Surgical pearl: tumescent anesthesia reduces pain of axillary laser hair removal.

BACKGROUND We describe the use of tumescent anesthesia before laser hair removal in the axilla to improve patient comfort during treatment. Our modified tumescent technique provides more extensive anesthesia than standard intradermal injections of local anesthetic agents and is less painful to administer. Compared with topical anesthetic creams, tumescent anesthesia has a quicker onset and delivers more complete anesthesia. Hair removal by laser or intense pulsed light sources is a painful procedure, especially in sensitive areas such as the beard, axilla, and groin. Recent trends in laser hair removal (longer pulse durations and wavelengths) offer better treatment of dark skin, but are even more painful. Topical anesthetic creams are commonly used to decrease discomfort, but are slow to act and can bemessy.We have found that axillary injection of tumescent anesthesia is extremely effective for reducing the discomfort of laser hair removal. In addition, the pain of injection into the subcutaneous fat is minimal (compared with the dermis) and, therefore, well tolerated by patients. The technique is quick, safe, and cost-effective, making it an important tool in our practice for a wide variety of procedures, including laser hair removal.