A couple of years ago, deal-of-the-day sites like Groupon seemed to be everywhere. Social media sites heavily advertised their deals. Many businesses sought to use them as marketing tools to drive customer traffic—including centers that offer laser hair removal services.

The business model is relatively straightforward: the site offers a deal a day, and if a certain number of people sign up for the offer, then the deal becomes available to everybody. Groupon pockets half the money the customer pays for the coupon while the other half goes to the retailer.

But the practice has had unintended consequences for the U.S. laser hair removal market. “Laser hair removal is now trending in the direction of waxing—so many centers have it. The profitability is just not there so that part of it is becoming very different,” says Dr. Jayson Dupré, medical director of Strella MedSpa. He argues that vast discount modalities have decimated any residual value in the treatment. “So many centers have encouraged a race to the bottom on price. As providers of service, we need to be mindful of the impact that undercutting price does to the market,” he says.

Indeed, the commoditization of the market has led to slowed growth in recent years. “In the U.S., though hair removal and skin rejuvenation remain consistently in-demand and are well-established procedures, these will not experience the strongest growth,” says Jeremy Seath, market research analyst at Millennium Research Group.

While there was initially widespread curiosity on how sites like Groupon may help drive business, some centers that tried the marketing tool once or twice claimed it wasn’t very helpful for business growth. Why? It boiled down to a question of demographics.

Experts like Dupré allege that the kind of customer who would come in for inexpensive hair removal treatments weren’t the kind of patients who would completely run the course on hair removal or weren’t coming in for additional procedures like Botox or laser resurfacing.


Some centers faced a second challenge when large numbers of people responded to Groupons: their schedules got overwhelmed with patients they weren’t making money on and they didn’t have the room or the staff capacity for patients who were paying the normal price. “Most of the practices that we’re aware of tried, found it was not beneficial and didn’t continue with those,” says Robert Ruck, vice president of worldwide marketing at Sciton.

However, not all industry experts are anti-Groupon. “A wave of consumers who otherwise wouldn’t have sought aesthetic treatments may test the waters with hair removal through these deals and ultimately opt into more complex treatments, such as body contouring,” says Jane Smith, marketing manager at Alma Laser.

The Wild East
Downward pressures on the hair removal market means that the profit margins largely depend on substantial patient volume. Experts warn that this phenomenon encourages these centers to cut corners, potentially putting patients at risk.

But experts also argue that a lack of proper standardized guidelines around training is also putting patients at risk.

“Ironically, people talk about the wild west. We have the wild east. You look at states that have good regulation around safe and effective use of medical lasers and really, the states leading that charge have been on the west coast,” says Dupré.

Dupré’s stance isn’t based on hometown loyalty, since he’s based in the east in Pennsylvania. “[Pennsylvania] has no real guidelines at all,” he says. “Today, you could be a street sweeper and you could be operating a laser on a patient tomorrow.”

To add to the confusion, certain well-meaning pieces of legislation may actually make this training hazard worse. Some states, for example, require that lasers be operated only in the presence of certified doctors, but don’t have training certification guidelines for those doctors, overlooking the fact that your average physician has little or no knowledge of how to operate a laser. Experts agree that proper laser training is a must whether the person operating the machine has a medical degree or an A.A. from a junior college.

The lack of regulations around who can perform these procedures has resulted in many patients either not getting the results they desire or, in getting more than they bargained for, suffering burns or scars from these devices. “Dermatologists and plastic surgeons I have spoken with estimate that 20-30% of patients they treat are seeking revisionary work to correct an ineffective or harmful procedure,” says Millennium Research Group’s Seath.

That said, from an overall market standpoint, the lack of regulations has actually had a positive impact on procedure volumes and unit sales.

While there have been criticisms by physicians regarding the lack of regulations throughout much of North America, there are also many physicians who feel that the onus is on the manufacturers of the devices to provide adequate training to their customers.

Laser manufacturer Lumenis offers extra safety features and invests in training to try to take a more proactive approach to customer laser safety. “You could kill somebody with a pencil if you wanted,” says Lee Pannell, vice president of sales and marketing at Lumenis. “It’s not just that it’s an unsafe device. If the wrong person uses the device in the wrong way, there can be complications.”

“Some companies when they ship it to you, you have to set it up on your own like a new cell phone where you take it out of the box and it works,” Pannell says. “We want to have a really safe device and err on the side of more safety by doing our own installation calibration and setup. And we have our clinicians doing the training.”

Body Sculpting
Another hot topic in the cosmetic laser market has to do with a fast-growing subsegment called body sculpting. Driven by strong direct-to-consumer marketing efforts, there’s significant demand for fat reduction procedures that do not require incisions or general anesthesia and that do not result in significant downtime for the patient.

The procedure—billed as a noninvasive alternative to liposuction surgery—uses a laser to destroy fat cells subcutaneously without damage to the overlying skin. Currently Zerona is the only manufacturer of this technology in the United States.

“Modalities such as body sculpting are bringing out so much more shape in the abdomen, arms, in ways that historically up until the last couple of years have only been able to be achieved with surgical interventions and liposuction,” says Dupré.

Nonetheless, a number of physicians feel that the technology currently available does not provide the results that patients are looking for, causing some patients to opt for minimally invasive procedures like laser-assisted liposuction.


“Noninvasive fat reduction is still not quite there. The segment shows growth in the sense of selling machines but it hasn’t had results yet,” says Dr. George Hruza, former president of the American Society of Laser Medicine and Surgery.

“I think the efficacy is coming up and you can get more results, but it’s nowhere near the point of saying body sculpting is the same as a tummy tuck,” says Pannell.

Part of the problem is that current methods of fat sculpting only work well for patients looking to destroy a limited pocket of fat. Because the destroyed fat is flushed through the lymphatic areas and liver, the treatment is not applicable for patients seeking to get rid of greater amounts of fat.

The future challenge of this procedure, then, is being able to zap much greater quantities of fat without overwhelming the body’s normal processes.

“I think the industry is still searching for something with predictable results, reasonable volume of fat per treatment and minimal side effects,” says Ruck.

Nevertheless, this technology has some of the fastest growth potential in the cosmetic laser segment, and unlike laser hair removal, the profit margins for these treatments are high, running around $3000 for six sessions.

However, rumors in the industry abound that manufacturers in this segment are keeping a close eye on the commoditization of the laser hair removal market. Experts in the field that wish to remain anonymous say OEMs are now requiring that customers sign agreements never to use sites like Groupon or Living Social.

“We’re definitely hearing about more of a trend among manufacturers who are trying to discourage them from using these sites,” says Dupré.

“I don’t think it’s legal. It’s a restraint of trade,” says Hruza. “Commoditization is a real concern, but in some ways, you can blame the companies themselves because they will sell the device to anybody.”

Click here to check out the DOTmed New Equipment Guide for surgical and cosmetic lasers.