Nd Yag or Alexandrite Laser for Coarse Hair?

Question

i have very coarse hair in my bikini, legs, and underarm area. while the hair on my arms and belly is normal. I am skin type 3-4 and i went to 2 doctors. first doctor told me that i require Nd yag because alexandrite lasers only work with very fair complexions and there is a risk of burn. While the second doctor told me that she will use Alexandrite laser because there is no risk. note the 2 doctors are very reputable doctors in this field however i dont know who to go with.

Michael Law, MD · Answer

Both the Yag and alexandrite lasers can work effectively for coarse hair. The skin color is what determines which laser will be safest and mot effective. Start by finding a medical practice that offers BOTH the yag and the alexandrite laser so you will be getting the best information possible.

The following can help in deciding the right laser and the right environment for laser hair removal

Laser hair removal has come a long way since the first laser for hair removal received FDA clearance in the mid 1990’s. Older generation lasers were slow, very painful and worked only on individuals with very dark hair and very light skin. Today, lasers can work on all skin colors and some lasers are even safe for treating tanned skinned. Lasers for hair removal can be performed on any (yes, any) area of the body.

When considering a hair removal laser treatment, consumers should ask the following questions:

1) Is this laser FDA approved for hair removal on my skin type and hair color?

There are several lasers for hair removal available. No one laser is ideal for every individual. Depending on your skin color and hair color, some lasers will be more effective than others.

The Ruby Laser: This is the "original " hair removal laser. Its deep red color at 694nm is very well absorbed by the melanin pigment in hair, making it an excellent choice for fine and light hair. However, because melanin is present in the skin as well, the Ruby laser cannot be used on patients with skin that is not very light, including tanned skin. Because of this limitation, slow repetition rate, and relatively small spot size, Ruby lasers have become less popular for laser hair removal in recent years.

The Alexandrite Laser: This laser produces reddish light. With its large (up to 18mm) spot size and high repetition rate, the Alexandrite laser is the fastest hair removal laser, and is suitable for rapid treatment of large body areas in patient with light to olive complexion. An entire back can be treated in less than 30 minutes.

The Diode Laser: This laser, consists of a high power laser diode emitting infrared (invisible) light at ~800-808nm. The longer wavelength allows deep penetration into the skin and safety for darker skin types, but with less efficacy for lighter and finer hair. A smaller spot size means a longer treatment. That may mean a more expensive treatment. A longer treatment may also increase discomfort and a need for topical numbing

The long pulse Nd:YAG: This laser can be used on all skin types, including tanned skin. Large spot sizes and fast repetition rates allow large areas to be treated quickly. Then disadvantage is less effective clearance for fine and light hairs than some other hair removal lasers.

IPL devices are not lasers, because they emit non-coherent light of many different wavelengths. However, because most of the light energy is in the shorter wavelengths, treatment of darker skin types is less effective than with the appropriate laser.

2) What is the spot size of the laser? A larger spot size offers not only the advantage of faster treatment, but also additional safety and efficacy. As spot size increases, a lower percentage of the delivered light energy scatters outside of the treatment area, increasing the depth of pentration, and allowing a lower energy setting to be used for treatment.

3) What type of cooling system is the laser equipped with? It is important that a laser have consistent cooling in order to ensure patient safety and comfort.

4) Is there a board-certified physician on site? Although complications with new lasers for hair removal are rare, in the event of a complication, you need to know who will provide medical attention.

5) Are treatments sold in a package or one at a time? Because every person will respond at a slightly different rate, and some individuals will require more treatments than others for complete clearance, most laser centers will offer individual sessions.

6) Are complimentary consultations and spot tests available? You should be able to meet the technician and experience a pulse or two before committing to a treatment.

Harold J. Kaplan, MD · Answer

Hi Hinder.  The bottom line is that both of these lasers will be safe for you when used correctly.  The Nd:Yg laser carries a much lower risk of blisters and burns for your skin type than the Alexandrite, but the Alexandrite may actually lead to quicker hair removal (less treatments).  In addition, the Alexandrite is probably more approriate for the normal hair, whereas the Nd:Yg will work just as well for coarse hair.

	To have the first MD say that the only laser for you is the Nd:Yg we think is misleading, but it is a safer laser for your skin type.  If safety is your primary concern, we would choose the Nd:Yg, whereas if faster results are your primary concern, we would consider the Alexandrite.  Good luck.

William Ting, MD · Answer

Hair laser removal using Nd:Yag wavelength is universally agreed upon to be safest for ethnic skin individuals where hair laser removal using Alexandrite wavelength is thought to be the superior among the current technology. With Cynosure's Elite MPX, you will be able to achieve the best of both worlds as both Nd:Yag and Alexandrite wavelengths are delivered. Make sure your hair laser removal is performed under supervision of a board-certified dermatologist or plastic surgeon so that any complication such as blistering, pigmentation or secondary infection can be intervened immediately and appropriately.

Elizabeth Slass Lee, MD · Answer

The ndYag is the safest laser to use with darker skin. Both are extremely effective for permanent laser hair reduction. An experienced practitioner can get good results with the Alexandrite in type 4 skin, but there is no question that the risk of hyperpigmentation is greater with this wavelength than for the Yag. If you have a choice between the two, go with the ndYag to minimize the risk of this less than desirable side effect.

Ron Shelton, MD · Answer

Both the Alexandrite laser and Neodynium Yag lasers are used on dark skin. However, the appropriate energy settings need to be used and not both frequencies on the NdYag laser. It is best to do test spots if an Alexandrite will be used, and it can help to do the same with NdYag. No laser is without risk of hyperpigmentation and even permanent hypopigmentation or scar when hair removal is performed.

Louis M. DeJoseph, MD · Answer

If your skin type is 3 to 4, the 1064nm yag laser would be the laser of choice. It is excellent on darker skin types. The alexandrite does carry a slighter risk on your skin type, but in very skilled hands, it can be used effectively. Just do your homework and ask the doctors to show you results of dark skinned hair removal that they performed. Hope this was helpful. Dr D.

Jordana S. Gilman, MD · Answer

The choice of which laser to use is based more on the amount of pigment in your skin and not on whether your hair is coarse or fine. Both lasers will get the job done, and can do so safely. Both lasers also have a risk of temporary or permanent discoloration. The NdYAG has less of a chance of discoloration, however, and since you have a choice between the two you should go with the NdYAG. You should be sure that you are being treated by an experienced provider in order to minimize the risks, and you may want to have a test spot before treating the entire area.

Shawn Allen, MD · Answer

To be on the safe side the ND YAG will be safer for a darker skin type and can use higher energies safely to get optimal results. That being said, the Alex is an excellent hair removal device for those with lighter skin. It sounds like you need a third opinion to break the tie. If one doctor owns the Alex and said dont use it , then perhaps seeking a NdYag makes most sense to be safe.

Mahmood Kara, MD - Account Suspended · Answer

I would highly suggest you find a reputable clinic that has a dual wavelength laser with both Yag and Alexandrite. The Clarity Laser from Leutronics has this feature and can safely and effectively treat all skin types and hair textures. Achieving optimal results will be determined by chosen technology, operator experience, settings used, treatment frequency.

Eugene Mandrea, MD (retired) · Answer

For skin types I and II  and III, the Alexandrite Laser is the best choice.

	For skin type IV,  it may or may not cause PIH (Post inflammatory hyperpigmentation). Due to the fact that you  have coarse hair,  the laser power will have to be high.

	A test spot  (behind the ear) might be helpful in this respect, but it will not guarantee absence of pigmentation.

	I would play it safe and go with the NdYag, which is best for types  IV and V

Nd Yag or Alexandrite Laser for Coarse Hair?

Answers (11)

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