Everything You Should Know Before Getting Laser Hair Removal

There's nothing more natural than body hair, but we live in a culture that glorifies silky smooth skin for women and tasteful manscaping for men (via Time). But constantly shaving, plucking, waxing, and epilating in an attempt to live up to these ideals can be time-consuming, lead to skin irritation and painful ingrown hairs, and cost a pretty penny over the years. It's no surprise, then, that many people want a permanent way to get rid of their unwanted body hair.

For years, that's exactly what laser hair removal (LHR) has promised, and the allure of being able to finally retire your razor or break up with your waxer has led many people to give this cosmetic procedure a try. In 2020, the global LHR market was valued at almost $444 million and is expected to grow by more than 20% in the coming years (via Grand View Research). More than half of LHR sessions are performed in facilities specializing in cosmetic procedures, while about a third are performed in dermatology clinics and a small percentage are done at home. According to Statista, in 2019 more than 450,000 LHR procedures were performed in the United States, making it the fourth-leading cosmetic use for lasers (behind treating sun damage, wrinkles, and facial redness).

But can LHR really deliver permanent results? How do you know which type of laser is right for you? Is the procedure safe and pain-free? How much does it cost, and is a cheaper at-home LHR device a better alternative? Here's everything you need to know.

Almost anyone with unwanted body hair can get laser hair removal (LHR). However, LHR is generally not recommended for pregnant women or for individuals who have or have had skin cancer (via the Cleveland Clinic). Certain medications, including prescription-strength retinoids like Accutane used to treat acne, can make people extremely sensitive to light. LHR isn't a good fit for individuals taking those medications. LHR shouldn't be performed in areas with keloid (raised) scars, and individuals with herpes who are prone to cold sores should speak with a healthcare professional before seeking LHR.

In most cases, LHR is considered a cosmetic procedure, and the body hair, while unwanted, isn't considered pathological from a medical perspective. But LHR can also be used to treat a medical condition known as hirsutism. According to the Mayo Clinic, hirsutism is a condition in women that causes excessive growth of thick, dark hair in a male-like pattern. Women with hirsutism have hair in areas such as the face, chest, lower abdomen, inner thigh, and back. Hirsutism is most often caused by high levels of male sex hormones (androgens) and is commonly seen in women with polycystic ovary syndrome (PCOS). Other causes of hirsutism include high levels of cortisol caused by Cushing syndrome and a condition known as congenital adrenal hyperplasia. Some medications, including minoxidil (Rogaine) and certain treatments for endometriosis, can also cause hirsutism.

Another technology you may see advertised as providing permanent hair removal is intense pulsed light (IPL). IPL, however, isn't technically a laser. As Lucy Xu, skin specialist and founder of London Premier Laser and Skin Clinics, explained to Harper's Bazaar: "In contrast to laser hair removal, it uses a broad spectrum of light with multiple wavelengths. This means it has more unfocused energy around the hair and skin area." By contrast, lasers use a single wavelength of light in a very concentrated and defined beam. This makes IPL much weaker than lasers. When used for hair removal, IPL tends to be less effective and necessitate more treatment sessions. It can also cause more discomfort.

But this doesn't mean IPL is totally useless. In fact, the wavelengths of light IPL emits can be particularly helpful for clearing up facial redness caused by broken capillaries or rosacea. IPL is often cheaper than laser treatment, although once you factor in the extra sessions you may need to see decent results, going with IPL may end up being pricier in the long run. Xu and other skincare experts recommend skipping IPL if hair removal is your main goal.

Unfortunately, laser hair removal (LHR) isn't a "one and done" procedure. As the Cleveland Clinic explains, most people need between six and eight sessions, spaced six to eight weeks apart, to see maximum results.

The reason for this is that LHR only works on hairs that are in the anagen (active growth) phase of their lifecycle (via HairFree). But our hairs aren't synced up; individual hairs right next to each other could be in completely different stages of their lifecycle. How long a hair remains in the anagen phase depends on where it is on the body. Hair on the chin, for instance, grows for about 11–12 months and then enters the catagen (resting) phase for about 2.5 months and the telogen (shedding) phase for about 2–3 weeks. By contrast, armpit hair is in the anagen phase for only about 3.5 months, groin hair grows for approximately 4.5 months, and leg hair is in this phase for about 5.5 months. Another key factor that can influence the number of sessions needed is hair density, as denser body hair requires more treatments. Some hair follicles in the anagen phase will survive the laser, and treatment may actually stimulate dormant hair follicles to "wake up" and start producing hairs, which could also require more sessions.

Although the term "laser hair removal" (LHR) is frequently used, the "removal" part isn't completely accurate, and the Food and Drug Administration (FDA) doesn't allow laser manufacturers to make this claim. Instead, lasers can be FDA-approved for providing permanent hair reduction (via HairFree). Why the semantic distinction? As Medical News Today explains, LHR can produce truly permanent results when the laser completely destroys a hair follicle, but often the follicle is simply damaged and hair will eventually regrow. The Mayo Clinic noted that "most people experience hair removal that lasts several months, and it might last for years ... When hair regrows, it's usually finer and lighter in color."

If you want truly permanent results, electrolysis is the way to go (via the Cleveland Clinic). It's the only FDA-approved permanent hair removal treatment. In electrolysis, a very thin needle is inserted into hair follicles one at a time. The needle delivers a small electrical current that destroys the cells in the hair follicle responsible for producing new hairs. Although each hair follicle only needs to be treated once to permanently remove its ability to produce new hair, the fact that follicles must be treated individually means that electrolysis can be a very tedious process, particularly for larger areas. And, like LHR, electrolysis is only effective when the hair follicle is in the anagen phase. Because of these factors, individuals may need weekly electrolysis sessions for a year or more.

Because laser hair removal (LHR) is generally considered a cosmetic procedure, you may be tempted to get it done at whatever place is closest or cheapest. But choosing a facility and provider is a decision you shouldn't make lightly (via HairFree). Start by making a list of clinics in your area. Check for reviews online to get a better sense of the quality of service they provide. Once you've shortlisted a few clinics, it's always good to call to get additional information such as the types and brands of lasers used, how long they've been in business, and the qualifications of the individual who will actually be performing the treatments.

Next, have an in-person consultation with all shortlisted clinics. Be sure this consultation is with the person who'll actually be performing the LHR. During the consultation you can discuss cost, number of treatments, potential side effects, and any concerns you have. Before you make your final decision, it's always a good idea to have a patch test done to see how your skin reacts and to help the provider fine-tune any laser settings. Wait a week or two before going ahead with actual treatment.

Avoid clinics that pressure you into making a decision on the spot or who advertise free initial consultations but then require a nonrefundable deposit. Clinics aren't legally allowed to call LHR permanent hair removal (simply permanent hair reduction), so watch out for any clinic that falsely advertises.

So what actually happens during a laser hair removal (LHR) session? An assistant will clean the skin and may shave it again if necessary (via the Mayo Clinic). Topical anesthetic might also be applied to the area to numb it. You'll be given goggles to protect your eyes from the light emitted by the laser. The lasers used for LHR are handheld devices, which the doctor or technician will press against your skin. Some lasers have a built-in cooling tip that dissipates the heat produced by the laser and prevents skin damage. In other cases, a cooling gel will be applied to the area beforehand. Small areas may only take about 15 minutes to treat, while larger areas may take as long as an hour.

Many people are concerned about pain with LHR. The good news is that, while the procedure is not completely painless, most people describe it as mildly uncomfortable rather than downright painful (via Healthline). While the cooling gel or laser's cooling tip prevents you from feeling the heat the laser produces, it may feel as if your skin is being snapped with a rubber band. The amount of discomfort you feel will depend on your individual pain tolerance and the area being treated. Generally, areas where the skin is thinner tend to be more sensitive and painful during LHR. The underarms and bikini area tend to be the most painful, while the legs, arms, and back tend to be the least.

If you're interested in laser hair removal (LHR) but don't want to shell out the big bucks to get multiple sessions from a professional, you may be tempted to try an at-home LHR device. According to the Cleveland Clinic, there are two devices approved for sale for at-home LHR. One is a true (but weak) laser, while the other uses intense pulsed light (IPL) technology. In both cases, these devices aren't as powerful as the options available at a dermatology clinic or medspa. That's both a good and a bad thing. On the plus side, these devices are safe for consumers to use and carry very low risk of injury when used correctly. On the other hand, they lack the oomph of professional lasers and are much less effective at removing hair. They also only work on people with light skin and dark hair, whereas certain types of professional lasers can be used on all skin tones and hair color combinations. In addition, these devices are small, so larger areas (like an entire leg) take a long time to treat.

At-home LHR devices may cost less than professional sessions, but that doesn't mean they're cheap. In a 2020 interview with Aedit, New York City dermatologist Dr. Tony Adar explained that these devices usually cost between $200 and $500. He noted that "although these devices have a favorable price point relative to in-office lasers, there is a considerable time investment for the DIY approach."