In this expert discussion panel, the challenges related to Laser Assisted Hair Removal or Hair Reduction (LAHR) will be discussed. The topics which will be covered during this panel are:

*The different Lasers used in LAHR
* LAHR during pregnancy
*LAHR during Isoteritinoin treatment
*Paradoxical hypertrichosis
*Leucotrichia (Leukotrichia) after LAHR
*How to perform safe LAHR in tanned skin

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This webinar is about laser assisted hair removal challenges. This is a very common procedure that most of the aesthetic and cosmetic spas are doing it and there are lots of things that we have to learn before doing it. Scientifically speaking, laser assisted hair reduction is a more correct term in comparison to laser assisted hair removal because of some areas like the face or neck that even after a complete course of treatment we will see hair in these areas.

For a patient with dark skin, thick hair that also has an inflammatory process on their skin you should first do something for their inflammation like giving systemic antibiotics because if a patient with dark skin and inflammation is subjected to laser, he might show post inflammatory hyperpigmentation easily. So you should first treat the inflammation and then go for laser assisted hair reduction.

In a few patients who were treated with a long pulse laser, after several times hair will become longer and increase which we call paradoxical hair growth. Luckily this is not a common complication and mostly occurs in Middle Eastern females with type 4 skin. A possible solution for this problem is retreating with higher influence. Cooling the area that will be exposed to laser and the area around can prevent paradoxical hair growth from happening.

Some patients who have been treated with laser assisted hair reduction will come back to you and complain about white hair. This will happen to the doctors which are over-cautious, using a low influence will only affect melanin and the energy is not enough to affect the hair follicle itself. So the melanin will get destroyed but the hair will be remaining. We should have enough knowledge and experience when we are setting up the fluence to avoid these kinds of complications.

We have so many home-use devices for hair reduction and they are becoming more popular because of the lockdown due to COVID-19. At first, we taught it will affect the clinical hair removal treatments but it seems home-use devices couldn’t replace clinical laser assisted hair reduction. These devices work in some areas but generally speaking there is still a need for a professional procedure to achieve quick and long-lasting results.

Using a device with contact cooling for curly surfaces will be challenging because you have to make sure the cooling is covering all the skin below it otherwise, some areas will be cooled and some won’t. As a result, some areas of the skin will be exposed to laser without cooling and this might lead to some burns. So selecting the right device is an important part of treatment. You should also make sure your devices are in good condition because a damaged device will lead to burned skin or poor results.

When to start laser assisted hair reduction? For this, you should balance the psychological impact of hypertrichosis and psychological trauma from the pain during the procedure. A couple of years after puberty seems to be good to start from exposed areas like hand and face however there is no age limit toward the laser and it is safe at any age.

Serum prolactin, lactation, pregnancy, and isotretinoin association with laser assisted hair reduction will also be covered in the webinar.