"Lasers have gotten very popular, but they don't fulfill all a dermatologist's needs for hair removal. When lasers came along, many dermatologists didn't understand that they can't do everything that electrolysis does," says Lesly Davidson, M.D., a dermatologist in private practice in Mount Pleasant, S.C.
Electrolysis, which uses current passed through a needle inserted down the hair follicle, has existed since the late 1800s, Dr. Davidson says. And it's the only method approved by the Food and Drug Administration (FDA) for permanent hair removal. In contrast, she says that FDA-approved lasers are approved for permanent hair reduction only.
Because lasers work by destroying pigment, Dr. Davidson says, "Lasers are great for removing dark hair on white skin, but they're not great for removing other colors of hair — particularly white or vellus hair."
Electrolysis works on these hairs because its mechanism of action has nothing to do with pigment, she says. However, it's more time-consuming than lasers because it must be done hair by hair.
No direct comparison
Establishing direct comparisons between laser treatments and electrolysis is difficult because prices in both arenas vary depending on factors such as the body area being treated and how much and what kind of hair is present, Dr. Davidson says.
"The average electrolysis treatment costs between $35 and $52 for a half-hour," she says.
In one case, treating an average patient's bikini line required about 20 treatments (averaging 24 minutes each) over two years.
"The total cost was $601," Dr. Davidson says.
In contrast, Dr. Davidson says dermatologists typically charge in the neighborhood of $300 to $500 per laser treatment session.
"According to the American Society of Plastic Surgeons, the average price of a laser treatment is $429," she says.
A typical bikini line treatment requires three to six sessions. At a rate of $500 per treatment, "That's up to five times as expensive as electrolysis. But it's a lot more convenient," although patients also will require ongoing maintenance laser treatments to keep the hair away, she says.
"It's not that one treatment is better than the other. Each has advantages in different situations," Dr. Davidson says. If a patient is concerned about predominantly white facial hair, "Laser is not going to treat that at all," she says.
If an African-American patient with very dark skin wants to remove dark hairs, "You can't do a treatment that's going to be effective in that scenario" because patients would experience burning, Dr. Davidson says.
Additionally, many physicians will not treat certain body locations such as the eyebrows and between the eyes with lasers. "There have been many reports of eye damage caused by lasers in these areas," Dr. Davidson says. "In fact, the French Society of Dermatology recommends not ablating eyebrows with lasers (Le Jeune M, Autié M, Monnet D, Brézin AP. Eur J Dermatol. 2007;17(6):553-554. Epub 2007 Oct 19)."