Laser Beard Removal

Dear Doctor Rockoff,

I am a 34 year-old male with light brown skin (I'm half-Mexican).  Shaving has always been the bane of my morning existence because my skin is fairly sensitive while my beard is quite thick in density and extremely thick in the case of the diameter and coarseness of each hair.  After enduring a lot of discomfort and shedding a lot of blood shaving and after spending thousands on different shaving creams, blades, electric razors and prescription products -- I decided to take a more radical approach.  I started laser treatments to remove my beard several months ago.  While the average male undergoing this treatment needs only 3-4 treatments to achieve total beard removal, I have had about 7 treatments -- and counting.  Slowly but surely, at the rate of about 10% at a time, my beard is disappearing, blotch by stubborn blotch.  Apparently, I have the most resilient beard of any of the hundreds of patients ever treated by my laser treatment clincian.

The clinician has expressed surprise at the evidently strange way my skin reacts to the laser treatment.  First, mild but unremarkable redness.  Then after about two days I experience an incredibly prolific outbreak of tiny whiteheads on my face and neck.  After the whiteheads go away (I have to shave for work, unfortunately), my skin takes on a very coarse texture.  Eventually, my skin reverts more or less to normal, except for the blotchy appearance of my beard, which is to be expected.  Do you have any idea why I would break out in this strange way?  My guess is that it's just the heat from the laser?

I also occasionally pick at my face in general -- but particularly during the healing process after a laser treatment. I'm ashamed to say that I agressively picked at what used to be some sort of pimple below the corner of my mouth.  Terrible habit of mine.  This time, I really have learned my lesson because I may have permanently disfigured myself. The result of my picking and peeling and extruding the pimple is now a wart-like bump protruding from the skin. It is slightly light in tone and, again, about the size of a wart (though, mercifully, not quite as "tall" since I drained it of blood during my final attempt to pick at it. It looks a little bit better now since it has stopped scabbing over but now it just looks like a wart and feels somewhat hard. I worry that there is no chance this thing is going away -- especially since it is hard to miss when I shave.  

About 5 years ago I had this same syndrome with a mosquito bite on my calf that a dermatologist ultimately cauterized -- but the freezing only caused a permanent scar (probably my dark skin).  Someone told me about an absurdly expensive, non-prescription cream called "Re Vive" that is supposed to increase Epidermal Growth Factor and correct scarring.  I will try anything at this point since it's been a couple of months now.  I would very much appreciate your general recommendations.

Many thanks, Doctor.

RMS

[Alan Rockoff, MD]

I think you made a wise choice to have laser removal of your beard hair, since that technique is perhaps the only way to eliminate your shaving problems.  Some patients, regardless of skin type, do take quite a number of sessions to achieve clearing.

I can't explain the little whiteheads.  Your suggestion--the heat of the laser--sounds as reasonable as any.  In any case, that is temporary.

As to the bump induced by picking, that too is independent of skin coloring.  Picking can produce a bump made of granulation, or healing, tissue.  That can persist for months, or even longer if you pick at it further out of frustration.  Still, it will dispappear altogether in time, almost without question.

I advise you to apply a Vitamin E-containing cream to the spot daily, and to otherwise leave it alone.  Gradually, over time, the spot will become smoother and lighter and in the end go away.  Estimated time of disappearance: 4-6 months.

Best.

Dr. Rockoff

[RMS]

Thanks very much, Dr. Rockoff.  Your advice is helpful and a comfort.

Best,
RMS