Contraindications of laser hair removal & Risks
Laser hair removal has become a popular solution for those seeking to get rid of unwanted hair in a lasting and effective way. As a cutting-edge technique, it offers many advantages over traditional hair removal methods. However, like any medical procedure, it has specific therapeutic indications, contraindications and certain potential risks.
This article aims to provide a comprehensive overview of these aspects, to help you make an informed decision before embarking on a laser hair removal treatment. Whether you’re an ideal candidate or have specific concerns, we’ll guide you through the essential information to assess whether this method is the best option for you.
THERAPEUTIC INDICATIONS
All skin types, from the lightest to the darkest, can undergopermanent laser hair removal if the right laser is used.
The easiest cases to treat are those with thick, dark hair (which, by definition, contains a high level of melanin) and fair or poorly pigmented skin. With such indications, only 5 to 8 sessions are required.
When the hair is light, blond or red, there’s a good chance that laser treatment won’t be effective. However, for some blond or redheaded subjects, the results were convincing. It is advisable to carry out a hair assessment during an initial consultation, followed by two trial sessions to determine the feasibility of the treatment.
Finally, white hairs cannot be treated by laser, as there is no melanin present.
Ingrown hairs and folliculitis
The laser can also be used to treat ingrown hairs and folliculitis.
It has two functions:
- Curative, as it removes ingrown hairs,
- Preventive, as it removes the hair and prevents further ingrown hairs. These are more frequent in dark-skinned or black patients, on the bikini line and legs in women, and on the beard and neck in men.
Permanent laser hair removal can remedy this problem by directly attacking its cause: the hair itself. Excellent results are obtained on subcutaneous hair and microcysts, which disappear in just a few sessions.
Shaving is not recommended in this case, as it can increase the number of folliculitises.
Hirsutism
Hirsutism is a condition affecting almost 10% of women. Hirsutism occurs when coarse, black hairs grow on areas with little or no hair, such as the upper lip, chin, neck, inter-mammary fold, umbilical-pubic line…
Hirsutism is a complex medical problem requiring joint follow-up with a gyneco-endocrinologist.
Permanent hair removal can be a solution to hirsutism. Some endocrinologists recommend combining permanent hair removal with hormone treatment. Indeed, as long as hormone treatment is not adopted, hair regrowth will occur (to a lesser extent) even in the case ofpermanent hair removal.
Hypertrichosis
Hypertrichosis is excessive hair growth in areas where the woman already has hair. Hair distribution is normal, but there is an increase in the length and diameter of these hairs. Note that the number of hairs does not increase, only their size (length and diameter). This type of hair spreads over a large part of the trunk, hands and face.
Hypertrichosis is most often genetic (Mediterranean women) and light phototypes are spared. Unlike hirsutism, hypertrichosis does not require hormonal testing.
Anti-androgens are ineffective. Laser hair removal techniques have made considerable progress in the treatment of hypertrichosis.
At what age should I start laser hair removal?
The ideal age to start laser hair removal is determined by the age at which hormonal maturity is reached, i.e. around 25 for women and 30 for men.
It is still possible to start laser hair removal.
PRECAUTIONS TO BE TAKEN
Before the laser hair removal session:
Sun exposure is forbidden for two months prior to the session, as are sessions in a UV booth.
UV rays stimulate the production of melanin, which rises to the surface of your skin. The laser will confuse your skin’s natural melanin with that produced by the sun, causing burns. Only thick textiles can provide effective protection against the sun’s rays.
Six weeks before the session, the use of tweezers and wax must be discontinued. These hair removal methods pull out the hair bulb, so the laser will not be effective.
We also recommend that you refrain from steam baths, saunas or body scrubs on the days preceding your laser hair removal session.
After the laser hair removal session :
Redness, sensations of heat and irritation are to be expected for a few hours, or even a few days for the most sensitive areas, after hair removal. You can alleviate these sensations by applying Biafine-type creams to areas that have been depilated.
For the next few days, you should continue to apply this soothing cream to the treated area. However, redness, irritation, warmth and swelling should be monitored, and a medical examination should be carried out for a proper diagnosis and prescription.
Ten days after the session, a number of activities should be avoided:
- Sauna
- Hammam
- Scrub
- Swimming pool
- UV exposure (sun, UV cabins)
- Self-tanners
- Photosensitizing drugs
- Beta carotene
RISKS & POSSIBLE COMPLICATIONS
Laser hair removal is safe if the contraindications are respected. There are several types of contraindication tolaser hair removal, some of which are temporary and others permanent.
TEMPORARY CONTRAINDICATIONS
These temporary contraindications allowpermanent laser hair removal under certain conditions.
- Photo-sensitizing and anti-acne medications
They may constitute another temporary contraindication to laser hair removal: in some cases, it may be necessary to wait until treatment has been completed before carrying out tests prior to a hair removal session.
- Tanning and betacarotene
Recent exposure to the sun or ultraviolet rays, use of self-tanning lotions or tanning activators (such as Oenobiol®) delay laser treatment (some lasers, such as Clarity Lutronic, can treat tanning residue; your practitioner will inform you accordingly if your indication allows).
- Taking anticoagulants
These drugs are sometimes implicated in the side effects of laser treatments. Laser impacts can cause small hemorrhages in the tissue. It is therefore advisable to inform the laser physician if you are taking anticoagulant medication.
- Naevi (moles)
Moles must be bypassed by the laser beam, as there is a risk of degeneration.
- Herpes
Herpes outbreaks on the treated area(s) must have been treated prior todefinitive laser hair removal. For patients with herpes labialis, a preventive treatment will be prescribed before the laser hair removal session.
- Evolving skin infections
To avoid adding aesthetic risk and the trauma of an evolving lesion, it’s best to wait for complete healing.
- Severe allergic reactions in progress
Allergic reactions such as bullous dermatitis, recent urticaria or recent allergic skin reactions are temporary contraindications, as the skin is in the midst of a reaction or regeneration phase, and this process must not be altered bythe action of the laser.
DEFINITIVE CONTRAINDICATIONS
These contraindications preclude definitive laser hair removal treatment.
- Pregnancy
Pregnancy is a medico-legal contraindication to permanent laser hair removal (although no malformation has ever been observed to date).
- Keloids (colored or raised scars)
The presence of keloids is not a contraindication to permanent laser hair removal.
However, they require special monitoring and must be bypassed by the laser beam.
- History of allergy and cold urticaria
As lasers are equipped with refrigeration devices, they cannot be used on patients with cold urticaria.
- Bleeding history
Some patients react with haematomas or haemorrhages to very slight trauma: the laser must be used with great caution in these cases. Hemophilia also remains a contraindication to laser treatment.
- Tattoos
The tattoo pigment absorbs the laser light, releasing very high levels of thermal energy and causing a burn: treatment close to a tattoo therefore presents a risk. However, thanks to a specific procedure, we are now able to treat an area close to a tattoo.
- Poor venous circulation (heavy legs)
If a vein becomes hard, yellowish and painful, it’s probably superficial phlebitis.
RISKS & COMPLICATIONS OF LASER TREATMENT
Permanent laser hair removal can be risky, which is why it must be carried out in a medical center.
Several types of complications can arise following apermanent laser hair removal session. Most are not serious and last only a few hours to a few days. If in doubt, contact your doctor.
- Burns
These burns particularly affect dark, tanned or recently exposed (even untanned) skin, or skin that has previously taken beta-carotene or self-tanners.
They appear as scabs or even bubbles, and occur when the stratum corneum (the layer furthest from the epidermis) has exceeded its heat tolerance threshold.
Infection must then be avoided by applying a mild disinfectant, and they must be protected from light and oxygen and kept soft. They should therefore be protected with a Vaseline dressing to allow the new skin to reconstitute itself before the scab falls off. The duration of this treatment should not exceed 3 weeks.
These scabs can lead to hypopigmentation or hyperpigmentation, which is usually reversible. More rarely, scars will remain visible and reduce in size over time. In this case, the doctor will prescribe a suitable medical treatment.
- Pigment disorders
They can manifest themselves in two ways: hyperpigmentation (an increase in the skin’s usual color) or hypopigmentation (a decrease in the skin’s usual color).
The risk of post-inflammatory hyperpigmentation increases with skin type, while hypopigmentation occurs in pigmented areas or those with burn sequelae. These problems are generally transitory, but can last several months. In some cases, they may require specific treatment with creams dispensed by the doctor. Hypopigmentation usually disappears with the first exposure to the sun.
- Hematomas
They may appear in patients on anticoagulant therapy (aspirin or anti-vitamin K).
- Paradoxical regrowth
In certain areas with fine down, the laser can stimulate the down, transforming it into real hair. For this reason, never pluck the down. The main factors favoring this paradoxical regrowth are hormonal disorders in the context of polycystic ovary syndrome, and the use of certain medications such as corticoids and Finasteride®.
The areas to avoid containing down on women are the neck, cheeks and arms, while on men it’s the cheekbones, neck and shoulders.
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