IPL Facial Laser Hair Removal in Transgender Patients: A Four-Year Retrospective Review

Laser hair removal (LHR) is an essential gender-affirming procedure for transgender patients, yet limited data exist on its safety and tolerance in this population. This study evaluates treatment parameters, outcomes, and side effects of intense pulsed light (IPL) LHR in a large cohort of transgender patients.

A retrospective cohort study was conducted on 115 transgender patients treated at tertiary dermatology laser center in the United Kingdom between December 2020 and March 2024. The study included transgender patients, aged 18 and over, who had received at least one treatment of LHR. Patient demographics, laser settings, treatment outcomes, and adverse effects were extracted from electronic records.

The average patient age was 34 years (20-73). Fitzpatrick skin types 2 (46%) and 3 (29%) were most common, with brown hair (67%) being the predominant hair color. Fourteen patients had previous electrolysis and 90 patients were on hormone therapy. All patients were treated with IPL device, with the most common wavelength being 695 nm (75%). The typical fluence used ranged from 19 to 21 J/cm², with 20 J/cm² (25%) being the most common. Visual analog scores (VAS) for pain averaged 5 during treatment, peaking at the third session (VAS 7). Thirty-five patients (30%) required additional test patches, with subsequent change in settings. Common expected side effects included redness (70%), perifollicular swelling (56%), and burning hair odor (53%), with no scarring or burns reported. Fifty-nine patients completed the treatment, requiring an average of eight treatments (4-13), and 52 patients remaining under follow-up.

This large retrospective study reports the safety and tolerance of IPL facial LHR as a gender-affirming procedure in a real-world transgender patient cohort, and highlights the common treatment parameters used in our population. The study emphasizes the need for personalized laser settings, close monitoring, and future research on quantitative efficacy and standardized treatment protocols to improve effectiveness and improve safety for transgender patients undergoing LHR.