Recent developments in laser technology have made dermatologist-directed laser hair removal efficient, virtually pain-free, and generally safe for a large proportion of the general public. Laser hair removal is an in-demand, out-of-pocket procedure that appeals not only to cosmetically inclined patients but also to individuals with an otherwise limited interest in cosmetic procedures, including athletes and some men. It has appeal across a range of ages and is appropriate for teens and adolescents to patients in mid-life. And yet many dermatologists do not offer laser hair removal in their practices, surrendering this service to local medspas and non-core specialists. This tactic may be unwise for practices individually and for the specialty in general, as it undervalues our expertise and relinquishes revenues that could benefit dermatology practices. Laser hair removal continues to be an opportunity for appropriate dermatology practices and deserves renewed consideration.

Early Experience

My experience with laser hair removal began in my earliest days of practice, in an office that leased a laser for several days each month. There was significant interest in laser hair removal, and the practice reaped revenues from the service. However, the practice also lost out on some revenue opportunities by not having a device available every day. Patients could rarely be treated on the day they presented and sometimes had to book several weeks in advance in order to have access to the laser.

When I opened my own practice, I knew that laser hair removal was still popular and that patients needed access to safe and effective dermatologist-directed laser hair removal. I decided I would offer laser hair removal and purchased my own laser in order to meet patient demand. I selected the Soprano XL diode laser (Alma Lasers), and am pleased with the selection. It is suitable for use on most skin types and allows for rapid treatment. There are other good systems on the market, and practices should research to determine which device best meets the needs of their practice.

I have never regretted the decision to offer laser hair removal, and I feel strongly that dermatologists can successfully integrate laser hair removal into their practices, despite growing competition from non-core specialists and from non-physician providers, like medspas and salons. There is sufficient demand for this service that dermatologists in most areas of the country will have a suitable patient base to justify the offering. Additionally, laser hair removal can complement the service offerings of practices at any point on the aesthetic spectrum: It's a basic service for a practice that wants to offer a narrow panel of offerings, but it is a foundational service that can accent even the most advanced cosmetic dermatology services. It is a service that can attract new patients, convert existing ones, and serve as a gateway to other procedures and services.

Attract, Retain, Grow

Given that dermatologists specialize in the management of the skin, hair, and nails, laser hair removal falls naturally within our expertise. Despite wide agreement on this point, some dermatologists seem to inaccurately believe that laser hair removal is not a worthwhile endeavor. They wrongly believe there is too much competition for the service and that it cannot be economically viable.

Suppose a local Medspa is providing laser hair removal for $100 a session. Can you realistically match the price and still break even? Quite possibly. And if patients return to your practice for other medical or cosmetic dermatology needs, that's a good thing. Suppose she or he purchases skincare when presenting to the office for hair removal. What if a friend or family member is interested in other cosmetic procedures? The laser hair removal patient almost certainly has older or younger family members who will need a medical or cosmetic dermatologist, and your patient will likely refer you.

Once the patient gains experience with your practice and sees the high level of care you provide, he or she will become a loyal patient. He or she will be more likely to pay your standard rates for other procedures. By attracting and retaining that low-priced laser hair removal patient, you can now avoid competing on cost for other cosmetic procedures. The patient will realize they are paying not just for a specific filler, but for your expertise and service.

Conversely, patients who come to you for fillers or toxins or other energy-based procedures may be interested in laser hair removal (See Dr. Lima-Maribona's Tip on p. 31). If you are going to inject a patient's face or lips, then you should offer a solution to the unwanted hair on that upper lip. Similarly, if you offer sclerotherapy or laser leg vein treatments, it makes sense to also offer laser hair removal. So many aesthetic practices market fat-reduction devices for a “swimsuit ready” body, so why not provide hair removal, too?

Of course, you could decide not to compete on cost for laser hair removal. Many practices do this rather successfully. Just as you may be willing to pay more for a luxury brand or a top-quality restaurant, patients very often will pay a bit extra for the dermatologist's expertise. A key element of this strategy is marketing yourself as an expert and providing patients an exceptional practice experience.

Your reputation in the area and the word-of-mouth buzz you generate are important. Patients may be willing to pay higher fees to receive treatment at a medical practice rather than at a medspa, especially if your practice is well established in the community and recognized for providing excellent care. Perhaps ironically, one of the ways that I built a loyal patient base in my community was by effectively treating pigmentary irregularities in patients who had undergone laser hair removal treatments at other facilities. Positive testimonials and recommendations from those patients established the perception in the community that I am an effective medical dermatologist dermatologist and that I can provide laser hair removal in a medically-supervised setting that may reduce the risk for adverse events.

Optimizing Time and Resources

Another consideration is who can administer laser services in your practice. In Miami, I am able to deputize my physician assistant to perform laser hair removal. I can assess the patient and devise the treatment protocol that my PA can administer. That frees me up to provide other services in the practice, further increasing our practice revenues.

This is not to suggest that laser hair removal is not viable in a setting where the dermatologist must administer treatment. But it is important to understand and investigate all your options.

My staff members are all trained to discuss practice offerings with interested patients. During the time that the patient is undergoing laser hair removal treatment, the PA can talk to him or her about medical dermatology and/or other cosmetic concerns, encouraging the patient to schedule appropriate follow- up visits. All staff are also very familiar with our dispensed products and can discuss these with patients, as appropriate.

Responding to Demand

My practice has several lasers and devices, and we have found significant demand for many energy-based procedures. We offer IPL, blue light, fat reduction devices, tightening devices, and fractional resurfacing devices. Even though the public may perceive some of these devices and procedures as more “advanced” or as having more “cache value,” laser hair removal remains incredibly popular—among both women and men.

Patients prefer convenience, and the notion of one-stop shopping is very appealing. Offering laser hair removal is one more way to assure you meet patient demand.

As dermatologists practicing in today's healthcare environment, we drive demand of our own. We increasingly seek products and services that enhance our practices, open new revenue streams, and improve the practice bottom line. For many practices, laser hair removal can achieve these goals.

Competition for our services is only going to grow, as noncore specialists face their own economic challenges and nonphysicians spot opportunities. Rather than yield to competition, I encourage dermatologists to continue to assert our expertise and to defend our role as skin and hair specialists. If we relinquish hair removal, what will be next?

Dr. Lima-Maribona is director of Bay Pointe Dermatology & Cosmetic Center in Coral Gables, FL.