These three parameters determine what actually happens when the light energy is absorbed by the tissue chromophore be it melanin, hemoglobin or water, with the amount of tissue damaged being determined by the temperature/time combination. Hair grows in several phases (anagen, telogen, catagen) and a laser can only affect the currently active growing hair follicles (early anagen). Hence, several sessions are needed to damage the hair in all phases of growth and force it to revert to a vellus non-colored small hair. Multiple treatments depending on the type of hair and skin color have been shown to provide long-term reduction of hair. Most patients need a minimum of eight treatments. Current parameters differ from device to device but manufacturers and clinicians generally recommend waiting from three to eight weeks between sessions, depending on the area being treated. The number of sessions depends on various parameters, including the area of the body being treated, skin color, coarseness of hair, reason for hirsutism, and sex. Coarse dark hair on light skin is easiest to treat. Certain areas (notably men's faces) may require considerably more treatments to achieve desired results. Laser does not work well on light-colored hair, red hair, grey hair, white hair, as well as fine hair of any color, such as vellus. For darker skinned patients with black hair, the long-pulsed with a cooling tip can be safe and effective when used by an experienced practitioner. Typically the shedding of the treated hairs takes about two to three weeks. These hairs should be allowed to fall out on their own and should not be manipulated by the patient for certain reasons, chiefly to avoid infections. Pulling hairs after a session can be more painful as well as counteract the effects of the treatment. Some normal side effects may occur after laser hair removal treatments, including itching, pink skin, redness, and swelling around the treatment area or swelling of the follicles (follicular edema). These side effects rarely last more than two or three days. The two most common serious side effects are acne and skin discoloration. Some level of pain should also be expected during treatments. Numbing creams are available at most clinics, sometimes for an additional cost. Some numbing creams are available over the counter. Use of strong numbing creams over large skin areas being treated at one time must be avoided, as this has seriously harmed, and even killed, patients. Typically, the cream should be applied about 30 minutes before the procedure.