Many people tolerate the procedure just fine without any anesthesia, but of course pain threshold can vary from person to person. If necessary, a topical anesthetic can be applied 30 minutes to one hour prior to the procedure, but caution must be used when treating a large body surface area as too much absorption can be dangerous. Most lasers used for hair removal have a built-in cooling device which also helps to make the treatment more comfortable.
The only anesthesia that is used for laser hair removal is topical cream, not general anesthesia. The topical medications need to be used with great caution. If they are applied over a large surface area or under occlusion, such as covering with plastic wrap, enough of the medicine can be absorbed to be dangerous. Make sure if you are applying an anesthetic cream, your laser physician lets you know the size of the area to be treated and the amount of medicine to be applied for numbing. Many of my patients tolerate laser hair removal without any anesthesia at all.