shiningthroughpcos

[shiningthroughpcos]

When it comes to managing Polycystic Ovarian Syndrome (PCOS), the science and evidence-based aspects are merely part of the process. There’s something deeply valuable in sharing personal experiences. For many of us navigating PCOS, hearing from others who have been and still remain on a similar journey to us can provide comfort, solidarity, and the kind of invaluable insights that no medical textbook or journal article can offer. Our personal stories, our hardships and successes become a bridge between medical knowledge and lived reality, offering emotional support, validation, and most importantly, a sense of community.

In this post, we'll dive into two real-world narratives from people with PCOS who have undergone LBHR, focusing on their expectations, challenges, and emotional journeys. One is Bella, one of my friends clients, and the other is a client turned good friend who have all bravely consented to me sharing their stories on their behalf. Through these stories, I hope to shed light on the complexities of laser treatment for those living with hormonal imbalances and excess hair growth, offering a more complete understanding of what it’s like to walk this path. To remind you how common it is, and to remind you that you are not alone. 

Nadia: Managing Paradoxical Hypertrichosis

Nadia, a 23-year-old woman with PCOS, has been battling hirsutism for years. By the age of 19, she had tried what seemed like every hair removal method under the sun. Off of the recommendation of a friend, she finally opted for laser-based hair reduction, hoping for smoother, hair-free skin. But after purchasing a package of around 7-8 sessions, Nadia noticed that rather than a reduction, her hair growth was increasing in some areas. Patches of thicker, coarser hair were appearing on her face and neck—an outcome completely opposite of what she had expected.

“I freaked out. I completely freaked out. I remember feeling so lost and confused, feeling like I had absolutely 0 control over my own body. I felt uncomfortable in my body, and like my femininity had been completely stripped from me. It wasn’t even the hair that bothered me, it was the excess. I don’t think there is anything worse than finally taking the leap to fix something that makes you so self-conscious, just to end up with it getting worse.” 

After finding the skin clinic I was employed at and booking in a consultation with me,  Nadia learned that what she was experiencing was common and had a name. It was called paradoxical hypertrichosis—a common side effect of laser treatments, where hair growth is triggered rather than reduced. The emotional toll was heavy. Not only did she have to deal with all of the physical changes, but the unexpected outcome left her feeling defeated and apprehensive about whether she even wanted to continue treatment.

However, with my help, we began to manage her condition. We created an individualised treatment plan based on Nadia’s individual hair assessment and switched to a different laser modality, and spaced out her sessions differently. It took some time, but the paradoxical hypertrichosis subsided within a few months. 

“I’m just really grateful I met you, if I didn't it would have taken me way longer to find help. I needed someone to help me understand more about why my body was reacting the way it was and help me manage it properly. It’s just like when I first realised I had some kind of hormonal issue. I went to the doctor like you’re supposed to, like everybody tells you to. And nobody took me seriously. I feel like the same thing happened when I went to start laser, they just wanted to sell me all these extras. I never even had a consultation that was as thorough as my first appointment with you. Nobody ever told me about the side effects, or what could go wrong. That’s why it was such a shock to me I think.”

I asked Nadia if she would be comfortable sharing her story because while I know how hard it was for her, it’s something that has happened to so many women with PCOS. I feel like her story perfectly encapsulates how important it is for service providers to conduct proper consultations, making their clients aware of the pros AND cons of lasers as a treatment. You cannot give your consent to any treatment if you are not fully informed of the potential risks like paradoxical hypertrichosis. While many people say this side effect is rare, it is not rare in my experience and it can happen to anybody and everybody. This emphasises just how important it is to find an experienced clinician who has dealt with PCOS patients and laser treatments.

Bella: Navigating Expectations

Bella, my good friend of 5 years who was diagnosed with PCOS in her late teens has struggled with excess hair growth for years. She felt immense relief when she discovered laser-based hair reduction. The idea of a "permanent" solution to hirsutism gave her hope, and she went into her first consultation with high expectations. The clinicians she saw initially gave her a great pitch about LBHR being a great treatment option for somebody looking for significant, long-term hair reduction. However, they failed to explain to her that

It was not an overnight fix

Nor was it a guarantee of complete removal—especially for someone with PCOS.

At first, she was incredibly eager. She completed her six recommended sessions, only to find that while her hair growth had slowed, it hadn't disappeared. In fact, some areas seemed to regrow more quickly than she expected. Disappointed, she realised that the hormonal imbalances caused by PCOS would continue to affect her results, meaning she’d need ongoing maintenance treatments.

“I felt so frustrated, like all my money had gone down the drain. They didn’t really explain to me properly that the laser wasn’t permanent hair removal, I feel like there should be more education around that area. But they did help me adjust my mindset after the fact. We had taken a photo at my first consultation and after my 3rd laser session. I was at my 6th session when I felt like I was unhappy because there was still some hair growth. Once they showed me my photos from earlier sessions, I realised what a big difference the sessions had made. It made me really appreciate how much better it had gotten. The hair used to be so thick, and I had hyperpigmentation in the area as well as texture from constantly shaving. I wouldn’t have realised if I hadn’t been shown those photos.” 

“I feel like I was so obsessive and particular at the start because the amount of hair growth I had felt so debilitating at times. It was literally all I could see when I looked at myself. So because I felt a lack of control over my appearance, it set my expectations real high.”

While it wasn’t the permanent solution Bella had hoped for, her journey shifted from wanting perfection to embracing her progress. She learned that managing expectations was key to making peace with the treatment and finding satisfaction in the results she did achieve.

The Power of Shared Experiences

As we come to the end of this series on LBHR for those managing PCOS, it’s clearer more than ever that this journey is deeply personal, and results can vary from one person to the other. And while we've delved deep into the science behind treatments like LBHR, it’s the shared experiences and personal stories that provide true insight into what it’s like to live with PCOS and pursue this form of hair reduction.

Whether it’s navigating the highs and lows of treatment, managing unexpected outcomes like paradoxical hypertrichosis, or finally gaining a sense of autonomy after years of struggling with hirsutism, each story reminds us of the strength it takes to seek solutions for a condition as complex as PCOS. Through the case studies and anecdotes shared in this blog, I hope you’ve found guidance, reassurance, and a deeper understanding of what LBHR can offer.

As you move forward with your own decisions about PCOS management, remember to consult with trusted clinicians, do your own research, and take comfort in knowing that you’re not alone. The emotional impact of PCOS cannot be understated, and pursuing treatments like LBHR can be both challenging and empowering all in one.

Most importantly, never underestimate the value of our shared experiences—whether they come from clinicians, friends, or other people with PCOS. Our stories are a powerful tool for understanding, connection, and, ultimately, making informed choices about how exactly to navigate your own journey.

L 🤍

[shiningthroughpcos]

Urbana. (2023, January 27). Laser-Based Hair Reduction Checklist [Image]. https://www.urbana.ie/blog/what-is-the-success-rate-of-laser-hair-removal/

[shiningthroughpcos]

I have PCOS and I didn't feel a change until I went on Metformin and started laser. I've been managing my hair with laser too but I know my some areas are resistant so its gonna take some time. What do you think of electrolysis?

Hello, and thank you for your message!! 😊

Electrolysis is a great option for areas that are resistant to laser treatment. Unlike laser, which we know targets the pigment in the hair follicle, electrolysis uses an electric current to directly destroy the follicle, making it effective even for lighter or finer hairs that laser might miss.

I recommend booking a consultation to see if you’re a good candidate. We typically suggest electrolysis after the bulk of hair in an area has been reduced with laser.

Keep in mind that electrolysis can be slower and more expensive since it targets one follicle at a time, and many clinics charge by the time spent in treatment. But in combination with laser, it can be an ideal solution for long-term results. I think you'd benefit from discussing your options with your specialist so you can come up with a treatment plan that suits you.

[shiningthroughpcos]

Maximising Your Laser Results: Preparation, Aftercare, and Realistic Expectations

Hello again! If you’ve been following along, you’ll know that LBHR is one of the most popular treatments for managing excessive hair growth caused by PCOS. But as we dive deeper into this process, it’s important to recognise that booking your consultation is only the first step. Preparation, aftercare, and understanding how to maintain your results are key, especially since, for many of us with PCOS, the typical six sessions recommended for most people will not be enough (Liew, 2002).

Preparation for LBHR: Setting Yourself Up for Success

Avoiding Prolonged/Excessive Sun Exposure: One of the most important pre-session steps is to avoid direct sun exposure. Tanned skin can increase the risk of burns or pigmentation changes due to the laser (Alamri et al., 2023).

Shaving Before Treatment: Make sure to shave the treatment area a day before your session—this allows the laser to effectively target the root of the hair follicle without the hair shaft getting in the way (Mustafa & Jaafar, 2015).

Avoid Waxing or Plucking: It’s crucial not to remove the hair from the root (like with waxing or plucking) before your laser sessions, as the laser needs the follicle intact to adequately target the melanin within the hair follicle.

Check Medications and Skincare Products: Some medications or topical skincare products, known as ‘photosensitisers,’ can increase your skin’s sensitivity to the laser. Always inform your clinician about your prescriptions and skincare routine, even if it seems minor (Kerstein et al., 2014).

Aftercare: Protecting Your Skin for Optimal Healing

Cool Down: During your session, cooling methods like a cold air attachment or cooling gel may be used to soothe the skin. At home, continue to keep the area cool—use ice packs or aloe vera gel to relieve any redness or irritation. This is particularly important for darker skin tones, as clinical endpoints (like redness and swelling) may appear later (Vaidya et al., 2023).

Moisturise Regularly: Keep the treated area moisturised using a thick, emollient-type moisturiser to help protect the skin from excessive water loss. Avoid any products with ingredients like retinol or AHAs/BHAs for 2-3 days post-treatment, as these can irritate the more sensitive, lasered skin (Vaidya et al., 2023).

Avoid Sun Exposure: Just like before your treatment, protecting your skin from the sun afterward is essential. Use a broad-spectrum SPF 50+ to prevent hyperpigmentation (Hamzavi et al., 2020).

Gentle Cleansing: Stick to mild cleansers, and avoid hot showers, saunas, or strenuous workouts that cause sweating for at least 24-36 hours post-treatment. Sweating can trap moisture in swollen hair follicles, potentially leading to rashes or infections (Arsiwala & Majid, 2019).

Maintaining Results and Understanding the Process

While LBHR offers long-term reduction in hair growth, it’s important to remember that this journey is a process—it’s not an instant fix. For those with PCOS, the typically recommended six sessions are often not enough, and you’ll likely need additional treatments to see significant changes. Here’s why:

Hormonal Impact: With PCOS, fluctuating hormone levels continuously stimulate hair growth, which means more than six sessions are often necessary to achieve lasting results. Each session weakens the hair follicles further, which is why consistency is key. Remember, if you’re waxing between sessions, you’re removing the root that the laser targets, so it’s best to stick with shaving.

Regular Treatments: Consistent treatments, spaced every 4-6 weeks, are essential for targeting hair during its active growth phase. While this may feel frequent at first, patience and consistency are what lead to noticeable results. You’ll likely notice slower hair growth, and the hair that does return will be thinner and sparser. In my experience treating patients with PCOS, most clients start seeing these effects around the 6-7 session mark, with hair shedding naturally after it weakens.

Maximising My Results: What Else Should I Do?

Stay on Top of Hormonal Management: Since PCOS is closely linked to hormone imbalances, working with a healthcare provider to manage your hormones—whether through medication or lifestyle changes—can enhance the effectiveness of your laser treatments. For me personally, hormonal management became much more controllable after I was prescribed Metformin by a specialist. While I can’t recommend specific treatments, I strongly encourage seeing a medical professional to keep your PCOS under control.

Choosing the Right Clinic/Clinician: Not all lasers are created equal. Ensure you select a clinic with advanced technology and experience in treating individuals with PCOS, especially across diverse skin tones. You may have heard that darker hair on lighter skin achieves quicker results, but modern laser modalities can effectively treat all skin types. Regardless of your skin tone, as long as you have dark hair, there’s a suitable laser for you.

LBHR is a powerful tool for managing PCOS-related hair growth, but achieving the best results requires thoughtful preparation, diligent aftercare, and realistic expectations. With consistency and proper support, this journey can lead to significant, long-lasting results. Don’t hesitate to consult with your healthcare provider to tailor your treatment plan, and always be patient with the process. By following these guidelines, you’ll be well on your way to maintaining and maximising your results

L 🤍

References

Alamri, G. E., Bondagji, M., Kinkar, L. I., Almasoudi, E., Fageeh, S. M., Asiri, L. G., & Bahashwan, E. (2023). Knowledge and attitude regarding the use of sun protection to prevent adverse laser events among the general population in Saudi Arabia: A cross-sectional study. Cureus. https://doi.org/10.7759/cureus.50157

Arsiwala, S., & Majid, I. (2019). Methods to overcome poor responses and challenges of laser hair removal in dark skin. Indian Journal of Dermatology, Venereology and Leprology, 85(1), 3. https://doi.org/10.4103/ijdvl.ijdvl_1103_16

Hamzavi, I., Fatima, S., Braunberger, T., Mohammad, T., & Kohli, I. (2020). The role of sunscreen in melasma and postinflammatory hyperpigmentation. Indian Journal of Dermatology, 65(1), 5. https://doi.org/10.4103/ijd.ijd_295_18

Kerstein, R. L., Lister, T., & Cole, R. (2014). Laser therapy and photosensitive medication: A review of the evidence. Lasers in Medical Science, 29(4), 1449-1452. https://doi.org/10.1007/s10103-014-1553-0

Liew, S. H. (2002). Laser hair removal. American Journal of Clinical Dermatology, 3(2), 107-115. https://doi.org/10.2165/00128071-200203020-00004

Mustafa, F. H., & Jaafar, M. S. (2015). Shaving area of unwanted hair before laser operation is useful in cosmetic procedure: A simulation study. Journal of Dermatology & Dermatologic Surgery, 19(1), 36-42. https://doi.org/10.1016/j.jssdds.2013.10.001

Spritzer, P. M., Marchesan, L. B., Santos, B. R., & Fighera, T. M. (2022). Hirsutism, normal androgens and diagnosis of PCOS. Diagnostics, 12(8), 1922. https://doi.org/10.3390/diagnostics12081922

Vaidya T., Hohman, M. H., & Kumar, D. D. (2023). Laser Hair Removal. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK507861/

[shiningthroughpcos]

Urbana. (2023, January 27). What can cause laser treatments not to be successful [Image]. https://www.urbana.ie/blog/what-is-the-success-rate-of-laser-hair-removal/

[shiningthroughpcos]

Can I ask how the Nd:Yag machine can bypass melanin in the skin like you mentioned while still targeting the melanin in your hair?

Sure!! So we know that laser works through the principle we spoke about called selective photothermolysis. Basically, the wavelength of the Nd:YAG laser a much longer wavelength compared to other lasers like the Alexandrite (Thomas & Houreld, 2019.)

Melanin absorbs different wavelengths of light, and shorter wavelengths (like those used in Alexandrite lasers) are absorbed more strongly by melanin. This makes shorter wavelengths more effective for targeting hair in lighter skin tones but riskier for darker skin, as there's more melanin in the skin itself that could absorb the energy and cause burns or hyperpigmentation (Krasniqi et al., 2022.) This is where Nd:YAG comes in.......

Now because the Nd:YAG laser uses a longer wavelength, it penetrates deeper into the skin, past the epidermis (where our melanin is typically more concentrated) and targets the melanin in the hair follicle (Abdelrazek et al., 2023). This depth reduces the risk of surface skin damage, which is what makes it a safer option for people with darker skin types (Abdelrazek et al., 2023.) The machine itself cant tell the difference—it’s all about how the wavelength interacts with tissue.

Urbana. (2023, January 27). How lasers treat different skin types [Image]. https://www.urbana.ie/blog/what-is-the-success-rate-of-laser-hair-removal/

References

Abdelrazek, W., Moftah, N., & Hamdy, A. (2023). Clinical efficacy and safety of ND-YAG laser in hair reduction. Minia Journal of Medical Research, 0(0), 0-0. https://doi.org/10.21608/mjmr.2023.179655.1236

Krasniqi, A., McClurg, D. P., Gillespie, K. J., & Rajpara, S. (2022). Efficacy of lasers and light sources in long-term hair reduction: A systematic review. Journal of Cosmetic and Laser Therapy, 24(1-5), 1-8. https://doi.org/10.1080/14764172.2022.2075899

Thomas, M. M., & Houreld, N. N. (2019). The “in’s and outs” of laser hair removal: A mini review. Journal of Cosmetic and Laser Therapy, 21(6), 316-322. https://doi.org/10.1080/14764172.2019.1605449

[shiningthroughpcos]

Understanding Laser Treatment: Fitzpatrick Skin Types and How Laser Energy Targets Melanin

Hello again! If you’ve been following my posts, you’re now familiar with the ins and outs of PCOS and laser-based hair reduction (LBHR). Today, we’ll go a bit deeper into the science behind LBHR. Don’t worry, the technical details like laser settings are for the professionals to handle! Howeverrr, understanding the basic principles of how laser treatments work can help you maximise your results. Not only does this knowledge empower you during your sessions, but it also reinforces the importance of sticking to your post-care routine to ensure the best possible outcome. Today, we’re specifically focusing on how lasers work with different skin types and why cooling methods during your laser session are essential to safe and effective treatment to keep the skin safe

Cooling Methods During Laser Treatment

Throughout your laser session, cooling may be applied either with a cold air attachment or a cooling gel. Both are crucial for minimising discomfort and preventing thermal (heat) damage to the skin. Erythema (redness) and perifollicular oedema (swelling around the hair follicles) are completely normal signs of effective treatment. In fact, we look for these indicators as confirmation that the laser energy has been adequately absorbed by the hair follicles, leading to the long-term reduction we’re after.

Cooling is a vital step during laser treatments, helping to reduce trapped heat in the treatment area and minimise discomfort. Whether through cold air attachments or cooling gel, this process helps protect the skin and prevent overheating. For those with darker skin types, clinical endpoints—such as redness or swelling—might be delayed due to the skin's color. This is why cooling is especially important to ensure safety and effectiveness during and after the session.

Understanding Skin Types: The Fitzpatrick Scale

When discussing laser treatments, we often refer to the Fitzpatrick Skin Type rating. This scale isn’t perfect, but it serves as a useful tool to gauge how someone’s skin might react to UV exposure. FST goes beyond just looking at your skin’s current appearance. It’s about how your skin responds to UV exposure, considering your ethnic background and potential to pigment. 

For example, I grew up in the Middle East in a very hot climate and was deeply tanned as a child. Now, I have paler skin, but that doesn’t mean I can be treated using the same settings as someone with blonde hair and blue eyes who burns incredibly easily under the sun, or even someone from the same background as me who has much darker skin. Each of us reacts differently based on our skin’s potential to pigment.

This scale helps clinicians assess the safest treatment parameters, ensuring that each session is as effective and as safe as possible. While it touches on race, it’s important to understand that it’s not an exact measure—it’s more of an indicator to help guide treatments with both safety and efficacy in mind. This rating scale helps us determine which laser modality is safest and most effective for each person. The scale ranges from:

Type I: Very fair skin, always burns, never tans.

Type II: Fair skin, usually burns, tans minimally.

Type III: Medium skin, sometimes mild burns, tans gradually.

Type IV: Olive skin, rarely burns, tans well.

Type V: Brown skin, very rarely burns, tans deeply.

Type VI: Dark brown or black skin, never burns, tans very easily.

Australian Radiation Protection and Nuclear Safety Agency. (2018, March 13). Fitzpatrick Skin Type [Image]. https://www.arpansa.gov.au/sites/default/files/legacy/pubs/RadiationProtection/FitzpatrickSkinType.pdf

Laser Technology: Alexandrite and Nd:YAG

Different lasers are used depending on the patient's skin type. The Alexandrite laser is a go-to for lighter skin types (Fitzpatrick I-III). It operates at a wavelength of 755 nm, which targets the melanin in the hair follicle with great precision. However, this laser can pose a higher risk for hyperpigmentation or burns in darker skin types, which brings us to the Nd:YAG lasers.

The Nd:YAG laser, with a longer wavelength of 1064 nm, is ideal for darker skin types (Fitzpatrick IV-VI). Its longer wavelength penetrates deeper into the skin and is less absorbed by the melanin in the epidermis, reducing the risk of skin damage while still targeting the melanin in the hair follicles. This is how we adequately treat deeper skin types 

British Lasers. (2023, June 9). Understanding how laser functions [Image]. https://britishlasers.com/newest-laser-hair-removal-technology/

How Laser Energy Targets Hair Follicles

No matter the laser type, all hair reduction treatments function by targeting melanin, the pigment found in both hair and skin. Laser energy is absorbed by the melanin in the hair follicle, heating it up and eventually destroying the follicle, preventing future hair growth. This process is called selective photothermolysis, a term that refers to the selective destruction of melanin in the hair while minimising damage to the surrounding skin.

Selective Photothermolysis: Protecting Darker Skin Types

For those with darker skin (higher on the Fitzpatrick scale), there’s understandably a concern about potential skin damage due to the presence of more melanin. But with selective photothermolysis, we can protect darker skin by using specific lasers like the Nd:YAG, which safely bypasses the melanin in the skin while still targeting the melanin in the hair follicle. This ensures effective treatment without causing harm to the surrounding tissue.

Laser hair reduction is a highly customisable treatment that needs to be adapted to your skin type for safe and effective results. The right cooling techniques, understanding your Fitzpatrick skin type, and choosing the correct laser modality are all essential to getting the best possible outcome—especially for those of us managing PCOS-related hair growth. Remember, whether you have light or dark skin, modern laser technology ensures that we can achieve long-term hair reduction safely.

L 🤍

[shiningthroughpcos]

is it possibly PCOS related that most of my hair follicles have more than one hair in them? in my armpits especially

Hi!!! 😊

Thank you for your message—it’s a good question.

What you’re describing, this thing where multiple hairs grow in one follicle (it's called polytrichia or even compound follicles), can happen for many reasons. It’s not necessarily directly linked to PCOS, but it could very well be influenced by hormonal changes, including those caused by PCOS. People with PCOS often experience changes in hair growth patterns because of elevated androgen levels, but it’s also possible for this to occur naturally in some areas, like the armpits, regardless of having PCOS. Hair in this area is naturally a lot more coarse and dense as well.

If it’s something you’re concerned about or if it’s causing any discomfort, it’s always a good idea to chat with a healthcare provider or a derm for advice. I can only tell you my professional opinion, but they can help pinpoint the cause and discuss options.

I hope this helps! Feel free to reach out if you have any more questions—I’m happy to answer whatever questions you have🤍

[shiningthroughpcos]

Understanding Laser-Based Hair Reduction (LBHR): A Tailored Solution for PCOS

Living with PCOS often means managing a range of challenging symptoms, including hirsutism, or excessive hair growth. For many of us, finding a reliable and long-term solution to reduce unwanted hair feels like an endless journey. Laser-Based Hair Reduction (LBHR) stands out as a promising option—especially for those grappling with the persistent, stubborn hair growth that accompanies PCOS.

LBHR uses advanced technology to target the hair follicle beneath the surface of the skin, addressing the root cause rather than offering a temporary fix. This precision sets LBHR apart from traditional methods like shaving and waxing. This is why we recommend shaving before your session; we’re targeting the melanin in the root of the hair follicle rather than the hair shaft itself.

The Science Behind LBHR

Contrary to popular belief, LBHR does not target hair directly. Instead, it employs concentrated light to focus on the pigment within the hair follicle (Ibrahimi et al., 2011). The concept of selective photothermolysis (SPTL) is crucial here, as it selectively damages the hair follicle while protecting the surrounding skin, leading to long-term results (Ibrahimi et al., 2011).

The extended theory of SPTL suggests that laser treatment can effectively disrupt the stem cells and nutrients within the bulge of the hair follicles through the diffusion of heat, significantly delaying terminal hair growth (Ibrahimi et al., 2011). Unlike waxing or shaving, which offer temporary solutions, LBHR leads to lasting changes in hair growth patterns, making it particularly valuable for those with hirsutism (Kang et al., 2021).

The Theory Behind Laser Based Hair Reduction [Image]. (2019). DermaNu Clinic. https://www.dermanuclinic.com/blog/laser-hair-removal-and-how-does-it-work.aspx

Why LBHR is a Game-Changer for Managing PCOS Symptoms

For those of us with PCOS, excess hair growth can feel overwhelming and exhausting. We’ve already discussed how hormonal imbalances, particularly elevated levels of androgens (male hormones), lead to hair that grows thicker and faster. While traditional hair removal methods like shaving or waxing may seem more accessible and cost-effective in the short term, they only provide temporary relief. These methods often require frequent maintenance—whether weekly or bi-weekly—which can quickly become burdensome.

LBHR offers a more targeted, long-term approach. One of its key advantages for people with PCOS is its ability to significantly reduce hair over time. By damaging the hair follicle and the cells responsible for regrowth, laser treatments decrease both the density and thickness of hair, impeding the rate of growth and leading to longer-lasting results.

Many of us with PCOS have noticed visible changes—hair that grows back slower, finer, and thinner after consistent laser sessions. Since a full hair growth cycle takes around a month, it’s important to schedule your initial treatments about four weeks apart to target hair during its active growth phase. While it’s impossible to pinpoint the exact phase each individual hair is in (as each one can be in a different phase), treating hair every four weeks increases the likelihood of targeting a significant portion during the anagen phase. This approach helps weaken the hair progressively, session by session.

Additional Benefits Beyond Hair Reduction

Skin Texture and Odour Management

In addition to reducing hair growth, LBHR helps improve skin texture and manage odour. For people with PCOS, hirsutism can sometimes result in rough skin, often known as “chicken skin” (keratosis pilaris). With less hair growth, the skin’s surface gradually smooths out over time.

LBHR also helps reduce body odour by minimising hair in areas where sweat and bacteria tend to accumulate. This can be especially helpful for those who struggle with odour related to excessive hair growth, as less hair means fewer places for moisture and bacteria to be trapped.

Minimises Ingrown Hairs

One of the major benefits of LBHR, particularly for individuals with PCOS, is the reduction of ingrown hairs. Unlike waxing or shaving, which can lead to ingrown hairs as the hair grows back, laser treatments target the hair follicle itself, thereby reducing the chances of hair growing incorrectly beneath the skin.

Time-Saving in the Long Run

While LBHR may require an initial commitment of several sessions, it ultimately saves time in the long run. People with PCOS often have to deal with daily or weekly maintenance using other methods, whereas LBHR significantly extends the period between hair regrowth, reducing the time and effort spent on hair removal.

Less Irritation

Unlike traditional methods like shaving, which can lead to irritation, razor burns, and cuts, or waxing, which can cause skin trauma, laser treatments tend to be gentler on the skin when performed by a trained clinician. This makes LBHR a great option for individuals with sensitive skin, including those dealing with PCOS-related sensitivity.

Improved Confidence and Emotional Wellbeing

For many with PCOS, excessive hair growth can be a source of insecurity. The long-term results from LBHR can contribute to improved self-confidence and emotional wellbeing, as it minimises the need for constant hair removal and reduces the psychological burden of managing hirsutism.

Weighing the Challenges of LBHR for PCOS

However, LBHR isn't without its challenges. The process requires multiple sessions over several months, which can be both time-consuming and costly. The financial commitment is often the largest barrier, especially since those with PCOS typically need to treat larger areas of the body where hair growth is most excessive. Depending on the severity of hirsutism and an individual’s hair type, results may vary. While I and many others with PCOS have experienced a reduction in hair growth, it’s crucial to understand that LBHR does not permanently remove hair. Rather, it reduces it, and hormonal fluctuations can still lead to regrowth. I know I’ve mentioned this before, and it may seem repetitive, but it’s frustrating to see how often LBHR is misadvertised as a permanent solution.

A specific challenge we've touched on previously—and which is essential to emphasize—is paradoxical hypertrichosis. This condition occurs when the heat from the laser stimulates hair growth in areas where it was previously sparse or absent. This is most likely to happen when non-hairy areas are treated or where the hair is finer and lighter. Since laser targets the pigment in the hair follicle, it can be less effective on finer hair, complicating proper targeting. If paradoxical hypertrichosis does occur, the only way to manage this unexpected hair growth is through continued treatments at higher settings. This underscores the importance of only treating areas where hair growth is already a concern and being cautious of clinics that offer full-body laser packages without proper consultation. While these packages may seem cheaper in the short term, they could lead to more frustration down the line.

It’s also important to address a common misconception, much like with shaving, that laser can increase hair growth in certain cases. Paradoxical hypertrichosis most often occurs on the face and neck for women, as well as the upper torso for men and individuals with hormonal imbalances. It’s more common than many realize, affecting up to 10% of laser clients, particularly those from ethnic backgrounds associated with darker and coarser hair. I wish someone had informed me about this earlier because, having started laser treatments at a young age, I’ve personally experienced hair growth on my back where I previously had very little. This has been a frustrating outcome, and I’m sharing this to ensure others don’t face the same situation unknowingly.

Making Informed Choices

As we navigate the complexities of LBHR, it’s essential to approach treatment with a well-informed perspective. While LBHR has proven to be a valuable option for many, understanding both its potential and limitations can empower individuals with PCOS to make the best decisions for their unique circumstances.

Education and Consultation

Before starting LBHR, thorough consultations with experienced clinicians are crucial. They can provide tailored advice based on individual hair types, skin tones, and specific needs. It’s also important to have open conversations about any concerns regarding paradoxical hypertrichosis and other potential side effects, especially how LBHR interacts with sun exposure and medications. This proactive approach ensures that you’re prepared for the process and can make necessary adjustments based on your body’s responses.

Realistic Expectations

Setting realistic expectations is key. While many individuals see significant improvements in hair density and texture, it’s essential to remember that each person’s experience can and will vary. Some may require fewer sessions, more sessions, or different settings to achieve their desired results. By acknowledging this variability, you can reduce the risk of frustration and disappointment as you embark on your hair reduction journey.

Holistic Approach to PCOS Management

Finally, it’s vital to view LBHR as part of a broader strategy for managing PCOS symptoms. Combining laser treatments with lifestyle changes and medical management can yield even more benefits. This holistic approach can help address not just excess hair growth but also other aspects of PCOS, such as hormonal imbalances and skin health.

While LBHR offers a promising solution for those grappling with the challenges of hirsutism due to PCOS, it’s crucial to remain educated, set realistic goals, and seek professional guidance. By doing so, you can navigate this journey with confidence, taking significant steps toward reclaiming your comfort and self-esteem. If, after following along, you decide that LBHR is not the right option for you, that’s completely understandable. The most important thing is having all the information needed to help you arrive at this conclusion.

Until next time 🤍

References

Ibrahimi, O. A., Avram, M. M., Hanke, C. W., Kilmer, S. L., & Anderson, R. R. (2011). Laser hair removal. Dermatologic Therapy, 24(1), 94-107. https://doi.org/10.1111/j.1529-8019.2010.01382.x

The Theory Behind Laser Based Hair Reduction [Image]. (2019). DermaNu Clinic. https://www.dermanuclinic.com/blog/laser-hair-removal-and-how-does-it-work.aspx

[shiningthroughpcos]

staying on anon bc i’m shy. but the amount of trouble i had getting a diagnosis for my PCOS was literal insanity. i genuinely felt so misunderstood, and every specialist i saw was so unhelpful. i eventually was diagnosed after a while but i realised that it was only once i saw a female gyno that i was taken seriously. it didn’t occur to me that every doctor i saw before her was a male. and it’s exactly like u mentioned, all they would tell me was to lose 10-15 pounds, and all they really cared about was my periods being regular for fertility.

I'm really sorry to hear. Your experience is sadly way too common, I went through the exact same thing when I was younger. It's frustrating beyond words, and in the moment it genuinely feels like a joke. Like you feel sick, and you’re experiencing all of these symptoms but nobody believes you. And even if they do believe you, your concerns are brushed off or reduced to just weight loss and fertility. It can be very hard to endure, especially when we know that PCOS impacts so much more, and being heard is so important for getting the right care.

I’m glad you finally found a female gyno who took you seriously. It’s crazy how much of a difference it makes when you meet somebody who truly listens and understands.

Thank you for sending this in, I was very happy to see your message because your story is exactly why I wanted to write about this—it’s not just about symptoms; it’s about finding validation and support.

Thank you for sharing, even anonymously! It's so important for people to hear stories like yours. 🤍

[shiningthroughpcos]

Hair Removal 101: Exploring Hair Reduction Methods for Managing Hirsutism

Hello again, and welcome back to Shining Through PCOS! Today we’ll be diving into a topic that many of us with and even without PCOS face—hair removal. We will be exploring traditional methods such as waxing, shaving, as well as laser-based hair reduction, examining their pros and cons to help you make informed choices about what’s right for you in your journey.

Understanding Hair Growth Cycles

Before we delve into specific methods, it’s essential to understand how hair growth cycles work. Hair grows in three phases: the anagen (growth), catagen (transition), and telogen (resting) phases (Natarelli et al., 2023). The anagen phase, which can last for years, is the active growth stage during which the hair shaft forms and emerges from the surface of the skin - and around 85% of the hairs on the human scalp are in this phase at any given time (Kintz et al., 2015, p. 1-22). The catagen phase is a shorter period where the hair stops growing, and its structure becomes fully formed and hardened. The base of the hair, or bulb, begins to shrink and break down, to prepare the hair for shedding. The length of this phase typically varies depending on the type of hair (Kintz et al., 2015, p. 1-22). After the catagen phase comes the telogen, or resting phase, where hair growth pauses, but the hair follicle remains dormant. Around 10-15% of our hairs are in this stage at any given time, and this percentage can increase as we age. During telogen, the hair is more easily shed—a process you’’ hear often referred to as 'shedding.' Shortly after, the cycle restarts, with new growth being triggered by the activation of stem cells in the bulge area of the outer root sheath (Kintz et al., 2015, p. 1-22).

Waxing: A Time-Honoured Technique

Waxing is a popular hair removal method that involves applying warm wax to the skin and quickly pulling it off, removing hair from the root (Kang et al., 2021). One of its main advantages is that it provides longer-lasting results compared to shaving, as it disrupts the hair follicle and can lead to regrowth over time that is much finer. Waxing also acts as a natural exfoliant, removing dead skin cells and leaving your skin feeling smooth.

However, waxing may not be the best option for everyone, particularly those with sensitive skin or certain skin conditions. It can also be painful, especially for those new to the process, and will require regular appointments/ at-home treatments to maintain results (Kang et al., 2021). While waxing is effective, it may not provide the long-term solution that many with PCOS seek. 

In fact, I vividly remember my own experience with waxing at 12. And yes, aged 12 (I’m a HAIRY Middle Eastern woman :P) I was eager to try it, but after the session, my skin reacted unexpectedly—blood rushed to the surface, leaving me these dark bruises that were quite painful. It wasn’t actual bleeding, but my skin bruised so badly, and I believe it might have been purpura. The next day at school, I remember how concerned my teachers looked because it looked like I had fallen or been injured. That experience definitely made me rethink waxing as a method, especially for those of us with sensitive skin.

Shaving: Quick and Convenient

Shaving is arguably the most accessible hair removal method since it requires minimal tools and can be easily done at home. It offers a quick way to remove hair from the surface of the skin without the pain that comes with waxing. However, because shaving only cuts the hair at the surface, it doesn’t address the hair follicle itself. As a result, regrowth tends to happen quickly and can feel coarser or stubbly for some individuals.

One of the major drawbacks of shaving is the potential for irritation, ingrown hairs, and cuts, especially for those with sensitive skin. There's also the ongoing debate about whether shaving can make hair grow back thicker. In my opinion, it really varies from person to person. I have known people who shave their faces daily without any issues, while I’ve personally experienced hair growing back thicker and longer in certain areas after shaving. 

What I’ve noticed is that many people with finer or lighter hair don’t seem to experience stimulated hair growth after shaving, while those of us with coarser or darker hair, myself included, often deal with thicker, faster regrowth. It’s a frustrating reality that highlights how hair growth patterns can vary depending on individual hair types, textures as well as ethnicity. I’ve also observed that people like myself from cultures typically associated with thicker body and facial hair—like Mediterranean, Middle Eastern, and South Asian backgrounds—often face more challenges with stimulated hair growth after shaving. This contrasts with some of my friends from other backgrounds, who tend to have finer hair and don’t experience the same regrowth issues.

All in all, although shaving can be convenient, it usually requires more frequent upkeep compared to waxing or laser treatments. For those of us with PCOS, I’d recommend using shaving mainly for in-between laser sessions rather than as a long-term solution.

Laser-Based Hair Reduction: A Game-Changer for Hirsutism

Now, let’s discuss laser-based hair reduction (LBHR), a method that stands out for its effectiveness in managing excess hair growth, particularly for those of us with PCOS.

One of the key benefits of LBHR is its ability to target dark, coarse hairs—which are often a result of hormonal imbalances—by damaging the hair follicles and delaying future growth (Ibrahimi et al., 2011). For many of us with PCOS, this can offer a sense of relief and a much-needed confidence boost, as it provides long-term results and reduces the frequency of hair removal sessions. I’ve personally found that after multiple treatments, the density and thickness of my hair significantly reduced, making it much more manageable. The general consensus is to recommend 6-8 sessions to see a substantial clearance in hair. Personally, I have found that this takes many more sessions for those of us with PCOS as our hair growth is hormonal which inherently makes it more resistant to hair reduction methods.

Another often overlooked benefit of laser is its potential to improve skin texture and reduce body odour  (Fazel et al., 2020). Coarse hair, particularly in areas like the underarms, can trap sweat and bacteria, leading to stronger body odour. By reducing hair growth, LBHR can help alleviate this issue  (Fazel et al., 2020). Similarly, the appearance of 'chicken skin' or keratosis pilaris—those tiny bumps we see on the skin—can improve, as there’s less hair growth contributing to clogged follicles and texture irregularities (Li et al., 2022).

However, LBHR isn't without its challenges. For one, the process requires a series of sessions over several months, which can be time-consuming and incredibly costly (Marks et al., 2019). Depending on the severity of hirsutism and the individual’s hair type, results can vary. While I, and many of us with PCOS, have experienced a reduction in hair growth, it’s important to understand that LBHR will not permanently remove hair—it reduces it, and hormonal fluctuations can still cause hair regrowth down the line.

Another significant concern is the possibility of paradoxical hypertrichosis, a phenomenon where laser treatment can actually stimulate hair growth in areas that were previously hair-free (Snast et al., 2021). This is especially important to consider when clinics offer full-body laser packages that may seem like a great deal. Treating areas where you don’t have noticeable hair can backfire, as the heat from the laser can activate dormant follicles, causing new hair to grow. Ironically, the only way to manage this growth is through continued laser treatments with higher settings, which can feel frustrating and counterintuitive (Snast et al., 2021).

This is also where the popular complaint, "laser made my hair grow back even worse," often stems from—when treatments aren’t conducted by a qualified professional. If the laser settings aren’t properly calibrated to your specific skin and hair type, it can lead to inconsistent results, including unwanted stimulation of hair growth. Additionally, for those with darker skin tones, extra caution is required, as there’s a higher risk of hyperpigmentation or burns as adverse effects. This underscores the importance of finding a skilled practitioner who can adjust settings and techniques appropriately for your skin type. This is why it’s essential to consult with a knowledgeable clinician who understands the intricacies of PCOS and the unique challenges of treating hirsutism. 

While LBHR may not solve everything, it’s one of the most effective tools we currently have in managing the emotional and physical burden of hirsutism. Ultimately, combining laser treatments with lifestyle changes and medical management, if necessary, can make a world of difference.

Finding What Works for You

In summary, while waxing and shaving have their place in hair removal routines, laser-based hair reduction often emerges as the most effective long-term solution for managing hirsutism, especially for those of us dealing with the challenges of PCOS. Each method has its pros and cons, and what works for one person may not work for another and above all else, it’s essential to consider your unique needs, preferences, and skin type when deciding which method to pursue.

In our next post, we’ll explore the technology behind LBHR, how it works, and why it may be a more suitable option to manage the excessive hair growth that all too often accompanies PCOS. 

Until next time,

L ᥫ᭡

References:

Fazel, Z., Majidpour, A., Behrangi, E., Fathizadeh, S., Nokandeh, M., Atefi, N., & Ghassemi, M. R. (2020). Using the hair removal laser in the axillary region and its effect on normal microbial flora. Journal of Lasers in Medical Sciences, 11(3), 255-261. https://doi.org/10.34172/jlms.2020.43

Ibrahimi, O. A., Avram, M. M., Hanke, C. W., Kilmer, S. L., & Anderson, R. R. (2011). Laser hair removal. Dermatologic Therapy, 24(1), 94-107. https://doi.org/10.1111/j.1529-8019.2010.01382.x

Kang, C. N., Shah M., Lynde C., & Fleming P. (2021). Hair Removal Practices: A Literature Review. Skin therapy letter, 26(5), 6-11. https://pubmed.ncbi.nlm.nih.gov/34524781/

Kintz, P., Salomone, A., & Vincenti, M. (2015). Hair analysis in clinical and forensic toxicology. Academic Press.

Li, M., Bai, Y., Duan, Z., Yuan, R., Liu, X., Liu, Y., Liang, X., Wu, H., & Zhuo, F. (2022). Efficacy and safety of long-pulsed 755-nm alexandrite laser for keratosis Pilaris: A split-body randomized clinical trial. Dermatology and Therapy, 12(8), 1897-1906. https://doi.org/10.1007/s13555-022-00771-5

Marks, D. H., Hagigeorges, D., Manatis‐Lornell, A. J., Dommasch, E., & Senna, M. M. (2019). Excess hair, hair removal methods, and barriers to care in gender minority patients: A survey study. Journal of Cosmetic Dermatology, 19(6), 1494-1498. https://doi.org/10.1111/jocd.13164

Natarelli, N., Gahoonia, N., & Sivamani, R. K. (2023). Integrative and mechanistic approach to the hair growth cycle and hair loss. Journal of Clinical Medicine, 12(3), 893. https://doi.org/10.3390/jcm12030893

Snast, I., Kaftory, R., Lapidoth, M., & Levi, A. (2021). Paradoxical Hypertrichosis associated with laser and light therapy for hair removal: A systematic review and meta-analysis. American Journal of Clinical Dermatology, 22(5), 615-624. https://doi.org/10.1007/s40257-021-00611-w

[shiningthroughpcos]

Llamas-Molina, J. M., Carrero-Castaño, A., Ruiz-Villaverde, R., & Campos, A. (2022). Tissue engineering and regeneration of the human hair follicle in Androgenetic alopecia: Literature review. Life, 12(1), 117. https://doi.org/10.3390/life12010117

Infographic created by L.S on Canva 2024.

[shiningthroughpcos]

Clinic Spots Holistic Healthcare. (2016). Comparison of Hair Removal Methods [Image ]. https://www.clinicspots.com/blog/laser-hair-removal-process-in-india

[shiningthroughpcos]

Understanding Hirsutism: How PCOS Affects Hair Growth

Hello again, and welcome back to Shining Through PCOS! Today we’re continuing a topic that resonates deeply with many of us living with Polycystic Ovarian Syndrome (PCOS)—hirsutism—and how our hormone imbalances contribute to this challenging symptom.

The Hormonal Connection to Hirsutism

Hirsutism, the growth of coarse, dark hair in areas where men typically grow hair, is one of the most distressing symptoms of PCOS. While it’s not uncommon for women to experience unwanted hair growth at some point, for those of us with PCOS, it often feels like a relentless battle against our own bodies. Understanding the underlying hormonal imbalances can help us navigate this challenge with more compassion for ourselves.

Previously, we discussed how some of the conditions we deal with as a result of PCOS overlap. At the heart of hirsutism in women with PCOS are elevated levels of androgens, often referred to as “male hormones.” While everyone has these hormones to some degree, women with PCOS typically have higher-than-normal levels (Rizvi et al., 2023). This hormonal imbalance is primarily due to something called insulin resistance, a condition where the body’s cells become less responsive to insulin, leading to higher levels within the bloodstream (Barber et al., 2019). Elevated insulin can stimulate the ovaries to produce more androgens, which in turn contributes to symptoms like hirsutism, acne, and irregularities in ovulation (Rosenfield & Ehrmann, 2016).

Understanding the Role of Androgens

Androgens play a crucial role in hair growth, but not in the way we might hope. In women with PCOS, the overproduction of hormones like testosterone can lead to the development of male-pattern hair growth (Mihailidis et al., 2015). Common areas for hirsutism include the face, chest, and back, making it a source of significant emotional distress for many of us (Mihailidis et al., 2015).

I remember grappling with so much embarrassment over the abundance of body hair I dealt with as a child. I felt perpetually frustrated and humiliated in my own skin. It’s a tough battle to handle feelings of inadequacy, especially at a young age when you’re not only worried about your self-perception but also how others perceive you. Many people may tell you it’s “just body hair,” but they underestimate the toll it can take. It affects how you perceive yourself, deprives you of your femininity, and impacts your ability to relate to others and feel a sense of normalcy and autonomy. It’s so much more than just hair.

For many women, including myself, it goes beyond mere appearance; it’s about how we feel in our skin. The pressure to meet certain beauty ideals can lead to feelings of shame and isolation, particularly in visible areas where hair growth can’t be ignored. It's vital to remember that these feelings are valid, and seeking support—whether through friends, family, or professional help—can be an important step in managing the emotional toll of PCOS.

Finding Hope in Treatment Options

While hirsutism can be a challenging aspect of living with PCOS, the good news is that effective treatment options are available. Laser-Based Hair Reduction (LBHR) has emerged as a popular choice for many women looking to manage excess hair growth. However, it’s essential to remember that LBHR targets the symptoms, not the underlying hormonal imbalance. Combining this treatment with lifestyle changes and, in some cases, medications like anti-androgens can create a more comprehensive approach to managing hirsutism (Narang et al., 2018).

As a student dermal clinician, I believe it is crucial for service providers to be as transparent as possible. While LBHR is an excellent treatment for addressing the rate of hair growth, length, and density, it is not a simple fix. It becomes even more complex with how LBHR is marketed as “permanent removal” when it is, in fact, “permanent reduction.” This requires a multidisciplinary approach, which can be a lengthy process. Providers must understand when a client needs this comprehensive approach and when to refer patients for aspects of a condition that may be outside our scope of practice.

Unfortunately, patients are often taken in without understanding the complexity of their condition and are not encouraged to seek medical advice regarding their hormonal levels. It’s essential for providers to discuss all aspects of PCOS instead of offering LBHR as a mere band-aid solution.

In future posts, we’ll delve deeper into these treatment options, discussing their benefits and limitations while emphasising the importance of a tailored approach for each individual.

L ᥫ᭡

References

Mihailidis, J., Dermesropian, R., Taxel, P., Luthra, P., & Grant-Kels, J. M. (2015). Endocrine evaluation of hirsutism. International Journal of Women's Dermatology, 1(2), 90-94. https://doi.org/10.1016/j.ijwd.2015.04.003

Narang, G. S., Jasleen, J., Kaur, J., & Kaur, T. (2018). Cutis vertices gyrate: A case report. International Journal of Contemporary Pediatrics, 5(4), 1693. https://doi.org/10.18203/2349-3291.ijcp20182592

Rizvi, M., Islam, M. A., Aftab, M. T., Naqvi, A. A., Jahangir, A., Ishaqui, A. A., Iqbal, M. Z., & Iqbal, M. S. (2023). Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students. PLOS ONE, 18(5), e0285284. https://doi.org/10.1371/journal.pone.0285284

Rosenfield, R. L., & Ehrmann, D. A. (2016). The pathogenesis of polycystic ovary syndrome (PCOS): The hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocrine Reviews, 37(5), 467-520. https://doi.org/10.1210/er.2015-1104

[shiningthroughpcos]

Hi, I just wanted to say that I think this is a really great topic to write about. It made me look up PCOS on here and I realised there isnt much info at all 💜

Hi!! Thank you for reading I really realllyyyy appreciate it 🫶🏼 I was looking myself after I posted my first intro post and realised the same thing. I was hoping to find an infographic, or even some personal stories on here to repost but sadly I couldn’t find much at all. Hopefully I can post some on here to change that.

[shiningthroughpcos]

It's PCOS awareness month!

[shiningthroughpcos]

A PCOD and PCOS diet plan emphasizes balanced nutrition to manage symptoms and improve hormonal health. It includes high-fiber foods like whole grains, fruits, and vegetables, along with lean proteins and healthy fats. Reducing processed foods and refined sugars helps control insulin levels, while anti-inflammatory foods, such as berries and fatty fish, support overall health and weight management.