Hot new procedure: Laser hair removal
Like other laser procedures before it, laser hair removal has the potential to generate high profits for your same-day surgery program. If the laser hair removal system is less painful and longer-lasting than electrolysis, as current users say it is, experts predict that at least 5 million procedures will be done annually, and eventually about 20 million procedures could be done each year.
"We’re in our infancy with this procedure," says David J. Goldberg, MD, president of the Wausau, WI-based American Society for Laser Medicine and Surgery, chief of dermatologic surgery at New Jersey Medical School in Newark, and director of the Skin Laser Center of New Jersey in Westwood. Goldberg is involved in research protocols for ESC Medical Systems in Needham, MA, ThermoLase in San Diego, and Palomar Medical Technologies in Beverly, MA.
"The advantage of all the laser hair removal methods over electrolysis is that you can target large areas quickly with less discomfort and without the scabbing you see with electrolysis," he says.
Laser hair removal is used by women to remove hair from the cheeks, chin, upper lip, and along the bikini line. Men use the procedure to remove hair from the back and shoulders. Providers report that up to 30% of patients are men.
There are three primary approaches for laser hair removal:
• Epilight Hair Removal System from ESC Medical Systems.
The Epilight uses light to destroy the pigment in hair follicles but is not a true laser, because a laser only puts out one color of light. The Epilight puts out multiple colors. It is not yet approved by the U.S. Food and Drug Administration.
30% to 40% removed with one treatment
The original FDA testing protocol allows physicians to treat patients once. Testing shows that 30% to 40% of the hair is removed immediately after one treatment, says Michael Gold, MD, owner and founder of Gold Skin Care Center in Nashville, TN. His facility is the lead testing site. Since hair follicles are destroyed over time, 60% of the hair is gone at three months and slightly less than 60% at six months, he says, adding that testing at 30 sites as part of a multicenter study will determine the appropriate interval between treatments and how many treatments are needed.
"This system can be used with multiple color hairs and multiple skin colors, but because it has so many different parameters, as opposed to a laser with which you fire a button, physicians need to use this machine appropriately," Goldberg says. "It has a longer learning curve."
• Nd:YAG laser from ThermoLase.
This laser was the first FDA-approved system and is used with a carbon solution on the skin, Gold says. The carbon solution is absorbed into the hair follicle. The laser bombards the hair follicle and destroys the hair, he says.
"The problem is that all the data shows that at three months with one treatment, all the hair is back," Gold says.
Goldberg is participating in studies to examine the impact of multiple treatments. "We have found that with progressive treatments, the results got better and better," he says. "Even if hair returned, it was thinner, and intervals between sessions became longer."
While Goldberg says this technique can be used on all hair and skin colors, Gold says it is best used for dark hair and light skin.
• Long-pulse ruby laser from Palomar Medical Technologies; Sharplan Lasers in Allendale, NJ; and MEHL/Biophile International Corp. in Gainesville, FL.
These companies have received FDA clearance for their laser systems, which are similar except that the Palomar system has a cooling device at the tip, Gold says. The ruby laser eliminates 40% to 50% of hair after three months, and most of it is regrown at six months, he says. Multiple treatments are being studied, Gold says.
The ruby laser is specifically designed for dark hair and light skin.
How much will it cost me?
Lasers cost from $100,000 to $150,000 to purchase. Charges for the procedure vary from $100 to $3,000, depending on the machine and the area targeted. Gold says the average charge per session runs about $300, with approximately three to five sessions necessary to remove hair.
The procedure isn’t permanent, at least not in every case, Goldberg says. The goal is not to have permanent hair removal but long-term results, he says.
"For example, a woman could get her bikini area done before summer and have the area clear of hair into the fall," Goldberg says. "The goal is six to 12 months, and we’re going in that direction already."
If the procedure isn’t done properly, patients can experience hypopigmentation with the ruby laser or blistered skin with the Epilight, Gold warns. "You need to be well-taught before you get into doing this," he says. Providers have the option of taking courses and completing preceptorships with hands-on training, offered by researchers and laser manufacturers. (See source box, below.)
Who should perform the procedure is regulated by state boards of medical examiners, Goldberg says. Gold allows any health care professional to use the machine who has been trained by him and attended appropriate courses and preceptorships.
"We have electrologists and registered nurses doing it in our office," Gold says. "Unfortunately, some states don’t allow anyone but the physician to use it. "
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