I Had Laser Hair Removal in 1997. Are There Any Known Long Term Effects from Those Treatments?

Back in 1997 when I was 18, I was taken to a doctor in philadelphia for facial laser hair treatment. The first couple of treatments, used a laser that required wiping a black salve type liquid on my face and finally, after several treatments later, they started using a clear cooling gel with a different laser. The treatments were extrememly painful and, in the end, extremely ineffective. Are their known risks/long term effects to these first lasers to be concerned about now?

Doctor Answers 1

Short and long term side effects of laser hair removal

Laser hair removal side effects are usually seen fairly rapidly after the treatment.  Most of them are temporary, such as hyperpigmentation or even burns.  Hypopigmentation can sometimes last a very long time.  If the burns are deep enough, they can result in permanent scars.

However, if you had no side effects after the treatments, they will not show up years later.  Lasers used for hair removal are in the visible light spectrum.  

There are lasers that use ultraviolet light to treat diseases such as psoriasis or vitiligo.  Those can potentially have long term side effects because ultraviolet light can cause damage to the DNA, the genetic code of the cells, and years later may result in precancerous or even cancerous skin lesions.  That is rare but can happen.

Here are some more details on laser hair removal side effects:

Laser hair reduction works by targeting the pigment (melanin) in the hair follicle. Melanin then absorbs the heat delivered by the laser and transfers it to the nearby growth control center of the hair follicle (stem cells). Heating of the stem cell area causes the hair to become lighter and finer until it is small and fine enough not to be seen above the skin surface. The hair is not actually destroyed, nor is the hair follicle scarred.

Under certain conditions, like hormonal changes during menopause or in women with polycystic ovary syndrome, the treated hair follicles can get activated again and start producing dark terminal hairs that again grow above the skin surface.

Because the laser actually preferentially targets the darker areas, the major potential side effect is burning the epidermis (surface layer of the skin), since it also contains melanin. That can result in darkening or lightening of the skin. If the burn goes beyond the epidermis into the lower layers of the skin, actual scarring and skin texture change can result.

It is extremely important to make sure that laser hair removal is not performed on anyone who has had sun exposure to the area to be treated within at least 6 weeks before laser hair removal. When the skin tans, the melanin darkens and the difference between the skin and hair color is significantly reduced. That makes it more likely that the laser will hit the pigment in the epidermis and cause a burn.

It is also important to carefully and accurately determine the person's skin type prior to the procedure. That is done by means of a detailed questionnaire, and not by just glancing at the skin and making a judgment. Skin type determines the proper settings on the laser that will also minimize the potential for side effects.

To decrease the risk of side effects, it is best to have the procedure done by a board-certified, trained and experienced physician, to do careful skin typing and to avoid sun exposure for at least 6 weeks prior to treatment.

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