Laser hair removal (transgender)

I’m a 20 year old trans girl and I’ve been on hormones for 9 months (cyproterone acetate 50mg per day, but switched to 25mg 2 weeks ago; 6mg oral estrogen a day). I’ve already had laser hair removal last year, before i started hormone therapy - I bought an all inclusive package of 6 treatments at a laser clinic where all of my treatments were done by a dermatologist. She used a GentleLase Pro Alexandrite on me. I have very fair skin (I would say type I) and dark brown hair, which is very dense and thick on most areas of my body. Not sure what settings she used but my face and brazillian were incredibly painful, my legs were painful but less than the aforementioned, and I didnt feel anything on back, shoulders, arms and underarms. My treatments were 6 weeks apart. During treatment, my skin would turn red and afterwards develop little red dots that would subside within 2 days usually, and there was a lot of shedding with each treatment. But, I have noticed that about 3 months after the first treatment, the hairs that were gone had started to grow back (much finer in the beginning, and would turn back to thick in a month and look the same as before). I never had a cumulative result because as soon as i would go in for one session, the hairs that previously fell out would return. After the completed 6 sessions, all of my hair was back to normal in a couple months. Then i went on hormones and about 2 weeks in half of my facial hair DISAPPEARED. It didnt shed, i didnt see hairs on my pillowcase or on my fingers after washing my face. They just vanished. Hairs went away on the rest of my body to a varying degree, but no more than 50%. I was left with a few fine hairs on my cheeks and patchy thick hair on my chin and upper lip. I had a full coverage thick beard all over my face and neck beforehand. Now i have repurchased the same 6 treatments with the same clinic again, as I thought it was my high testosterone that was previously stimulating regrowth. I already had one session today. She used 16-18j with a 15mm diameter, 20ms pulse width and 2Hz. Treatment was less painful than before but i had redness and perifollicular edema, and a couple hours later i have the same little red dots, especially over my chest and stomach. I am wondering if these settings are good and if you suspect that the poor outcome was due to testosterone. As soon as i went on hormones, my hair was reduced. The problem is that my back hair is much finer than before. It was not thick before, but now its finer so I’m not sure if laser would work. I told her that. I also don’t know if paradoxical hypertrichosis is possible when im using an antiandrogen. She treated my back with 18j, but i plan to up the energy next time. What are your opinions and advice?

I can’t speak on hormones and their effects on hair growth. When it comes to your laser treatment, the first 6 treatments that you had it would have been better if they started with 18mm spot 16-20j since larger spot sizes have deeper penetration and low pulse like down to 3ms but 5ms is fine. On 15mm spot penetration is shallower and it’s used on finer hair but on 15mm spot joules should preferably be higher in 24-26j range. Were you using numbing creams during treatments? I suspect they had to raise your pulse width because of low pain tolerance. The lower the pulse the more painful the treatments.

The hair you present now is finer and not dense so I’m not sure how much more reduction you’ll see but chances of of seeing great outcome with finer hair is lower. At some point you will have to transition into electrolysis if you want total removal as laser won’t catch all finer hair.

She said that she used a pulse width od 10ms last time, but raised it to 20ms this time around because it penetrates deeper. That’s what she told me. I’ll ask her to switch the spot diameters next time between areas where i still have thick hair and those on the pictures where my hair is thin. Is that a good option? Thanks for your reply.

And I was not using any numbing agents. Btw, on my groin and face she used 14j on the 15mm spot, and I cant imagine raising more that a few joules on my face because it ws incredibly painful, especially on the chin, there i still had thick hair. Maybe it would be possible when my hair becomes patchier.