Laser Hair Removal: The Challenge of Treating People with Darker Skin and Hair

E. Victor Ross, MD

Dermatologist at Scripps Clinic Carmel Valley Laser & Cosmetic Dermatology in San Diego, CA. He has received honoraria, research support and loan of equipment from Lumenis and has also served as a consutant for the company.

In the past decade, laser hair removal has rapidly grown to become one of the most popular dermatology procedures. In fact, there was a 51 percent spike in laser hair removal procedures from 2012 to 2014, according to the American Society for Dermatologic Surgery. While laser hair removal technology has been around for approximately two decades, we are still learning how to best treat patients effectively including individuals with dark skin and hair.

eValuating Options

To evaluate the best laser hair removal treatment approach for all skin types, Scripps Clinic participated in a multi-center study, which was presented at the American Society for Laser Medicine Surgery 2016 annual meeting in Boston. The study explored the use of the vacuum-assisted handpiece of the 1060nm diode laser, without the use of topical anesthetics, on various skin types. All patients underwent seven months of laser hair removal and follow-up consultations were conducted six months after the patients' final treatment. Overall, the patients observed about 70 percent hair reduction in the treated area. The study found that Lumenis' Lightsheer INFINITY laser system was effective on all skin types, including darker skin.

It had been considered a challenge to treat large areas in patients with darker skin, however, with the INFINITY platform's wavelength of 1060nm combined with a 22x35 mm spot and lower fluences, we are now able to treat patients with darker skin more quickly and with less pain.

The platform can be equipped with two diode wavelengths, including 805nm and 1060nm, and features a high speed 22x35mm spot hand piece which utilizes the vacuum-assisted High-Speed Integrated Technology (HIT)™ to treat large body areas, like the back or legs. The technology and the spot size leads to a quicker, more comfortable hair removal treatment. And, in my own personal experience with the 1060nm system, the new hand piece further enhances the speed and comfort of the procedure. Like most 1060nm systems, the laser is best used for darker hair types, rather than sandy brown or other lighter hair types, and the longer pulse duration (about 50ms) is not optimal for very thin hairs.

Treatment Paradigm

Depending on the patient's skin and hair type, there are a range of different approaches to hair removal. Based on recent data and my experience, I recommend using a longer wavelength for hair removal procedures when treating darker hair and skin types while using a shorter wavelength for lighter hair and skin types.