The only way to know if your laser hair removal will be covered by your insurance is to look over your policy and call your provider. If you have a medical condition that produces inconvenient hair growth that has a demonstrated negative impact on your life and a doctor has determined that laser hair reduction is the best course of action, your insurance company may cover the cost of the treatment. An insurance company will only cover laser hair removal if there is a good basis to believe it is a medically required surgery.
Request that your doctor advocate on your behalf to improve your chances of getting your claim granted. A competent medical practitioner is in the best position to offer your insurance company with a compelling argument. For your treatment, make sure you see a doctor that is a qualified laser specialist, such as Dr. Manu Aggarwal. Although laser hair reduction is available in some spas, medspas, and esthetician offices, insurance will only cover the procedure if it is done in a medical doctor’s office, such as the Vein Care Center.
Is laser hair removal covered by insurance with PCOS?
Most people have a hair removal regimen, whether it’s plucking a few stray hairs or shaving the common hair-growing areas. The amount of hair that needs to be removed varies from person to person. Hair removal procedures are not all made equal, and unwanted hair can be both bothersome and embarrassing. Shaving can lead to folliculitis, a skin disorder in which pustules or blisters grow around hair follicles, causing redness and inflammation. Folliculitis can produce scars in extreme circumstances.
Excessive hair growth is common in women with Polycystic Ovarian Syndrome (PCOS). Dark, coarse hair can accumulate in a variety of places on the face and body, causing self-esteem issues, especially in young women going through puberty. Folliculitis and PCOS are both real medical diseases that necessitate the use of laser hair removal (LHR). However, the expense is unlikely to be covered by insurance.
Is laser hair removal covered by health insurance?
Laser treatments are often not covered by most health insurance policies, but they can be negotiated.
How can I reduce my facial hair from PCOS?
Treatment Alternatives
- Birth control pills and anti-androgen meds like Aldactone are examples of medications (spironolactone)
- Swelling, scarring, and skin redness are all possible side effects of electrolysis.
- Hair removal with lasers (this method works best on fair-skinned people with very dark hair)
Does laser hair removal work on face with PCOS?
PCOS (Polycystic Ovarian Syndrome) is a disorder that affects about 10-15% of women. Multiple tiny cysts form along the margins of the ovaries as a result of this condition. In addition, PCOS causes an overabundance of androgen, a male hormone that causes undesirable hair growth on the face, back, chest, lower thighs, and belly. Because of the additional hormones in their bodies, people with PCOS may develop thicker, darker, or abundant body hair.
When it comes to undesirable body hair, women with PCOS have options. In fact, laser hair removal is an excellent therapy option for PCOS sufferers. The procedure might help you get rid of or reduce unsightly body hair. This approach can reduce the need for shaving, waxing, or plucking on a regular basis.
Laser Hair Removal For PCOS
For women who have seen an increase in hair growth due to PCOS, laser hair removal is an effective therapy option. This treatment can not only quickly reduce excess facial and body hair, but it can also provide life-changing benefits for those who are self-conscious as a result of this problem. Typically, people with PCOS would require more laser hair removal sessions to attain their desired results. On average, the body may require 10-12 treatments, while the face may require 12+ sessions.
What To Expect From Results
Laser hair removal helps for PCOS, and many people who have the condition have had fantastic outcomes. Regular maintenance treatments every 12-15 weeks, forever, may be required to maintain a reduction in hair growth. This is especially true when it comes to facial hair development. While laser hair removal does not guarantee permanent hair removal, it does result in hair that is finer, lighter, and slower to recover.
Why So Many Sessions Are Needed With PCOS
Internal hormone imbalances in the body are unaffected by laser treatment. Because laser hair removal operates on the skin’s surface, there are some restrictions to what it can accomplish. Hair growth is continuous and resilient in people with PCOS. The effects must be maintained once a satisfactory reduction in hair growth has been achieved (after a full course of laser sessions). Because each person’s hormone profile is unique, the frequency and number of these treatments will vary. Larger body areas may require fewer maintenance treatments, but facial hair should be maintained every 8 to 12 weeks.
Are You a Candidate For Laser Hair Removal?
A person with a fair skin color and dark body hair is usually the greatest candidate for laser hair removal. Treatments with intense pulsed light (IPL) can be utilized on practically any skin tone. During laser and powerful pulse light treatments, the light is directed at the hair follicle, which absorbs the energy and is destroyed.
How can I get rid of PCOS hair?
Electrolysis is the only method of hair removal that has been recognized by the FDA as a permanent method of hair removal. 1 Electrolysis is an excellent alternative for the hundreds of women with PCOS who want to permanently get rid of thick hair on their face, chest, and back.
Is PCOS treatment covered by insurance?
Insurance coverage is not available: While some health insurance policies exclude fertility treatment, most will at least cover the diagnosis and treatment of underlying conditions that can lead to infertility, such as polycystic ovary syndrome (PCOS), endometriosis, fibroids, and certain male-specific conditions, such as prostate cancer.
Electrology and the Hirsute Polycystic Ovary Syndrome Patient
Ricardo Azziz, M.D., M.P.H., M.B.A., Professor Departments of Obstetrics & Gynecology and Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, and Teresa Petricca, CPE, Executive Director, American Electrology Association, Birmingham, Alabama
Most Hirsuit Patients Have PCOS
Hirsutism is a symptom of underlying androgen excess, also known as hyperandrogenism. As a result, non-androgenic causes of hirsutism (i.e., those not caused by an excess of testosterone) are uncommon, accounting for less than 1% of affected people in our experience. Idiopathic hirsutism (IH) is a more common cause of hirsutism that is diagnosed by excluding a patient who is visibly hirsute but has normal circulating androgens and ovulatory function (2). It should be noted, however, that approximately 40% of hirsute women who claim to be routinely menstruating actually do not ovulate effectively (are oligo-anovulatory), and hence are likely to have PCOS rather than IH (3). In general, between 5% and 15% of hirsute women will be diagnosed with IH (2). However, many of these patients merely have degrees of hyperandrogenemia that are not detectable with normal clinical androgen testing, and this diagnosis may be more symptomatic of “inaccurate” hormonal assays. Nonetheless, the 5? -reductase activity in the skin and hair follicles is likely hyperactive in some of these women, resulting to hirsutism despite “normal” circulating androgen levels.
Androgenic causes of hirsutism are by far the most common, accounting for 75 percent to 85 percent of hirsutism cases. PCOS affects about 70-80 percent of hirsute women, the hyperandrogenic-insulin-resistant-acanthosis nigricans (HAIRAN) syndrome affects about 3%, 21-hydroxylase deficient non-classic adrenal hyperplasia (NCAH) affects 2-8 percent of patients, and ovarian or adrenal androgen-secreting neoplasms (ASN) affects only a small percentage of patients (4). PCOS, the most common diagnosis in the hirsute patient, is essentially an exclusionary diagnostic, meaning that it is identified in patients who have evidence of ovulatory dysfunction in the absence of biochemical or clinical indications of hyperandrogenism, and after other disorders have been ruled out (i.e. NCAH, HAIRAN syndrome, ASNs, thyroid and prolactin dysfunction).
Hormonal Treatment of Hirsutism in PCOS
Hirsutism is not only disfiguring on the outside, but it can also be a substantial hindrance to a young woman’s social life and emotional well-being, lowering her quality of life. As a result, treatment should begin as soon as the diagnosis is confirmed, in order to reduce the number of terminalized hair follicles. Furthermore, because hirsutism is often a symptom of a more serious underlying endocrine or metabolic disease, these patients should be evaluated as soon as feasible. Because the majority of hirsute people have PCOS, they are more likely to experience infertility, irregular monthly bleeding, endometrial cancer, type 2 diabetes, and probably cardiovascular disease.
Hormonal therapy for hirsutism consists of drugs that either reduce or block androgen production or free androgen levels. Combination oral contraceptives, long-acting GnRH analogs, ketoconazole, and insulin sensitizing medications can all be used to decrease ovarian androgens. However, surgery that temporarily suppresses ovarian androgens, such as laparoscopic ovarian drilling, has no effect on hair development. Furthermore, glucocorticoid-adrenal androgen suppression has a minor, if any, influence on hirsutism. Nonetheless, androgen suppression by itself has a minor effect on undesired hair growth.
The majority of women with clinically significant hirsutism will require the addition of androgen-blocking medicines. Spironolactone, flutamide, and cyproterone acetate are examples of androgen receptor blockers (which is also a progestin that suppresses ovarian androgen secretion). Finasteride, in turn, inhibits 5 -reductase and the peripheral conversion of T to DHT, reducing androgen-dependent hair growth. Overall, all androgen-blocking medicines have equal results, hence the most essential factor in choosing patient selection will be adverse effects (5,6). The major goals of hormonal therapy in the treatment of hirsute women are to fix the underlying problem, halt new hairs from developing, and maybe reduce the growth of existing terminal hairs. Although hormone therapy alone can cause hair thinning and loss of pigmentation in terminal hairs, it rarely reverses the process of hair terminalization.
As a result, women with hirsutism must have any residual undesired terminalized hairs mechanically removed.
Mechanical Means of Treating Hirsutism
Many hirsute patients turn to shaving, bleaching, or depilation, which are safe and effective ways to reduce the appearance of undesired hairs with minimal adverse effects. However, plucking and/or waxing in androgenized skin areas should be avoided because these techniques not only do not kill hair follicles, but they also have a high risk of causing folliculitis and hair shaft damage, which can lead to ingrown hairs and further facial damage. Electrology and, perhaps, laser hair removal are two techniques for destroying undesired hair follicles.
However, most studies have been uncontrolled and included fewer than 50 patients, none have been blinded, and all have used a variety of treatment protocols, equipment, skin types, and hair colors investigated. Patients with lighter complexion (Fitzpatrick skin colors I-IV) and dark colored hairs have the best results with laser hair removal. Although full hair loss is unusual, repeated therapies are required, and it is unknown at what point several treatments provide the most benefit. In general, treatment with ruby, alexandrite, or diode lasers, or IPL, yields similar success rates, while the nd:YAG laser’s success rate may be slightly lower. Overall, laser hair removal should not be termed “permanent,” at least not based on existing research, according to the FDA’s position.
Electrology
Electrology is a procedure that has been used for over a century to destroy undesired hair follicles. Electrology is divided into three types. Electrolysis is the use of one or more sterile needles/probes and direct or galvanic current (DC, e.g. from a battery) to achieve chemical destruction of the hair follicle. Thermolysis creates heat by increasing the frequency of alternating current (AC, like with conventional electricity) and delivering it through a single sterile needle/probe, which destroys the hair follicle. The thermolysis current is also known as short wave or high frequency current. Finally, the Blend or dual modality treatment employs both of the aforementioned currents, which are delivered concurrently or sequentially using a single sterile needle/probe to induce dual action hair follicle destruction. The three modalities (multiple needle galvanic, thermolysis, and the Blend) all successfully achieve the goal of eliminating hair-producing cells in the hair follicle.
Dr. Charles E. Michel, known as the “Father of Electrolysis Hair Removal,” was a St. Louis, Missouri opthamologist who spent years researching the best way to remove ingrown eyelashes. In 1875, he stated that by simply introducing a needle charged with negative galvanic current into a hair follicle, he was able to eliminate ingrown eyelashes. Professor Paul M. Kree of New York improved this technique by employing numerous needles in 1916. Professor Kree was instrumental in the rising acceptance of electrolysis as a viable hair removal therapy since his multiple needle approach was significantly faster than the single needle procedure that had previously been employed, though it was still slow by today’s standards.
Dr. Henry Bordier of Paris, France, stated in 1923, about 50 years after Dr. Michel’s research, that hairs may be destroyed by applying high frequency or AC current. Thermolysis was born as a result of this discovery. Unlike manual multiple needle electrolysis, the new thermolysis equipment provided such a high-intensity current that it was timed by an automatic timer. Modified medical diathermy devices were the only high frequency thermolysis equipment available until the late 1930s. These early machines lacked calibrated dials for judging timing and intensity, and humidity and temperature had a significant impact. Thermolysis equipment today is extremely calibrated and precise. The treatment time on some epilators is as short as 1/1000th of a second.
In 1938, Henri St. Peirre and Arthur Hinkle of San Francisco, California, began creating a machine to destroy hair follicles using a mixture of the two currents previously utilized, AC and DC, in an attempt to combine the speed of the AC with the efficiency of the galvanic (DC) approach. Mr. St. Pierre was given a patent for a machine that produced electrology using the Blend modality in 1948.
Electrolysis in the Treatment of Hirsutism
Electrology is recognized by the US Food and Drug Administration (FDA) as a method of permanent hair removal. The FDA defines needle-type epilators as “a device intended to remove hair by damaging the dermal papilla of a hair” in Title 21, CFR, Sec. 878.5350. Only electrologists are authorized to advertise permanent hair removal since no other technology for hair removal has the unique identity of “killing the dermal papilla of a hair.” Other hair removal methods, such as lasers, have not been able to attain this level of detail.
Electrolysis (also known as electroepilation) is the only procedure for permanently removing hair that has been demonstrated to cause long-term hair loss (7,8). Repeated treatments have been found to result in permanent damage (alopecia or hair loss) in 15% to 50% of the hairs treated (9). The amount of treatments required varies from person to person. To attain the best outcomes in the shortest amount of time, it’s critical to stick to the prescribed treatment regimen. While electrolysis is a painless technique, because each hair follicle is surrounded by its own network of nerve endings, it is difficult to remove hair growing tissue without causing discomfort. Despite the fact that some regions of the body are more sensitive than others, changes can be made to keep the treatment comfortable. Some individuals may require the use of topical anesthetics, such as EMLA Cream, prior to treatment (an emulsion of lidocaine 2.5 percent and prilocaine 2.5 percent , Astra-Zeneca Pharmaceuticals LP).
After electrolysis, side effects such as scarring might occur, especially if the procedure is performed incorrectly (10). However, scarring is uncommon nowadays, and when electrolysis is performed by a qualified electrologist using modern equipment and techniques, there should be no obvious skin damage. Years ago, the usage of older galvanic devices caused scarring since the needles were made of unshielded metal, which could cause skin burns. To prevent this from happening, galvanic device needles are now protected (insulated). The safety and effectiveness of needle-type electrolysis have been shown over the course of over a century of use.
It’s also worth noting that electrologists are frequently the first people a hirsute sufferer seeks help from. According to their responses to a standardized questionnaire, 40 percent of 779 consecutive new clients seeking electrology had possible risk factors for hyperandrogenism (11). When a sample group of these at-risk women was tested, almost 20% of them had a hirsutism score of six or above, with PCOS present in more than half of them. Surprisingly, only 26% of at-risk customers who were referred for a free medical evaluation followed through, demonstrating the extent to which hirsute women are unaware of the medical treatment options available to them.
Selecting an Electrologist
The only national organization dedicated to needle electrologists is the American Electrology Association (AEA). The AEA makes a concerted effort to educate its members about PCOS. To get the best and most complete treatment for the hirsute woman, AEA members appreciate the need of developing a rapport and working relationship with endocrinologists and other medical specialists that treat PCOS. Locating an electrologist who is both an AEA member and a Certified Professional Electrologist (CPE) is an useful consumer guide to finding a practitioner who stays current in their area. The electrologist who has earned the CPE designation has passed the AEA’s thorough national testing and has continued to meet the requisite continuing education and/or re-testing requirements. A certificate from the AEA with a current year validation sticker serves as proof of membership. The membership roster is also listed in the AEA Referral Directory.
Third Party Reimbursement of Electrology
Electrolysis treatments are typically not covered by Health Maintenance Organizations (HMOs). Specific stipulations in some insurance contracts, however, may allow electrology patients or consumers to seek payment. Before requesting a letter from your primary care physician, it’s a good idea to check your contract. The letter from the doctor must say that “electrolysis is medically necessary” as part of the overall treatment for the disease (e.g. PCOS, CPT code 256.4; or Androgen Excess, CPT code 256.1). After that, you must send this letter to your insurance company.
Depilatory therapies are already considered “medical care” for insurance purposes, according to a precedent (Abernathy v. The Prudential Insurance Company of America, No. 21178, Supreme Court of South Carolina, March 31, 1980). Plaintiff sued her insurance in this case after it refused to reimburse her for the expense of depilatory procedures (i.e. electrolysis) that her doctor had advised. The policy listed “doctors’ services for surgical operations and other medical care” as “qualifying expenses,” but it also said that “anything not ordered by a doctor or not necessary for medical care of illness” was not covered. The plaintiff’s verdict was upheld by the South Carolina State Supreme Court, which noted that “medical care… must be conducted by or under the guidance of licensed medical personnel.” Furthermore, the court determined that because plaintiff undertook treatments on the advice of her physician, the costs were medically “essential” and thus not barred from coverage under the insurance.
SUMMARY
Hirsutism is not only disfiguring on the outside, but it can also be a substantial hindrance to a young woman’s social life and emotional well-being, lowering her quality of life. Hirsutism is usually a symptom of underlying androgen excess, most commonly PCOS, and its associated morbidity. As a result, the hirsute woman should undergo a complete examination and begin hormone suppressive therapy as soon as the diagnosis is made. Although hormone therapy alone can sometimes cause terminal hairs to shrink and lose pigmentation, it seldom causes undesirable hairs to disappear. Electrology and, perhaps, laser hair removal are two techniques for destroying undesired hair follicles. Long-term data on laser hair removal, however, is still available. Electrology has been in use for over a century and results in the permanent eradication of undesired hair follicles. Electrology is divided into three types: electrolysis, thermolysis, and a combination of both electrolysis and thermolysis. Electrology has been used for over a century, and only electrologists are allowed to advertise permanent hair removal, according to the FDA. Furthermore, it should be noted that electrologists are frequently the first people hirsute patients seek help from, and as such, the electrologist is a vital member of the therapy team caring for these patients. The significance of choosing a well-trained and skilled electrologist, on the other hand, cannot be overstated. Because electrology regulation differs so considerably between states, other techniques of measuring practitioner quality, such as the CPE certificate, become crucial when selecting an electrologist. While third-party reimbursement for electrology is not always available, it is worth investigating this payment option further, potentially with the patient’s physician’s help. Overall, electrology is an efficient and safe way for hirsute PCOS patients to completely remove unwanted hairs.
REFERENCES
- Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. A prospective investigation evaluating the prevalence of polycystic ovarian syndrome in unselected Black and White women in the Southeastern United States. J Clin Endocrinol Metab, vol. 83, no. 3, pp. 3078-3082, 1998.
- R. Azziz, E. Carmina, and M. E. Sawaya. Idiopathic hirsutism is a type of hirsutism that occurs for no apparent reason. Endocrine Reviews, vol. 21, no. 3, pp. 347-362, 2000.
- R. Azziz, W. T. Waggoner, T. Ochoa, E. S. Knochenhauer, and L. R. Boots. In Alabama, idiopathic hirsutism is a rare cause of hirsutism. Fertil Steril, vol. 70, no. 8, 1998, pp. 274-8.
- Sanchez LA, Knochenhauer ES, Gatlin R, Moran C, Azziz R, Gatlin R, Gatlin R, Gatlin R, Gatlin R, Gatlin R, Gat Experience with over 1000 consecutive patients in determining the differential diagnosis of clinically apparent hyperandrogenism. The American Society for Reproductive Medicine’s Annual Meeting, Orlando, Florida, October 20-25, 2001 (Abstract O-294. Fertil Steril 76:S111 (Supplement), 2001
- S. Venturoli, O. Marescalchi, F. M. Colombo, S. Macrelli, B. Ravaioli, A. Bagnoli, R. Paradisi, and C. Flamigni. In the treatment of hirsutism, a prospective randomized trial compared low dose flutamide, finasteride, ketoconazole, and cyproterone acetate-estrogen regimens. J Clin Endocrinol Metab, vol. 84, no. 3, pp. 1304-1310, 1999.
- P. Moghetti, F. Tosi, A. Tosti, C. Negri, C. Misciali, F. Perrone, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, Muggeo, A randomized, double-blind, placebo-controlled experiment compared the efficacy of spironolactone, flutamide, and finasteride in the treatment of hirsutism. J Clin Endocrinol Metab, vol. 85, no. 1, pp. 89-94, 2000.
- Peereboom JDR Wynia, E Stolz, T van Joost, JDR Wynia, JDR Wynia, JDR Wynia, JDR Wynia, JDR Wyn A comparison of the effects of diathermy and the blend method for electrical epilation of beard hairs in women with hirsutism. 1985, Arch Dermatol Res 278:84-86.
- RN Richards and GE Meharg. Electrolysis: the results of 13 years and 140,000 hours of practice. 1995, J Am Acad Dermatol, 33:662-666.
- RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner, RF Wagner Cutis 45:19, 2nd edition, 1990.
- Histologic alterations of human hair follicles after electrolysis: a comparison of two procedures, Kligman AM, Peters L. 1984, Cutis 34:169176.
- L. Farah, A. J. Lazenby, R. L. Boots, R. L. Azziz, and the Alabama Professional Electrology Association Study Group Polycystic ovarian syndrome is common among women who seek therapy from community electrologists. J
FIND OUT WHAT TRAININGS ARE AVAILABLE IN YOUR STATE
For practicing electrology, each state has its own set of criteria. To learn more about the training programs available in your state, use the map or the list below.
Is getting laser hair removal worth it?
While laser hair removal does not permanently remove hair (only electrolysis is FDA-approved for permanent hair removal), it significantly reduces hair growth to the point where you can quit shaving.
It can be done anywhere on the body, and the machine is capable of covering enormous areas quickly. The legs, the back, the underarms, the bikini line, the stomach, the face… There are no restrictions on where you can undergo laser hair removal.
When it comes to pain, laser hair removal is in between shaving (which is painless) and waxing (which is painful) (holy hell that hurts). Before and after the laser treatment, the experts use ice to numb the area. According to Charles, it also becomes less painful as the treatments go and the hair becomes finer.