The following is an excerpt from the Glow Journal podcast. To listen to the full interview, subscribe now on iTunes or Spotify
In this instalment of our Ask An Expert series with our friends at Candela Medical, we’re taking YOUR questions to Kirsten Cachia. Laser hair removal has been one of our most highly requested subjects this year so, for our final instalment of our Ask An Expert series this season, we are finally answering your questions.
Away from our regular brand founder conversations, I am frequently asked so many highly specific questions about the skin. Given that I am an educated consumer and by no means an expert, it would be extremely unethical for me to even attempt to address your skin concerns- which is why I have long insisted on taking those questions to a qualified expert. That’s why I truly love producing this Ask An Expert series with Candela. Although the series itself is sponsored, doctors legally and ethically have to remain completely objective in interviews like this. For this reason, this series is the single most authentic way for me to integrate branded content into the podcast because it’s giving you, the listeners, completely unbiased expert answers to your most specific skin questions.
GLOW JOURNAL: This has been, without question, one of our most requested ask an expert conversations, so naturally we’ve received a lot of questions. I’m going to start with the broad ones and then we’ll get into the specifics. So, to start, what actually is laser hair removal?
KIRSTEN CACHIA: Laser hair removal is based on a selective photothermolysis. In other words, we we use a specific wavelength that is attracted to melanin within the hair follicle and also the stem cells that surround the hair follicle. Once the photons of light have been absorbed by the melanin in the hair and the stem cells they are converted to heat, and it is this heat that partially destroys the target.
Okay, so how does it work? What is the laser actually doing? How is that preventing the hair growth?
The mechanism, selective photothermolysis, is the heat from the light. Once it’s been converted to heat, it actually heats up the hair follicle and the steam cells to the point of destruction. Therefore those stem cells that usually that do produce a new hair are much weaker and they can’t produce the same quality hair that they were producing before. So over the course of your treatments, the hair becomes finer, it becomes lighter, it becomes less dense. You notice all these patchy areas, although we can only promise an 80% reduction in hair growth, what is left are just a few residual hairs and they may need a touch up every three to six months.
Is there a difference between laser hair removal and IPL?
Yes, there is a great difference between laser and IPL. Laser is a beam of light, which means it is one wavelength. It is one colour. It is non divergent. It travels in the same direction at the same time, every single time, it travels to the same depth of penetration every time and it is very intense.
IPL, on the other hand, is short for Intense Pulse Light. IPL is a broad band of light within the spectrum of light. It covers all of the colours in the spectrum. It ranges from 400 nanometers to 1200 nanometers, so therefore you’re using many wave lengths, not just one wave length. It picks up on lots and lots of chromophores within the skin. Just for an example, for hair reduction, we usually use between the 600 nanometers and the 900 nanometer range. And those many wavelengths cover many colours, and therefore you can see the penetration ranging from the epidermis to the dermis. The IPL light also travels in many different directions so therefore, again, it picks up on different chromophores within the skin and different sizes of hairs. It is great for hair reduction, although you need to be especially careful with the darker skin types.
I assume this varies from person to person, but roughly how many sessions are usually required and how long would we need to wait in between appointments?
Yes, it does. You’re very right- treatment sessions will depend on person to person. It also depends on the type of hair, course medium fine, the ethnicity of the client, the anatomical region that you are treating, the hormonal activity and the age of the client as well. On average, anywhere between six and 12 session are required. Depending on the anatomical region, intervals between those sessions can range anywhere from four weeks to eight weeks in the first few treatments. And as we start to see a reduction in the hair growth, we will stretch those treatment intervals out to 12 weeks in some cases.
A few listeners have written in to ask if laser is truly permanent or not. You’ve mentioned that we can expect about an 80% reduction. When can we expect to see hair growth again?
We know that it is FDA approved, and FDA approval of laser hair reduction is for 12 months after your last treatment, within your course of treatments. And the reason for this is due to hormonal changes that occur throughout one’s life. Also health changes, medications that you might stop taking or start taking. Not many people experience regrowth within the first 12 months after their full completion of treatments, but it must be noted that if any of the above changes do occur, it is possible that they will get a little bit of regrowth during that first 12 months, especially if their hormones change. But, on average, most people can continue with the occasional maintenance treatments maybe once or twice a year and they really don’t notice any regrowth. And that can last up to 10 years.
I think that’s really good that you’ve brought up things like hormones and changes like that, because if we went and got a facial treatment, you wouldn’t expect that to last just forever because the skin changes, and really, at its core, this is a skin treatment. That’s what we’re dealing with.
You’re right. It is.
A lot of the questions that we received centred around the process of laser hair removal itself, and what to expect on the day. One listener asks “Does it hurt?” while another asks “How can I make it not hurt?”
Yeah, this is one of the main concerns of clients, and quite rightly too- who wants to have a really painful treatment? And why would you, when we’ve got such great devices and such great cooling devices that we don’t have to have a painful treatment.
Although, we know that there are a lot of people out there that are hyper-sensitive and they do have a high flight reactions, especially to thermal devices, where there’s lots of heat and lots of swelling within the hair follicles. So we suggest that you wear very loose clothing on the day. You might want to take an anti-histamine, if you’re used to taking anti-histamines, prior to coming in, some clients like to apply an over-the-counter topical numbing cream, which they can apply themselves and remove themselves just prior to the treatment, and that makes their treatment a lot more comfortable as well. I know with our devices here at Candela, we have two cooling options, which is your air cooling option which is amazing. We can turn it up for those sensitive areas. And we also have a cryogen cooling option, which is a spray that is emitted to treat the skin just before the pulse. And that’s even colder than the air cooling. And most people don’t feel a thing, especially on the legs and arms, maybe just a little bit in those sensitive areas.
A number of listeners have asked “Why aren’t I allowed to have false tan on for my appointment?” And on that note, is it possible for any laser or even IPL to work effectively over a false tan?
Any type of pigment on the skin or in the skin, whether it is fake tan, gradual tan, bronzer or real tan will absorb the light, and therefore you will experience a type of burn on the skin. Worst case scenario, you will get post-inflammatory hyperpigmentation, and even worse than that, you can blister and hypo pigmentation can occur where the melanacites have been completely destroyed and you end up with white spots on the skin. So definitely no.
I think anyone who’s ever been to a clinic and they have tried to remove all of their tan but there might be a tiny bit left and they get sent home and they’re so disappointed… it’s for a reason. I’ve had so many girlfriends messaged me saying “I went all the way to my appointment and they’ve sent me home,” but they’ve done the right thing. It’s nothing to be upset about.
I honestly can’t give you one reason why you can treat [tanned skin].
Another listener has asked “If I’m getting my Brazilian and underarms done, does it matter if I’m a little bit suntanned in other areas?” I’ve got thoughts on this, because I’m just against a sun tan in general?
A lot of people will come in like that. If the therapist is very careful, you can cover those tanned areas and you can treat the areas that have been covered and were protected by their clothing when they’ve been outdoors. So, for instance, the underarm and the Brazilian area are usually well covered with clothing. So yes, if they’re very, very careful and only treat within those areas, yes, it can be done.
On that note, I was sent a lot of questions from people about how to actually prepare for an appointment- other than obviously removing false tan. One listener has asked “How long should my hair be before my first session?”
Our pre-treatment procedure is shave the area anywhere between 12 to 24 hours prior to the treatment with a brand new razor. So no hair should be protruding from the hair follicles. And if there is even one to two millimetres protruding from the hair follicle, it will burn and it will create the plume, the smoke that you can smell, and also potentially that burnt hair can burn the skin. Not to mention the energy that’s taken up by the hair on the outside of the hair follicle, you may not get as much absorbed into the bulge and the bulb of the hair follicle either.
You’ve just covered this, but I did have another listener ask about whether or not she should shave her arms before an appointment. Is that important too?
Even the finest hairs, we recommend that you do shave prior to coming into the treatment. And on any area that you are thinking of having laser done, it should be shaved prior to the treatment. You can trim if you really don’t want to shave the upper lip. But yes, as long as you trim as close to the skin, as you possibly can, that’s another option for those tiny little areas.
Is there anything else that we should know in terms of prepping before a laser hair removal appointment?
Yes. If you regularly exfoliate and moisturise, there will be a better cell turnover and therefore the skin will be more hydrated and it will also be healthier. The laser also has a better chance of penetration if you have well exfoliated skin.
If you’re having your facial hair lasered, we highly recommend a good skincare regime that includes tyrosinase inhibitors such as vitamins A, B, and C, any of the other brightening ingredients, licorice extract, lactic acid just to name a few, and most importantly a sunscreen, and a physical sunscreen is your best option.
One listener asks “Can I have laser while breastfeeding? I miss it as I couldn’t do it while I was pregnant.”
This is also one of our contraindications, along with fake tan and suntan. The reason why it’s on our contraindications list is because your hormones are governing your hair growth. When you’re pregnant and you’re lactating, [your hormones] are obviously different. So when you stop breastfeeding they go back to normal and there is evidence that the hairs can synchronise after you’ve finished breastfeeding, and this means that you get a new growth of hair and they are all in that growth stage, so it’s the best time.
Could you talk me through the aftercare process? Why are we advised to avoid things like sun exposure and intense exercise?
Laser basically makes your skin sensitive to the sun, so therefore, if you went straight out into the sun or even for the next two weeks, you went out and deliberately tried to get a tan, you would burn. Just don’t do it.
As for exercising, we say that you need to avoid that only until the follicles release all of the heat from the laser, which is usually about 24 hours. And then you can go back to doing your normal exercise regime.
A listener has asked “Do I really need all of the aftercare products the clinic is trying to sell me?”
There are three main products that you should definitely purchase. A post-laser gel is so important because it contains anti-inflammatory ingredients. It is also going to help prevent post-inflammatory hyperpigmentation occurring.
The second, actually the first product, is your sunscreen- obviously. That’s going to protect you from getting burnt out there in the sun.
Your third product is either an AHA exfoliant which helps to lift off those dead skin cells, and/or your brightening serum, so your tyrosinase inhibitors, especially if you have darker skin and the therapist has advised that you will need to prevent post-inflammatory hyperpigmentation.
Now you mentioned that laser hair removal is TGA approved, which I think is really important to know. Are there any risks involved with laser hair removal? I’ve been asked quite a lot about risks and side effects with one listener asking if it’s maybe too soon to really know what the risks are, given that laser is a newer technology in the grand scheme of things.
Well, actually laser and IPL hair reduction has been really popular since the 90s, and there’s also been thousands and thousands of peer reviewed papers and articles written about the benefits of laser hair reduction. If you choose a reputable operator that has obtained hight standard qualifications, and is using the right device, then you should feel very confident in their ability to give you the best treatment possible.
That is so important because I think that’s actually come up in every single Ask An Expert episode- go with a qualified operator. This is another thing that gets asked a lot- “Do lasers cause cancer?”
Laser and IPL light is non-ionising light, so therefore they can’t cause cancer. They do not cause cell mutation, and the reason for that is the wavelength that we use. Anything over or longer than 400 nanometers is non-ionising. Anything under 400 nanometers, for example UVA and UVB are ionising wavelengths.
Quite a lot of listeners were asking about specific hair colous and skin tones which, again, you’ve touched on, but I think it’s worth spending a bit more time on. Several listeners have asked about blonde hair and what the best option for blondes and those with both fair skin and fair hair might be.
Unfortunately, there is not a laser or an IPL device on the market that can treat blonde hair, and red hair for that matter. And this is all to do with the type of melanin in the hair bulb.
If you have a dark skin and dark hair, you have a dark brown melanin and the light is attracted to this and it works extremely well. With some blondes and red heads, it is a different type of melanin. It’s a very pale melanin. Particularly with red heads it’s a yellowy orange type of melanin, and the light is not attracted to this type of melanin, so therefore you don’t get any absorption. You may get some slight results, but you won’t get the results that you’re really looking for.
That is so interesting because I can only imagine how many people with fair hair have been sold a course of about six sessions and been disappointed. You’ve mentioned those with dark skin- what should they know ahead of their appointment and what would be their best laser hair removal options?
Dark skins, as I mentioned, have a really dark melanin. Not just in the hair follicles, but in the skin as well. So therefore we can’t treat them with the wavelengths that have a higher absorption into the melanin. The ND YAG 10 64 wavelength is specifically designed to treat these skin types and ethnicities as it has a low attraction or low absorption to melanin in the skin. It also has the ability to penetrate a lot deeper and so therefore it can heat the follicles, those deeper follicles, and down in the dermis where the blood vessels are supplying the dermal papilla of the hair and it that heat can destroy those blood vessels and damage the stem cells that are creating new hair growth without causing any adverse reactions in the epidermis.
A listener asks “I have visible dark red hair and fair skin. Is laser worth my time?”
With some red heads and with some blondes, you do need to check to see if there a decent amount of melanin in the bulb of the hair. So if you pluck a hair out and have a look at the colour of the bulb and you notice that there is some dark pigment there, we recommend or suggest that you do two to three treatments, wait for four to six weeks after the third treatment, see if there is anything happening. If you are getting any reduction, if you are, keep going with your treatments and if not after the third treatment, then there’s your answer and you need to stop
Another listener asks “I have pale skin with dark hair, so perfect for laser. Why is my hair still growing back so quickly?”
This could be a range of reasons. One could be hormonal. The operator, unfortunately, may not be using the right parameters. Or the hair in that area is just too fine and it just can’t absorb enough energy quickly enough to destroy it.
This is a very specific question, but one listener has written in saying “I got stimulated hair growth on my shoulders, and the girl said to fix it they would just turn the setting up higher than normal. Why don’t they just do that from the start?”
Yeah, this is a really big subject. First of all, we need to know- why was that hair stimulated? That’s really, really important. Our rule of thumb is never treat where there is no hair growth, because this is one of the reasons why we get stimulated hair. Those hair follicles that don’t have hairs in them are actually dormant hair follicles, just waiting to be woken up. So we need to know, how was the hair stimulated in the first place?
However, if there has been stimulated hair, then it might require a higher setting than before because that stimulated hair might be finer than the original that the therapist was actually treating. But prevention is better than cure, so only treat where there is actual hair growth.
A number of questions were sent in regarding laser on different areas of the body. Is laser on the face safe, even though facial hair is generally quite fine?
Yes, definitely. Laser on the face is safe, although it is a hormonal area. So you need to be extremely careful. You need to determine whether the hair is terminal and not vellus hair. That vellus, soft, fine, downy hair, again, is just too fine to hold onto the energy or get it in there quick enough to destroy that very fine hair. So as long as the hair is terminal, and as long as they’re very careful to only treat where the hair is, then they’ll get a really, really great result- and a safe result, too.
Two areas that popped up quite a bit, one of which you’ve just mentioned- the chin and the upper lip. A few listeners have asked if laser hair removal in those areas might lead to either pigmentation or to more hair growth.
Again, if you have a therapist who has studied laser and who knows what they’re doing and they are using the right wave length for the right skin type, there should not be any pigmentation issues.
If the hair is coarse, it will be treated successfully. Also, the therapist should be recommending some brightening serums to prevent the heat causing post-inflammatory hyperpigmentation. If they using the right parameters, the hair will be reduced rather than stimulated.
Now what about the eyebrows? A few people asked if it’s safe for even advisable to have laser hair removal in this area.
It’s not advisable for a couple of reasons. One, if you have a look at the stages of hair growth, you’ll notice that the eyebrows have a different amount of anagen hairs and we can destroy those eyebrows really quickly. It’s very difficult to create a good shape to an eyebrow with a round spot size. So the short answer is not advisable.
Is it safe to have laser hair removal carried out over or even near a tattoo?
Tattoo ink is another type of pigment, so therefore the light is attracted to it. And because we’re using a thermal device with a thermal wavelength, it’s going to absorb it into that tattoo ink really quickly and easily. It’s going to heat that ink, and because that ink is quite deep and very, very dense, it will create a blister, no doubt about it, because, again, the ink is dark. Even if you are using your laser, say, a centimetre away from it, you will get scattering underneath the tissue. And again, it will absorb down on a deeper level. So, what they should do is cover the tattoo with a damp white cloth and stay away from that tattoo by at least three to five centimetres.
I received quite a number of questions about laser hair removal and hormones, which we have touched on, but a lot of questions on this subject. Is it true that laser hair removal is often reversed by hormonal changes? And if so, is there any way to avoid it?
Hormones govern hair growth, as we mentioned earlier, and it’s inevitable that throughout our lives, they are constantly changing. For females, you go through puberty, some go through pregnancy, and then everybody goes through menopause eventually. There could be health reasons that your hormones change, and therefore your hairs can regrow due to any of these reasons. And, unfortunately, that is unavoidable.
Now what about the pill and pregnancy. Can they cause that hormonal regrowth as well?
Look, everybody is different, and if you do notice this happening, if you notice that you’ve just started taking the pill, some women do get more hair growth during pregnancy and some women get less during pregnancy. But if you do notice this happening, it is always best to make an appointment with your doctor to discuss the effects that you’ve noticed as soon as possible.
And can you still have laser if you have an hormonal imbalance- something like polycystic ovary syndrome?
Yes. PCOS sufferers have several side effects, and excessive hair growth is just one of them. We definitely do treat them for hair reduction, although we go through all of this in consultation and we really let them know that we can’t promise the same results as say, somebody else. They might need ongoing treatments for many years. This is something that the therapist will talk them through and discuss before every single treatment that they have, consequently.
The feedback that I have been given is that it does slow the hair growth down and it can reduce the amount of hair.
A few listeners had questions about eczema. Is laser hair removal safe for eczema prone skin?
Yes, laser is safe for eczema prone skin and psoriasis sufferers. As long as the condition is not severe at the time of treatment, you can go ahead.
Finally, I received many, many questions about at home IPL devices. I have a lot of thoughts here, but I’m not the expert! These devices, are they effective or are they even safe?
Well, what is that saying? You get what you pay for?!
But on a serious note, laser is not something that you would do at home to yourself with the device that you’ve bought online. One, there’s no way of knowing if the device is safe or not, but really on a technical level, you’re looking at a comparison of a laser device that you’re receiving from a professional clinic and you need to wear protective eyewear because the wavelength is so strong, whereas you purchase one for home and there’s no protective eyewear. That should be telling you that this wavelength that they’ve sold me is definitely not strong enough.
And secondly, with our professional devices, we have something that is called calibration and we need to calibrate our devices so that we know that it’s delivering exactly the right amount of energy with every single pulse. But with the home devices, there is no calibration. So you don’t know if you’re getting a low energy with one pulse, a high energy with the second pulse. It’s just so unpredictable that we would never recommend it.
