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IPL for Hair Removal

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Aesthetic Applications of Intense Pulsed Light

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Abstract

The hair follicle is a complex, hormonally active structure, which constitutes the foundation for hair growth. The hair growth cycle has three phases: anagen, catagen and telogen. The anagen phase is the growth phase, the catagen phase is the regression phase and the telogen phase is the rest phase. The hair follicle is the most susceptible to IPL treatment during the anagen phase. The melanin is the target chromophore for hair removal.

Hirsutism is a dermatological condition in women represented by excessive hair growth, distributed in a male-like pattern. Hypertrichosis is represented by excessive growth of coarser and longer hair than is normal for the age, sex and race of the person. Occasionally, hair removal can also have non-cosmetic applications (hair removal of flaps, treatment of areas with recurrent folliculitis, etc.). Nowadays, there are three methods of permanent hair removal: electrolysis, IPL and laser treatment. As in lasers systems, the mechanism of action of IPL hair removal is based on the principle of selective photothermolysis: light is absorbed by the target endogenous chromophore (melanin) in dermal papilla and the bulge area of anagen hair follicles, produces thermal energy destroying hair-producing papilla with sparing the epidermal melanin. The heat-induced destruction of the hair shaft leads to hair “dropout”. The partial injury to the germinative zone leads to telogen-shock response, prolonged telogen dropout, and development of dystrophic hairs which are thinner in texture and have variable pigmentation.

Initial consultation should include a thorough anamnesis, including questions to identify endocrinological problems; physical examination of the desired anatomic region; and matching of expectations—since most patients interpret “permanent hair removal” as no hair regrowth ever. Patients should be explained that multiple treatments are usually needed. If no improvement is obtained after 7–8 sessions, treatment interruption should be considered. Preparations should include sunscreen for 4–6 weeks before the treatment (and between treatments); shaving; signing an informed consent and pre-procedure photographs; and applying safety precautions (eye protection, skin preparation, etc.). Most physicians perform treatments 4–6 weeks apart. Treatment parameters need to be adjusted according to the previous results. The darker the skin and the brighter the hair, the less effective the treatment will be.

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Author information

Authors and Affiliations

  1. Plastic Surgery “Technion” Faculty of Medicine, Rambam Health Care Campus, Haifa, Israel

    Yehuda Ullmann

  2. Plastic and Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel

    Yehuda Ullmann & Yeela Ben Naftali

Authors
  1. Yehuda Ullmann
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  2. Yeela Ben Naftali
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Editor information

Editors and Affiliations

  1. Emergency District Hospital, Cluj Napoca, Romania

    Lucian Fodor

  2. Director Plastic and Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel

    Yehuda Ullmann

Multiple Choice Questions

Multiple Choice Questions

9.1.1 Q1: During Which Phase Hair Follicle Is the Most Susceptible to IPL Treatment?

  1. (a)

    Anagen phase.

  2. (b)

    Telogen phase.

  3. (c)

    Catagen phase.

  4. (d)

    Regression phase.

9.1.2 Q2: Which One of the Following Statements Regarding Melanin in IPL Photoepilation Is Correct?

  1. (a)

    Melanin absorbs light in the range of 690–1000 nm.

  2. (b)

    Erythromelanin granules are present in red hair.

  3. (c)

    Due to paucity of melanin in blond hair, it is less susceptible to IPL treatment.

  4. (d)

    All answers are correct.

9.1.3 Q3: What Is the Most Common Hormonal Cause of Hirsutism ?

  1. (a)

    Cushing disease.

  2. (b)

    Polycystic ovary disease.

  3. (c)

    Hypothyroidism.

  4. (d)

    Adrenal gland hyperplasia.

9.1.4 Q4: Which of the Following Is the Most Suitable Laser for Photoepilation in a Dark-Skin Individual?

  1. (a)

    Alexandrite laser.

  2. (b)

    Ruby laser.

  3. (c)

    Nd:YAG laser.

  4. (d)

    Diode laser.

9.1.5 Q5: For Each of the Following Wavelengths, Select the Corresponding Laser Type:

  1. A.

    755 nm

  2. B.

    694 nm

  3. C.

    1064 nm

  4. D.

    810 nm

    1. (a)

      Ruby

    2. (b)

      Alexandrite

    3. (c)

      Diode

    4. (d)

      Nd:YAG

9.1.6 Q6: Prior to IPL Hair Removal, What Would You Recommend to Your Patient?

  1. (a)

    Do no shave for 4–6 weeks before the procedure.

  2. (b)

    Do not tan for a few weeks before the procedure.

  3. (c)

    Use depilatory creams as a preparation, a week before for the procedure.

  4. (d)

    Use Wax hair removal as a preparation, a week before for the procedure.

9.1.7 Q7: Which One of the Following Statements Regarding the Pain in Photoepilation Is Correct?

  1. (a)

    Longer wavelengths are more painful.

  2. (b)

    Longer pulse delays are more painful.

  3. (c)

    Higher fluences are more painful.

  4. (d)

    Topical anesthetic agents are mandatory in small areas.

9.1.8 Q8: Which of the Following Would Minimize Complications in Photoepilation of Dark Skin Patients?

  1. (a)

    Shorter wavelengths.

  2. (b)

    Shorter pulse durations.

  3. (c)

    Cooling systems.

  4. (d)

    All answers are incorrect.

9.1.9 Q9: Which One of the Following Statements Regarding Post-Procedure Complications in IPL Photoepilation Is Correct?

  1. (a)

    Post-treatment pain is common.

  2. (b)

    Scarring is an uncommon complication.

  3. (c)

    Paradoxical hypertrichosis is more common in skin type III.

  4. (d)

    All answers are correct.

9.1.10 Q10: Which One of the Following Statements Regarding the Treatment Is Not Correct?

  1. (a)

    Avoiding sun exposure between treatments is important.

  2. (b)

    When side-effects or complications are encountered, the fluence may be decreased by about 2–4 J/cm2.

  3. (c)

    The usual treatment interval is 3 months.

  4. (d)

    The brighter the hair, the less effective the treatment will be.

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Ullmann, Y., Ben Naftali, Y. (2020). IPL for Hair Removal. In: Fodor, L., Ullmann, Y. (eds) Aesthetic Applications of Intense Pulsed Light. Springer, Cham. https://doi.org/10.1007/978-3-030-22829-3_9

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