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Key Takeaways
- Laser hair removal for hidradenitis suppurativa may help reduce flares, particularly when treatment begins earlier in the disease process before significant tunnels have formed.
- My own HS flares became smaller and less frequent during laser treatment and eventually stopped in the areas that were treated.
- Nd:YAG and Alexandrite lasers currently have some of the strongest evidence specifically for HS, so the type of laser matters.
- Laser hair removal is NOT a root cause treatment. It may help control flares in a treated area without addressing the underlying inflammatory picture associated with HS.
- Treatment may require multiple sessions, often spaced several weeks apart, rather than being a one-and-done procedure.
- Insurance coverage remains challenging, but the HS Foundation offers a prior authorization template that your dermatologist may be able to submit to support medical necessity.
Have you ever been nervous to tell someone that you have hidradenitis suppurativa (HS)?
I have.
HS isn’t exactly something you casually bring up over dinner. The flares can be incredibly painful, and depending on where they show up, you may feel embarrassed or uncomfortable talking about them, let alone showing someone what’s happening.
For years, my HS flared in my armpits. And like so many people with this condition, I mostly suffered in silence.
Then, during a trip to Boulder, Colorado, I finally opened up to a friend about what I was dealing with. To my surprise, she told me that she had HS too.
Her flares were along her jawline, making them much harder to hide than mine. She’d done a ton of digging into possible options and mentioned something I’d never heard suggested for HS before:
Laser hair removal.
I was skeptical.
But that conversation ultimately led me to the treatment that made a bigger difference in my HS flares than anything else I’d tried.
That doesn’t mean laser hair removal for hidradenitis suppurativa works for everyone. And there’s something else I want to make crystal clear from the beginning:
Laser hair removal is not a root cause fix for HS.
But if you’re struggling with painful, recurring flares and you’re an appropriate candidate, it may be an option worth discussing with your dermatologist.
And today, we know considerably more about who may benefit, the types of lasers used for HS, and why the stage of your disease matters than I knew when I started treatments about ten years ago.
So let’s dig in.
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In This Episode:
- The unexpected conversation that led me to the treatment that finally stopped my armpit HS flares
- Why the stage of your Hidradenitis Suppurativa (HS) could determine whether laser hair removal is worth considering
- The two types of lasers to ask your dermatologist about before booking anything
- The most current guidelines for laser hair removal for hidradenitis suppurativa
- What insurance companies still get frustratingly wrong about this HS treatment
- Is laser hair removal for hidradenitis suppurativa a root cause treatment?
Quotes
“Don’t just Google “laser hair removal near me” and book an appointment. The laser used for HS has to be a specific type.”
“Insurance companies still may classify laser hair removal as cosmetic, despite the fact that someone is seeking it specifically for HS relief.”
Links
FREE WORKSHOP: Hidden Gut-Skin Triggers
Need more help? My virtual clinic is here to help you!
Healthy Skin Show ep. 103: Hidradenitis Suppurativa: The Tip That Stopped My Flares
Efficacy of laser hair removal in hidradenitis suppurativa: A systematic review and meta-analysis
Laser hair removal for HS: How does it work?
Laser Hair Removal for Hidradenitis Suppurativa | The Expert Weighs In
HS Foundation Prior Authorization Insurance Coverage Form for Laser Hair Removal
425: Laser Hair Removal for Hidradenitis Suppurativa: The Treatment That Finally Stopped My HS Flares
When my friend first told me about laser hair removal, I’ll admit that it sounded pretty random. Why would removing hair help an inflammatory skin condition? And if this was a legitimate option, why hadn’t anyone mentioned it to me before?
Still, I trusted her. So when I returned home, I brought it up with my dermatologist. Thankfully, they were willing to try it with me.
I began going in approximately every four to six weeks for laser hair removal sessions specifically targeting my armpits, because that’s where my HS flared.
Then I started noticing something: If I did have an HS flare between treatments, it was smaller. The flares also became less frequent with each treatment.
And eventually, they stopped in those treated areas.
I believe I ultimately had around six sessions, and that was about ten years ago. My experience was incredibly positive. But if I were making the same decision today, there are several things I would want to know first. Because our understanding of hidradenitis suppurativa laser treatment has continued to evolve.
What Stage Is Your Hidradenitis Suppurativa?
One of the biggest factors to consider before pursuing laser hair removal for HS is how far your condition has progressed.
HS is generally divided into three clinical stages known as Hurley stages.
- With Hurley stage 1, you may experience bumps, tenderness, and occasional flares, but tunnels haven’t yet formed beneath the skin.
- Hurley stage 2 involves recurring abscesses, scarring, and some tunnel formation.
- By Hurley stage 3, there may be widespread, interconnected tunnels and abscesses throughout an affected area.
And those tunnels matter when we’re talking about laser hair removal.
The evidence we currently have suggests that laser hair removal tends to work best earlier in the disease process, ideally before significant tunneling has developed.
Why?
Because once tunnels form beneath the skin, they can make it more difficult for the laser to effectively reach the hair follicles we’re trying to target.
That doesn’t necessarily mean someone described as Hurley stage 2 couldn’t benefit. Some stage 2 cases may have minimal tunneling.
This is exactly why you need an experienced dermatologist to evaluate your skin rather than trying to determine candidacy based on something you read online.
Which Laser Hair Removal Is Best For HS?
Here’s another incredibly important detail:
Don’t just Google “laser hair removal near me” and book an appointment.
Laser hair removal for hidradenitis suppurativa isn’t the same thing as getting cosmetic hair removal at your local med spa.
Historically, laser-based HS treatments have included CO2 lasers, which have been used for decades and may also be used in more advanced disease. But this is a more invasive approach and isn’t the same thing as the hair-removal treatment I’m discussing here.
When it comes specifically to laser hair removal for HS, two options discussed in the newer research have particularly important evidence behind them:
- Nd:YAG lasers
- Alexandrite lasers
So if you’re considering laser hair removal for HS, that’s a conversation to have directly with your dermatologist. Ask what laser they use. Ask whether they have experience treating hidradenitis suppurativa with it. And ask whether you’re an appropriate candidate based on your disease stage and the amount of tunneling present.
The device matters. Your disease stage matters. And the experience of the person treating you matters.
Can Laser Hair Removal Trigger an HS Flare?
Here’s something else that’s changed since I went through treatment.
Dermatologists may now consider using some form of medical therapy alongside laser treatment, particularly to help reduce the possibility of triggering a flare when treatment begins.
Depending on the individual, that could include an antibiotic, spironolactone, or another appropriate medical treatment.
That doesn’t mean everyone needs medication with laser hair removal. It means this is another important question to bring to your dermatologist:
“Based on my HS, do you recommend any medical therapy alongside laser treatment to reduce my risk of flaring?”
Remember, you’re treating skin that’s already prone to significant inflammation. This is why I don’t recommend approaching HS laser treatment like a cosmetic procedure you simply schedule on your lunch break without talking to someone who understands the disease.
How Many Laser Hair Removal Sessions Does HS Require?
Another thing that’s changed is how many treatments someone may need.
Older recommendations often referenced approximately three sessions spaced four to six weeks apart. Current approaches may involve closer to four to eight sessions, sometimes more depending on the individual.
In my case, I believe I had six. But your treatment plan may look different. What I think is more important than focusing on a magic number is understanding that this is a process.
My HS didn’t disappear after the first treatment. Instead, I watched the pattern change. The flares became smaller. Then less frequent. And eventually, in my case, they stopped.
Here’s The BIG Caveat: Laser Hair Removal Isn’t A Root Cause Fix
This is the part of the conversation I don’t want you to miss.
Because if you’ve lived with HS for years and I just told you that my flares eventually stopped after laser hair removal, it’s understandable to think: “THAT’S IT. That’s what I need!”
Maybe it could help you. And if it does, I will genuinely celebrate that with you. Pain relief matters. Being able to move your arm without an angry lesion rubbing against your clothing matters. Not worrying about another flare showing up matters. Feeling comfortable participating in your life again matters.
We don’t need to dismiss symptom relief simply because something isn’t addressing a root cause.
But symptom control and root cause work aren’t the same thing.
Laser hair removal can help address flares occurring around the hair follicle and sebaceous gland in a specific treated area.
What it doesn’t necessarily answer is:
Why is your body producing this level of inflammation in the first place?
That’s still an important question.
And you don’t have to choose between the two.
You deserve relief now AND the opportunity to ask deeper questions about why this is happening.
What Does Root Cause Work For HS Look Like?
I want to be careful here because no single “HS root cause” applies to everyone.
And I don’t want you walking away from this article believing that you need to run out and buy a particular supplement, eliminate another food, or follow someone else’s protocol.
Your case is your case.
But if you’ve only focused on controlling what you see on your skin, there may be a bigger inflammatory picture worth investigating.
That’s one of the reasons I’m so passionate about helping people stop thinking about chronic skin problems as something that exists completely separately from the rest of the body.
And I’ve seen what can happen when someone begins looking at their individual picture more deeply.
One woman, KB, went through my Skin Rash Rebuild program while struggling with HS.
She shared that…
Remember, this is KB’s individual experience and outcome, not a promise of what will happen for everyone who goes through the program.
But I think her experience illustrates something important: There can be value in looking beyond what’s happening at the surface. That’s true whether laser hair removal works beautifully for you, helps somewhat, or isn’t appropriate for your particular case.
Will Insurance Cover Laser Hair Removal For Hidradenitis Suppurativa?
This part still frustrates me.
I paid out of pocket for my treatments.
And even today, insurance companies may classify laser hair removal as cosmetic, despite the fact that someone seeking it specifically for HS isn’t doing so because they simply don’t want body hair.
They’re trying to manage a painful chronic inflammatory skin condition.
Fortunately, there’s a resource I didn’t have when I went through treatment.
The Hidradenitis Suppurativa Foundation offers a prior authorization template specifically for laser hair removal that healthcare professionals can use when seeking insurance approval. (See the show notes above for the link to the form!)
Submitting the form doesn’t guarantee your insurance company will cover it. But it gives you and your dermatologist a resource to help make the case that you’re requesting this treatment for medical necessity rather than cosmetic purposes.
Questions To Ask Your Dermatologist About Laser Hair Removal For HS
If you’re thinking about trying this, don’t feel like you need to walk into your appointment already knowing everything.
But I would bring a few questions with you:
- What Hurley stage is my HS, and how much tunneling do I currently have?
- Based on my disease stage, am I a good candidate for laser hair removal?
- Which type of laser would you recommend for my HS?
- Do you offer Nd:YAG or Alexandrite laser treatments?
- How much experience do you have using laser hair removal specifically for hidradenitis suppurativa?
- How many sessions would you anticipate in my case?
- Should we consider medication alongside treatment to reduce my risk of flaring?
- Will your office submit a prior authorization request to my insurance company?
- What should I realistically expect laser hair removal to improve, and what is it unlikely to change?
Bring the HS Foundation prior authorization template with you, too. You may learn about that resource before your doctor’s office does.
What I Want You To Remember
I spent years quietly dealing with hidradenitis suppurativa before one conversation with a friend introduced me to something I’d never heard about. Laser hair removal. I was skeptical.
But for me, the flares in my armpits became progressively smaller and less frequent with treatment until eventually they stopped. That was my experience. It doesn’t mean you’ll have the same result.
But if you have earlier-stage HS without significant tunneling, I think laser hair removal is absolutely worth discussing with a dermatologist who understands HS and has experience using the appropriate lasers.
And if it works? Let yourself celebrate that win.
You don’t have to diminish meaningful relief because a treatment isn’t addressing everything underneath.
At the same time, remember that fewer flares in one treated area don’t necessarily tell us why your body developed this inflammatory pattern in the first place.
Those are two different questions. And I believe both deserve answers.
Want To Understand What’s Driving The Inflammation Underneath?
If you’re managing your HS flares but still feel like no one has helped you understand why your body is doing this in the first place, that’s exactly the conversation I want to continue with you.
In my free Hidden Gut Skin Triggers webinar, I’ll show you some of the overlooked connections between your gut, immune system, and chronic inflammatory skin symptoms that may help you start seeing your health through a very different lens.
This isn’t about replacing your dermatologist or telling you to stop treatments that are helping.
And it’s definitely not about handing you another giant list of foods to eliminate.
It’s about helping you ask important questions about the inflammatory picture happening underneath your skin, so you’re not just chasing the next flare.
If you’re ready to stop guessing and start connecting the dots, save your spot for my free Hidden Gut Skin Triggers webinar.
More than 4,000 people have already gone through this training, and I’d love for you to join us.
Frequently Asked Questions: Laser Hair Removal for Hidradenitis Suppurativa
Does laser hair removal help hidradenitis suppurativa?
Laser hair removal may help reduce hidradenitis suppurativa (HS) flares, particularly when used earlier in the disease process before significant tunnels have formed beneath the skin. In my own experience, my HS flares became smaller and less frequent with each laser treatment until they eventually stopped in the treated areas.
That said, results vary, and laser hair removal doesn’t work for everyone. Talk with a dermatologist experienced in treating HS to determine whether you’re a good candidate.
What is the best laser hair removal for hidradenitis suppurativa?
The Nd:YAG and Alexandrite lasers currently have some of the strongest evidence for laser hair removal specifically for HS. That’s why you shouldn’t assume that any laser hair removal provider or device will offer the same potential benefits.
Before scheduling treatment, ask your dermatologist which laser they use and whether they have experience using it specifically for hidradenitis suppurativa.
What stage of hidradenitis suppurativa responds best to laser hair removal?
Laser hair removal tends to work best with earlier-stage HS before significant tunneling has developed. This is often associated with Hurley stage 1, although some people with Hurley stage 2 and minimal tunneling may potentially still benefit.
Once extensive tunnels have formed beneath the skin, laser hair removal can become less effective because those tunnels can interfere with reaching the hair follicles being targeted.
How many laser hair removal sessions are needed for hidradenitis suppurativa?
Treatment plans vary, but current approaches may involve approximately four to eight laser hair removal sessions, and some people may need additional treatments. Sessions are often spaced about four to six weeks apart.
I personally believe I had around six sessions. My improvement was gradual, with flares becoming smaller and less frequent before eventually stopping in the treated areas.
Can laser hair removal cure hidradenitis suppurativa?
Laser hair removal should not be considered a root-cause cure for HS. It may meaningfully reduce or even eliminate flares in a particular treated area for some people, but that doesn’t necessarily address the underlying inflammatory factors contributing to the disease.
Can laser hair removal cause an HS flare?
Because you’re treating skin already prone to inflammation, discuss this with your dermatologist before starting. Dermatologists may consider using medical therapy alongside laser sessions in some cases to help lower the risk of flaring when treatment begins.
Ask your dermatologist whether an antibiotic, spironolactone, or another medical treatment might be appropriate alongside laser therapy based on your individual case.
Does insurance cover laser hair removal for hidradenitis suppurativa?
Unfortunately, insurance companies may still classify laser hair removal for HS as a cosmetic procedure, so coverage can be challenging.
However, the Hidradenitis Suppurativa Foundation offers a prior authorization template that your dermatologist can use to request insurance coverage based on medical necessity. Approval isn’t guaranteed, but it’s a valuable resource to share with your doctor. We’ve linked that form for you in the show notes for this episode.
Should I see a dermatologist before trying laser hair removal for HS?
Yes. Don’t simply book cosmetic laser hair removal at the first place you find online. Your dermatologist can assess your Hurley stage, determine whether significant tunneling is present, discuss which laser is appropriate, and decide whether additional medical treatment should be used alongside your laser sessions.
Ideally, look for someone who understands hidradenitis suppurativa and has experience using laser hair removal specifically for HS.
