This document summarizes various methods for temporary and permanent hair removal. Temporary methods include shaving, tweezing, bleaching, and depilatory creams. Permanent methods discussed are electrolysis, thermolysis, and laser/IPL treatments. Key factors for effective laser hair removal include appropriate wavelength and pulse duration based on skin and hair characteristics. Multiple treatments spaced 1-3 months apart are typically needed to achieve significant hair reduction. Potential side effects include pain, pigmentary changes, and infection if not performed properly. Permanent hair removal is difficult to achieve and regrowth may still occur.

1. Prof. Osama B Moawad
Energy Based Hair Removal

2. Human hair growth
patterns convey social
information about sex,
age, and racial
background
Excess Hair

3. The presence of
excessive hair can be a
source of distress that
can lead to such
psychological problems
as anxiety, depression,
and reduced quality of
life.
Excess Hair

4. Excess Hair
Hypertrichosis Hirsutism

5. Hypertrichosis
Hypertrichosis is
defined as hair growth
that is abnormal for the
age, sex, or race of an
individual at any body
site that is not
androgen dependent

6. Hirsutism
Hirsutism is
defined as the
abnormal growth
of terminal hair in
women in male-
pattern (androgen-
dependent) sites,
such as the face
and chest

7. Temporary Methods of Hair
Removal
Bleaching does not
remove the hair follicle,
but it serves to lighten the
color of the external hair
shaft so that it is less
noticeable

8. Temporary Methods of Hair
Removal
Trimming
Trimming of hair is the
treatment of choice for
young children with
either localized or
generalized
hypertrichosis. It is safe
and does not accelerate
hair regrowth

9. Temporary Methods of Hair
Removal
Shaving is one of the
oldest and most frequently
used methods of hair
depilation. Contrary to
popular belief, shaving
does not affect the width or
rate of regrowth of
individual hairs
Shaving

10. Temporary Methods of Hair
Removal
Tweezing or plucking is a
temporary method of
epilation that is used for
small areas of excess hair.
Drawbacks include treatment
discomfort and risk of
folliculitis, pigmentation,
redness, follicular distortion
(which makes subsequent
treatment difficult), and
scarring
Tweezing

11. Temporary Methods of Hair
Removal
provide
inconsequential
transmission of
electric current
into the follicle
with subsequent
rapid hair
regrowthElectronic
tweezers

12. Chemical Depilatory
Agents
• act to separate the hair
from its follicle and the
surrounding skin surface
through reduction of
disulfide bonds
• chemical depilatories are
most appropriate for
weekly hair removal from
small areas.
Temporary Methods of Hair
Removal

13. Mechanical epilation
Threading
This method is used
extensively in Arabic
countries and may
produce folliculitis ,
erythema, and
sepigmentary changes
Temporary Methods of Hair
Removal

14. Temporary methods of hair
removal
Six weeks of relatively hair-free skin is typically
achieved

15. Sugaring
The non-Western
technique of sugaring is
another temporary hair
removal method.
Sugaring is similar to
waxing except that a
sticky paste isapplied to
the skin instead of
melted wax or acold
polymer. Sugaring is
often preferred for large
surface areas, such as
the back or legs
Temporary Methods of Hair
Removal

16. Energy Based Hair Removal- MSI

17. Energy Based Hair Removal
Types
Laser
Light
Radiofrequency

18. Energy Based Hair Removal
Action on Hair
Photothermal destruction
through local heating
Photomechanical
destruction through the
generation of schock waves
Photochemical destruction
through the creation of
singlet oxygen radicals

19. Electrolysis and
Thermolysis
Permanent Methods of Hair
Removal
Electrolysis, thermolysis, and a
combination of both are three
popular procedures used for
epilation or permanent hair
removal
All three methods involve the
insertion of a small needle or
probe into the hair follicle
through which an electric
current is delivered, resulting in
the production of a microscar
that s is barely perceptible at the
skin surface

20. Electrolysis is more effective
on anagen hairs; therefore,
shaving within a few days
before electrolysis greatly
increases its efficacy because
it ensures that only growing
anagen hairs are epilated
Although the combination
treatment is slower, it is
significantly more effective
than the individual use of
each method and is less
painful .
Permanent Methods of Hair
Removal
Electrolysis and
Thermolysis

21. Recently, a home used device
(no, no hair ) uses the principles
of thermal transference to heat
the hair shaft through a
thermodynamic wire. .
Permanent Methods of Hair
Removal
Electrolysis and
Thermolysis

22. Fine
Black
Fine
Brown
Fine
Blond
Thick
White
The Radiofrequency (RF) Current is less painful than
waxing or traditional ways of removing hair.
Radiofrequency

23. It induce micr-scars
Radiofrequency

24. However these micro-scars with good technique may
be imperceptible
Radiofrequency

25. Magic Bullets!!

26. Factors affecting Laser HR
Laser and
IPL
Wavelength
Fluence
Pulse duration
Spot size
Cooling

27. The Recipe of Permanent Hair
Removal
1.Appropriate wavelength
.2 Adequate energy (fluence)
destroy the follicle
3.Pulse durations 10ms-400ms
4.Spot sizes that maximize laser
parameters
5. Sufficient surface cooling

28. The target chromophore in laser-assisted hair removal is the
melanin rich hair shaft and bulb.
Melanin

29. Melanin is Major Chromophore
Hair follicles that are less pigmented (blond) as well as
those pigmented with pheomelanin-containing (red)
instead of eumelanin-containing (dark) hair are less
susceptible to photoepilation procedures
Effective Not
Effective

30. Long pulsed
alexanadrite 755nm
Long Pulsed and
Superlong Pulsed
810nm Diode
Long Pulsed
1064nmNd YAG Laser
Wavelength: The Longer the Safer
Lasers/ light sources with wavelengths of about 600–
1100 nm are absorbed by melanin

31. The ability to remove hair without damaging the surrounding
skin is based on selective photothermolysis.
Pulse Width: The Shorter the
Safer

32. Q switched Nd:YAG laser, with or without topical carbon
suspension, destroy hair mechanically temporary
No Cooking with ultrashort pulse width

33. Plus Width: Shorter for thinner, lighter
Shorter pulses, with equivalent fluence, have
achieved superior LHR, particularly when the
hair shafts are lighter and thinner.

34. Pulse Width: Longer for thicker, Darker
However, to achieve permanent hair reduction, the heat
must diffuse through the entire surrounding tissue of the hair
follicle. The durations in the milliseconds are necessary

35.  To achieve permanent hair
reduction, the heat must
diffuse to the entire
surrounding tissue of the
hair follicle.
 Thermal damage to the hair
follicle and surrounding
stem cells reaches its peak
at a pulse duration of 400
msec.
New Recipe for Hair Cooking

36. Super-long-pulse technology is more safer for the dark skin
New Recipe for Hair Cooking
Super-long Pulsed Technology

37. The Larger Spot Size
Faster
Deeper
More
energy

38. Comfort Safety Efficacy
Effective Cooling is a Must

39. Non-laser light sources
Flashlamp-generated intense pulsed light
at wavelengths longer than 590 nm
lasers and IPL devices both work quite
well for hair removal.
The decision to use an IPL or laser
determined by the physician’s bias and
familiarity with a specific device
Intense Pulsed Light (IPL)

40. 12/18/2009Hair Removal
40

41. elos (electro-optical synergy).
E. Light
Pulses of bipolar radiofrequency and
pulsed visible light delivered within
the same pulse to reduce intensity
and thus potential side effects.

42. Skin
compression
Pain Reduction
Expels blood
Increasing the
amount of light
reaching this region
Pneumatic Skin Flattening
(PSF)

43. Non-laser light sources
A novel, low-
energy, pulsed-light
device for home-
use hair removal
(Silk’n™)
(Silk’n™)
Home Use LHR

44. Am I a Good Candidate for LHR?
A medication history
screening for hormonal
conditions
Prior staphylococcal or
herpes simplex
keloids or hypertrophic
scars

45. Endocrine dysfunction
Anatomical region
skin pigmentation
Hair color, thickness
Hair growth cycle
Depth of follicles
Individual Skin or Hair characteristics
Factors affecting LH Results

46. What Body Area Can Be Treated?

47. Treatment of Light Hair
The use of elos has cleared 52% of blond hair and a
44% clearance of white hair after four treatments the
18-month follow-up
Photodynamic therapy may provide another option.

48. Melanin in the epidermis competes with the hair follicle as a
chromophore, potentially leading to side effects
Treatment of Dark
Skin types (IV–VI)

49. Longer
wavelengths
Longer
pulse
width
Lower
Energy
Efficient
Cooling
Treatment of Dark Skin
Types ( IV–VI)

50. The Long Pulsed Nd:YAG 1064nm is considered
to be the safest hair removal device in patients
with dark skin
Treatment of Dark skin (IV–VI)

51. Combined Hair Removal Therapy
Prof Moawad believe that combining two different technology such as E-light
(effective in treating lighter hair) and long pulsed Nd YAG 1064nm (effective in
treating deeper hair follicle in darker skin) is very promising

52.  Avoid plucking, Waxing, or
Electrolysis 2 weeks before
laser therapy .
 Shaving and bleaching are
allowed.
 Depilatory creams may be
used because the hair shaft
is not absolutely necessary
to hair removal
Prior Your Laser Hair Removal
Session Remember!!!

53. Is Laser Hair Removal Painful?
Laser treatments for hair removal are generally well
tolerated except in large or sensitive areas topical
anesthetic cream may be applied

54. Preparation of Laser Hair
Removal
Skin should be cleaned and all makeup and skin
creams removed

55. The hair is shaved so that the thermal damage occurs in the
follicle as opposed to on the surface of the skin.

56.  All lasers and IPLs used for hair
removal are potent eye hazards
therefore, protective eyewear
should be given to all persons
 It is prudent to treat the “unibrow”
away from the eyes.
 Lasers and IPLs should not be
used to remove the lower eyebrow
What Areas of the Body
Can be Treated?

57. Area of unwanted hair is precisely marker
Patient Education

58. The Recipe for Hair Cooking
Treatment parameters are individualized
Pulses are delivered in a slightly overlapping
mode.
The highest tolerable fluence and the largest
spot size are used
Vaporization of the hair shaft, perifollicular edema
and erythema are good end points

59. The ideal treatment parameters are individualized for each
patient Pulses are delivered in a slightly overlapping mode using
the highest tolerable fleunce with the largest spot size
Patient Education

60. What Do I Expect Immediately
after LHR Light Hair?
The ideal immediate response is vaporization of the hair shaft, is
followed a few minutes later by the appearance of perifollicular
edema and erythema.

61. •Laser-induced perifollicular erythema and edema generally last for
minutes to a few hours.

62. Moderate to severe pain is another indicator that the fluency
may be too high.

63. The discomfort is described as feeling like a small rubber band snapping
against the skin, insertion of fine needles or pin-point heating
IS LASER HAIR REMOVAL PAINFUL?

64.  Cooling mechanisms such as a cooling
plate, spray, or gel protect against
thermal damage of darker skin.
 Hair epilation with minimal epidermal
damage is achieved by balancing
thermal destruction with cooling.
 Efficient Cooling is essential for safe
laser hair removal in dark skin
Patient Education
Comfort Safety Efficacy

65. After therapy, patients
should be given ice to
decrease pain and
reduce swelling. Patients
may also be given a mild
corticosteroid cream to
decrease erythema.
Patient Education
Postoperative care

66. Postoperative care
Antibiotic ointment is
recommended if
epidermal injury is
noted and makeup
may be applied the
Day after
Patient Education

67. What Can I Expect After ……?
Patient Education
Hair casts will shed the first week of therapy, and this shedding
should not be confused with hair growth

68. Avoid Sun Exposure and Tanning
Postoperative Care
Patient Education

69. Before
During
After
Avoid Sun Exposure or Tanning, apply Sunblock, Bleaching ,
Mild steroids and Antibiotics
Patient Education

70. •Expect 20– 30% hair loss per treatment; as low as a 4% and
as high as a 70% per-treatment
Patient Education
How Much Hair Will Grow Back?

71. Treatments are spaced 1-3 months apart,
although shorter treatment interval may be more effective
Patient Education
How Soon Will It Grow Back?

72. Patient Education.
Significant permanent hair reduction according to FDA
definition , may require at least 5-7 treatments
How Many Sessions Do I Need?

73. Patient Education.
• After
An average, (75% -905) reduction in hair after 5-7 treatment in
patients with dark hair and light skin and may be reduced in
patients with dark skin or with light hair
How Many Sessions Do I Need?

74. count Color Thickness
Patient Education
How Do My Hair Look after finishing my laser treatment?

169. What are the Potential Side
Effects of LHR?
Pain
Erythema
Perifollicular edema
Pigmentary alterations
Blistering, Crusting and Erosions
Superinfection, and Folliculitis
Pruritis and Urticaria

170. Poor Technique
Skipped Areas
No Overlapping

171. Thermal Epidermal Injury
Blisters
High Energy

172. Thermal Epidermal Injury
High Energy
No Efficient Cooling
Pigmentary Changes

173. Pigmentary change
Thermal Epidermal Injury
Overlap more than 25%

183. Conclusion
Rather than being a
simple physics
problem of targeting
pigmented structures
and heating them until
they or adjacent
structures are
destroyed, laser hair
removal relies on a
complex set of
biologic events
following laser
treatment.

184. Conclusion
‘‘only with a better
understanding of
hair biology and the
histologic evidence
of laser induced
changes that we
will begin to truly
understand the
mechanism of laser
induced hair
removal

185. Conclusion
Studies have found diode, ruby, and alexandrite
lasers as well as the IPL to be of similar efficacy

186. Conclusion
The overall cosmetic outcome is determined not only by the
absolute number of hairs, but also by the diameter, length
and color of hairs in the treated area.
ThicknessColorCount

187. Today there is no evidence for a complete and persistent hair
removal efficacy after laser and photo-epilation.

188. Additional studies are needed to assess the appropriate
number and timing of treatment sessions in order to obtain
even longer and perhaps permanent hair removal

189. Moawad Skin
Institute
189
In the end, growth delay is easy, but permanent
hair removal is hard, Persistent is Impossible with
Current Technologies