Patients with darker skin types have more melanin in their skin so that there is a higher risk of hypopigmentation, or lightening of the skin in the area of treatment. Blisters or even burns are possible. For this reason, darkly-complected African-Americans (Fitzpatrick VI) are not good candidates. Patients with lighter skin types have minimal risk because there is much less melanin in the skin to absorb the laser energy. Patients with white, grey, or very blond, wispy (“vellous”) hairs do not respond well because there is minimal melanin present around the hair follicle or in the hair shaft itself. The most favorable combination for treatment is dark hair and light skin.

Many patients with darker skin types may still be treated, but with lower energy settings to avoid burning the skin. This includes most Asian, Hispanic, southern Mediterranean, middle Eastern, and East Indian skin types. Lightly-complected blacks may also be treated. There is less “differential” to expoit between skin color and hair color. I tell these patients that they should expect to have more treatments, perhaps as many as 10.

For the same reason, it is best for patients to avoid tanning prior to treatments. Tanning increases the melanin content in the skin, absorbing more of the laser energy. This makes the treatments more uncomfortable and lower energy settings must be used, compromising the effectiveness.

It does seem unfair that people with darker skin types are not as good candidates, but this is simply a reality of the physics of the treatment. Lightly-complected patients with light hair are not good candidates either.

Unlike other techniques such as waxing, there is no need to grow out the hair before treatment. It can be helpful to have a few days growth of hair to help demonstrate the area to be treated.

Treatments vary in length from just a few minutes to treat a small area (for example, the upper lip) to a few hours for very large areas (the back, or both legs). Most treatments take 20 - 30 minutes. Patients are quite comfortable and tolerate the laser treatment well. The feeling is similar to the snap of a rubber band on the skin. No anesthetic is required. We have treated many teenagers and even some 11 and 12 year-old girls.

The number of treatments depends on the individual and the area treated. Facial hair cycles quickly so that the second treatment may be performed 4 weeks after the first. This allows hair that is in its resting phase to enter the growth phase, so that it may be treated. Each additional treatment provides greater clearance of hair. My advice is that patients schedule two treatments 4 weeks apart to provide an effective “1 – 2” combination. Additional treatments are at the patient's discretion.