Hair has a three phase growth cycle: anagen, catagen and telogen. The anagen phase is the growth phase. The catagen phase is the transitional phase. The telogen phase is the resting phase. Laser energy is effective only during the active phase, the anagen phase. During the catagen and telogen phases the laser is not effective in destroying the hair follicle. Because at any one time, some of the hair will be in each of these different phases, removal of the hair requires multiple sessions. Subsequent treatments will be performed once you notice the regrowth of hairs, usually in four to six weeks when the hairs in the resting phase convert to the active phase.

Who is a candidate for Laser Hair Removal?
Most hair removal lasers work by targeting the dark pigmentation in the hair follicle. Therefore, those patients with dark hair and light skin are the best candidates. The best candidate for laser hair removal has the following characteristics:

•  Light skinned with dark hair
•  Do not have blonde or red hair
•  Do not have a recent tan
•  Have coarse hair
•  Have realistic expectations

The laser used for hair removal is the Cynosure Apogee-40 Enhanced TKS Laser. It utilizes the best known combination of clinical factors to isolate the energy of the treatment to the hair base and not the skin or other unwanted areas. The result is a more effective treatment for patients with a larger range of skin tones treatable. The Apogee Laser increases both the destructive effect on the hair follicle and the protective effect on the skin.

What will happen at the initial consultation?
The initial consultation will begin at our office in St. Louis, Missouri, with a complete medical history and exam. You should tell Dr. Jones if you have any history of scarring, pigmentation problems, epilepsy, herpes, lupus or psoriasis. Medications that may make the skin more sensitive to laser energy include: non-steroidal anti-inflammatory drugs (Ibuprofen), tetracycline (minocin), griseofulvin, phenothiazines, thiazide diuretics (HCTZ), sulfa drugs, chemotherapy drugs, and aspirin.

The areas you wish to have treated will be examined with a focus on skin pigmentation and hair color. A test patch may be recommended to determine whether your hair will respond favorably to the laser. Other options available to you will be discussed along with risks and limitations. The costs of the treatment will be explained. Photographs will be taken.

Risks and Limitations
Although laser hair removal is generally safe and effective, possible side effects of the procedure include:

•  blistering, burning, or crusting of the treated skin
•  lightening of the skin in the treated area
•  darkening of the skin in the treated area

If you have darkly pigmented skin, you may notice a temporary lightening of the treated skin. Darkening of the skin almost always resolves over time. Topical creams can be used to facilitate lightening if necessary.

How are Laser Hair Removal treatments performed?
Patients should stay out of the sun for two to three weeks before the procedure. Treatments should not be performed on a suntan or sunburn. If you have dark skin, you may be asked to use a bleaching cream on the area to be treated for two weeks before the procedure. The night before the procedure you should shave the areas being treated. Do not wear makeup, deodorant, perfumes or powder on areas to be treated. One hour before the procedure, the area for hair removal is covered with a prescription anesthetic cream to numb the skin.

Laser hair removal is performed in the office. You will be asked to wear protective goggles. A cool gel will be applied to the area to ease the sensation of the laser pulse. The laser pulses have the sensation of a pinprick and are delivered quickly. The treatment time depends on the size and number of areas treated. An upper lip takes only minutes whereas the back may take 45 minutes to one hour. You can return to work or home after the treatment.

What can I expect after the Laser Hair Removal?
The area treated will appear like a moderate sunburn for 24 hours. Occasionally, the treated skin becomes slightly crusted or may blister. Antibiotic ointment should be applied to the area if there is any blistering or crusting. Avoid using Retin A cream, Renova or an astringent for 72 hours after the procedure.

You may continue with normal activities. A broad-spectrum sunscreen of SPF 30 or higher should be applied whenever you are exposed to the sun. Swimming and strenuous exercise should be avoided for the first 48 hours.

You may notice hair "growing" in the treated area within 10 days of the treatment. This is not regrowth, but the hair follicle falling out. You may shave these hairs, but avoid waxing, plucking or bleaching hairs between sessions.

What is the long-term outcome for most people?
Most patients are satisfied with the results of laser hair removal. However, some people (10 percent) do not respond very well. Unfortunately, the non-responders are unpredictable.

Each individual has a different metabolism, hormonal level, hair quality and number of hair follicles, all of which can influence the result. Some people achieve permanent hair removal. However, at this time, most patients may need touch-up treatments one to two times per year.

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