Other less commonly used anesthetic methods include application of forced cooled air to the treatment site, local infiltration of anesthesia, regional nerve block, or a combination thereof. Most importantly, before starting the procedure, proper eye protection is critical for the patient, proceduralist, and any observers in the treatment room. Each device requires the use of specific goggles unique to that machine’s particular wavelength.
Therefore, goggles are not interchangeable between laser or IPL devices of other wavelengths. Additionally, because of the risk of ocular damage, treatments should not be performed in the periocular zone. At the start of the procedure, a test spot on an inconspicuous area should be performed before the full treatment.
Adjustments to the laser’s parameters should be made to achieve perifollicular edema or faint erythema as an appropriate endpoint. The proceduralist should avoid treating pigmented lesions or tattoos, which can easily induce burns. After the procedure, ice packs should be applied to the treated area to reduce pain and swelling. Erythema and edema can be seen immediately after treatment.
Topical steroids may be given at the discretion of the practitioner, but if the patient sustains burns during the procedure, high-potency topical steroids should be applied immediately afterward and for the next several days. If hyperpigmentation ensues, hydroquinone and topical steroids can be applied daily in combination with mild chemical peels as necessary. Hypopigmentation should be addressed with sun avoidance and potentially with treatment with a 1,550-nm nonablative fractionated laser.103–105 Patients should practice strict sun avoidance for a minimum of 6 weeks before and after each treatment. Subsequent treatments to a given area may be repeated every 4 weeks.
Conclusion
Laser hair removal devices effectively provide a durable and efficient method for unwanted hair removal. Possessing a detailed understanding of each laser’s properties is critical for the clinician to accurately customize individual treatments to the unique patient. Laser technology within the scope of hair removal continues to evolve from its beginnings in the mid-1990s.
Current research is directed toward optimizing safety, efficacy, and comfort for patients of all skin types. In the future, these improvements will probably have longer-lasting treatment results while minimizing untoward side effects.