Hair removal can be scary and painful. From shaving, tweezers and waxing, now comes laser hair removal. Popularity with the procedure has many businesses cashing in.

"I absolutely love it," said Sheree McCall.

The Highland, Kan., woman said she had laser hair removal done on her face three years ago and has recently made an appointment to have her legs done.

Laser hair removal is the fourth most popular minimally invasive cosmetic surgery, the American Society of Plastic Surgeons says. Its popularity has made laser hair removal a financial cornerstone for many dermatologists and plastic surgeons, the organization says.

Amanda Kurtz, an aesthetician at Midwest Laser Aesthetics in St. Joseph, said that patients need to ask the right questions, though. Because Missouri and Kansas do not require individuals to be board certified or licensed, anyone can purchase a laser and advertise for hair removal services, she said.

"It can be scary," said Mrs. Kurtz.

Mrs. Kurt, a licensed aesthetician and board certified by the state of Missouri, said that her facility and more reputable cosmetology clinics will have medical staff on hand. Midwest Laser has a physician and three nurse practitioners available. Only a handful of businesses offer the service in St. Joseph and, according to a state directory, there are hundreds of licensed salons, spas and medical clinics in Missouri.

Ms. McCall said she was referred by a friend. "I was so worried about how much it would hurt and cost and then if it would even work," she said. "It bites. If you can get a tattoo you can do this, but it can sting a little."

Almost 20 years since the FDA approved the first laser machine, women’s facial hair still tops the list of unwanted hair.

"But it is becoming more popular with the men and teenagers," Mrs. Kurtz said. "That’s what the trend is right now."

Mrs. Kurtz said the average cost can run $50 and up. The average number of treatments is five, since some patients take only three and others can take up to seven. After that, you should only require maintenance treatments, about two per year on average. Yet every process is different, since everyone has different hormone levels, ethnicity and skin types.

For best results, patients should have dark hair. Blondes and redheads might not reap the rewards of laser hair removal.