Smooth sailing: Planning for warmer weather with laser hair removal

Sunny days are ahead, and that means sundresses, shorts and swimwear that leave little to the imagination. If you are craving a soft, smooth look for the summer, your best bet is to start thinking about laser hair removal while it's still cold and the weather feels less than spring-like.

As with most things, the key to results, especially before summer, is timing. If you want beautiful, silky-smooth skin before your next beach vacation or to feel more comfortable in your own skin, planning is essential.

If you want your laser hair removal journey to be smooth sailing, let ASPS Member Surgeons Iliana Sweis, MD, FACS and Sara Dickie, MD, help you understand the process.

How does laser hair removal work?

The fastest way to kill your dreams of a smooth, hair-free summer is to be impatient. Unfortunately, laser hair removal doesn't occur overnight. It is a process. When patients understand how lasers work to create a smooth canvas, it can help them through what may feel like a long and arduous trek to the finish line.

"Lasers are pretty simple machines, actually," said Dr. Sweis. "They emit a specific wavelength that's absorbed by the pigment in the hair follicles and in the hair shaft. So, the process, the whole process, is called selective photothermolysis. The laser emits this specific wavelength that's absorbed by the melanin in the hair shaft and in the follicle. Then this light energy from the laser turns into heat, which damages the hair follicle."

She added that patients can think of the hair follicle as the root of a plant. When you damage or destroy the root, the plant can't survive. When you damage or destroy a hair follicle in the skin, you reduce the amount of hair in the area being treated with the laser.

Planning ahead means understanding you are in for multiple sessions

Laser hair removal may seem simple enough; however, the hair growth cycle can be confusing. It is also one of the points that can frustrate patients when they don't see immediate results after a single session, or even after multiple laser treatment sessions.

"There are phases of hair growth," said Dr. Sweis. "There's the active anagen phase. There's a transitional phase called the catagen. And a shedding, kind of resting, phase called the telogen. The laser only affects those follicles that are in the active growth phase, or the anagen phase."

Only a small percentage of a patient's hair is in the active anagen phase of growth at any given time.

"This phase can last three to four months for pubic hair and axillary hair," said Dr. Dickie. "The hair on our scalp is in this phase longer. For laser hair removal to treat all the hair in a given area, multiple sessions over months are necessary to treat as close to 100 percent of the hair follicles in a given area."

As a result, patients must stick to their treatment plan and undergo multiple laser treatment sessions and may not see results in the first few sessions. At any given time, the hairs on our bodies are in different growth phases.

"It may look like, 'I've got, you know, a full beard or a bikini, and therefore all of this is now growing, it's getting longer,'" said Dr. Sweis. "Yes, on the surface, that's true. But we have to think about what's happening at the follicle level."

This deeper understanding helps explain why achieving lasting results requires a series of treatments over time.

"Most laser treatment providers will recommend a package of around six treatments for the best outcome," said Dr. Dickie. "Patients may then need a session once a year to try and catch any stragglers or new hair that develops after their sessions are complete."

Often, these treatments are spaced four to six weeks apart, depending on the patient. However, results can vary, and laser hair removal treatment plans should be tailored to each patient.

"The facial hair, like the upper lip and chin, tends to be more hormonal," said Dr. Sweis. "So, that's usually going to be finer. The hair on the face, when we treat it, sometimes takes longer than the underarms or bikini area because it's finer and doesn't absorb as much laser energy as thicker, darker hair. For legs, arms and back, we usually tell patients to expect a significant reduction within eight treatments. It doesn't mean it's all going to be gone, but you should see a nice reduction. But when we're talking about, say, the face, ladies who have a mustache or excess skin along the chin, sometimes it can take 12 or more sessions to really get that treated."

Are you a candidate for laser hair removal?

Other factors, such as the amount of melanin in the hair and hair thickness, can also affect how many sessions a patient may need to see results. The ideal laser hair removal patient typically has fair skin and dark hair.

"Almost all patients are candidates, but the best results are seen in patients with lighter skin and darker hair," said Dr. Dickie. "This is because the pigment is what is being heated by the laser to kill the follicle. If the skin is as dark as the hair or the hair as light as the skin, you can risk loss of skin pigmentation or lack of treatment altogether. Darker-skinned individuals should see a physician who is skilled at treating skin of color to avoid these risks. They will also have the most effective lasers to treat darker skin tones. Not all lasers are the same when it comes to skin type, so choose your provider wisely."

Results can even vary for the same person across different regions. Fine or lightly colored facial hair may respond differently from thicker, darker hair along the bikini line. In some patients, electrolysis may be a better option for hair removal. Laser hair removal for patients with darker complexions can also be more challenging, which is why it is recommended to seek someone with extensive experience and training in this field for the best results.

Laser hair removal isn't just a treatment option for patients who want a silky look and feel for summer. Dr. Sweis mentioned how laser hair removal can also help boost confidence in individuals with hormonal conditions, such as polycystic ovary syndrome (PCOS). This is a hormonal disorder that can cause excessive facial hair in women, especially on the chin and upper lip. Laser treatments can help reduce this hair and alleviate some of the shame and embarrassment some women feel due to excessive facial hair growth.

More than cosmetic, laser hair removal offers some patients, not just physical results, but truly transformational emotional results as well.

Smooth sailing means putting in the prep work

If you want silly results, you are going to need to invest more than just your time. You'll need to do a little prep work, which is another reason it pays to plan ahead and not wait until the summer months to schedule your laser hair removal treatments.

The end of winter and the beginning of spring may be the perfect time to consider laser hair removal, as most people are still pale from the cold, dark winter months. Again, the darker an individual's complexion, the lower the laser settings should be to reduce the risk of burns or hyperpigmentation. That means before your sessions, stay out of the sun and lose the self-tanners.

Dr. Sweis also recommended reviewing your overall health and wellness. Some medications can increase photosensitivity, increasing the risk of burns and skin irritation. A patient also needs to ensure they don't have any active skin infections before starting treatment.

Patients should also plan to let their hair grow a little between sessions to allow the last to do its job.

"There will still be hair growth happening between sessions," said Dr. Dickie. "It's important not to wax during this time and only shave. The laser has to have a hair bulb in its follicle to 'see' in order to treat it. If there is no hair bulb because it's been plucked or waxed, the laser will not work."

It can be tempting to pluck stray hairs unaffected by the laser, but for the best results, resist the urge to wax or pluck between sessions.

Prep work also means taking care of your skin in between sessions. Dr. Sweis suggested avoiding laser hair removal treatments right before sun-drenched vacations, when patients may be exposed to high levels of UV rays.

"If you expose sensitive skin to the sun within a week or two after having laser hair removal, it can hyperpigment," said Dr. Sweis. "So, you want to make sure that you're not going to Hawaii a week after your laser, and you didn't just come back from Hawaii the week before your laser. You also want to make sure that if the area's going to be even slightly exposed to the sun, make sure you have protected it with adequate sunscreen."

Even before summer vacation begins, break out the SPF and make sure you are protecting your skin.

What to expect from laser hair removal?

It's best to start by thinking of laser hair removal as laser hair reduction. For the most part, when you destroy the root, you destroy the hair. Typically, that means once you undergo a complete course of laser hair removal, you are hair-free for life, but you may still find a few hairs over time.

"You will never, once it's gone, you'll never have the same amount of hair that you had there before, never, if you have a normal response," said Dr. Sweis. "But 10 years later, you might have a few hairs here and there, absolutely. Most patients at that point might tweeze one or two. They're not going to necessarily come back for laser hair removal."

Is laser hair removal permanent? Yes, for the most part, but it isn't unusual for a few strays to pop up here and there eventually.

Don't short-change yourself – see a professional

Once the weather warms up, there is no shortage of ads telling you to hit your local tanning place or med spa for some color and hair removal. Treat carefully because not all "lasers" are created equal.

"The term 'laser' is so overused and sometimes inaccurately used," said Dr. Sweis, adding that she has seen patients claiming they tried laser hair removal and it didn't work, only to review their records to find that the patient either didn't receive enough treatments or that they weren't really being treated with a laser.

Lasers are powerful and potentially dangerous devices that can cause serious side effects and complications like burns, which can cause infections, scarring and hyperpigmentation. Dr. Sweis also explained that, in very rare situations, patients may experience a paradoxical side effect that actually stimulates hair follicle growth.

Patients may be expecting cosmetic results, but these machines can cause real medical issues, which is why it is so critical that patients do their homework before seeking treatment and work with an ASPS Member Surgeon or other medical specialist.

A red flag? Upon walking into a laser hair removal treatment center, the individual is ready to take the patient back for their first session, no questions asked. Patients should expect to complete an intake form and have their medical history reviewed before any treatments.

You should also ask how long the individual has been performing laser treatments, who is calibrating or adjusting the laser settings and whether a physician is onsite to review treatment settings or manage complications when necessary.

Start now to be warm-weather ready!

If you are ready to take the plunge, physically and metaphorically, then now is the perfect time to start planning your laser hair removal journey with a skilled plastic surgeon.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.