Laser hair removal using the Neodymium:YAG laser can be an effective and safe process for all skin types; however, some individuals may experience side effects like folliculitis as a side effect of treatment.
Laser hair removal can cause side effects like erythema and perifollicular edema, crusting, purpura and paradoxical hypertrichosis [2]. These reactions usually resolve themselves over time.
Background
Unwanted hair is an extremely common issue among both men and women. Treatment options for unwanted hair include shaving, waxing, plucking, chemical depilatories and electrolysis; however these methods only offer temporary solutions and often cause pain. Laser therapy has become a widely utilized way of eliminating unwanted hair; specifically the 694nm ruby laser has become the official laser tool used for hair removal; however this tool has also been linked with burning and scarring effects.
Folliculitis is an inflammation of hair follicles and may appear as red pimples filled with pus. Folliculitis may cause itching and burning of the skin and typically resolves itself without treatment; however, left unchecked it can result in scarring and pigmentation changes [1. These complications may discourage patients from seeking laser hair removal treatment, so it is crucial that we identify risk factors associated with folliculitis to help ensure its prevention during laser hair removal treatments [1, 2, 3, 4, 5].
Ongoing complications from laser hair removal include erythema, vesiculation & crusting of the treatment area, hypopigmentation (depending on skin color), and paradoxical hypertrichosis [2]. Hypopigmentation is believed to occur due to suppressed melanocytes in the epidermis; however, other possible causes include subtherapeutic thermal injury and release of inflammatory mediators as potential contributors [3.].
Purpura, commonly seen in laser hair removal treatments, appears as purple spots on the skin and usually heals within three to five days after receiving laser hair removal treatment. Tanning increases chances of purpura occurring. To decrease these complications and ensure safe procedures are carried out it is advised not to undergo laser treatment on tanned skin as doing so increases chances of purpura occurring.
Laser hair removal may result in another side effect known as Atopic Dermatitis, an itchy scaly rash typically appearing on the abdomen and chest but which can also appear anywhere else on the body. PDL treatments for port-winkle lesion often trigger this condition as Levine and Geronemus (1995) conducted research that demonstrated PDL as being more effective at treating Atopic Dermatitis than topical corticosteroids.
Methods
Folliculitis-commonly referred to as Barber’s Itch, Razor Bump or Hairy Skin Rash-is an infection of the hair follicle that manifests as painful red or pus-filled pimples or dark spots on the surface of skin. This condition develops when hair follicles that produce unwanted hair become inflamed with dead cells build-up and eventually blocked with more serious forms such as boils & blisters if left untreated correctly. Although anyone is susceptible, certain risk factors increase risk; such factors include:
Hair removal with laser technology offers a safer, more effective, and permanent way of eliminating unwanted hair than shaving, waxing or depilators; however, as with any medical procedure it carries with it potential risks such as Laser Induced Folliculitis.
Laser-induced Folliculitis is an adverse reaction of Laser Hair Removal that may occur through direct or indirect damage to surrounding tissues, typically self-limiting but potentially uncomfortable and dissatisfying for patients undergoing LHR, particularly in cases with curly or pili multigemini hair that could potentially make this more likely. This adverse reaction might dissuade individuals from seeking this service in future (ie, patients more prone to developing it).
Though most treatments for folliculitis may help ease symptoms and enhance skin appearance, they don’t address its source. Milan Laser’s innovative approach enables permanent disablement of hair follicles to prevent future outbreaks of folliculitis.
At our practice, we utilize two laser technologies for hair follicle removal – one geared for lighter skin tones and another specifically tailored to darker ones – creating custom treatments plans tailored specifically for each client that ensure we reach all hair follicles in their treatment area.
Milan Laser’s hair removal services can also help prevent ingrown hairs by targeting their source follicles with our Nd:YAG laser. By targeting these follicles directly, our treatment prevents razor blades or harsh waxes from damaging protective layers on skin surface while damaging hair follicles themselves.
Results
Folliculitis is an often-incurable complication of laser hair removal. Folliculitis occurs when inflamed follicles produce red pimples filled with pus, leading to red, itchy bumps on the skin that may result in permanent scarring if left untreated properly. Laser treatment will typically reduce and eventually eliminate this condition altogether.
Laser hair removal works by applying wavelengths of light that absorb melanin pigment found within hair follicles. A pulse duration equal or lesser than thermal relaxation time ensures selective photothermolysis.
Laser treatment affects only hair follicles while leaving nearby tissues undamaged, while simultaneously avoiding the vascular, muscular and adipose layers of the skin – thus significantly decreasing risk of scarring and burns.
Pseudofolliculitis barbae is a chronic inflammatory condition, manifesting as itchy papulopustular lesions in areas prone to shaving such as beard area for men or legs in women, such as beard region of male beard or legs of women. Razors, waxing and epilators may aggravate symptoms; while there are several clinical treatments available that do not address root cause but may only provide limited improvement.
Up until now, the best treatment for this condition was a combination of oral antibiotics and topical corticosteroids. While these medicines may help alleviate symptoms and prevent future outbreaks, their success varies considerably; hence this research was designed to identify a more efficient solution that not only alleviated symptoms temporarily but would treat their source permanently to avoid future outbreaks.
Attaining this objective required the use of a diode laser with an 810nm frequency and 30-millisecond pulse duration that targeted only hair follicles, without damaging surrounding tissues. All patients received laser treatment which resulted in either complete hair-growth delay (ranging from three to eight weeks) and reduced papules/pustules counts; even two longstanding pseudofolliculitis cases showed significant improvement of chronic changes such as hyperpigmentation or fibrotic papules).
Conclusions
Laser Hair Removal has quickly become one of the premier cosmetic procedures, but it does come with its share of risks and complications. These include laser burns and their sequellae, leukotrichia, paradoxical hypertrichosis, and folliculitis – an inflammation of hair follicles which appears as red pimples with hair in their centers (Sycosis barbae) or pus-filled bumps elsewhere on the body called folliculitis; Folliculitis often results in pain, itching or burning; often mistaken for contact dermatitis; treatment includes topical corticosteroid creams as well as antibiotic ointment.
Laser-induced folliculitis results from laser light penetrating the skin tissue through hair follicles, but its full impact is dependent on various other factors including their number and size, hair type (fine, thick, curly or coarse) as well as epidermis thickness.
Most complications from laser treatments are temporary and will resolve over time, with scarring being the most serious complication, lasting up to six months and most often seen when too much laser energy was applied or the epidermis wasn’t properly cooled down.
For optimal results, it is advised to utilize low-energy laser settings and avoid oversaturation of the treatment area. An effective cooling technique such as the ice cube technique has proven successful at reducing erythema and edema after treatment; additionally, moisturizing cream applied afterward will further lessen any side effects from treatment.
As with other treatments, pretreatment cleansing of the follicles is important in combatting folliculitis. Furthermore, refraining from shaving, waxing or plucking for three weeks before any laser treatments helps minimize irritation and reduce ingrown hairs that contribute to this condition. Blue Water Spa also offers medical grade skin care modalities like microneedling that can soften scars caused by folliculitis – ingrown hairs can become an ongoing problem with curly or wavy hair types in some individuals as folliculitis attacks become chronically worse over time.
