Why isn't laser hair removal working for me?

Question

I have very dark this hair and my skin is very white. I'm of middle eastern decent. I've been doing laser hair removal for a while (a few years) but the hair keeps growing back. I know its supposed to be permanent hair reduction but the results are not very good. I've switched to a local company because the last place I was getting laser hair removal done wasn't so good and they went out of business. Could there be an underlying medical problem?

Anil R. Shah, MD · Answer

Ineffective laser hair removal may be a result of inappropriate wavelength, underpowered laser (low fluence or handpiece that requires replacement), underlying medical or hormonal condition (i.e. polycystic ovary disease), or provider with not using appropriate technique or settings.There is no single best laser system, but characteristics of a good laser hair removal office and laser are as follows for Middle Eastern hair removal

-Experience treating Middle Eastern Skin- Staff must be knowledgable about Middle Eastern Skin and understand how to treat it.  If the fluence is too low, more hair can result (hypertrichosis) rather than hair loss

-Proper wavelength- Diode and Nd:YAG are the two best lasers for Middle Eastern hair removal.  In my office, we prefer the diode as it requires less sessions and tends to be more effective in targeting and treating hair (more hair removed per session)

-Appropriate cooling- All laser systems need cooling to provide safety and comfort.  Uncomfortable laser hair removal tends to result in lower laser hair settings and can cause actual more hair to occur rather than less hair.

Hope that is helpful.

J. Matthew Knight, MD · Answer

Thanks for your question.  Certainly, there are medical conditions that cause hirsuitism (too much hair) like posycystic ovarian syndrome, adrenal problems/tumors, certain medications, etc and you should explore this with your primary care physician if you're worried.However, there are many reasons why laser hair reduction doesn't work.  There are a few different main types of lasers for LHR (Nd:YAG, Alexandrite, diode) and they all work differently.  YAG tends to be the least effective and hurt the most, but it's widely used because it's safest for darker skin types.  Since you're fair skinned, see if switching the type of laser being used helps.  Also undertreatment can lead to suboptimal results - make sure the provider is using enough energy on you, but not so much that it causes problems.

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