Excess hair growth with a hair removal laser

Very pleased to meet you Dr. Irwin! I'm dermatologist for over 30yrs. I have started to work on laser hair removal with IPL machine (Palomar) and I was very excited to treat my daughters to relieve them from unwanted hair. The result for myself was amazing (50 yrs old at that time). BUT my 3 daughters 16, 19, and 22 years old, after improving during the first sessions, they developed paradoxical thick hair growth on their face, buttocks and arms, which is killing me and them! I shifted them on Ndyag and Alex, but the result in those areas is disappointing after over 50 sessions for about 9 years in different clinics in Paris!! My question to just understand, do you think the fact they started first with IPL plays a role in this resistance? Now they are followed by endocrinologist and gynae, they received androcur for 2 years to help... but still. What do you advise me to do? Stop or continue? IPL, Yag or Alex? I hope to find an explanation with you. Sincerely yours, Dr. Mona.

Thank you for writing. The more we all stay in touch, the better we’ll be able to help our patients. This is such a good question and not talked about much. We have had 2 or 3 patients over the years with this complication of excess hair growth. In my reading of the research, there is a small but significant (approximately 5%) group of patients who get an increase in hair with hair removal lasers. Also, in my reading, it can happen with any hair removal laser, including Alexandrite (“Alex”), Diodes, Nd:Yags and IPL based systems. If you find research that disagrees with this, please let me know.

Also, why this occurs is not clear. It seems to happen more in younger patients than older ones, and is VERY resistant to treatment, as you and your daughters discovered. I’m also wondering if this might be under reported when it happens, so the companies may not have any true idea of how often this complication occurs.

My opinion would be to avoid laser hair removal in patients who show this tendency for at least several years, and then to try cautiously a test area (about 2 x 2 cm) at a less exposed site. You did all the right things by having them see an endocrinologist and gynae to help with any potential hormone issues, or possible polycystic ovary syndrome, or endometriosis.

Other options to treat excess hair growth include:

  • Waxing
  • Electrolysis
  • Sugaring
  • Shaving

I hope this helps, at least with some peace of mind, that this wasn’t anything that could be predicted ahead of time. Dr. I

Dr. Brandith Irwin, MD

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