The Center of Aesthetic and Reconstructive Surgery of York, P.C

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The Center of Aesthetic and Reconstructive Surgery of York, P.C
Apple Hill Medical Center
Suite 292
25 Monument Rd
York, PA 17403
Appointments: 1.717.741.4746
Fax: 1.717.741.5666

Unwanted body hair is a problem for both women and men. Traditionally hair may be removed by shaving, plucking, waxing and electrolysis. In the early 1990’s, the reports of using laser energy to selectively damage and disable actively growing hair follicles were published, and since the mid-1990s, laser hair removal has become the "gold standard" method for hair removal.

There are several laser hair removal systems available today; they all work using the principle of selective photothermolysis, in which a carefully timed pulse of laser energy passes through the skin and is absorbed and converted to heat energy at the hair follicle. Because longer wavelength laser light penetrates deepest, the most common lasers used are the Ruby, Alexandrite, Diode, and indeed: ND:YAG lasers, all red or infrared lasers.

Laser hair removal works best in lighter skin, darker haired patients. Because the target chromophore (pigment that absorbs the laser light) in the hair follicles is a melanin pigment, and there is a greater concentration of melanin in the hair, the skin absorbs less laser energy and more is absorbed by the hair follicle. Tanned skin and darker skin types may rob laser energy as it passes through the skin to the hair follicle. The infrared ND:YAG lasers is less dependent on skin color than the Ruby or Alexandrite lasers. In fact, this type of laser has been used to treat pseudofolliculitis barbae, observed in men, frequently African-American, secondary to shaving, with no complication of pigmentation changes of the neck or facial skin. This is the only laser that is approved for darker pigmented patients.

Multiple treatments are necessary for best results. This is because the laser energy has its greatest effect on growing, or anagen hair follicles; as the dormant, or telogen hairs become active, usually within three weeks to three months, some new hair growth will be observed. The female face, armpits, and bikini lines are the areas that respond fastest to laser treatments; backs, arms and legs are usually need more treatments over time. Repeated laser treatments appear to induce a permanent reduction in the amount of visible hair. Some hair growth, however, may occur over time; if this occurs, the hairs are usually finer and grow much slower than before treatment. Total hair removal may be possible with repeated treatments over time.

As noted, there are alternative laser systems available for hair reduction. All laser systems attack the melanin pigment that is produced in the bulb, and possibly the bulge, of the hair follicle. Actively growing hairs are the longest and deepest. The melanin pigment (the target for laser hair removal) is most abundant in the hair bulb and less abundant in the skin.

The reason for the center using the ND:YAG lasers over other lasers on the market is that as the wavelength of laser light increases from 630-nm to 1100-nm, epidermal (skin) melanin absorbs progressively less radiant energy. This means that the epidermal layer containing cutaneous melanin is not going to heat up as much when it sees ND:YAG lasers energy as opposed to that of shorter wavelengths such as a 755-nm Alexandrite or 810-nm diode laser. Then, as the amount of melanin in the epidermal layer increases, these shorter wavelengths have to expend more and more energy to penetrate the epidermis; this applies more heat to the skin and less to the hair follicle. This means a greater chance of pigmentation changes of the skin or blistering. The longer wavelength ND:YAG laser's photons "slide through", giving a greater probability of destroying the hair follicle with associated less expenditure of energy. Properly designed, the laser energy will target the melanin and hair follicles, while sparing adjacent structures, including melanin in the epidermis. The optimum pulse duration should be longer than the thermal relaxation time of the epidermis, allowing heat energy to be conducted away, but shorter than the thermal relaxation time of the hair follicle, confining the heat to the structure. This process is facilitated by cooling the skin, leaving the deeper hair follicles more vulnerable and by having longer pulses that enhance the heating and expand the zone of thermal damage to the hair follicle.