Leg laser hair removal in Singapore: half or full legs, ingrown hairs, sessions and what to expect

How it works

Laser hair removal for legs: how it works on leg hair

Laser hair removal uses pulses of light that are absorbed by melanin, the dark pigment in the hair shaft. The heat travels down the hair to the follicle that produces it, and damages it enough that fewer hairs grow back, and those that do are usually finer and lighter. Cooling is applied to the skin with every pass to protect the surface.

Leg hair is often a good match for laser: it tends to be dark and coarse against lighter skin on the thighs and calves. Fine, pale hair has little pigment for the laser to heat, and white, grey, red or very blonde hair is not reliably treated by any laser.

At SkinRev Lab, leg laser is performed by Dr Sin Yong on the Lutronic Clarity II, which carries two wavelengths. The 755 nm alexandrite wavelength is strongly absorbed by melanin and suits fairer skin and finer dark hair. The 1064 nm Nd:YAG wavelength is absorbed less by skin pigment and reaches deeper, so it is the safer choice for tanned or darker skin. On the legs, the choice can differ between the shins, which tan, and the inner thighs, which are often naturally darker.

The areas

Half legs, full legs, knees and feet

'Half legs' does not mean the same thing at every clinic. It usually means the lower legs, from just below the knee to the ankle, but some people want the thighs instead. Full legs covers both, and whether the knees, the feet and toes or the bikini line are included is worth confirming. The bikini line and Brazilian area are planned as separate areas.

Stubble shows first on the lower legs, so many people start there. The thighs often carry finer hair, and the inner thighs and the area just above the knee are prone to friction and to ingrown hairs in people with coarse hair. The knees and the feet and toes are small areas with thin skin over bone, quick to treat but often felt more.

Full legs are one of the larger areas, so a session takes longer than the underarms or upper lip, and pricing reflects the areas chosen. Other areas, such as the underarms or bikini line, can be treated in the same visit.

Sessions

How many sessions legs usually need

Hair grows in cycles, and only follicles in the active growth phase carry a pigmented hair that can conduct the heat to the root. At any one visit, a share of follicles are resting, so a single session cannot reach them all. That is why leg laser is given as a course, with sessions about four to eight weeks apart; the legs are usually spaced further apart than the face.

The leg studies are reasonably encouraging. In an assessor-blinded randomised trial in people with skin types III and IV, four sessions at eight-week intervals on the legs reduced hair by about 74% to 84% 18 months after the last session, with both 755 nm alexandrite and 1064 nm Nd:YAG. In a study of long-pulsed Nd:YAG on the lower legs, more than half the hair was still gone a year later in 40% of areas treated five times, but in none of the areas treated only once.

A Cochrane review found about 50% short-term reduction with alexandrite and diode lasers, but the trials were small and long-term removal was not documented. In practice, the number of sessions depends on your hair colour and thickness, skin type and hormones, and is planned at consultation; occasional maintenance sessions are common once the main course is finished. Results vary between people.

Bumps and dots

Ingrown hairs and strawberry legs

'Strawberry legs' is the everyday name for dark dots at the hair follicles on the legs, usually clearest a day after shaving. It is not one condition. The dots can be dark stubble seen through the skin, plugged follicles, keratosis pilaris, folliculitis, ingrown hairs, or flat brown marks left by earlier bumps, and many people have two or three of these at once.

Laser helps the parts driven by hair. Fewer coarse hairs means fewer stubble dots and fewer hairs that can curl back into the skin. In a study of 37 people with skin types IV to VI and razor bumps that had not settled with conservative care, one long-pulsed Nd:YAG treatment to a small area under the chin left an average of 1.0 bump after 90 days, against 6.95 in an untreated area next to it. That study was on the beard area, but the principle, fewer hairs and fewer bumps, is the same on the legs.

Waxing does not avoid the problem. In a study of 28 women who developed follicular bumps after waxing, including on the thighs, biopsies looked like pseudofolliculitis, and a fragment of hair shaft was found in a quarter of them. Laser does not clear plugged follicles, keratosis pilaris or dark marks on its own; those need exfoliating care, sun protection and time, and sometimes a separate treatment.

Sun

Tans, shins and Singapore's sun

A tan is extra melanin in the outer layer of the skin, which is exactly what competes with the hair for laser energy. Recently tanned or sunburnt legs raise the risk of burns, blisters and pigment change, so a session is usually postponed until the tan has faded. Self-tan sits on the surface and must be removed before treatment.

Legs tan easily without noticing, from shorts, beach weekends, runs or hiking holidays, and the shins usually see far more sun than the thighs. Tell the clinic about holidays and outdoor sport when you plan the course, so that sessions fall before a trip rather than straight after it.

Use a broad-spectrum sunscreen on any treated skin that sees the sun for the whole course, and avoid deliberate tanning. If your skin is naturally darker, or tanned from regular outdoor sport, the 1064 nm wavelength and conservative settings are usually used, sometimes after a test patch.

Preparation

Shaving before and between sessions

Laser needs the hair root in the follicle, so stop waxing, epilating, plucking and hair removal creams about four weeks before your first session. Shaving is fine, and the legs should be shaved the day before each session so that the laser energy goes down the hair rather than burning hair lying on the surface.

Between sessions, shave or trim only. Treated hairs shed over about one to three weeks after a session; they may look as though they are still growing at first, and it is fine to shave them. Do not pull them out.

On the day, come with clean skin and no body lotion, oil or self-tan on the legs. Do not apply your own numbing cream over large areas such as both legs unless the clinic has told you exactly what to use, how much and where; numbing products spread over a large area can be absorbed in amounts that are not safe.

Comfort and aftercare

Does leg laser hurt, and what is aftercare like?

Each pulse feels like a quick snap or warm prick, and the cooling applied with each pass makes it more tolerable. On the legs, the shins, knees and ankles, where skin lies close to bone, are usually felt more than the thighs and calves. Dense, coarse hair is felt more than sparse hair, and the sensation usually eases as the hair thins over the course.

Afterwards, expect redness and small raised bumps around each follicle, with a warm, sunburn-like feel, which usually settle within hours. That day, avoid hot showers, saunas, the gym and perfumed products on the treated skin, and keep it out of strong sun.

Contact the clinic the same day if you notice blisters, crusting, grey or white patches, or pain that gets worse rather than easing. Do not pop blisters or pick crusts.

Safety

Risks, who should wait, and when to see another doctor

A multicentre prospective study found that side effects of laser hair removal were uncommon and usually self-limiting, and highest in darker skin treated with an older short-wavelength ruby laser; it recommended long-pulsed Nd:YAG for darker skin types. The American Academy of Dermatology lists blistering, cold sore flares, infection, scarring, and lightening or darkening of the skin as possible side effects; skin colour usually returns to normal in time, but some colour changes are permanent.

Paradoxical hypertrichosis, where treatment is followed by more hair near the treated area, is mainly a face and neck problem: a meta-analysis found it in only 0.08% of treatments elsewhere on the body. Moles inside the area are shielded or avoided, as are tattoos, and any changing or irregular mole should be checked by a doctor, if needed a dermatologist, before laser.

Treatment is usually deferred in the situations below. If leg bumps are painful, hot, swollen, spreading or full of pus, or keep returning and leaving scars, see a GP or dermatologist first. Sudden new hair growth in a woman, especially with irregular periods or acne, should be checked for a hormonal cause before a course of laser.

• Recently tanned, sunburnt or self-tanned legs: wait until it has faded.
• Pregnancy: treatment is usually deferred.
• Recent isotretinoin or other medicines that make the skin sensitive to light or slow its healing: discuss with the doctor first.
• Active infection, folliculitis, eczema or broken skin on the legs: treat and let it settle first.
• A tendency to keloids, vitiligo, or pigment change after earlier laser or IPL: extra caution, a test patch, and sometimes a different plan.
• Grey, white, red or very fine blonde hair: no laser wavelength targets it reliably.

Alternatives

Alternatives: shaving, waxing and electrolysis

Shaving is quick and suits any hair colour, but stubble returns within a day or two and frequent close shaving causes razor bumps. Hair removal creams last a few days and can irritate; epilators often cause folliculitis and ingrown hairs.

Waxing removes hair from the root, so legs stay smooth for about four to six weeks, but it does not reduce the follicles, and bumps and ingrown hairs can appear as the hair regrows. At SkinRev Lab, CityLink Mall, leg waxing is S$58 for half legs and S$98 for full legs for women, and S$68 and S$118 for men, GST included. Do not wax in the four weeks before a laser session.

For hair that is too light for any laser, electrolysis from a trained electrologist treats each follicle with a fine probe; SkinRev does not offer it, and it is slow for an area as large as the legs. Leaving leg hair alone, or trimming it, is also a perfectly reasonable choice.

At SkinRev Lab

Leg laser at SkinRev Lab: consultation and pricing

Leg laser hair removal is performed by Dr Sin Yong (MBBS Singapore, MRCS Edinburgh, MSc Practical Dermatology Cardiff) on the Lutronic Clarity II. At consultation he looks at your hair colour and thickness on each part of the leg, your skin type, recent sun exposure, any history of ingrown hairs, folliculitis or keloids, and your medicines, and checks whether the dots or bumps you are worried about are hair-driven or something else.

He then explains which wavelength suits the shins, thighs and knees, whether a test patch is sensible, and how a course is likely to run. The options discussed include laser, waxing or shaving, and no treatment at all. Leg laser is priced at consultation, because it depends on whether you choose half or full legs, the knees and feet, and the number of sessions your hair is likely to need. Results vary between people.

Treatment is available at SkinRev Lab, #B1-28 CityLink Mall, 1 Raffles Link, Singapore 039393, linked underground to City Hall and Esplanade MRT, open daily 11am to 8pm (WhatsApp +65 8266 9585), and at IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, beside Orchard MRT, Monday to Saturday (WhatsApp SkinRev Lab on +65 8266 9585 or IN Eternity Clinic on +65 8815 3008).

Sources

References & sources

1. Davoudi SM, Behnia F, Gorouhi F, et al. Comparison of long-pulsed alexandrite and Nd:YAG lasers, individually and in combination, for leg hair reduction: an assessor-blinded, randomized trial with 18 months of follow-up. Arch Dermatol. 2008;144(10):1323-1327.
2. Lorenz S, Brunnberg S, Landthaler M, Hohenleutner U. Hair removal with the long pulsed Nd:YAG laser: a prospective study with one year follow-up. Lasers Surg Med. 2002;30(2):127-134.
3. Haedersdal M, Gøtzsche PC. Laser and photoepilation for unwanted hair growth. Cochrane Database Syst Rev. 2006;(4):CD004684.
4. Ross EV, Cooke LM, Timko AL, et al. Treatment of pseudofolliculitis barbae in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser. J Am Acad Dermatol. 2002;47(2):263-270.
5. Khanna N, Chandramohan K, Khaitan BK, Singh MK. Post waxing folliculitis: a clinicopathological evaluation. Int J Dermatol. 2014;53(7):849-854.
6. Lanigan SW. Incidence of side effects after laser hair removal. J Am Acad Dermatol. 2003;49(5):882-886.
7. Snast I, Kaftory R, Lapidoth M, Levi A. Paradoxical hypertrichosis associated with laser and light therapy for hair removal: a systematic review and meta-analysis. Am J Clin Dermatol. 2021;22(5):615-624.
8. American Academy of Dermatology. Laser hair removal: FAQs. AAD public website.

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