Which laser is best for beard removal on skin type III or IV?

There are several lasers available to reduce your beard hair.  What's more important is choosing a physician and a center with extensive experience rather than a specific laser, since nuances and setting variations make a big difference in lowering complication rates and increasing rates of success. 

Lasers for hair removal target the hair pigment.  This is why laser hair removal is not effective on blonde or white hair.  It is also why treating darker skin types is more challenging.  Pigment on the skin competes with the pigment in the hair.  As a result, different settings must be selected to protect the skin.

In general, I favor the Gentlemax laser, which allows me to select between an alexandrite or an Nd:Yag laser.  For darker skin I favor the Nd:Yag wavelength and for the fairer skin types I favor the alexandrite.  Other lasers, such as diodes and others out there may also be effective.  You have indicated in your question that you are skin type 3 or 4.  This gives your physician several options.  If you are truly type 3 skin (always tan, sometimes burn in the sun), then I would select the Gentlemax using the alexandrite component.  If you are type 4, I would want to evaluate your hair and skin contrast to choose the proper settings and laser.  Either way, you should have success.

The white heads are simply the result of inflammation in the hair follicle following the treatment.  It can actually be somewhat of a good sign that the laser is targeting the proper areas (i.e. the follicle), although I do understand the white head aftermath is a nuisance.  As a result, talk to the physician performing the procedure.  You might be a good candidate for a benzoyl peroxide wash.

I wish you luck.  Stick with it, because the beard  hair should respond very well.  I strongly recommend having physicians involved in your care rather than a spa environment, as it will markedly diminish risk to your skin and increase the chances for success.

Warmly, Robert Anolik, MD

There are several questions here.

First, for your type of skin the alexandrite is a very tricky laser.  It can be used in Type 3 carefully, buy for type 4 it has a much smaller safety window.  I would recommend something in the 810nm range like the Lightsheer or the Duet.

As for the pain.  The beard hair is so thick that it absorbs large amounts of hear and thus can be very painful.  So yes, it is normal to have this be painful.

The pimples is a result of the folliculitis that occurs with hair removal.  Not a concern, and you may get small whiteheads, but as long as you don't play with them, they should not be of any long term consequence.

Laser hair removal is safe in the right hands.  I would avoid the medispas that do not have a physician present.  They are more likely to have problems with your color skin.