Pain and Discomfort

There are few studies in which pain from laser treatments have been evaluated exclu­sively. Because pain is subjective, the degree of such a sensation can be quite arbitrary. Nonetheless, like erythema, pain or discomfort is a common adverse event associated with nonablative laser treatments. In one study, pain produced by alexandrite and diode lasers was compared [117]. In the same study, the size of the treatment area was evaluated. The larger the treatment area the more there was pain, when the diode laser was compared to the alexandrite in this study. However, it should be noted that the outcome was not as clear – cut as the authors conclude. Alster et al. [118] evaluated hair removal in skin types IV-VI, and reported a high incidence of discomfort/pain in these 20 female subjects using a long – pulsed Nd:YAG laser. For hair removal, the site of application plays a role in the discomfort associated with the procedure. For example, there are areas such as bikini lines and along the shin bone that are sensitive to laser hair removal. In addition, IPL can be more painful because of lower selectivity and higher energy requirement for efficacy [119]. There are interventions used to reduce the discomfort with laser procedures, including cooling, use of topical anesthetic creams, and flattening the treatment area, which are discussed in greater detail.