It is important for any patient interested in laser hair removal to find a dermatologist and technician with experience in the treatment. Patients should also maintain realistic expectations and clear understandings of the risks and potential side effects.
During an initial consultation, the technician determines an ideal laser device to use and provides a prediction of the outcome of the treatment. The technician evaluates the patient’s skin type and hair color, as well as the coarseness of the targeted area. A history of previous hair-removal treatments including methods used (e.g., shaving, plucking, waxing, depilatory creams, electrolysis, lasers), frequency, last treatment date and the response is considered.
A spot test in a small site is generally done to assess the patient’s response to laser hair removal and to determine the setting for laser treatment. The best sites for this test are in low-visibility areas with the same skin type as the area intended for treatment. To assess patient reactions and how effective the treatment is likely to be.
Laser hair removal is avoided in patients with active skin infections. Those with a history of herpes simplex virus may require antiviral medications and certain other infections may require antibiotics starting one day prior to treatment to reduce the chance of an outbreak. Antibiotics may also be prescribed prior to laser hair removal if the nasal (around the nose) or perianal (around the anus) areas are involved. If the patient has used the oral retinoid isotretinoin in the past year, a risk for atypical scarring exists and treatment is postponed until sufficient time has passed (usually six to 12 months).
Certain skin diseases (e.g., psoriasis, vitiligo) may be at risk of flares following laser hair removal. Waxing, plucking or electrolysis needs to be avoided for at least six weeks before treatment, but shaving and depilatory creams may be used without problems.
Tanning makes the hair follicle-less responsive to laser hair removal and increases the risk of adverse effects. Hyperpigmentation (darkening) of the skin may occur in patients with a dark tan and the tan may absorb the laser more than the hair, making the treatment ineffective. Because of this, treatment must be postponed until the tan has completely faded and the use of sunscreens is encouraged. In addition, patients should avoid the use of sunless tanning products prior to treatment.
The area to be treated is shaved one day prior to treatment. Alternatively, scissors may be used to trim the hair to just a few millimeters above the skin’s surface. Patients with darkly-pigmented skin can be pretreated with topical tretinoin (a retinoid) or bleaching creams to lighten their skin prior to treatment. Individuals may also be instructed to arrive with a clean and cosmetic-free face on the day of the treatment.