Carolina Laser and Cosmetic Center in Winston-Salem, North Carolina specializes in dermatology and cosmetic procedures, including Botox, Restylane, Perlane, Juvederm, Evolence, Dysport, Sculptra, Latisse eyelash treatment, liposuction, laser hair removal, laser tattoo removal, laser skin rejuvenation and wrinkle resurfacing and vein treatment (laser and sclerotherapy).

Laser Hair Removal | Frequently Asked Questions About Laser Hair Removal

1. What do CoolGlide treatments feel like?

As the name implies, the CoolGlide handpiece cools and soothes as it glides along your skin. When the pulse of light is delivered, some patients experience a mild pinching or stinging sensation. No local anesthesia or pain medication is typically required; however some patients may prefer to use a topical anesthetic when sensitive areas are treated.

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2. How many treatments will I need?

Most areas require 3-6 treatments. However, the number of CoolGlide treatments required for optimal long-term benefits depends on multiple factors - hair thickness, the area treated and your hair's growth cycle. Interestingly, not all hairs are actively growing at the same time and actually go through three distinct phases: growth, regression, and resting. CoolGlide treatments work by disabling the hair that is principally in the active growth phase at the time of treatment. Since other hairs will enter this active growth phase at different times, additional treatments may be necessary to disable all of the hair follicles in a given area.

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3. What happens after the treatment?

Immediately following your CoolGlide treatment, the area may appear a bit red and swollen. Three to seven days after treatment you may experience what seems to be regrowth of hair. Actually, most of these hairs are being shed as a result of your treatment and are not regrowing. Between treatments you should not wax or pluck your hair, but it is permissible to shave.

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4. What are the possible side effects?

Although patients experience few side effects, the most commonly noticed are slight reddening and local swelling of the skin, similar to a sunburn. These effects typically last for several hours or less. In rare instances, blistering may occur. Consult with your medical professional for complete information on the benefits and risks of treatment.

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5. How does the CoolGlide compare with electrolysis?

Electrolysis is a tedious, invasive, and painful process that involves inserting a needle into each individual hair follicle and delivering an electrical charge to them one at a time. Electrolysis often requires years of treatments at regular intervals. By delivering light energy to hundreds of hair follicles at a time, the CoolGlide effectively treats an area in just seconds that would take over an hour with electrolysis.

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6. How much does it cost?

Fees paid for laser hair removal may be tax deductible medical expenses, like other payments to doctors and dentists. Fees are per treatment session and can be paid at the time of treatment with Visa, MasterCard, check or cash.

The fee for pre-laser consultation is $100. This amount is deducted from the cost of your first treatment, if you decide to proceed for treatment. Consultations about laser can usually be arranged within a week or two simply by calling our special LaserLine at (336) 659-2663 where our staff who have had laser hair removal themselves can take the time to discuss your wishes and options, and answer your questions. No referral is required. Treatment may be scheduled for the same day as the consultation if there is a time slot is available, or may be scheduled for a later date.

* Prices subject to change without notice. All long haired areas must be trimmed prior to treatment. Minimum of four sessions required. Please call our LaserLine at (336) 659-2663 if you have questions, to inquire about other areas not listed, or to schedule an appointment. You do not need to be referred by your doctor. Please feel free to inquire about other areas not listed.

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7. Is laser hair reduction covered by insurance?

Most private insurance companies do not offer reimbursement for "cosmetic" procedures like laser hair removal; however, consult your insurance carrier for more information.

The removal of unwanted terminal hair for the management of hirsutism, congenital or drug-relate hypertrichosis, pseudofolliculitis, trans-sexual states, and some skin grafts may be covered by some private insurance plans. There may be an additional charge for any paperwork we have to do if your are trying to get reimbursed by your private insurance plan.

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8. Is laser hair removal "permanent"?

"Permanent hair removal" means: "ALL the hair is gone, FOREVER!"

There is NO hair removal method (including laser) which can guarantee anybody "permanent hair removal".

The most realistic description of the results after laser treatment is: "long-term hair REDUCTION". This means: "After four to six treatments the total amount of hair is greatly reduced -- generally by 70% to 90% -- and hair which does grow is often much finer and lighter in color." Most people are very pleased with this degree of improvement, as long as they know that this is what to expect before they have laser hair removal treatment.

It is important for you to realize that after having between five and ten treatment sessions it is VERY LIKELY that there WILL BE a very substantial reduction in both the amount of hair and also a reduction in the thickness and color of the hair in the treated areas. You should expect that this reduction in hair may last for many years.

This long-term hair reduction is exactly what most people want, but could be an issue, for example, in men who have their armpits lasered. If hairy armpits come back into fashion 5 years from now, people who have had CoolGlide Xeo™ treatments on their armpits will be probably be out of fashion!

Because lasers have been used for hair removal for only the last seven years, we can't know if the results will continue to be felt in 10 or 20 years. However, we do know that stable, long-term hair reduction commonly lasts for at least two years, and some patients who had their last treatment six or seven years ago are still enjoying a high degree of hair reduction.

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9. How much hair will grow back, and how fast will it grow back?

Lasers work by destroying hair roots which are active at the time of treatment, and which have enough pigment to absorb sufficient laser energy. The hair shafts in the treated hair follicles will fall out, or be "shed" 1-3 weeks after treatment.

After the first treatment, hair regrowth may resume within a few weeks or it may be anywhere from 2-4 months before any true hair growth is observed, as previously dormant hair follicles become active, and hair follicles which were stunned but not killed recover and start to produce hair shafts again. Some people find that there is not much extra hair reduction after the second treatment, then they notice a substantial further reduction after the third or more commonly the fourth treatment. After five to ten treatments there may be little or no regrowth for many years. In other cases you may wish to have additional treatment after a period of time.

Hair fibers that regrow after laser treatment generally are finer and lighter in color, and so are much less of a cosmetic problem. Reductions in coarseness and color can occur independently of each other.

New terminal hair appearing in androgen-sensitive sites (mainly the face, axillae and genital area) after successful laser epilation could result from androgen-stimulated conversion of previously dormant vellus hairs, which are not affected by the laser as long as they remain dormant and unpigmented.

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10. Am I a good candidate for laser hair removal? Am I being "vain"?

Our laser, and the long wavelength, allows treatment of people with all skin colors, and treatment of even light brown hair. Because hair which is naturally blonde, light red or white does not have enough pigment in the roots, it cannot be reliably treated with any type of laser. Fewer treatments are needed when the hair is dark and the skin is light colored -- so to get maximum effect from each session avoid tanning, but even people who have black skin can be successfully treated with our laser.

Children can be treated, for example if they have a congenital nevus or other problem with excessive hair, but the children must be old enough (for example, 12 years old) to understand and cooperate with treatment.

Laser hair removal is not just for "cosmetic" problems. Patients with excess hair because of medications (for example, organ transplant patients who are taking cyclosporine) can benefit from laser hair removal; as can patients who have problems with ingrown hair and folliculitis under prosthetic devices.

Many people at some time before laser hair removal have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have laser hair removal are no more vain than anyone else. What does distinguish them is a desire to get the most out of life. Looking after our appearance is not a fault. After all would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the courage to want to change something that you find unacceptable. I emphasize that you should only have laser hair removal if it is for you. It is a big mistake to have laser hair removal if it is just for somebody else.

Normal, reasonable people who have realistic expectations tend to be excellent candidates for laser hair removal.

Am I being vain?

Many people at some time before laser hair removal, laser treatment of unwanted blood vessels, or before BOTOX® treatment for wrinkles or excessive sweating have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have BOTOX® treatment, laser hair removal, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after our appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have BOTOX® treatment, laser hair removal, and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

As Dr. Richard Glogau of San Francisco has noted: the same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and well dressed, and often careful in their diet, exercise, and other aspects of health maintenance leads our patients to seek help for their wrinkles and frown lines.

These individuals are normal healthy people, and the same degree of self-interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of BOTOX®. Our patients simply want to look their best.

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11. Questions to ask yourself when considering laser hair reduction:

• How much are you bothered by your facial hair? Hair on other areas?
• How much are you bothered by the time you spend removing, treating, or concealing your facial hair? Hair on other areas?
• How uncomfortable does your facial or other unwanted hair make you feel in exchanges of affection (such as intimate exchanges with your partner)?
• How uncomfortable does your unwanted hair make you feel when you meet new people?
• How uncomfortable does your unwanted hair make you feel when you go to social gatherings, dine out in a public restaurant, go to a supermarket or other public place?
• How uncomfortable does your unwanted hair make you feel when you go to work or class?

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12. What are Hirsutism and Hypertrichosis?

• Hirsutism is excessive growth of hair in androgen (testosterone)-dependent areas of a woman’s body where terminal hair is not normally found, including the face, neck, chest or medial thighs.
• Hypertrichosis is excessive growth of hair in non-androgen dependent parts of the body (ie. Areas other than the face, neck, chest and medial thighs).

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13. What is Unwanted Female Facial Hair?

Growth of hair on the face which is coarser, longer or more profuse than is "normal" for the age and race of the woman. Unwanted Facial Hair is a chronic problem for about 2 million Canadian women (and about 22 million American women) who remove facial hair at least once a week.

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14. How can I get the best value from each treatment?

To get the best results with the smallest number of treatment sessions, please pay attention to the following guidelines as you work with us:

A. Avoid waxing / sugaring / plucking / EpiLady and electrolysis
Because the laser beam seeks out and destroys ACTIVELY GROWING hair roots, it is important (if you want to get the best value from your treatment) NOT to wax / pluck / sugar / use EpiLady-type pluckers or have electrolysis for at least SIX WEEKS before laser treatment. These things temporarily remove the pigmented part of the hair follicle which the laser needs to use as a target when it destroys the hair follicle.

B. Tanning should be avoided!
Cutera CoolGlide is the safest and most effective laser for ALL types of skin, even people of dark skin who cannot be safely treated with other hair removing lasers. Many Italian, Greek, and East Asian have been successfully treated with our laser.

BUT: the lighter your skin color at the time of treatment, the better the laser beam can get through the skin to the hair roots, where it is needed.

SO: tanning is not a BIG deal, but if you avoid tanning and stop using artificial "tanning" creams for six weeks before treatment, you will get the maximum possible benefit from each treatment session. People with very dark skin (and people who are really into tanning) sometimes need one or two extra sessions to reach their desired degree of long-term hair reduction.

It is also a good idea to minimize tanning for a few weeks after laser treatment, to reduce the chance that your tan will be somewhat uneven.

Recommended Obagi Healthy Skin Protection SPF 35 sold in our office.

C. Shaving or clipping the hair? Good idea!
Shaving or clipping the area to be treated is not a problem. In fact, we like the areas to be shaved the day of treatment or the day before. Some people find that the skin is less sensitive if it is shaved at least a few hours before treatment. Another advantage of shaving the area to be treated BEFORE you come in is that YOU can shape the area to be treated exactly the way YOU want it to be. This is of particular importance in areas like the sideburns, temples, and bikini line / bikini area.

Excess hair should be removed from the treatment area before laser treatment, because hair ABOVE the surface of the skin will simply absorb and waste laser energy and keep it from getting to the hair roots, where it is needed. There may be a small extra charge if we have to shave extensive areas before starting laser treatment.

Contrary to popular belief, shaving DOES NOT make hair grow back thicker, faster, darker or more profusely! So go ahead and shave before treatment, and between treatments!

D. Hair Dye and Bleaching? No problem!
Because the laser beam only acts on the hair ROOTS, it is OK to dye and/or perm hair in the areas to be treated. Likewise, it is OK to bleach hair in the areas to be treated because bleaching will not affect the color of the roots.

E. Timing:
It takes 6 to 12 weeks for the next crop of hair roots to become active and develop pigment which is the target for the laser. So, to get the best value from your laser hair removal treatments, you should wait 6-12 weeks between treatments.

There is no harm in having treatments MORE FREQUENTLY than every 6 weeks, or having treatments less than 6 weeks after waxing, plucking, etc. -- but this is less efficient, and could increase the total number of treatments needed to get a good result.

Also, while there is no harm in waiting MORE THAN 6-8 weeks between treatments (for example, if there has not been much regrowth after your last laser treatment), there is usually no extra BENEFIT to waiting longer than 12 weeks between treatments.

F. Medications?
We are not aware of any medications which should not be taken while you are getting laser treatment. Anabolic steroids should certainly NOT be taken unless medically necessary, because these can increase male-pattern hair growth in some cases. Women to take injections of testosterone & estradiol as part of therapy for menopause and to increase libido often experience unwanted hair growth, which can be treated with laser hair removal.

Medicines which inhibit hair growth (for example, spironolactone, certain birth control pills, Euflex, Androcur and Vaniqa cream) might slightly reduce the pigment in hair roots and make laser treatment less efficient, but this seldom interferes with the effectiveness of laser treatment. Cutera CoolGlide laser hair removal can certainly be done WHILE you are on those medicines, if you wish. These "anti-androgenic" medicines produce gradual but temporary effects, and will not remove unwanted hair from areas that are independent of androgen regulation.

Pre-treatment with medicines like Zovirax, Valtrex or Famvir is NOT necessary, unless you tend to get a lot of cold sores in the area to be treated.

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15. What is a "test area", and why is it sometimes performed?

"Test areas" are small areas of skin that are treated at various laser energy levels prior to treatment of large surface areas on darker skin types. "Test areas" are done on darker skin types to determine the level of energy that is best for that individual, and checked up to one week later to make sure there was no burning or pigment change. Light skin types generally don't have to have test areas done. This may be done at the same time as your consultation, and a $50 fee is required for this test. The fee for the "test area" is deducted from the cost of your first treatment.

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16. Moles, freckles and tattoos in the area to be treated?

Small moles and freckles do not require any special precautions. Large, dark moles and freckles which are to be treated may require a reduction in the intensity of the laser light, the same way that the intensity would be reduced when treating a dark-skinned or tanned person. Tattoos might require a "test area" to make sure that they will not absorb an excessive amount of laser energy, which could cause fading of the tattoo, discomfort, or even a burn. We generally prefer not to treat tattoos, but this is seldom a problem because quite often there is not much hair growth in tattoos. Be sure to tell Dr. White and her staff if you have permanent lip liner or permanent eyebrow liner, because these are tattoos and special precautions may be needed if there will be laser treatment in those areas.

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17. What will happen on the treatment day?

HELLO LASER, GOODBYE RAZOR!
Lasting hair removal has never been this easy!

Other than your regular skin care routine, there is no standard "prep" for this procedure. Please do not wear makeup on the areas to be treated, because some kinds of makeup can absorb and waste laser energy, or even heat up to the point where your skin would be irritated. Makeup will need to be removed before treatment, and may be re-applied immediately after treatment if you wish, in a room we have set aside for this purpose. There are no restrictions on what you may eat or drink prior to your appointment.

Please shave or clip the areas to be treated before you come in for treatment. Freshly shaved skin is more sensitive, and there is less discomfort if you wait at least an hour between shaving and having laser treatment. Shaving also allows you to shape the exact area you want treated -- this is sometimes very useful in the bikini area. Excess hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the hair root, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin.

When you come for treatment, it is important not to wear any makeup -- or at least wear simple water-based makeup that can be easily removed -- because makeup can sometimes absorb laser energy. This could interfere with treatment, or even cause overheating of the skin surface and burning. Makeup can be re-applied immediately after Altus CoolGlide Xeo™ laser treatment, if you wish.

After all of your last minute questions have been answered and paperwork handled, the areas you wish to have treated will be cleansed and pre-treatment photos may be taken. Everyone in the treatment room must wear protective goggles when the laser is turned on. The Cutera CoolGlide is a high powered laser system, and can cause eye injury if proper eyewear is not worn while the laser is used.

The length of the procedure itself can range from a few minutes for the upper lip to an hour or more (for example, a man’s chest and back). You may save considerable time, as you reduce or eliminate the need for shaving and other hair removal methods.

If you decide before coming in that you would like to have additional areas treated, please call ahead so that we can schedule enough time to accommodate your needs.

The process is very simple...

Cooling pads are applied to the skin for a few moments before the area is treated. Immediately before the laser is used on an area, the cooling pad is removed and a thin coat of clear gel is lightly smoothed over the skin, then the laser pulses are quickly and evenly applied by our carefully trained and supervised staff.

You can bring a friend or family member if you like -- quite often mothers and daughters will come in together for laser treatment. If you want to let the person with you watch your treatment, that person must wear the special laser goggles to prevent laser light from getting in the eyes.

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18. Does it hurt?

The laser emits only light. You may feel a tingling or snapping sensation like a rubber band. There is no bleeding and no open wound is created. Some people find the FIRST laser treatment more uncomfortable than subsequent treatments. Maybe this is because there are more hair roots which are destroyed during the first treatment; and perhaps also because some people are more apprehensive during the first treatment, because they are not sure of what to expect.

Many patients find that they have less discomfort if they shave the area to be treated at least a couple of hours BEFORE coming in for treatment, because freshly shaved skin is often somewhat more sensitive. Shaving before coming in for treatment also allows you to shape the area to be treated exactly the way YOU want it. This is of particular importance in areas like the forehead, sideburns and bikini/pubic hair areas.

While some areas of the body like the upper lip and pubic hair area are more sensitive than others, many patients report little or no discomfort. If there is unusual discomfort, please let us know so that we can apply more cooling or adjust the settings on the laser.

People who have had waxing, sugaring, and/or electrolysis (or treatment with other lasers) usually report that CoolGlide Xeo™ causes less discomfort, and sometimes there is almost no discomfort.

Another possible explanation for reduced discomfort with the Cutera CoolGlide compared with other lasers is that the long wavelength of the Cutera CoolGlide delivers more energy into the deeper part of the skin where the hair roots are -- and wastes less energy in the top 2 millimeters of the skin where many of the nerve endings are.

Cooling gel pads are usually applied immediately before and after treatment, and soothing gel is used during the procedure. In addition, the Cutera CoolGlide laser has the ability to reduce the frequency of pulses and increase the cooling time in sensitive areas, to maximize your comfort.

EMLA™ anesthetic cream is occasionally used in very sensitive areas or by those who think they have a very low pain threshold. EMLA™ can be purchased through our office, and a very thick layer should be applied an hour before the procedure. Most people do best with cooling gel packs and Aloe, and do not bother with EMLA anesthetic cream.

Some people find it helpful to simply take two or three plain Tylenol and/or Advil a couple of hours before coming in for treatment. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time.

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19. Why does the hair sometimes look like it's “growing” for 1-3 weeks after laser treatment?

Lasers destroy hair roots which are active at the time of treatment, but do not remove hair shafts instantly. Hair shafts in the treated hair follicles will fall out, or be "shed" mostly in the first week after treatment, with all of the treated hairs falling out within 2-3 weeks.

It is normal that some hairs in the treated area may not fall out within 2-3 weeks. These will treated in the next session.

These hairs which are being shed will come out on their own. It is best not to shave the treated area or to wash it with anything but mild soap like Dove or Cetaphil and your bare hand (no Buf-Pufs, washcloths or Body Washes) for 3-4 days after laser treatment, because some people find that their skin is irritated by these things.

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20. Are there any restrictions on my activity after treatment?

Since the laser does not burn or cut the skin in any way, no bandages are necessary. You can return to work the same day and resume all your regular activities. To reduce the chance of uneven tanning in the treated areas, you should minimize sun exposure and tanning for a week or two after treatment.

It is OK to resume shaving or clipping hair in the treated area after 3-4 days. You should NOT have waxing / sugaring / plucking or electrolysis, because these things will temporarily remove pigmented hairs from the hair roots and reduce the effectiveness of your next laser treatment. Sometimes after plucking, waxing or sugaring the hair will become thicker and darker, because one of the ways that the body defends itself from chronic irritation is to produce thicker, darker hairs.

Shaving really is the BEST temporary way to remove unwanted hair before laser treatment, and between laser treatments. Shaving leaves the hair SHAFT in the hair follicle, so the hair shaft can be a target for laser energy, heat up and KILL the hair follicle.

You can shave as often as you want. It has been shown in scientific studies that:

• Shaving does NOT make hair grow faster.
• Shaving does NOT make hair grow thicker.
• Shaving does NOT make hair grow darker.
• Shaving does NOT make hair grow more profusely.

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21. Pre-treatment instructions:

1. Please do not do any waxing, plucking or sugaring for 6 weeks before treatment, because hair follicles which do not have hair shafts in them to absorb laser energy will not be killed by the laser energy.
2. Please try to minimize tanning for a week or two before treatment: a fresh tan can interfere a bit with the effectiveness of the CoolGlide Laser treatment, though this is less of a problem than with older, short wavelength lasers.
3. Please do not wear makeup on the areas to be treated, or at least wear makeup that is easy to remove. If makeup absorbs laser energy, less energy will reach your hair follicles and hair shafts, and if the makeup heats up it could irritate or burn your skin. Makeup can be re-applied immediately after laser treatment, if you wish.
4. Please shave or clip the areas to be treated the day before treatment or on the morning of treatment. This way, the skin will be less sensitive. Shaving before you come in also allows you to shape the exact area you want treated -- this is sometimes very useful in areas like the hairline and sideburns, and in the bikini area. Excess hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the hair root, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin.
5. Some people find it helpful to simply take two or three plain Tylenol and/or Advil 2 hours before coming in for treatment. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time.

During the treatment, remember that: “We want to be doing this FOR you, not doing it TO you.” Unexpected discomfort is nature’s way of telling us something is wrong, so please tell us and we will go slower, apply more cooling, or adjust the power of the laser for you.

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22. Post-treatment instructions:

1. Redness often has faded greatly by the time you get home. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favorite moisturizer, for example, DCL Anti-Itch Lotion. The hair follicles may appear slightly more obvious or a bit pink for the next day or two, but this is seldom a cosmetic problem, and generally much less obvious than after waxing or sugaring.
2. Try to avoid tanning for a week or two after treatment, because occasionally the tan could be somewhat irregular (lighter and/or darker in the treated areas.) Obagi Healthy skin Protection is an excellent sunscreen.
3. Hair shafts will be released from hair follicles in the treated area for a week or two after treatment. You do not need to do anything, but you may gently exfoliate or shave the areas if you wish.
4. Shaving, depilatory creams like Nair or Neet, or bleaching are OK between laser treatments. Plucking, waxing and sugaring should be avoided because these things could reduce the effectiveness of your next laser treatment.
5. Blistering or scaling after laser hair removal is very uncommon, but usually resolves over a few days or a week with a bit of Polysporin cream several times a day. Please call us if this happens, or if you have any other problems or questions.

Dr Anne L. White, Carolina Laser and Cosmetic Center in Winston-Salem, North Carolina, has trained internationally in the latest techniques of cosmetic procedures, including Botox, Restylane, Perlane, Juvederm, Evolence, Dysport, Sculptra, Latisse, liposuction, laser hair removal, laser tattoo removal, laser skin rejuvenation and wrinkle resurfacing and vein treatment (laser and sclerotherapy).