Can Laser Hair Removal Help Reduce Hidradenitis Suppurativa Symptoms?

Understanding Hidradenitis Suppurativa and How Laser Hair Removal Can Help

Hidradenitis suppurativa (HS) is a chronic, painful skin condition that causes inflamed, tender lumps to form under the skin. These lumps typically develop where skin rubs together, such as the armpits, groin, under the breasts and around the genitals. The lumps may break open and leak pus, resulting in tunnels under the skin. HS is thought to be caused by a problem with the immune system and is three times more common in women than men.

While there is no definitive cure for HS, treatment focuses on managing symptoms and preventing flare-ups. One way to potentially help reduce HS breakouts is by removing hair from problem areas through laser hair removal. Here's what to know about how laser hair removal may help ease HS.

What Causes Hidradenitis Suppurativa?

Doctors don't know exactly what causes HS to develop, but it seems to be related to a malfunction of the immune system. Some theories suggest the following factors may play a role in the development of HS:

• Genetics - HS tends to run in families, so genes may make some people more prone to developing the condition.
• Hormones - HS is more common after puberty, during menstrual cycles and in pregnancy, suggesting hormones may help trigger flare-ups.
• Smoking - Smoking is associated with a higher risk of developing HS.
• Obesity - Being overweight or obese increases HS risk.
• Friction - The constant rubbing of skin in certain areas, like the underarms, groin and under the breasts, may trigger HS.
• Bacteria - A bacterial infection may be involved, but it's unclear if bacteria causes HS or if HS leads to bacterial infection.

Symptoms of Hidradenitis Suppurativa

HS leads to painful, inflamed lumps under the skin. Common signs and symptoms include:

• Small, tender red lumps or bumps under the skin that may resemble pimples or boils.
• Nodules that enlarge, break open and leak pus.
• Painful abscess formation.
• Scarring and skin hardening in chronic HS.
• Sinus tract formation - tunnels that connect abscesses under the skin.
• Itching, burning and pain, especially during flare-ups.

HS often flares up periodically. Remission with no symptoms can last for months or even years between flares. Areas commonly affected include:

• Armpits (axillae)
• Groin and genitals
• Buttocks
• Under the breasts
• Inner thighs

Complications of Hidradenitis Suppurativa

If HS becomes severe and widespread, it can cause a number of complications:

• Scarring - Draining abscesses and tunnels between lesions can lead to significant scarring.
• Skin infection - Bacteria on the skin can enter open HS wounds, causing infection.
• Cellulitis - This serious bacterial skin infection causes red, swollen skin that is warm and tender.
• Abscesses - HS has a high recurrence rate of painful abscesses.
• Restricted movement - Scarring between skin surfaces can restrict mobility.
• Lymphedema - Swelling can occur from lymph node scarring or removal.
• Depression - Many people with HS experience depression and poor body image related to living with this condition.
• Squamous cell carcinoma - Long term HS carries a small risk of this skin cancer developing in affected areas.

How Does Laser Hair Removal Help HS?

While HS is not caused by poor hygiene, the friction between skin surfaces in areas with hair seems to trigger or exacerbate HS breakouts. Removing hair through laser hair removal may help reduce outbreaks by:

• Eliminating trapped hair beneath skin that can cause inflammation and infection.
• Decreasing sweat and bacteria buildup by getting rid of dense hair that creates moist environments.
• Reducing skin on skin friction, irritation and ingrown hairs in areas prone to HS lesions.
• Improving access to apply medicated creams and clean HS wounds.
• Preventing painful HS tunneling between hair follicles.

Benefits of Laser Hair Removal for HS

Laser hair removal offers a number of advantages for managing HS:

• Long lasting smooth skin - Most patients enjoy smooth skin for several months after a course of treatments before maintenance touch ups are needed.
• Fast treatment time - Each laser session only takes 10 to 20 minutes to treat small areas like the armpits or groin.
• Fewer ingrown hairs - Laser only targets the hair follicle without damaging the skin, resulting in fewer ingrown hairs compared to shaving or waxing.
• Permanent hair reduction - After a series of treatments, laser can permanently destroy a significant amount of the hair follicles in an area.
• Precise - Lasers can selectively target dark, coarse hairs without affecting surrounding skin.
• Less irritation - Laser hair removal avoids the nicks, bumps and irritation that can occur from shaving HS prone areas.

What to Expect During Treatment

Here's a rundown of what to expect with laser hair removal sessions:

• The doctor trims hairs in the treatment area for optimal laser absorption.
• Laser safety eyewear will be provided.
• The handheld laser device glides over the skin, delivering pulses of light. It feels like a light rubber band snapping sensation.
• Multiple passes will be made during the session to target all hairs.
• Skin is soothed with a cooling spray or cold packs during the procedure to minimize discomfort.
• Redness and slight swelling are normal after treatment and resolve within a few hours.
• Use of sunscreen is recommended to avoid discoloration in treated areas.
• Shedding of dead hairs may occur over 1-3 weeks post treatment.

How Many Laser Sessions Are Required?

Because hair growth occurs in multiple phases, several laser sessions are required to disable all follicles in a treatment area. On average, 4 to 7 sessions spaced about 8 weeks apart are needed to see the best results.

Maintenance sessions can keep skin smooth and prevent hair regrowth. HS patients commonly receive touch up treatments once or twice per year after completing an initial laser hair removal series.

Preparing for Laser Hair Removal with HS

Proper preparation can help make laser hair removal more comfortable and effective for those with HS:

• Avoid plucking, waxing or electrolysis in the treatment area for 4 to 6 weeks prior since the hair follicle needs to be intact for the laser to work.
• Shaving the area is fine in the days leading up to a session.
• Make sure the skin is free of lesions, nodules, active HS tunnels or open wounds. Reschedule treatment if a flare up occurs.
• Clean the skin thoroughly and apply a topical numbing medication approved by your dermatologist before laser therapy.
• Avoid sun tanning before and after laser treatments.
• Stay well hydrated by drinking extra water the day of laser removal.

Types of Lasers Used for HS

The most common laser systems used for HS hair removal include:

• Alexandrite lasers - The original hair removal lasers work best for lighter skin tones.
• Nd:YAG lasers - These devices are better for darker complexions.
• Diode lasers - Diode lasers are versatile for all skin types.
• Intense pulsed light - IPL can treat larger areas but is less effective for thick dark hair.

Your dermatologist will recommend the most appropriate laser based on your individual hair color and skin type.

Risks and Side Effects

When performed by an experienced dermatologist, laser hair removal is considered very safe. Potential side effects include:

• Skin irritation, blistering or crusting (rare when proper settings are used)
• Changes in skin pigmentation such as lightening or darkening (uncommon with today's advanced lasers)
• Infection risk if treatment occurs over open HS wounds

Finding a Qualified Laser Hair Removal Provider

It's important to have laser hair removal performed by an experienced, board-certified dermatologist who specializes in using lasers to treat HS patients. Be sure to verify qualifications and view before and after photos of their work during any consultations.

Reputable dermatology offices will use one of the top laser systems approved by the FDA such as Cutera, Cynosure, Candela or Lumenis. Beware of med spas offering hair removal with older, outdated or "too good to be true" discounted lasers.

The Cost of Laser Hair Removal for HS

The average cost per laser hair removal session ranges from $200 to $500 depending on the size of the treated area and geographic location. Larger areas like the back or legs, as well as more populated metro areas will be more expensive. Expect to pay in the range of:

• $200 - $300 for a small area like the upper lip
• $250 - $450 for axillae, bikini line, or groin
• $100 - $250 for the underarms
• $250 - $600 for the chest or abdomen
• $600 - $900 for full legs
• $400 - $700 for the back

Many dermatology clinics offer laser hair removal packages with discounted pricing if multiple treatments are prepaid upfront. Some insurance plans may cover laser therapy for HS, especially if previous treatment approaches have not helped manage symptoms.

The Takeaway

For those struggling with the painful, disruptive symptoms of hidradenitis suppurativa, laser hair removal offers a safe, effective adjunct treatment option. Removing hair from common HS problem spots can help reduce skin friction and disease triggers. Seek out an experienced, board-certified dermatologist to perform the laser treatments to ensure the best results and minimize complication risks.

With a series of sessions, laser hair removal can provide long term hair reduction and smoother skin. While not a cure, it can be an useful part of an overall HS treatment plan to help manage breakouts and discomfort. Removing hair in areas prone to HS flares can help make living with this condition easier.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.