Is Laser Hair Removal Safe? A Look at 4 Scientific Studies
Laser hair removal has steadily grown in popularity, as a quick, effective, non-invasive method for removing and permanently reducing unwanted facial and body hair.
According to the American Society for Aesthetic Plastic Surgery, laser hair removal was the third most popular non-surgical aesthetic procedure carried out in 2012 (with the number of treatments exceeding 1.2 million).
Given that all surgical procedures involve a degree of risk, our aim in carrying out this study was to determine the safety of laser hair removal, based on the findings of relevant clinical research.
Laser Hair Removal Regulation
The FDA’s Center for Devices and Radiological Health regulates electrolysis and laser equipment, with the practice of professional hair removal generally being regulated by state and local authorities.
This means that, providing a laser device is FDA registered and approved for commercial use, you may rest assured that it has been rigorously tested for safety.
However, regulation surrounding the qualifications of the operator of this powerful equipment is less stringent, depending upon the state in which you are living.
How Lasers Work (In Brief)
Lasers use a light beam to target the dark pigment, melanin, found in hair and skin, and in concentration at the base of the hair root around the hair follicle. The light from the laser is absorbed by the melanin, to produce heat, which damages the follicle causing the hair to fall out, a process known as selective photothermolysis.
The aim is to sufficiently disable the follicle to prevent future re-growth of the hair, by matching a specific wavelength of light and pulse duration to obtain optimal effect on the target whilst having minimal effect on the surrounding tissue.
Laser hair removal is generally more effective for those with light skin and dark hair, although technology is advancing rapidly and there are now certain lasers that may be used for darker skin.
"Normal" Side Effects
Some side effects of laser hair removal, such as itching, redness and swelling are very common and only temporary. This should be fully explained prior to any treatment regime being commenced, together with advice as to what you can do to alleviate them.
Patch tests i.e. laser treatment carried out on a small, unobtrusive area several days prior to treatment should be used to minimise potential risks, and enable the clinician to ensure that the laser is set correctly for your hair colour and skin type.
For information on what you should do to minimise risk see: What you Should do Before and After Laser Hair Removal
Other Potential Risks/Side Effects
Some of the other, less common but potentially more severe side effects, usually as a result of incorrect use of lasers include:
- Allergic reactions – a numbing cream can be used prior to treatment to minimise pain, which could cause an allergic reaction. This should be discovered through patch test.
- Burns – lasers use very powerful, concentrated light which, if absorbed by the skin surrounding the target hair follicle, may cause burns. These are not usually severe and are transient and comparative to minor sunburn.
- Hyperpigmentation – light causes your skin to produce more pigment cells (as in tanning) to protect itself. Therefore, it is possible that your skin may react to the laser light by producing additional pigment cells and causing patches of darker skin (more likely with light skin).
- Hypopigmentation – laser light aims to penetrate the skin and target the pigment cells beneath, which surround the hair follicle. If the laser is set incorrectly it will also attack the pigment in the skin of the treatment area, causing a loss of colour i.e. lighter patches (more likely with darker skin).
- Scabs – your body uses scabs as a defence mechanism to protect damaged skin. Laser light can cause scabbing to occur – usually fairly minor and comparative to those produced by tattooing.
- Infections – Damaged skin is prone to infections. Incorrectly used lasers can easily cause damage to the skin and the consequent infections have the potential to be serious.
- Bruising – Bruises can occur as a result of damage to the small blood vessels near the surface of the skin.
- Changes in Sensation – occurs if the nerve endings are damaged, resulting in tingling or numbness.
- Increased Hair Growth – this is a rare occurrence, and the reason is not fully understood, although there are several theories which I will not expand on for the purposes of this article.
Given all the potential risks, the real question, what is the likelihood of these occurring? In order to address this question I identified two sources of evidence:
Study 1 - Birmingham Skin Centre Research
This piece of research was carried out due to a lack of published data on the incidence of side effects from laser hair removal by The Birmingham Skin Centre, City Hospital, Birmingham, UK.
- A multicentre study was carried out to determine incidence and type of side effects experienced in relation to both skin type and laser used.
The study revealed that incidence of side effects were low, and in the majority of cases were temporary. The highest levels were seen in patients with darker skin who had been treated with the long-pulsed ruby laser.
Research Paper - Review of 30 Scientific Studies
The Objective of this review was to summarize efficacy and adverse effects from hair removal with Ruby, Alexandrite, Diode and Nd:YAG lasers and intense pulsed light (IPL)
- Scientists analysed and reviewed the results of 9 randomized controlled and 21 controlled trials for laser hair removal and IPL
From 9 randomized controlled and 21 controlled trials, the majority of the evidence was concerned with laser hair removal, with limited information on the results of IPL.
In terms of safety the review found that post-operative side effects were low for all the laser systems.
I conclude from these that laser hair removal is inherently safe if carried out by a qualified, experienced practitioner.
Study - Rise in Hair Removal Lawsuits
There has reportedly been a rise in laser hair removal lawsuits, which does not appear to support these conclusions.
However, as demand for laser hair removal has grown, so the demand for cut-price treatments has increased. Together with lack of federal regulation, this has led to a substantial incidence of under-qualified, non-medically trained operators in many states.
A recent clinical survey entitled “Treatment Errors resulting from use of lasers and IPL by medical laypersons: results of a nationwide survey” reported that the most common laser treatment errors are more likely to occur when performed by non-medical professionals.
This survey is outlined in brief below:
- Study looked at the most common laser and IPL treatment injuries and errors by non-medical operators highlighted as a result of a nationwide survey.
- 50 patients who had been affected by treatment errors were surveyed
- Questionnaires were standardised
- Photographs were taken of injuries
The injuries, according to the survey, were as follows: Pigmentation changes: 81.4%, scars: 25.6%, textural changes: 14.0% and incorrect information: 4.6%
The causes of the injuries were identified as follows: Excessive energy: 62.8%, wrong device: 39.5%, darker skin/tanned: 20.9%, no cooling: 7.0%, incorrect information: 4.6%
The conclusion was that laser hair removal should not be carried out by insufficiently trained, non-medical operators with inadequate diagnostic abilities. In addition, that their lack of knowledge often led them to make unrealistic promises to the consumer.
Further surveys have shown that whilst only a third of laser treatments were carried out by medical laypersons in the period 2008 – 2012, of all hair removal malpractice lawsuits 85.7% were against them. Furthermore, 64% of these were performed outside of a medical facility.
For more information about this particular study, read our full article about it.
What About Home Laser Hair Removal?
Given that the overwhelming evidence supports the view that laser hair removal is safe, but only in the hands of a qualified and experienced medical practitioner, what does that say about home treatments?
It is important to understand that home lasers are not as powerful as those used commercially, and they have inbuilt safety mechanisms to ensure that light is not emitted if it detects that the skin is not suitable.
Also, to avoid eye damage, it is necessary to press the device against the skin before it will work. The final study that I looked at is entitled “Permanent hair reduction with a home-use diode laser: Safety and effectiveness 1 year after 8 treatments”
Study 4 - Home Laser Hair Removal Safety
- All patients had naturally brown or black hair and skin type Fitzpatrick I - IV
- 8 treatments were given at monthly intervals
- Laser used was a diode laser at three different fluences
- A fourth area was left untreated as a control.
- Hair counts were taken at each treatment and periodically for a year following the last treatment.
In terms of safety, the only observed side-effects were mild erythema (redness) and edema (swelling), which were temporary and usually resolved within hours of treatment.
The study concluded that home laser hair removal is safe and effective however the sample size of 15 is small so the results are indicative but not conclusive.
Conclusion - Is Laser Hair Removal Safe?
To summarize of all of the available evidence, including that outlined in this article, laser hair removal is inherently safe, but must be used by or closely supervised by a medically trained, qualified and experienced practitioner in a safe and controlled environment.
This means that when you're looking for a laser hair removal salon, you should ask the right questions and make sure that you're being treated by a professional.
Cautionary note:- Laser hair removal has only been available commercially since the mid 90’s and so there is a lack of information concerning the long-term effects on the skin.
Here are some related articles relating to the safety of laser hair removal and how to find a laser salon:
- Permanent hair reduction with a home-use diode laser: Safety and ef... - PubMed - NCBI
- Evidence-based review of hair removal using lasers and light sources. - PubMed - NCBI
- Treatment errors resulting from use of lasers and IPL by medical la... - PubMed - NCBI
- Incidence of side effects after laser hair removal. - PubMed - NCBI