Laser Hair Removal: How It Works, Who It Suits and What to Watch For

What is laser hair removal and how does it work?

The hair root and the hair itself contain a pigment called melanin, which gives hair its colour. The light emitted by laser or IPL (intense pulsed light) devices is absorbed by this pigment and turned into heat. This heat damages the root structures that produce the hair, slowing down and reducing new hair growth.

This principle is called “selective photothermolysis”: the light is set so that it affects the dark target more than the surrounding skin. For this reason, the more marked the colour difference between the hair and the skin, the more effectively and safely the procedure can be done.

There are various types of laser that work at different wavelengths, as well as IPL systems. Some are considered safer on lighter skin and others on darker skin. Which device and which settings are suitable for you is decided after your skin and hair have been examined.

Hairs do not all grow at the same time; each hair is at a different stage of growth. Light mainly affects hairs in the active growth stage. This is the main reason why more than one session is needed.

What is it used for?

• Reducing unwanted hair in areas such as the legs, underarms, bikini area, arms, back, chest and face
• For frequently recurring ingrown hairs and irritation after shaving or waxing, where the doctor considers it appropriate
• For increased hair growth due to hormonal causes (hirsutism), as a supportive method alongside assessment of the underlying cause

In women, dense male-pattern hair growth on the face and body should first be investigated for a hormonal cause if it has started recently or if it comes with signs such as irregular periods, acne or hair loss. Laser reduces hair but does not remove the cause.

Who is it suitable for?

A marked response is usually seen in people with light skin and dark, thick hair. Today, with suitable wavelengths and careful settings, the procedure can also be done on darker skin; in that case, however, experience and care become even more important.

Doctors often use the Fitzpatrick classification to assess skin type. This classification consists of six groups, ranging from very light skin (type I) to very dark skin (type VI), based on how easily the skin burns and how much it tans in the sun. Your skin type directly affects which device and which energy level are chosen.

Who is it not suitable for, and what needs attention?

• Pregnancy: There are not enough studies on the safety of laser hair removal during pregnancy; it is therefore usually recommended to postpone it until after giving birth.
• Skin that has recently been sunbathed, tanned or exposed to a sunbed: the risk of burns and pigment spots increases.
• Active infection, an open wound, an eczema flare-up or an active cold sore in the treatment area
• A history of cold sores (herpes): be sure to tell your doctor before the procedure, especially for the face and around the lips.
• Medicines that cause sensitivity to light, and oral vitamin A derivative medicines used to treat acne (be sure to mention them if you are using them now or have used them recently)
• Conditions involving sensitivity to light, vitiligo, a tendency to keloids (excessive scarring)
• Tattoos or permanent make-up in the area: these areas are usually not treated because the pigment would absorb the light.
• Moles in the area that have not been examined or that are changing in colour or shape: a doctor’s assessment is needed first.

This list is not complete; tell your doctor about all your health conditions and the medicines you use. Also clearly mention herbal products and any skin diseases you have had at the consultation before the procedure. Suitability can only be decided after an examination.

Who should perform it, and where?

Although laser hair removal may look simple, it is a medical procedure that, in inexperienced hands, can lead to burns, permanent pigment spots and scars. Your skin type and suitability should be assessed before the procedure. In Turkey, these matters are regulated by the Ministry of Health, including who may perform this treatment and where; ask in advance who will perform the procedure, whether there is medical supervision and whom to contact in case of side effects.

Protective eyewear suitable for the device must be available where the treatment is done, and both your eyes and the operator’s eyes must be protected during the procedure. Make sure there is a doctor you can turn to if a problem arises.

Preparing for the procedure

• In the weeks before the procedure, avoid sunbathing, sunbeds and tanning products; your doctor will tell you the appropriate period.
• Stop methods that remove hair from the root, such as waxing, tweezing and epilators, as long beforehand as your doctor recommends, because the root, which is the laser’s target, needs to be in place.
• Shaving is usually allowed during this period; you will be told before the procedure when the area should be shaved.
• On the day of the procedure, do not apply cream, perfume, deodorant or make-up to the area.
• If you have a history of cold sores and the face is to be treated, ask your doctor whether preventive medicine is needed.

The day of the procedure, step by step

1. Your medical history, medicines and expectations are discussed; your skin type and hair structure are assessed.
2. The informed consent form is read; your questions are answered and the form is signed.
3. The area is cleaned and shaved if needed. At the first session, a test pulse may be done on a small area.
4. You and the operator put on protective eyewear suitable for the device. Particular care is taken to protect the eyes when the face is treated.
5. The device head is placed on the skin and pulses are delivered. Most devices have a cooling system that protects the skin. You may feel something like a rubber band snapping or a hot prick.
6. At the end of the procedure the area is assessed; if needed, a soothing product or cold application is used, and aftercare advice is given.

After the procedure: the first 24 hours and the first week

In the first hours, redness, mild swelling and small bumps around the hair follicles are common and usually go away on their own. If your doctor has recommended it, cold application can be soothing.

• For as long as your doctor recommends, it is advisable to avoid hot showers, saunas, Turkish baths, intense exercise and swimming pools.
• Protect the area from the sun; use a broad-spectrum sunscreen on exposed areas.
• Do not scratch or rub the area; do not use irritating products (exfoliants, acid-based products).
• Some of the treated hairs will fall out on their own over the following days and weeks; do not pull them out.
• You may shave between sessions; avoid waxing and tweezing.

Expected side effects

• Redness and mild swelling: usually go away within a few hours to a few days.
• Tenderness, a mild burning sensation or itching
• Temporary change in colour: temporary darkening or lightening of the skin; more common on dark skin and on sun-exposed skin.
• Acne-like rash or inflammation around the hair follicles

There are also less common but important risks: burns and blistering, crusting, infection, scarring and permanent colour change. These occur most often on sun-exposed skin, on dark skin with unsuitable settings, or with inexperienced practitioners.

In a condition called paradoxical hair growth, hair in or near the treated area may increase rather than decrease. It is uncommon; it has been reported mainly on the face and neck, with fine hair and on dark skin. If you notice such a change, tell your doctor.

When treatment is done without eye protection, laser light can cause serious and permanent damage to the eyes. That is why eye protection is not negotiable.

Unless your doctor advises it, do not rub the area or apply heat or ice, and do not apply any cream or medicine on your own.

When will I see the result, and how long does it last?

After each session some of the hairs fall out, and over time the hair that grows back is sparser, finer and lighter in colour. A marked reduction is usually noticed after several sessions.

Most people usually need between 2 and 6 sessions; some people may need more. The interval between sessions and the number of sessions vary with the area and the person. Your doctor will recommend a plan that suits you.

After treatment is complete, the reduction in hair can last for months or even years. However, some hair may grow back, especially due to hormonal influences, and maintenance sessions may be needed from time to time.

Realistic expectations: what laser cannot do

• It does not remove hair completely and for life; the correct expression is “long-term reduction”.
• Its effect is usually weak on blonde, red, grey and white hair.
• If there is a hormonal cause, new hair growth may continue unless that cause is treated.
• Results are not achieved in a single session; you need to follow a regular session schedule.
• Everyone responds differently; two people may get different results in the same area with the same device.

Alternatives