Can laser hair removal cause more hair growth?

Photographed by Eylul Aslan.

Growing up as a Greek Cypriot girl in a small Essex town, my schooldays were a blur of pretty girls with fair hair pointing out my sideburns, telling me I had a moustache or sniggering at the dark fuzz on my legs during PE lessons. It knocked my confidence big time, and what followed were years of obsessive shaving, plucking, waxing, threading and covering my face in more or less all social situations. I couldn't let it hold me back from scoring my dream career, though, and a few years later I landed my first magazine job. But while most young women treat themselves to a designer bag or a holiday with their first pay packet, mine went on laser hair removal at a top west London clinic.

Soon, I was going to be completely hair-free and all the bullying, shaving rashes and painful ingrown hairs would be a thing of the past. But the reality couldn't have been further from what I had imagined.

Laser sent my hair into overdrive 

I started with the most obvious area first – my face, including my cheeks, upper lip, chin and neck – but four laser sessions into a course of eight, each costing a huge £125 a pop, I was having to shave almost twice daily to keep the hair under control.

Perplexed, upset and virtually broke, I brought this up with the manager of the clinic, who encouraged me to keep at it, and that I would soon notice a difference. But by session seven, I had to contend with a full-blown lady beard and shaving wasn't enough to keep my excess hair under control. After that, I was embarrassed to show my face, and rarely left the house. I'd spend at least an hour plucking my stubble and covering my constant five-o'clock shadow with multiple layers of thick concealer, full-coverage foundation and heavy powder.

But I just didn't understand.

As someone with light olive skin and jet black hair, I was the perfect candidate for laser hair removal. I followed the rules down to the letter, including attending every appointment consistently, avoiding sun exposure and shaving the area instead of plucking or waxing. By now, I was supposed to be smooth and hairless – so why were things worse?

If you read the small print on the back of the consent form, you'll notice that laser specialists do warn you, albeit covertly. Alongside client success stories and impressive 'before and after' pictures, they state that there is a tiny chance that the treatment can result in the complete opposite of what anyone getting laser hair removal actually wants: stimulated hair growth.

It's very uncommon, but it happens, and I turned out to be living proof.

Paradoxical hypertrichosis 

“It has been reported that 85% of laser hair removal patients have had no regrowth in the months to follow,” says Dr. Anjali Mahto, a consultant dermatologist at Skin55. "However, there is a condition known as paradoxical hypertrichosis, which is a rare risk of laser hair removal, where the hair can grow back thicker after laser." It sounds like something out of a horror film, but the thing is, no one really understands exactly why this happens in laser patients, although there are a couple of big elements that could contribute.

The strength of the laser 

“It’s extremely rare for an individual to find hair growth worse following laser hair removal,” says Dr. Mahto. “However, if this does occur, it has been hypothesised it could be due to a few factors, one being low-fluence (low energy) treatment.” Kevin Williams, laser expert and Lumenis ambassador who works with the Lumenis LightSheer System, believes the theory of photothermolysis can provide a further explanation. When hair is heated to 65 degrees, the hair follicle germ cells are destroyed, but anything below this could contribute to more growth.

“Often [during treatments] the hair follicle has only reached 45 degrees and therefore is at the temperature where hair is stimulated,” Kevin says. So why don't specialists stick to what they know will work? “The problem is rapid heating,” he adds. “While effective, it can be slightly uncomfortable” and often operators will end the treatment when it starts to get a little painful.

This makes sense to me and I think it's where things may have started to go wrong. More often than not, I couldn't feel the ping or even the zap of heat from the laser, which, according to specialists, could indicate that it was on a setting that was far too low for me. At the time, I thought it was because I had become accustomed to the twinge with every treatment. More importantly, I put my trust in the prestigious clinic and the specialists wholeheartedly.

Also, rather frustratingly, a different laser specialist saw to me each time, so they weren't fully aware of how my hair had been performing. Each new specialist also failed to assess my skin type before treatment, which is detrimental to understanding the setting I needed for the best results. This is why it pays to book in with the same specialist for every session.

Is it something to do with hormones? 

Two years after my laser treatment, I was diagnosed with the hormonal condition polycystic ovary syndrome (PCOS). Alongside weight gain, acne, irregular periods and shedding of scalp hair, one of the main features of the condition, which affects 1 in 5 women in the UK and can go undiagnosed for years, is excess facial and body hair, thanks to a surplus of male hormones.

According to Dr. Mahto, genetic or hormonal underlying factors like this may also have played a part. "It is not necessarily the laser hair removal which worsens the hair growth, but the underlying hormonal imbalance," she explains. "Having high levels of androgen (male hormones) in your body causes physical signs such as excess facial and body hair. The hair grown is often thicker and darker and harder to remove."

But there are ways to manage it.

How I got rid of my excess facial hair 

The thought of having to keep my head down on the Tube, cancel plans and spend hours plucking my face was too much to bear. So I went on a mission to try all manner of different hair removal treatments in a bid to find one that worked.

I was wary of letting another laser loose on my face when a friend with PCOS suggested IPL (Intense Pulsed Light) after amazing results. It feels similar to laser, but instead of harnessing a very targeted wavelength, it works on a much broader spectrum and enlists a shot of light to damage the hair.

I booked into the Tessa Stevens Health and Beauty Clinic in north London, where the machine of choice is the Ellipse, arguably the leader when it comes to IPL. But I'll be honest – it wasn't plain sailing.

After my very first monthly session, my stubbly hairs looked and felt thicker, darker and more obvious, but it was because they were shedding from the root. I was advised to exfoliate the area gently and encouraged to shave – never pluck or wax as this disrupts the growth stage. Three sessions in, the jet black stubble was gone and I felt liberated. That said, it's important to bear in mind that with IPL, hair is never permanently removed, just reduced. I still have downy hairs but they're so much lighter, finer and easier to manage – nothing like the wiry stubble I had to contend with before. Often, top-up treatments are required throughout the year to maintain the result.

Spironolactone, the secret pill

Thanks to Dr. Mahto, I was introduced to spironolactone during a hormonal acne breakout.  Some refer to it as a 'secret' or 'off-the-label' pill as it is usually used to treat high blood pressure, but it has anti-androgen effects, which means it blocks the male hormone testosterone, usually responsible for an overflow of sebum, spots and excess hair. This makes it really beneficial for PCOS sufferers.

Not only did it stop my skin from looking like a spotty oil slick but I noticed that it pretty much stopped my facial hair in its tracks. Since taking it, I haven't had to shave, pluck or book in for an IPL top-up. "It can potentially improve both scalp hair growth and hirsutism (excess hair)," says Dr. Mahto. She adds: “In this context, however, it should only be prescribed by a consultant dermatologist with experience in its use as it is an unlicensed treatment.”

Treatments won't have the same effects on everyone, although here's what to do if you're worried about your hair growing back worse.

“Not all lasers are the same,” says Dr. Mahto, “and the right laser or light device should be chosen based on skin type.” Options include IPL, Alexandrite and the Nd:YAG laser, which is a much better option for those with darker skin tones, but a consultation with a specialist should help you decide.

“Starting out on small areas is a good way to begin all-over hair removal,” explains Louisa Houlden, skin expert at Skin Matters Clinic. “When clients see results from a small area, they gain confidence and move on to bigger areas. We'd always recommend a patch test beforehand, but I'm confident with the Ellipse machine and what it can offer.” And she's right. After seeing the amazing results that IPL had on my face, I'm now moving on to my legs.

Monitor any underlying hormonal conditions

I didn't know I had PCOS until a few years after my laser treatments.

After a year of missed periods, I visited my GP who referred me for an ultrasound scan. Knowing what I was up against made dealing with the hair a little easier and I was advised that 8-12 sessions of IPL would be most effective. "If a client is suffering from hormonal issues that are linked to hair growth, they can still be treated effectively," says Hershey Punzalan, assistant trainer at Ministry of Waxing, which has recently introduced the Nd:YAG, a laser trained to work better on darker skin types. "Laser really helps those with excessive hair growth to manage it better," she continues. "However, they may find that they will need to have maintenance sessions more often than those who do not have hormonal issues."

According to specialists, having laser hair removal following sun exposure could risk damage to the skin (eg. hyperpigmentation), so always be honest and open about things like holiday plans or tanning. The same goes for disclosing any medication you are taking. "We aim for all our laser clients to receive a successful hair reduction," says Hershey. "In order for us to do this, we need to be aware if they are taking any medication or are undergoing any treatments that may hinder us from delivering results. Failing to do so could have a reverse effect treating an area which shouldn't be treated."

It's also important to be consistent. “A course of treatments is usually required at 4-8 weekly intervals to follow the hair growth cycle,” says Dr. Mahto. “If you miss a treatment, it may lead to slight hair regrowth as the treatment has to be consistent. Always speak to a professional who will advise of a proper treatment plan to achieve optimal results.”

Speak up if you're unhappy 

My hair growth was so bad that it actually made me break down in tears in front of the manager. I mentioned I wasn't happy that different specialists saw to me each time and that it was unfair for them not to take some responsibility. I managed to get a 100% refund but I know that some people aren't as lucky. Ask questions if there is something you don't understand, and if something doesn't feel right, voice it.

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