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Is it hair removal or hair reduction? When you shave your legs or underarms, you are removing the hair! What we want to do is reduce the amount of hair that grows there - to zero if we can - so you don’t need to shave anymore, or at least not very often!

The principle on which hair reduction is based is simple. We want to destroy the hair follicles so they stop growing hair. In order to do that, the hair follicle cells need to be active and a hair shaft needs to be present in the follicle. Hair follicles don’t grow hair all the time. They enter a dormant stage lasting 6 to 24 weeks, then they awaken and grow hair again. They are not susceptible to destruction when dormant. There may be a hair shaft in a dormant follicle but it is not growing. The hair follicles are not all synchronized together, so at any point in time, some of them are dormant, some are active, and some are in between. When we give a hair reduction treatment, some follicles are not at the right stage to be treated. Subsequent treatments need to be given about two months apart. At this interval, many follicles that were dormant at the last treatment will now be active. The treatments have a way of shocking the dormant follicles into waking up. After about three treatments, most of the follicles that were asleep will start to wake up together. The treatments have synchronized them. So we give the first three treatments about two months apart and then we do not treat the fourth time until we see synchronized regrowth, which may take up to five months, depending on the site on the body and the individual person. About four weeks after each treatment, you should notice that you are shedding some of your hair in a patchy distribution. Those are the active follicles that were damaged at your last treatment. Some of them will recover, but we’ll get them at the next treatment. Many patients will notice that much of the hair is still actively growing after the first few treatments. It may take more than one treatment to destroy even an active follicle. However, if we retreat too soon, the dormant ones will still be dormant, and you will end up needing many more treatments to get the job done than if we wait.  Results with hair reduction vary from person to person. We do not guarantee results. However, the vast majority of patients are very pleased with the results achieved. The result in some patients is permanent. Others may require a touch-up every 6-12 months.

For hair reduction to work, the follicle cells must be active and there must be a hair shaft present. A hair shaft must be present in the follicle because hair reduction techniques all depend to some degree on heating the hair shaft. The only way a laser causes hair reduction is by heating the hair shaft so hot that the heat then diffuses to the surrounding follicle cells and destroys them. The laser beam treats an area of skin that contains several hair follicles with each firing. The laser energy is absorbed by both the skin and the hair shaft. If the laser heats the hair hot enough to burn the hair follicle cells right next to it, why doesn’t the laser just burn the hair follicle cells directly as well as the surrounding skin? Dark objects absorb light energy much more strongly than light objects. A coarse dark hair shaft surrounded by pale white skin is the ideal situation for laser hair reduction. The hair shaft absorbs most of the energy and the heat diffuses from the hair shaft to the surrounding tissue. The hair follicle cells are closest to the shaft, so they get the hottest. This is how the follicles are selectively targeted. A blond or red or grey or fine hair surrounded by naturally dark or tanned skin is the worst situation for laser hair reduction. The skin absorbs more laser energy than the hair shaft. There is no way to selectively target the follicle cells. If the laser is hot enough to destroy the follicle cells, it will destroy the surrounding tissue as well. Lasers don’t work well here.

We use ELOS®, from Syneron, Inc. It combines radiofrequency  ELectrical energy, with intense pulsed light Optical energy, and the Synergy between them means it works better than if they were used separately. Neither needs to be as strong as a laser, so it doesn’t hurt as much as a laser. ELOS® selectively targets the follicles in two ways. Radiofrequency (RF) is the real follicle killer. It passes through the tissues and destroys the follicle. But it can’t pass through the hair shaft so it is concentrated more in the tissues right around the hair shaft as it deflects around the shaft. The tissue right around the hair shaft is the follicle that we actually want to receive more energy than the rest of the tissues. In addition, the tissues offer resistance to the flow of this energy. The energy flows more easily through warmer tissues because tissues offer less resistance the warmer they are. The intense pulsed light (IPL) fires first and warms the hair shaft - not really hot, but enough to warm the surrounding hair follicle. This lets even more RF flow through the hair follicle. But lighter hairs are still a problem. They don’t warm as much with the IPL as the coarse dark hairs do. So the hair follicle doesn’t warm as much. Therefore the effect of the RF is not as strong on lighter-haired individuals. The RF will work alone on light hair without the IPL because the deflection around the hair shaft concentrates more RF into the hair follicle. But it works better if the IPL can heat the hair follicle first. With the lighter-haired individuals, it just takes more treatments!  Following are examples of what can be achieved with ELOS®