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Ricky Hussey writes:

Epilation performed by laser was performed experimentally for about 20 years before it became commercially available in the mid 1990s. Intense Pulsed Light (IPL) epilators, though technically not a laser, use xenon flash lamps that emit full spectrum light. Hair color and skin type are the key factors that influence the success of laser hair removal. It's most successful on people with dark hair (brown or black) and light skin. Hair removal lasers have been in use since 1997 and the Food and Drug Administration approved it for “permanent hair reduction.”

Laser hair removal has become extremely popular because of its speed and efficacy, although some of the efficacy is dependent upon the skill and experience of the laser operator, and the choice and availability of different laser technology at the clinic which is performing the procedure. Some will need touch-up treatments, especially on large areas, after the initial set of 3-8 treatments Laser Hair removal can be performed on any area of the face or body and is faster and easier than other methods of hair removal.

Laser hair removal is effective only on short, apparentable hair. Two to three days before the procedure, you shave the area to be treated, and allow it to grow to a stubble. Avoid waxing or plucking the hair and electrolysis three weeks before treatment. Laser hair removal is not for everyone.

The absolute requirement is that one's hair must be darker than the surrounding skin. Several wavelengths of laser energy have been used for hair removal, from visible light to near-infrared radiation. Hair removal lasers are effective treatment for pseudofolliculitis barbae. Treatment cost varies with the size of the area treated.

From UK's Press Association:

Britons are spending more than ever on being nipped, tucked and pumped with Botox, according to a report. The booming cosmetic surgery market is set to break the £1 billion mark next year, market analysts Mintel predict. Botox, collagen wrinkle fillers and other non-invasive treatments have seen the biggest popularity increase.

Laser hair removal, chemical peels and teeth whitening are also part of the non-surgical treatments category. A total of 577,000 cosmetic operations and treatments were carried out in Britain this year, of which 472,000 were non-surgical. This compares with just 300,000 in 2005 of which 230,000 were non-surgical, Mintel's Cosmetic Surgery report says.

The total cosmetic surgery market is now worth just over £900 million - more than double the £430 million spent in 2005. Non-invasive treatments such as Botox and collagen fillers have become much more popular because they are seen as less risky and require repeat top-ups, the report adds.

From Wikipedia:

Epilation performed by laser was performed experimentally for about 20 years before it became commercially available in the mid 1990s. Intense Pulsed Light (IPL) epilators, though technically not a laser, use xenon flash lamps that emit full spectrum light. Laser and light-based methods, sometimes called phototricholysis or photoepilation, are now most commonly referred to collectively as "laser hair removal". One of the first published articles describing laser hair removal was authored by the group at Massachusetts General Hospital in 1998. The efficacy of laser hair removal is now generally accepted in the dermatology community, and laser hair removal is widely practiced.

Hair removal lasers selectively target Melanin: * Melanin is considered the primary chromophore for all hair removal lasers currently on the market. Melanin occurs naturally in the skin (it gives skin and hair its color). There are two types of melanin in hair: eumelanin (which gives hair brown or black color) and pheomelanin (which gives hair blonde or red color). Because of the selective absorption of photons of laser light, only black or brown hair can be removed. Both men and women seek laser hair removal services to have superfluous or unwanted hair removed.

Hair removal is commonly done on lip, chin, ear lobe, shoulders, back, underarm, abdomen, buttocks, pubic area, bikini lines, thighs, face, neck, chest, arms, legs, hands, and toes. Laser is attracted to dark pigment and therefore works best with dark coarse hair. Light skin and dark hair are an ideal combination, but new lasers are now able to target dark black hair even in patients with dark skin. Hair removal lasers have been in use since 1997 and the Food and Drug Administration approved it for “permanent hair reduction.”

Laser hair removal has become extremely popular because of its speed and efficacy, although some of the efficacy is dependent upon the skill and experience of the laser operator, and the choice and availability of different laser technology at the clinic which is performing the procedure. Some will need touch-up treatments, especially on large areas, after the initial set of 3-8 treatments. It has also been observed that some people seem to be non-responders – this is not confirmed and reasons are not known, and may in fact be due to lack of skill on the part of many laser operators and/or the type of machine and settings they are using. Keep in mind that it's hard to judge whether someone’s lack of results is due to a potential underlying medical condition that causes continuous growth and makes it seem like laser isn’t working, if the treatment wasn't performed properly, or whether for some people it just doesn't work for currently unknown reasons. In essence, you can’t determine what your personal results would be like unless you try it. Results depend on many variables involved, including the tech's experience, type of laser used, how settings are set, etc. It is recommended to start with one area and see how your hair reacts before committing to a set of treatments on many areas at once.

From the FDA:

Introduction
Hair Removal
Wrinkle Treatment
Dental Treatment
Eye Surgery
Other Medical Uses
Practitioners
Biostimulation Lasers

Laser Radiation Safety

From ASDS.net:

WHAT IS A LASER?
Laser stands for Light Amplification by the Stimulated Emission of Radiation. Lasers work by producing an intense beam of bright light that travels in one direction. The laser beam can cut, seal or vaporize skin tissue and blood vessels. The laser has the unique ability to produce one specific color (wavelength) of light that can be varied in its intensity and pulse duration. Ordinary light from non-laser sources is composed of many different colors and appears white. This broad spectrum of light can also be pulsed to a specific duration and varied in intensity as well as the exact range of wavelengths. This allows broad spectrum Intense Pulsed Light (IPL) the ability to specifically treat blood vessels and pigmentation. The wavelength and power output of a particular laser or IPL typically determines its medical application. When the laser or IPL light is directed at skin tissue, its light energy is absorbed by water or pigments found in the skin. Water is found in large amounts in all living cells. Pigments of the skin include hemoglobin, a protein that makes blood red, and melanin, the tan or brown-colored pigment. All three targets absorb laser light of different colors.

WHAT ARE THE BENEFITS OF LASER AND/OR IPL SURGERY?
Lasers may offer you and your dermasurgeon the following general benefits:

  • Improved therapeutic results
  • Reduced risk of infection
  • "Bloodless" surgery with most lasers
  • An alternative to traditional scalpel surgery, in some cases
  • Less scarring, in most cases
  • Precisely controlled surgery, which limits injury to normal skin
  • Safe and effective outpatient, same-day surgery for many skin conditions

WHAT TYPE OF LASER OR IPL SHOULD BE USED?
Different types of lasers and IPL are used to treat a variety of skin conditions, birthmarks and growths and cosmetic complaints. Presently, no single laser or IPL is capable of treating all skin conditions, but certain lasers can be tuned to a variety of colors of light or coupled to a robotized scanning device to expand their clinical effectiveness. Your dermasurgeon will carefully evaluate your individual condition and suggest the appropriate type of laser and/or IPL system to achieve the best results.

WHO IS QUALIFIED TO PERFORM LASER AND/OR IPL SURGERY?
Experts in skin care, dermasurgeons have extensive training and experience with laser and IPL surgery. In fact, most of the latest advances in laser and IPL technology and its applications were pioneered and refined by dermasurgeons.

WHAT ARE THE COMMON LASERS AND IPL USED IN DERMASURGERY?

CARBON DIOXIDE (CO2) LASER
The CO2 laser system can be used in several ways: "focused" for cutting skin without bleeding; "defocused" for superficially vaporizing skin; and "ultra pulsed" for facial resurfacing. By delivering very powerful, rapid pulsing or scanning of the latest generation of CO2 lasers, dermasurgeons are able to resurface the skin for cosmetic improvement. This technique removes fine lines and wrinkles of the face, smoothes acne scars, and rejuvenates aging and sun-damaged skin as it contours the skin surface.

When the CO2 laser's energy is defocused and not continuous (pulsed), the dermasurgeon can treat warts, shallow tumors and certain precancerous conditions.

When the CO2 laser energy is continuous and focused into a small spot of light, the beam is able to cut the skin. It is used in this way to remove skin cancers, to treat a variety of nonvascular and pigmented lesions and for eyelid operations. This technique is also used to remove warts and for some surgical incisions.

ERBIUM (ER):YAG LASERCARBON DIOXIDE (CO2) LASER
The high-powered erbium:YAG (Er:YAG) laser produces energy in a wavelength that gently penetrates the skin, is readily absorbed by water and scatters the heat effects of the laser light. These properties enable dermasurgeons to remove thin layers of aged and sun-damaged skin tissue with exquisite precision while protecting healthy surrounding tissue. The Er:YAG laser is commonly used for skin resurfacing to improve moderate facial wrinkles, mild surface scars or splotchy skin discolorations. Newer Er:YAG lasers have an extended pulse duration that allows them to act in a similar manner to the CO2 laser. Your dermasurgeon is best able to determine which of these lasers, alone or in combination, are best suited to correct your specific concern.

YELLOW LIGHT LASERS
Through the use of an organic dye, short pulses of yellow-colored light are produced. A popular yellow light laser is the pulsed dye laser. Because yellow light is more precisely absorbed by the hemoglobin than other colors, these lasers are effective in the treatment of blood vessel disorders, such as port wine stains, red birthmarks, enlarged blood vessels, rosacea, hemangiomas and red-nose syndrome. Certain yellow light lasers may also be used to treat stretch marks and are safe and effective for infants and children. The krypton and Nd:YAG lasers are dual light systems. The uses of the yellow light are similar to those already described.

The green light, in contrast, is used for the treatment of benign brown pigmented lesions, such as café-au-lait spots, the "old age" spots commonly found on the backs of the hands and lentigines or freckles. Green light lasers are also used for the treatment of small blood vessels on the face and legs.

RED LIGHT LASERS
The red light spectrum produced by the ruby or alexandrite light laser is emitted in extremely short, high-energy pulses due to a technique known as Q-switching. The Q-switched ruby or alexandrite laser systems were initially used to remove tattoos, but are now commonly used to treat many brown pigmented lesions, such as freckles or café-au-lait spots.

When the pulse duration of the ruby or alexandrite lasers is lengthened, it is effective in removing unwanted hair for long periods of time, sometimes even permanently.

OTHER LASERS 

THE Q-SWITCHED NEODYMIUM YAG (ND: YAG)
Delivering infrared light, it is used to remove tattoos and deep dermal pigmented lesions, such as nevus of Ota. This laser can also be tuned to produce a green light for the treatment of superficial pigmented lesions like brown spots, as well as orange-red tattoos.

KTP
The KTP emits a green light and is capable of treating certain red and brown pigmented lesions. When the pulse duration is lengthened, the Nd:YAG laser is also effective in removing hair and an inflammatory condition termed pseudofolliculitis barbae for months and sometimes permanently. This is particularly useful in the treatment of dark-skinned patients.

NEW TECHNOLOGIES: NON-ABLATIVE LASERS AND LIGHT SOURCES
Instead of heating and removing the top skin tissue, non-ablative (non-wounding) lasers work beneath the surface skin layer to improve skin tone and texture and minimize fine lines with few side effects and a speedy recovery. Light-based devices that produce a broad spectrum of light (wavelengths) with computer-controlled parameters of energy delivery (Intense Pulsed Light, or IPL) can be adjusted according to a patient's skin type and condition. This technology is primarily used for the treatment of benign red and brown lesions, hair removal and facial skin rejuvenation.

OTHER APPLICATIONS: HAIR REMOVAL AND LEG VEINS
Laser technology is presently being utilized for efficient and long-lasting body hair removal. The laser energy causes thermal injury to the hair follicle, stunting hair growth. Several laser hair-removal systems, including the diode laser, the long-pulsed alexandrite and Nd:YAG lasers and the IPL, are being used successfully with long-lasting results.

Until recently, lasers were used primarily for superficial facial veins. Thanks to the newest technologies, leg veins may be effectively treated with a variety of lasers and intense pulsed light systems.

From asds.net:

Laser hair removal has become one of the most common cosmetic procedures performed in the United States, ranked second among cosmetic procedures behind Botox injections in frequency of procedures performed. Laser hair removal utilizes beams of highly concentrated light designed to selectively penetrate into the hair follicles, to be absorbed by the pigment in the hair follicles and to destroy the hair within that hair follicle. A variety of lasers and light sources have been developed that may be employed in laser hair removal. The procedure was originally described to be performed on dark hairs on light skin; newer technologies have made the procedure safer for patients with darker skin and those of color. Various types of lasers are utilized with laser hair removal – the most common of which are alexandrite, diode, Neodymium YAG and intense pulsed light sources.

WHAT IT CAN HELP/CURE
Laser hair removal can remove unwanted hair in those individuals who have disease states in which unwanted hair growth can occur, or it can be performed on those individuals who have no active disease states and just want removal of unwanted hair. Most individuals will require a series of treatments over time which will result in the removal of the unwanted hair. Most of the lasers and light sources are FDA cleared for permanent hair reduction, which means reduction over time. Some individuals will see very long term hair removal which may last for many years. Others may require maintenance treatments over time to maintain their degree of hair loss. It is truly impossible to determine in advance who will require how many treatments and how long the hair will remain gone. As stated above, laser hair removal works best in those with dark hairs on lighter skin, however newer technologies and newer lasers and light sources have made the procedure safe and effective in those with darker skin and those individuals of color.

WHAT TO EXPECT BEFORE, DURING AND AFTER THE PROCEDURE
Prior to having laser hair removal, thoroughly check the credentials of the physician or technician performing the procedure. Although laser hair removal is the second most common cosmetic procedure, many clinics promise results that are just not realistic. Once you have the proper comfort level with the clinic where you are going to have the procedure performed, you will schedule an appointment.

Most patients will have the hair trimmed with a scissor to just a few millimeters above the skin surface. The laser and light source will be set with parameters which take into consideration your skin color, the hair color, the thickness of the hair, the location of the hair and the amount of energy needed for the treatment to be performed. Depending on the laser or light source used, both the patient and the technician will wear appropriate eye protection, to prevent the laser light from penetrating into the eyes, which in itself can be a significant danger. The area to be treated should be clean and dry. Again, depending on the laser or light source, either a cold gel or a special cooling device will be used to protect the outer layers of the skin. This also helps the laser light penetrate further into the skin. Many of these cooling devices are now part of the laser itself, and you will feel the cold when the laser is applied to the skin. The operator will then give a pulse of light to the treatment area and should then observe the area for several minutes to determine if the optimal parameters were used. They will also look to see that there are no adverse effects prior to continuing the procedure. When the procedure is finished, it is common for the area treated to have some redness and some accentuation of the hair follicles themselves. This is "normal," and should disappear over the next 12-24 hours, in most cases. At the conclusion of the procedure, most will have ice applied to the area treated, and some may use some special aloe gels or anti-inflammatory creams, lotions, or water to relieve any discomfort to the area.

Most individuals will be scheduled for another treatment 4-6 weeks later and the procedure will be repeated until hair growth has been eliminated. At each successive laser hair removal procedure, less hair should be found in the treatment area. Treatments will be resumed at a point in the future when, and if, hair growth occurs again necessitating further therapy.

COMPLICATIONS THAT CAN OCCUR
As with any laser treatment, complications can occur with laser hair removal. Both the physician and the patient must be aware that they may occur and be able to identify them and treat them appropriately. With laser hair removal, redness and swelling of the hair follicle, known medically as erythema and perifollicular edema, are "normal" events seen with most laser hair removal procedures. On occasion, pain and discomfort will occur with laser hair removal – most of this can be easily treated with over-the-counter pain medicines. Excessive pain during the procedure, especially during successive laser hair removal procedures, should be brought to the laser technician's attention immediately, so laser settings may be adjusted. Other adverse events, although rare, are seen and should be reported immediately to the physician in charge. These include blisters and burns, which can occur with every one of the devices on the market, and especially if there is a recent history of sun exposure or if one goes into the sun immediately after the procedure. Patients should be advised to avoid direct sun exposure for at least one week following all laser hair removal procedures. Blisters and burns, although rare, do occur, and on occasion, will lead to either too much or too little pigment remaining in the skin, conditions known as hyperpigmentation or hypopigmentation. And even rarer, true scarring results, with raised red scars known as hypertrophic scars and keloids.

All patients should be warned of these risks prior to laser hair removal procedures and all facilities should be well versed in how to handle these complications. Dermasurgeons are well versed in handling any of these complications, making these highly trained physicians and their facilities ideal locations for laser hair removal procedures.

QUESTIONS TO ASK YOUR DERMASURGEON
As with any cosmetic procedure, ask your dermasurgeon questions regarding their experience and training, including the training of any of the technicians who may perform the procedure. You should be able to get some degree of expectations from your dermasurgeon, as to how many treatments he or she may think you may require and learn about the follow-up and how you go about speaking with the physician's office if you have any questions. Dermasurgeons are skilled in this and many cosmetic laser treatments.

FOR MORE INFORMATION AND REFERRALS
For more information on skin conditions and treatments, along with a list of ASDS members in your state, please visit the Find a Dermasurgeon section of our Web site.

From asds.net:

ROLLING MEADOWS, Ill. -- As laser skin surgery becomes increasingly popular for treating acne scarring and reversing damage from sun exposure, a new study reported in Dermatologic Surgery, the peer-review journal of the American Society for Dermatologic Surgery (ASDS), shows that six in ten patients undergoing minimally invasive or non-ablative laser procedures said they are satisfied with overall improvements from the treatment.

According to lead author and a Fellow of the ASDS, Ashish C. Bhatia, MD, non-ablative rejuvenation systems treat acne scars and sun damaged or photoaged skin by stimulating collagen production. As the laser penetrates the skin, it also emits a cooling spray which prevents damage to the skin.

"Non-ablative laser treatments are becoming increasingly popular with patients compared with invasive lasers because they significantly decrease risks for adverse events and downtime, produce gradual improvement instead of sudden effects, and have a lower incidence of scarring and pigmentary changes," said Dr. Bhatia. By comparison, ablative procedures treat acne scars by removing the outer layers of skin to promote growth of new, smoother and more uniform layers. Possible adverse events include infection, bleeding, pigmentary changes and permanent scarring.

Dr. Bhatia noted that the acne scarring subjects reported higher satisfaction levels with the treatments than the photoaging subjects. This could be attributed to higher expectations of photoaging patients. "The results from this study show that patients first reported seeing changes in their skin between the third and fourth treatment," he said. "This helps us set up realistic expectations as to when they will see results. With therapies that do not produce immediate and striking results, it is helpful to provide guidance to the patients as to when changes should be seen.

This patient satisfaction study follows research published in Dermatologic Surgery in August 2005 that showed patients treated with less invasive or non-ablative lasers had significant improvement of mild to severe acne scars with fewer side effects common with ablative procedures.

"Research conducted by dermasurgeons is validating the safety and efficacy of non-ablative laser systems for treating acne scars and photoaging," said Gary D. Monheit, MD, president of the ASDS. "Although these procedures are becoming very popular with patients, expectations for their outcomes must be realistic."

Founded in 1970, the American Society for Dermatologic Surgery is the largest specialty organization in the world exclusively representing dermasurgeons, board-certified physicians who are specifically trained to treat the health, function and appearance of the skin and soft tissue with both medically necessary and cosmetic procedures. For more information on medical or cosmetic skin procedures visit asds.net.

From asds.net:

WHAT IS A LASER?
Laser stands for Light Amplification by the Stimulated Emission of Radiation. Lasers work by producing an intense beam of bright light that travels in one direction. The laser beam can gently vaporize and/or ablate skin tissue to improve wrinkles, scars and blemishes, seal blood vessels or cut skin tissue.
The laser has the unique ability to produce one specific color (wavelength) of light, which can be varied in its intensity and pulse duration. The newest laser systems have become remarkably precise and selective, allowing treatment results and safety levels not previously available.

WHAT IS SKIN RESURFACING?
Laser resurfacing to improve cosmetic flaws, such as wrinkles, acne scars, and aging and sun-damaged skin, is the latest scientific breakthrough in skin rejuvenation.

Using a wand-like laser handpiece, undesired skin cells and wrinkles literally disappear in a puff of mist and are replaced by fresh skin cells. One of the laser's most significant advantages over traditional techniques for skin resurfacing is that treatment is relatively bloodless. The procedure also offers more control in the depth of penetration of the skin's surface, allowing an increased degree of precision and safety in treating delicate areas.

WHO IS QUALIFIED TO PERFORM LASER SURGERY?
Dermasurgeons  have extensive experience with laser surgery and were among the first specialists to use lasers for skin renewal and treating a variety of skin disorders. Since results are technique-sensitive and entail an artistic component, it's important to select a dermasurgeon with demonstrated laser expertise

WHAT CONDITIONS CAN LASER RESURFACING TREAT?
Laser resurfacing is performed in the dermasurgeon's office to help:

  • Erase fine lines and wrinkles of the face
  • Smooth and tighten eyelid skin
  • Improve crow's feet around the eyes
  • Soften pucker marks and frown lines
  • Remove brown spots and splotchy, uneven skin color
  • Improve and flatten scars
  • Repair smoker's lines
  • Improve skin tone and texture

HOW DOES THE CARBON DIOXIDE (CO2) LASER WORK?
The newest generation of the CO2 laser delivers short bursts of extremely high-energy laser light. This revolutionary technology actually vaporizes the undesired skin tissue, one layer at a time, revealing fresh skin underneath. The laser's highly-focused aim enables the dermasurgeon to gently remove the skin's surface with a low risk of scarring and complications in properly selected patients.

HOW DOES THE ERBIUM (Er) LASER WORK?
The high-powered erbium:YAG laser produces energy in a wavelength that gently penetrates the skin, is readily absorbed by water (a major component of tissue cells), and scatters the heat effects of the laser light. These unique properties allow dermasurgeons to remove thin layers of skin tissue with exquisite precision while minimizing damage to surrounding skin.

The Er:YAG laser is commonly used for skin resurfacing in patients who have superficial to moderate facial wrinkles, mild surface scars or splotchy skin discolorations. Skin rejuvenation with the Er:YAG laser offers the advantages of reduced redness, decreased side effects and rapid healing compared to some other laser systems.

HOW DO NON-ABLATIVE LASERS WORK?
Unlike laser resurfacing technologies that heat and remove the top skin tissue, non-ablative or non-wounding lasers actually work beneath the surface skin layer. This novel approach appears to stimulate collagen growth and tighten underlying skin to improve skin tone and remove fine lines and mild to moderate skin damage. It offers the patient the benefits of few side effects and rapid healing with virtually no "downtime."

WHAT CAN BE EXPECTED DURING AND AFTER TREATMENT?
Discomfort is usually minor during the procedure, and your dermasurgeon can discuss the administration of any pain medication prior to treatment.

Following skin resurfacing, the treated areas usually are kept moist with ointment or surgical bandages for the first few days. The skin is typically red or pink and may be covered with a fine crust. The treated sites must be protected from sunlight after the procedure. Once healing is completed, sunblock lotion should be applied. In some cases, a pink surface color may remain for several days to several months. Make-up can be worn after about 7-14 days.

ARE THERE SIDE EFFECTS OR COMPLICATIONS?
Each year thousands of laser resurfacing procedures are performed successfully. Significant complications are rare, and the risk of scarring is low. Some patients may be at risk for varying degrees of pigmentation loss, particularly with the CO2 laser. Common minor side effects may include crusting, mild swelling, redness or brown discoloration at the treatment sites. These are usually minimized by surgical techniques and pre- and post-operative regimens.

WHAT ARE THE LIMITATIONS OF LASER RESURFACING?
Laser resurfacing is not a substitute for a facelift, nor can the procedure eliminate excessive skin or jowls. However, by tightening loose skin, laser resurfacing can improve certain folds and creases. Laser resurfacing offers an alternative to traditional resurfacing methods like dermabrasion, and can also work well in conjunction with or as an additional treatment to other cosmetic skin procedures such as chemical peelsblepharoplasty (eyelid surgery) and liposuction of the face and neck.