Your first laser hair removal session — how to prepare and what to expect

Most people come to their first appointment with one question in their head: will it hurt. And the question that really decides the result and the safety of the treatment is asked far more rarely — am I properly prepared for it.

Because laser hair removal is a treatment in which half the work happens before you walk into the clinic. Below you will find everything you need to know beforehand.

Why preparation decides safety

The laser acts on melanin — the pigment contained in the hair. The absorbed energy turns into heat, which destroys the hair follicle. This phenomenon is called selective photothermolysis: the heat is meant to stay in the hair follicle and not damage the surroundings, and that depends not only on the choice of wavelength but also on a suitably short pulse duration.

The problem is that melanin does not occur only in the hair. It is also in the skin, and it is what gives the skin its colour. A beam aimed at the bulb therefore meets pigment cells in the skin on the way. If its intensity is too high, it can cause inflammation — and from there it is a short road to a burn.

That is exactly why a tan before the treatment is a problem and not a whim of the cosmetologist. And that is why every treatment is preceded by a consultation.

One more thing follows from the same mechanism, worth knowing before you book. Since the laser hits melanin, a hair without melanin is invisible to it. Grey, white, red and very light blond hair does not respond to laser hair removal — and neither stronger equipment nor a greater number of sessions will change that. If your hair is light, say so when booking; at the consultation we will assess it directly and tell you honestly whether starting a series makes sense.

Skin phototype — this is where every appointment starts

Before we set any parameters, we determine the phototype of your skin on the Fitzpatrick scale — from 1 to 6, where 1 means a very fair complexion and 6 a dark one. Put simply, the phototype tells us how much melanin is in the skin: the darker the skin, the higher the melanin level.

And here comes something many people find counter-intuitive.

In the sun, the higher the phototype, the lower the risk of burning. With laser hair removal it is exactly the opposite — the higher the phototype, the greater the risk of a burn. And the greater the risk, the lower the intensity of the beam has to be.

That is why determining the phototype correctly is not a formality. It is the basis for choosing the parameters of the treatment.

We are helped in this by a melanin level reader. It emits three LED light beams that reach different depths of the epidermis and measure melanin at several levels. On that basis the system analyses and personalises the treatment parameters — so as to achieve maximum effectiveness without the risk of a burn.

Four weeks before the treatment

• 4 weeks before — Do not tan the area to be treated — neither in the sun nor in a solarium.
• 4 weeks before — Put away wax, tweezers, the epilator and depilatory cream. Only a razor remains.
• 1 month before — Stop using preparations with retinol. If the treatment involves the face — also fruit acids and cosmetics containing them.
• 24 hours before — Shave the hair smooth with a disposable razor — with one exception, described below.
• 24 hours before — Stop taking painkillers, anti-inflammatory and photosensitising medicines.

Why a razor, when wax gives a nicer result? Because shaving leaves the hair in the follicle and even strengthens it — and the laser needs a hair it can hit. A pulled-out hair is a target that is not there.

That one exception when shaving: leave a small unshaved patch of the treatment area. Thanks to it the cosmetologist will assess the colour, thickness and density of the hair and select individual settings for the device. We will shave that patch off on site.

Medicines and supplements — tell us about everything

This is the most often overlooked part of the preparation, and it can decide whether the treatment happens at all.

• Isotretinoin — after the course is finished, the treatment can be done only after 6 months.
• Antibiotics — about 2 weeks after finishing the medicine.
• Painkillers, anti-inflammatory and photosensitising medicines — stopped 24 hours before the treatment.
• Supplements — tell us about all the ones you take. The point is to rule out photosensitising ingredients. Pay particular attention to marigold, St John's wort, horsetail and angelica.

Not sure whether you are allowed to stop a given medicine? Do not decide that on your own — call the clinic. No aesthetic treatment is worth interrupting a course of treatment off your own bat.

What the treatment itself looks like

We start with a thorough consultation at which we discuss all the above matters and assess the skin. Only then do we prepare the treatment area and proceed with the hair removal.

The device has a built-in cooling system — the treatment area is cooled before the emission of light, during it and after it. That is what makes the treatment comfortable.

The first 72 hours after the treatment

Redness in the treated area is normal. It is a reaction of irritated skin and may last up to 72 hours.

During that time:

When to call the clinic: if blisters or weeping appear, if the pain increases instead of subsiding after the first day, if the skin in the treated area clearly darkens or lightens. Hyper- and hypopigmentation are the most common complication in people with darker complexions and are usually transient, but they call for a change of settings at the next appointment. It also happens — rarely — that the reaction is the opposite of the one expected, that is, increased hair growth at the edges of the treated area. Tell us about that too: it is a signal to change the plan, not a reason to stop the treatment.

• For 3 days give up the sauna, the swimming pool and heavy physical exercise — sweat and chlorine irritate the skin further.
• For 4 weeks do not tan, neither in the sun nor in a solarium.
• For at least 4 weeks use a UV filter of SPF 50.
• Stop using irritating cosmetics on the treated area.
• If the treatment covered the armpits — no antiperspirant for about 24 hours.

Why one treatment is not enough

Because the laser only acts on hairs that are currently in the growth phase. The rest is simply dormant at that moment and the beam will not reach it.

Even during the first appointment, usually 10 to 25% of the hair is removed. The following sessions hit the hairs that have entered the growth phase in the meantime — and that is where the intervals between appointments come from.

• Chest, back, thighs, calves — 8–10 weeks.
• Armpits, bikini line, forearms — 4–6 weeks.
• Face — 4 weeks.

These intervals are not a suggestion but a consequence of the hair growth cycle in a given area. Coming earlier will not speed up the effect — we will simply hit fewer hairs.

How many treatments in total? Usually several — we set the number after assessing the area, the colour and the density of the hair, and the plan is adjusted during the series. It is worth knowing from the start what the goal looks like: we are talking about a permanent reduction of hair, not about removing it once and for all. In studies, after three treatments the permanent reduction measured at least six months after the last session came to between about 42% and about 58%, depending on the type of laser. After the series is finished, in some people individual hairs come back and maintenance appointments are needed from time to time.

Before you book your first appointment

It comes down to three things: do not tan, for the last four weeks use only a razor, and tell us about all your medicines and supplements.

The rest — assessing the phototype, choosing the settings, planning the series — we take on ourselves.

Details of the treatment — areas, contraindications and prices — can be found on the page for laser hair removal.

This article was prepared by the team of Dr Kuschill MEDESTETIS clinics.