Ehsan is right: the biggest risk is a burn (and resultant hyperpigmentation or hypopigmentation).
Fifteen years ago when I started offering laser hair removal, the lasers were frightfully expensive and much slower than today's devices. Consequently, treatments were much more expensive as well, and so patients were desperate to get as much hair removed as possible, every time, in order to get their result in as absolutely few treatments as possible and control their costs.
There was pressure, therefore, to “turn up” the laser energy level. Which meant, consequently, that energy levels used were close to risking a burn.
Today, treatments are vastly less expensive, and the devices faster. There is less imperative to drive the lasers or IPLs to their highest energy levels for absolutely maximum effect every time. There is much more emphasis on treatment tolerability and safety.
Consequently, far fewer burns occur.
At my practice, we do laser and IPL hair removal *without anaesthetic cream*. Anaesthetic cream masks the patient's perception of the treatment (naturally!), and thus stops them from telling the therapist if the energy level seems too high. It is almost impossible to burn a patient if the treatment is patient-perceived as comfortably performed without anaesthetic cream.
Secondly, we aim for the treatment to be perceived at about 4 or 5 out of 10 on a 10 point pain scale. For if a patient has a laser or IPL treatment and feels nothing happening, there's nothing happening! So they must feel *something*. But it should be well tolerable.
Thirdly, in the case of treating an anxious or sensitive patient, we use Entonox. This relaxes the patient and diminishes their sense of discomfort without stopping them from telling us what they are feeling. Most patients love it, and are grateful.
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