essential for safe treatment. Thus, the use of a powerful device adapted to each skin type allows for effective and safe treatment.

In France, laser hair removal should always be performed by a medical practitioner.

• Shaving
Shaving is the simplest method but it is tiresome and must be performed almost daily.

• Mechanical hair removal methods
- Hair removal with tweezers
Hair removal with tweezers can only be used for small areas of the body. All manual hair removal methods involve a risk of pushing hair under the skin and lead to the formation of red and itchy "pimples".
- Waxing
This ancestral method must be performed every other week, presents a risk of burning, ingrown hair and infection when using non disposable wax.
- Chemical hair removal
Creams and foams containing thioglycolates are effective and totally safe if appropriately used. There is a risk of caustic burn if the sell-by date is not complied with, according to the areas of the body. We recommend against the use of chemical hair removal products containing soda-derived substances.

• "Permanent" hair removal methods
- Electric hair removal
Until recently, electric hair removal was the only method allowing for prolonged removal of unsightly hair. The doctor inserts a very fine needle in the hair to "coagulate" its bulb. The process is effective but very long and tiresome, treatment often lasting several years.
- Electrolysis
This technique used in English-speaking countries is not very well known in France, its effectiveness is comparable to that of electrical hair removal used in France.

Laser hair removal is a technique that makes it possible to treat rapidly and in the same session a very large area of the body, for a longer period of time and gradually deteriorating the hair.

One generally speaks of extended periods of hair removal, with a decrease in the amount of hair and in their diameter. Thus, after each session and according to the area of the body involved, one can notice increasingly long periods in-between hair removal sessions (4-6 weeks at the beginning and several months after some sessions). On the whole and after several sessions, hair removal is virtually complete.

Some types of skins require specific precautions or use of a specific laser (dark or black skin). Current hair removal lasers cannot remove light or white hair.

It is imperative to stay away from the sun in the weeks preceding a hair laser removal session, since tan is a contra-indication for the treatment. People under medication must warn their doctor since some drugs can lead to reaction to light and require postponement of the laser treatment.

The area to be treated must be shaved three days before the laser hair removal session.

You will be advised to use a hydrating and anti-redness cream during the hours following the treatment. Exposure to sun is a contra-indication, a solar shield must be used in case of sunny weather.

Laser hair removal is a safe treatment but, as a rule, some temporary side effects are possible, including darker or lighter marks, especially in dark skin and tanned skins. There is no risk of burn if the device is correctly tuned to the skin colour.

The treatment involves a series of impulses leading to a feeling of prickling and slight burn. One can compare the feeling of the treatment with that which one feels if one takes a series of blows with a rubber band. The majority of the patients will tolerate it without the need for anaesthesia. The patients who want it can benefit from a cream- based topical anaesthesia. In the few minutes following the treatment, the skin of the treated area turns slightly pink, and you might feel a little sunburned for a couple of days.

Each impulse of the laser treats a surface of approximately two square centimetres with ten hairs. The duration of each laser session will depend on the surface of the area to be treated. Hair removal on small areas like the lip or the chin takes a few minutes, whereas the treatment of a wide area like a leg or a thigh requires between twenty to fifty minutes.

The number of sessions necessarily depends on various parameters, the most important of which being the localization of the area to be treated and gender. In addition, resting follicles are not damaged by the laser. In general, it is necessary to foresee between three to six sessions, but it also depends on initial pilosity and the degree of hair removal required. Certain areas (back and face in men, for example) may require a prolonged treatment whose exact duration cannot bc predicted in advance.

The intervals between sessions depend on the area of the body to be treated and gender and are spaced progressively. Concerning the moustache and chin, an interval of 6 to 8 weeks is usual.

The above table provides an indication of the times in-between sessions and the number of sessions to consider in order to obtain excellent results. The number of sessions can be definitely more important in hairy areas depending on male hormones, in particular in men.

The price depends on the surface of the area to be treated and the number of sessions required.

Laser hair removal is not reimbursed by the French social security when it is performed for esthetic purposes. Hirsutism (excess hair) that is secondary to hormonal disease or drug intake may benefit from social security reimbursement.

A preliminary quote is given for any treatment costing more than 300 €

Results

1. Tina. S. Alster. Manual of cutaneous laser techniques (Lippincott-Raven, Philadelphia, 1997).
2. David. J. Goldberg. Laser hair removal (Martin Dunitz, London, 2000