Laser Hair Removal for Hidradenitis Suppurativa: How Does it Work?


Given that HS starts from blocked hair follicles, it makes sense that laser hair removal — which destroys the follicles — would be an effective treatment. In studies, this treatment has put some people with HS into remission. However, laser hair removal can be very expensive, and it doesn’t work for everyone.

How effective is it?

In studies, laser hair removal improved HS by 32 to 72 percent after 2 to 4 months of treatment. However, the treatment only seems to work in people with mild disease — those with stage 1 or 2 HS.

One advantage to laser treatment is that it doesn’t cause body-wide side effects like pills do.

Also, people usually have less pain and scarring with laser treatment than they would with surgery.

How does laser hair removal work?

Hair grows from a root at the bottom of hair follicles under your skin. In HS, the follicle becomes clogged up with dead skin cells and oil. It’s not clear why this happens, but it could have to do with genes, hormones, or problems with the immune system.

Bacteria in your skin feast on the trapped dead cells and oil. As these bacteria multiply, they create the swelling, pus, and odors that are typical of HS.

Laser hair removal aims a beam of intense light at the hair follicle roots. The light produces heat that damages the follicles and stops hair growth. When doctors use laser hair removal to treat HS, it seems to improve symptoms.

How many treatments do I need?

The number of treatments you need depends on the size of the area with HS, but most people need three or more treatments to see results. You’ll typically need to wait 4 to 6 weeks in between treatments, depending on the type of laser used.

What kinds of lasers does this treatment use?

A few different types of lasers have been investigated to treat HS. The carbon dioxide laser is a gas laser that emits a powerful beam of light. Doctors have been using this laser since the late 1980s, and it can produce long-term remissions.

The Nd: YAG is an infrared laser. It penetrates more deeply into the skin than other lasers. This type of laser seems to work best for HS, especially in areas of skin with dark and thick hairs.

Intense pulsed light therapy is another light-based treatment for HS. Rather than focus one beam of light, it uses beams of different wavelengths to damage the hair follicles.

Does it work for everyone with HS?

No. Laser hair removal isn’t a good option for people with stage 3 HS. Lasers can’t penetrate into areas of skin where there’s a lot of scar tissue. Plus, the treatment tends to be very painful when HS is advanced.

Lasers work best on people with light skin and dark hair. The laser needs the contrast to distinguish skin from hair, so it’s not ideal for those with blonde or gray hair. For people with darker hair and skin, the long-pulse Nd: YAG laser seems to work most effectively without damaging the skin’s pigment.

What are the risks and downsides?

It’s possible for the laser to irritate the treatment area. This could actually increase inflammation and make the disease worse.

After treatment with the Nd: YAG laser, some people have experienced a temporary increase in pain and drainage, but it doesn’t last for long.

Will insurance cover the cost?

Laser hair removal is considered a cosmetic procedure, so insurance typically won’t cover the cost. The cost can vary widely depending on the number of treatments you need. The average cost of laser hair removal is $285 per session, according to the American Society of Plastic Surgeons.

The takeaway

Laser hair removal seems to improve HS symptoms with few side effects, but studies done so far have been small. More research is needed to confirm that this treatment works.

Laser hair removal has a few downsides. It doesn’t work for everyone, it can take up to eight sessions to see an improvement, and the treatment is expensive and generally not covered by insurance.

If you’re interested in trying laser hair removal, talk to the dermatologist who treats your HS. Ask about the possible benefits and risks. Try hair removal on a small area of skin first to make sure you don’t have a reaction to the procedure.

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