Laser Hair Removal for Hidradenitis Suppurativa (HS)

Keep reading to learn the benefits and risks of laser hair removal, how to prepare for the procedure, and what to expect during and after the procedure.

“Laser hair removal is often recommended for people with HS to reduce hair follicles, which worsen HS symptoms,” says Pooja Rambhia, MD, a dermatologist with specialized fellowship training in cosmetic dermatology and laser surgery who practices in New York City.

Anna Eisenstein, MD, PhD, an assistant professor at Yale School of Medicine in New Haven, Connecticut, and the director of the Yale Hidradenitis Suppurativa Clinic, says that because of how laser hair removal works, only people with darker hair can benefit from the therapy. “It only works for hair that has pigment, so would not work on blond, gray, or white hair,” Dr. Eisenstein says.

There are some special precautions for treating people with darker skin, as we’ll see below.

Dermatologists perform the procedure in their office with a device that uses a laser to target the melanin, or skin pigment, in the hair follicle. “Pulses of the laser create heat, which destroys the hair follicle,” says Eisenstein. “This prevents hair from growing.”

The pigment in the hair follicle absorbs the light, which makes the laser effective.

On average, laser hair removal costs between $2,334 and $3,890 for a total of 6 to 10 sessions, according to a recent analysis. Typically, insurance doesn’t cover the procedure.

You should talk with your dermatologist before you begin the treatment to make sure the laser used will be appropriate for your skin and hair type.

“Your dermatologist will instruct you to shave the area, usually one to two days before the treatment, and may give you a prescription numbing cream to use on the area on the day of the procedure,” says Eisenstein.

“You should avoid waxing or plucking hair for several weeks before the procedure, as this temporarily eliminates the hair shafts that the laser targets,” she explains.

You can expect your dermatologist to cleanse the treatment area and offer a topical numbing cream to ease discomfort, says Rambhia. Then, they will use a handheld device and move it over the treatment area.

“The laser emits light energy that targets the follicles, which may feel like a quick snapping sensation or mild warmth,” says Rambhia. You may also feel some discomfort, “like a rubber band hitting the skin,” adds Eisenstein.

A cooling mechanism on the device is used to protect the skin and make you as comfortable as possible. “Most lasers used for HS are designed to minimize skin irritation,” says Rambhia.

Sessions are usually brief, depending on how large the treatment area is.

Are There Any Precautions for Darker Skin?

“For darker skin tones, specific wavelengths, such as the 1064 nm Nd:YAG laser, are preferred because they target the deeper hair follicles while sparing the surrounding skin,” says Rambhia.

“This wavelength is less likely to interact with melanin in the skin’s surface, reducing the risk of burns, hyperpigmentation, or hypopigmentation,” she says. “Proper laser selection and settings, combined with an experienced provider, ensure safer and more effective treatment outcomes for patients with darker skin tones.”

“After the procedure, the area may be red and warm for a few hours,” says Eisenstein. “Applying an ice pack can help.”

You should also keep the area moisturized and clean. “Protecting the skin from sun exposure by using sunscreen is essential,” says Rambhia.

Laser hair removal is safe and effective when performed by a trained professional. “The best results are achieved in a series of sessions tailored to the person’s skin type, hair type, and treatment goals,” says Rambhia.

Complications that may occur include temporary redness, swelling, or irritation in the treated area. Rarely, improper laser settings can cause:

• Burns
• Changes in skin color (pigmentation)
• Scarring

“Additionally, if performed during an active HS flare, there’s a risk of worsening inflammation or secondary infection,” Rambhia says. To reduce these risks, work with a dermatologist experienced in treating HS and ensure flares are controlled before treatment, she says.

To get the best results, you’ll need several laser hair removal sessions a few weeks apart. On average, each session reduces hair by 10 to 30 percent, says Rambhia. “You’ll also need maintenance treatments to keep the hair from regrowing,” says Eisenstein.

During this time, you should monitor your skin for any changes or side effects. This is especially important for people with HS, so that your dermatologist can take care of any flares promptly and make you feel as comfortable as possible.

• Laser hair removal is recommended for people with HS because it removes the hair follicle, where HS lesions originate.
• The procedure is generally safe and effective when practiced by a trained professional, but some risks are associated with the treatment.
• Discuss your treatment options with your dermatologist, who can tailor your treatment according to your skin type, hair type, and treatment goals.