ABC Primetime on lasers


ABC News did a nice piece discussing laser hair removal this week (5/2/2002):

Primetime: A Day at the Spa

[excerpted below]

Laser Hair Removal

More troubling to the experts Primetime spoke with is the rise in popularity of laser treatment to remove body hair. Such treatments are becoming available at more and more spas, and more than 1 million Americans had laser hair removal in 2001.

According to Dr. Roy Geronemus, a leading expert in laser treatments, dermatologists are seeing a “dramatic” increase in the number of complications from laser hair removal treatments. “These complications may have lifelong consequences,” he said

Primetime met one woman who received first- and second-degree burns on her cheek and neck while undergoing laser hair removal at an upscale spa in New York City. The woman, who is suing the spa, says she has been left with permanent scarring, and now, more than a year later, still does not uncover her face in public.

Geronemus is particularity concerned about training: some operators have only a weekend’s worth. And even with much more training, mistakes are made, he said. There are many different lasers for different skin types and too many operators use the wrong laser for the wrong skin, he said.

Furthermore, only 15 states require that only physicians can perform laser hair removal. In 20 states, including New York, there are no regulations at all.

To see if testers would be accurately told what to expect and what risks they might take, Primetime sent employees to spas in New York to document their consultations on hidden camera. The testers were all deemed high risk or poor candidates for laser hair removal by Geronemus.

Experts Primetime consulted say one of the most important things in laser treatment is assessing a customer’s suitability. Some lasers can be dangerous for some darker skin types, they add, and are ineffective on blond hairs. Primetime’s hidden cameras found that while some laser operators were careful to consider clients’ skin and hair type, others were willing to proceed with laser treatments without giving adequate warning of the potential dangers involved.

Lasers Ineffective on Blond Hair…

At one spa in New York City, the operator told a Primetime tester with fair skin and blond hair that she could get rid of unwanted hair and would not face side effects because of her skin and hair color.

The operator promised that after three sessions costing a total of $1,000, the tester’s hair would be gone “permanently.” But Geronemus said that was misleading: “Lasers just don’t work on blond hair at this time… It simply doesn’t work,” he said. “There’s no point in even attempting this procedure on this patient.”

When Primetime told the operator of the doctors’ opinion, she said that while the laser won’t work on many blonds, it will on some, and that you don’t know until you do it.

Laser hair removal works by targeting melanin, the pigment that gives hair and skin its color. The melanin absorbs the laser’s heat, thereby damaging the hair follicle. Blond and gray hairs do not have enough melanin for the system to work.

… And Can Be Risky on Darker Skin

Those with darker skin, and higher melanin, are at a much higher risk for side effects. Some lasers cannot distinguish the dark hair from the dark skin, so the skin may absorb the laser’s heat, which can cause burns.

When Primetime sent a black tester to a laser hair center in New York, the operator promised she would be safe and said any reaction would last only a few days. Primetime’s experts were shocked to hear the operator’s reassurances, explaining that the laser she planned to use on the black tester was the wrong laser and increased the risk of burning and scarring. There are more than 30 models of hair-removal laser on the market, but operators need to choose carefully which laser to use on which skin type, the experts said.

Dr. Elliott Battle, who has studied the effects of lasers on people with darker skin, said that all people of color, not just blacks, are at risk, including those of Mediterranean, Asian or American Indian background.

When contacted by Primetime, the operator insisted she could provide a safe procedure because she is careful and well-trained — though she wouldn’t give any details about that training.

If You Have a Tan, Hold Off

Even more risky, many experts say, is having laser treatment with a tan. When Primetime sent out a tester who goes to a tanning salon regularly, the first two laser salons she visited asked about her tan and turned her away, saying a tan was a problem. But at the third salon, the laser operator didn’t seem to notice the tester’s tan and never asked her about it.

Geronemus said the chance of complications goes up dramatically when a laser customer has a tan, and said spas should tell consumers with tans to come back a few weeks later, after staying out of the sun.

When confronted by Primetime, the laser operator said she had extensive training and can treat tanned people safely. She said her spa has a laser model approved by the FDA for use on tanned people. She had even told the Primetime tester she would use that model on someone which tan skin — but that was not the one she showed the tester.

“The mistakes that were made were fundamental mistakes and should not be made,” said Geronemus. “These are fabulous procedures if performed properly, but there can be significant consequences if not performed properly.”


It takes my tan longer than a few weeks to fade. I waited from October (the last time I was out in the sun) until January to resume laser treatments. I still had some an left but not enough to cause any problems.

I noticed that many diode lasers like the Apex 800 and the Lightsheer ET claim to work on tanned skin. But on the websites it also says that lower fluences are used on people with tan or dark skin. That would tend to reduce effectiveness.

I am currently undergoing treatment with the Lightsheer ET and am very impressed. The saphhire contact cooling is very effective and I have almost no post treatment pain or redness. You can feel it though while those hairs are getting zapped. The dermatologist and technician I go to are not currently using the Lightsheer on tanned skin.

They also have a Sciton Image 1064 Yag laser. I am considering asking about using that over the summmer but they don’t seem real big on that idea. They say the Yag laser requires more treatments to be effective.