A practice that has been growing since the 2000s
Intense pulsed light (IPL) hair removal devices saw rapid growth in the mid-2000s. Whether they are used by professionals – dermatologists, aesthetic doctors, operators acting under the responsibility of doctors, beauty salons – or private individuals, the principle is the same: the hair and hair bulb are destroyed by heat.
The light emitted by the device targets the melanin in the hair follicle, which determines the hair colour, while minimising the energy deposited in nearby tissues (the skin) to avoid burns. However, the amount of energy deposited in the hair follicle and the skin respectively is dependent not only on the characteristics of the device, but also on the characteristics of the individual (skin colour, contrast between the skin and hair colour, specific sensitivities, etc.).
A technology with numerous potential adverse effects
These devices are not harmless to health. Most of the time, the potential effects are minor: pain, erythema, a burning sensation, etc. Blisters or scabs can also appear as a result of using these devices. However, if misused, IPL hair removal can cause more serious effects such as pigmentation disorders and eye damage. These practices could also lead to delayed diagnosis of skin cancer, as the IPL could alter the colour of precancerous lesions, preventing the early detection of melanoma.
Include IPL systems in the regulations on medical devices
In practice, IPL hair removal was developed by certain professionals outside the legal framework defined by a 1962 decree (in French). This stipulates that hair removal by any means other than wax and tweezers may only be practised by medical doctors. As early as 2016, ANSES had highlighted the existence of an inconsistent regulatory situation, since beauty salons are able to use these devices to administer photorejuvenation treatments. More recently, rulings by the French Council of State (2019) and the Court of Cassation (2021) limited the scope of this exclusivity to medical doctors.
"Individuals and certain professionals may not know or fully understand the operation and principles of interaction with the skin. It is therefore necessary to better regulate the market for these devices and the use of this technology, in order to limit the adverse effects," explains Rémi Poirier, who coordinated ANSES's expert appraisal.
The new European Medical Device Regulation, which came into force on 26 May 2021, also covers non-medical cosmetic devices. This text now makes it possible to regulate IPL hair removal devices, which were not previously subject to any specific regulations.
In ANSES's view, the placing of these products on the market should be conditional on compliance with the same provisions as for medical devices using equivalent technologies such as laser. "Prior to marketing, manufacturers should be required to conduct tolerance studies that are as rigorous as those carried out for medical devices, in order to control the health risks," explains Rémi Poirier.
Offer a common core of training for professionals
There is currently wide variability in the training levels of the professionals who use these devices in the beauty sector. "In fact, there is currently no obligation in this area, and this is why the Agency recommends establishing a specific training framework for the use of these devices," says Rémi Poirier. According to the Agency, beauty professionals should be offered a common core of training that would enable them to acquire skills such as the ability to identify situations where a prior dermatological diagnosis is needed.
Contraindications and best practices to be followed
The Agency recommends that manufacturers of IPL devices intended for non-professionals provide users with better information on the contraindications and precautions to be taken before any hair removal.
As a reminder, IPL hair removal is not recommended in the following cases:
presence of any skin abnormality (relief, texture or colour) or disease affecting the skin, such as a history of skin cancer, psoriasis, herpes or a history of herpes on the area to be treated;
- in individuals taking photosensitising or anticoagulant medication;
- if any product (cosmetics, including self-tanners, essential oils, "natural" products, etc.) has been applied to the area to be treated;
- unsuitable skin colour or hair type: albino people, depigmented hair, downy hair, etc.;
- in individuals exposed, before or after hair removal, to natural or artificial UV light. In the case of exposure prior to hair removal, the hair removal treatment should not be carried out until the skin has regained its natural colour. Following hair removal, skin should not be exposed to UV light until any skin damage caused by the IPL has healed;
- for removing eyebrows, because of the risk of damage to the eye;
- in individuals under the age of 15;
- in individuals who are pregnant, breastfeeding or taking hormonal treatments likely to modify hair growth;
- if there is a tattoo on the area to be treated.
In addition, whether the device is used by a professional or at home, users are recommended to:
wear protective glasses;
- avoid removing hair from areas close to the eyes;
- shave the area to be treated beforehand and wash it with ordinary soap;
- avoid using any anaesthetic during an IPL session;
- avoid exposing the same area to the IPL beam more than once during the same session
- leave at least one month between sessions.