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Lose the Razor

Since no one wants to show up at Main Beach with unsightly tufts creeping out of their bikini or a back so furry it resists sunscreen, I'm fielding numerous questions on hair removal these days.
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Warm summer days bring less clothing and more exposed skin, but that can also expose patches of unwanted body hair. As no one wants to show up at Main Beach with unsightly tufts creeping out of their bikini or a back so furry that it resists sunscreen, I'm fielding lots of questions on hair removal these days. So here is the lowdown: The various methods of body hair removal range from cheap and simple things that you can do at home, to longer lasting spa treatments, to more permanent solutions provided at a physician's office. For a complete list hair removal options see here, but since I'm a physician specializing in laser surgery, I'll focus on laser hair removal, the most effective and long lasting of all the hair removal options.

Laser hair removal was developed by dermatologists at Mass General Hospital in the 90s who noticed that laser energy absorbed by pigment in dark hair follicles, heated these follicles and caused them to grow more slowly. Initially, only very small areas of dark hairs on fair skin types could be treated and the procedure was somewhat painful. Since then, the technology has evolved to treat virtually any area of the body with rapid pulses of energy shortening the treatment time. Further advances allowed us to reduce hair on several skin color types and with most patients experiencing only a mild to moderate pinching sensation. Today's lasers are now far more effective and patients generally require a treatment every 4-8 weeks and see significant hair reduction in 3-6 treatments. Treatments typically cost $250-900 per session, although costs vary throughout the country and depend on the surface area of skin that needs to be treated.

Laser hair removal is not without risks despite many advertisements that would have prospective patients believe that laser hair removal is as simple as waxing. Lasers are highly sensitive and delicate devices that require a high level of competence to operate safely. In rare instances and even in experienced hands laser hair removal can result in burns, blisters, scars, skin discoloration, or infection. In inexperienced and less well trained hands the complications can be more frequent and severe. Also, without a physician examination prior to laser treatment, serious medical conditions may be missed or improperly treated. A colleague of mine in Denver has collected a series of cases where untrained or unsupervised laser hair removal practitioners missed serious diagnoses of melanoma, viral infections and underlying hormonal disorders. In my own practice, I am frequently referred patients who had hair removal treatments by inexperienced practitioners that caused lightening or darkening of the treated skin often resulting in unsightly zebra like stripes. I also see patients who have been treated with the wrong type of laser or with ineffective device settings in unsupervised medi-spas.

Laser hair removal is a $650 million dollar a year industry in the United States and many people are trying grab a piece of that market by putting a laser in any hand that can be trained to fire one. State medical boards have been slow to recognize the risks of laser treatments and have been even slower to pass regulations requiring medical supervision of laser treatments. Many medical groups including the American Society for Dermatological Surgery are increasing their lobbying efforts to protect patients from the increasingly frequent complications caused by unsupervised laser technicians.

Until better consumer protection regulations are passed, it will be the consumer's responsibility to determine whether they are being treated by a qualified and trained practitioner. The American Society for Dermatological Surgery currently recommends that all laser hair removal treatments be performed by a qualified physician or a trained technician that is under direct, on-site supervision of a physician. Before starting any laser hair removal program, patients should insist on a consultation with a physician who is experienced and trained in hair removal. The physician should assess whether the hair growth and pattern is normal or the result of an underlying medical condition and determine the laser type and treatment settings to be used for treatment. Patients should inquire about the physician's experience with laser treatment and what to expect from each treatment. A helpful list of questions to ask your physician can be found at here. Keep in mind that you are paying for the physician's judgment and experience and not for someone to indiscriminately fire a laser at your skin which may do irreparable harm. This way you'll minimize your risk for potential complications and show off that smooth hairless skin this summer. This is an excellent web site with more information on laser hair removal and how to find a qualified physician with experience in this procedure.