By Eric Bernstein, M.D.

First of all, what is a laser?

A laser is a device that produces light of a single color or wavelength. In dermatology, these lasers produce pulses of high-energy light that is taken up by the desired target. In the case of hair removal, the target is the melanin pigment contained within the hair shaft. The tricky part of laser hair removal is targeting the hair shaft without damaging the melanin pigment in the surface of the skin. Thus the laser light has to be on long enough to heat the hair, but not too long to allow that heat to spread to the surrounding skin causing damage.

What laser is right for me?

The right laser for an individual patient depends upon the thickness of the hair and the patient’s skin type. Some lasers are faster than others, so for treating very large surface areas one may choose a laser that is able to treat large areas in a reasonable period of time.

In addition, if the hair on an individual patient becomes thinner and less dense following laser treatments, I often switch lasers to accommodate the change in the hair type and texture. There are a number of parameters that can be selected on a given laser. While each laser gives a unique color, or wavelength of light, other settings such as the energy, and how long the light stays on (the pulse duration) can be selected by the user. Because there are a number of settings which can be chosen during a treatment session, it is very important to have an experienced laser operater who understands how lasers work and the risks and benefits of various settings.

Is laser different for people with darker or tanned skin?

In my opinion, very dark skinned patients often do better with the Nd:YAG laser, while lighter skinned patients may respond better to the diode or alexandrite lasers.

Lasering people with dark skin is much more tricky than lasering people with light skin. However, the hair must be dark in order to be ‘seen’ by the laser. Lasers are absorbed by the pigmentation in the hair shaft which produces heat that then results in inflammation which sends a signal to the hair to go into a long-term resting period. The ideal laser patient that would be easiest to treat and respond best would be someone with very light skin and dark hair. However, people have all different degrees of skin and hair pigmentation. The trick with laser hair removal is to avoid injuring the surface of the skin where the melanin pigment lives, while effecting the pigmentation in the hair shaft. The problem is, your skin and hair don’t know whether they are supposed to absorb the laser light or not. Therefore, any dark pigmentation will absorb most forms of laser light. Certain lasers are somewhat less ‘noticed’ by epidermal melanin pigment. The laser that is most commonly used on very dark skin would be the Nd:YAG laser. This laser has the longest wavelength of any of the hair removal lasers, and thus is less absorbed by melanin pigmentation over-all. Because is it less absorbed by the melanin pigment in the surface of the skin, it runs less of a risk of injuring the surface of the skin.

It’s important that before any cosmetic procedure you contact your personal physician to discuss whether a particular treatment may be right for you. Make sure you consult your physician first prior to treatment.

About the Author: Eric F. Bernstein, MD, is a distinguished practitioner, researcher and innovator in the fields of dermatology and laser surgery. He received his MD from Yale University. He is the Chairman of the Board for the Laser Hair Removal Journal.

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