810nm半导体激光脱毛216例疗效分析

目的观察810nm半导体激光脱毛的安全性和临床疗效。方法应用半导体激光脱毛机对216例患者不同部位进行治疗，波长为810nm，光斑面积12mm×10mm，能量密度6～10J／cm2，脉宽5～400ms，治疗间隔6～8周。结果216例患者经4～6次连续治疗后均达到理想的脱毛效果，治疗后毛发明显减少，再生毛发细小，浅谈。治疗次数达到6次或以上可显著提高疗效。结论半导体激光脱毛安全有效。     

Alternative Method for Creating Fine Hairs with Hair Removal Laser in Hair Transplantation for Hairline Correction

Background

Foremost fine hairs in the frontal hairline region are critical in hair transplantation for hairline correction (HTHC) in women. However, there are few studies on a nonsurgical revisionary method for improving an unnatural foremost hairline with thick donor hairs resulting from a previous HTHC.

Objective

To investigate the efficacy and safety of using a hair removal laser (HRL) system to create fine hairs in Asian women with thick donor hairs.

Methods

Through a retrospective chart review, the HRL parameters, hair diameter (measured with a micrometer before and after the procedures), subjective results after the procedures, adverse effects, and the number of procedures were investigated. The reduction rate of the hair diameter was calculated.

Results

Twenty-four women who received long-pulse Neodymium-Doped:Yttrium Aluminum Garnet therapy after HTHC were included. The parameters were as follows: delivered laser energy, 35~36 J/cm²; pulse duration, 6 ms; and spot size, 10 mm. The mean number of laser sessions was 2.6. The mean hair diameter significantly decreased from 80.0±11.5 µm to 58.4±13.2 µm (p=0.00). The mean rate of hair diameter reduction was -25.7% (range, -44.6% to 5.7%). The number of laser sessions and the hair diameter after the procedures showed a negative correlation (r=-0.410, p=0.046). Most of the patients (87.5%) reported subjective improvement of their hairlines. Most complications were transient and mild.

Conclusion

HRL can be an alternative method for creating fine hairs and revising foremost hairline in Asian women with thick donor hairs.     

Pigmented guinea pig skin irradiated with Q-switched ruby laser pulses. Morphologic and histologic findings

Q-switched ruby laser pulses cause selective damage to cutaneous pigmented cells. Repair of this selective damage has not been well described. Therefore, using epilated pigmented and albino guinea pig skin, we studied the acute injury and tissue repair caused by 40-ns, Q-switched ruby laser pulses. Gross observation and light and electron microscopy were performed. No specific changes were evident in the albino guinea pigs. In pigmented animals, with radiant exposures of 0.4 J/cm2 or greater, white spots confined to the 2.5-mm exposure sites developed immediately and faded over 20 minutes. Delayed depigmentation occurred at seven to ten days, followed by full repigmentation by four to eight weeks. Regrowing hairs in sites irradiated at and above 0.4 J/cm2 remained white for at least four months. Histologically, vacuolation of pigment-laden cells was seen immediately in the epidermis and the follicular epithelium at exposures of 0.3 J/cm2 and greater. Melanosomal disruption was seen immediately by electron microscopy at and above 0.3 J/cm2. Over the next seven days, epidermal necrosis was followed by regeneration of a depigmented epidermis. By four months, melanosomes and melanin pigmentation had returned; however, hair follicles remained depigmented and devoid of melanocytes. This study demonstrates that selective melanosomal disruption caused by Q-switched ruby laser pulses leads to transient cutaneous depigmentation and persistent follicular depigmentation. Potential exists for selective treatment of pigmented epidermal and dermal lesions with this modality.     

Skin pigmentation and texture changes after hair removal with the normal-mode ruby laser

Promising clinical results have been obtained with the normal mode ruby laser for removal of unwanted hair. Melanin within the hair follicles is thought to act as target for the ruby laser pulses, whereas epidermal melanin is thought to be a competitive chromophore, responsible for potential side effects. This study aimed (i) to objectify postoperative changes in skin pigmentation and texture and (ii) to evaluate the importance of variations in preoperative skin pigmentation for the development of side effects 12 weeks after 1 treatment with the normal-mode ruby laser. A total of 17 volunteers (skin types I-IV) were laser-treated in the hairy pubic region (n = 51 test areas). A shaved test area served as control. Skin reflectance spectroscopical measurements, 3-dimensional surface contour analysis and ultrasonography objectified postoperative changes in skin pigmentation and texture. Blinded clinical assessments revealed postoperative hyperpigmentation (2% of test areas) and hypopigmentation (10%), whereas no textural changes were seen. Reflectance spectroscopically-determined pigmentary changes depended on the degree of preoperative skin pigmentation, fairly pigmented skin types experiencing subclinical hyperpigmentation and darkly pigmented skin types experiencing subclinical hypopigmentation. Three-dimensional surface profilometry documented similar pre- and postoperative surface contour parameters, indicating that the skin surface texture is preserved after laser exposure. Ultrasonography revealed similar skin thicknesses in laser-exposed and untreated control areas. It is concluded that normal-mode ruby laser treatment is safe for hair removal in skin types I-IV.     

Clinical comparison of four hair removal lasers and light sources

Background and objective: There are few clinical studies directly comparing the efficacy of multiple hair removal systems in the same individual. This study evaluates the efficacy of four highly popular systems for laser hair removal. Methods: In this prospective comparison study, 10 subjects underwent treatment of unwanted hair on the back or thigh. Subjects were skin types I–III, aged 18–55 years. All were treated twice with (1) an intense pulsed light with a red filter; (2) an intense pulsed light with a yellow filter; (3) an 810?nm diode laser; and (4) a 755?nm alexandrite laser. Four treatment areas, using commonly accepted parameters for permanent hair reduction, as well as a control non‐treated area were selected. Each treatment area was evaluated with a camera system specifically designed for hair counts at 1, 3, and 6 months after the second treatment by a blinded non‐treating physician. Clinical results and adverse events were also noted. Results: Evaluation of photographs at 1, 3, and 6 months revealed a significant decrease in hair counts (～50%) and hair coverage (～55%). In the hairs that remained after two treatments, no statistical difference was noted in hair length or diameter. There was no statistical difference in efficacy between the four different light devices. Minimal transient adverse effects were noted from all systems. The cryogen spray‐based alexandrite laser showed the highest pain scores. Conclusion: Although hair removal with commonly used systems is, as expected, highly effective, treatment with light‐based devices can cause less pain, yet show efficacy similar to laser systems.     

Evaluation of a super long pulsed 810-nm diode hair removal laser in suntanned individuals

BACKGROUND: Laser hair removal is based on the dual concepts of selective photothermolysis and thermal relaxation time. In most laser hair removal systems, light with emitted pulse durations of 2–50 ms targets hair follicles. Such pulse durations usually lead to post-inflammatory pigmentary changes in suntanned individuals. OBJECTIVE: In this pilot study, we evaluated the clinical efficacy and side effect profile of a modified 810–nm diode laser device (Palomar SLP 1000Á, Burlington, MA, USA) operating in a super long pulse mode (200–1000 ms). METHODS: Five suntanned subjects with Fitzpatrick skin types II–IV received either one or two laser treatments at eight test sites. Treatments were delivered to suntanned skin. Pulse durations of 200–1000 ms were evaluated with delivered fluences ranging from 23 to 115 J cm 2 . Subjects were followed for 6 months after the first treatment. Subjects were evaluated for hair removal efficiency, optimal pulse duration and delivered fluence, one versus two treatments, and associated complication rate. RESULTS: The average hair reduction, 34%, did not significantly vary with pulse duration or fluence. Clinical evaluations rated two treatments superior to one. CONCLUSION: The results show that efficacious and safe hair removal can be accomplished with an 810–nm diode laser delivering super long pulse durations at a wide range of settings in suntanned individuals. For optimal safety in tanned patients, the highest fluence (115 J cm 2 ) and pulse duration (1000 ms) should be avoided.     

810nm半导体激光脱毛疗效观察

目的观察半导体激光脱毛的效果,分析其疗效、治疗次数和能量之间的相互关系。方法应用MeD-iostar半导体激光脱毛机对169例患者共203个部位进行治疗,波长810 nm,光斑直径12 mm,能量密度在25~40 J/cm2之间,脉宽54~100 ms,治疗间隔2~3个月。结果173个部位治疗1~6次后痊愈,痊愈率为85.3%,16个部位治疗7~9次痊愈,有效率为97.6%;疗效与治疗次数密切相关;各部位治疗次数及能量均不相同。结论半导体激光脱毛创伤小,不良反应少,安全有效。     

半导体激光脱毛的临床疗效及安全性评价

目的评价半导体激光脱毛的疗效及安全性。方法使用808 nm半导体激光脱毛机对132例患者共169个部位进行了脱毛,并对经过3次及3次以上的90例117个部位的脱毛效果及安全性进行评价。结果共有90例患者117个部位接受了3次及3次以上的治疗,腋窝、上肢、下肢的1次治疗平均脱毛率达30%以上,2次治疗平均脱毛率达50%以上,3次治疗平均脱毛率达70%以上;唇部1次治疗平均脱毛率达15.6%,2次治疗平均脱毛率达29.8%,3次治疗平均脱毛率达36.8%。无1例出现水疱、紫癜、色素沉着及瘢痕。结论半导体激光脱毛是一种安全有效的脱毛方法。     

不同年龄成人头发的变化

目的 观察不同年龄成人头发的变化,探讨反映人老化的参照指标.方法 根据入选标准和排除标准征集志愿者,并依据年龄分为4组.头顶指定区域拍照后利用图像分析软件检测头发密度以及黑发率.该区域内随机拔取10根头发,利用目镜测微尺测量发干直径和毛球直径.同时,根据毛囊形态计算不同生长时期毛囊率.结果 共有96名志愿者加入本研究,男44例,女52例,年龄30~78岁.头顶头发密度、毛干直径、毛球直径、生长期毛囊率和黑发率随着年龄的增加逐渐减小,休止期毛囊率及白发率增多,并且60岁以上组明显减小,与其他3个年龄组差异有统计学意义,各组内部分指标存在性别差异.相关分析发现,毛干直径与毛球直径呈显著正相关.结论 头发的一些变化可能作为评价人老化程度的参照指标.     

Laser hair removal

Since 1996, there have been numerous advances in hair laser removal that utilize melanin as a chromophore. All of the devices on the market may be used in patients with light skin (phototypes I-III) and yield hair reduction near 75%. The ruby (694 nm) laser, alexandrite (755 nm) laser, and diode (810 nm) laser, as well as intense pulsed light are commonly used devices for hair laser removal. The long-pulsed Nd:YAG (1064 nm) laser represents the safest device for hair removal in dark-skinned patients because of its long wavelength, although the diode laser, alexandrite laser, and intense pulse light may be used. For treatment of light hair, combination radiofrequency and optical devices as well as photodynamic therapy are under investigation.     

An efficacy comparison of hair removal utilizing a diode laser and an Nd:YAG laser system in Chinese women

Abstract

Background: The 800 nm diode laser and the 1064 nm Nd:YAG laser have been used successfully for hair removal for many years. Objective: To compare the efficacy of a diode laser with a Nd:YAG laser regarding axillary fossa hair removal in Chinese women. Methods: Twenty-nine Chinese women underwent three treatment sessions at 4-week intervals with a diode laser (34–38 J/cm²) on one side and a Nd:YAG laser (34–40 J/cm²) on the other side. Assessments included the reduction of hair diameter following treatment, the regrowth rate in hair length, total hair reduction and the immediate pain associated with the treatments. Results: At follow-up visit number 1 (4 weeks after the first session), the average reduction in hair diameter on the diode laser side and the Nd:YAG laser side was 2.44 μm and –0.6 μm, respectively. The regrowth rates of the hair were 61.93 μm/day and 59.84 μm/day, respectively, which were not statistically significant (p > 0.05). At follow-up visit number 1, hair reduction was 60.09% and 41.44%, respectively. At follow-up visit number 2 (4 weeks after the second session), hair reduction was noted to be 78.56% and 64.50%, respectively, which were both statistically significant (p < 0.05). Immediate pain scores at the first session were 6.97 and 6.17, respectively; at the second session were 5.48 and 6.69, respectively; and at the third session were 5.76 and 7.45, respectively; all statistically significant (p < 0.05). Conclusions: The diode laser showed more efficacy and was found to be more comfortable than the Nd:YAG laser for axillary fossa hair removal in Chinese women.     

Laser Hair Removal

Laser-assisted hair removal is the most efficient method of long-term hair removal currently available. Several hair removal systems have been shown to be effective in this setting: ruby laser (694nm), alexandrite laser (755nm), diode laser (800nm), intense pulsed light source (590 to 1200nm) and the neodymium:yttrium-aluminium-garnet (Nd:YAG) laser (1064nm), with or without the application of carbon suspension. The parameters used with each laser system vary considerably. All these lasers work on the principle of selective photothermolysis, with the melanin in the hair follicles as the chromophobe. Regardless of the type of laser used multiple treatments are necessary to achieve satisfactory results. Hair clearance, after repeated treatments, of 30 to 50% is generally reported 6 months after the last treatment. Patients with dark colored skin (Fitzpatrick IV and V) can be treated effectively with comparable morbidity to those with lighter colored skin. Although there is no obvious advantage of one laser system over another in terms of treatment outcome (except the Nd:YAG laser, which is found to be less efficacious, but more suited to patients with darker colored skin), laser parameters may be important when choosing the ideal laser for a patient. Adverse effects reported after laser-assisted hair removal include erythema and perifollicular edema, which are common, and crusting and vesiculation of treatment site, hypopigmentation and hyperpigmentation (depending on skin color and other factors). Most complications are generally temporary. The occurrence of hypopigmentation after laser irradiation is thought to be related to the suppression of melanogenesis in the epidermis (which is reversible), rather than the destruction of melanocytes. Methods to reduce the incidence of adverse effects include lightening of the skin and sun avoidance prior to laser treatment, cooling of the skin during treatment, and sun avoidance and protection after treatment. Proper patient selection and tailoring of the fluence used to the patient's skin type remain the most important factors in efficacious and well tolerated laser treatment. While it is generally believed that hair follicles are more responsive to treatment while they are in the growing (anagen) phase, conflicting results have also been reported. There is also no consensus on the most favorable treatment sites.     

Hair shaft abnormalities after chemotherapy and tamoxifen therapy in patients with breast cancer evaluated by optical coherence tomography

Background Antineoplastic treatment for breast cancer is frequently associated with alopecia. Increasingly, changes in the texture and shape of regrowing hair after chemotherapy have been reported, without evaluation on a scientific basis. Optical coherence tomography (OCT) provides highly reproducible measurements of hair shaft parameters. Objectives This study aims to evaluate hair shaft alterations using OCT in chemotherapy‐induced alopecia and in patients taking tamoxifen. Methods The measurements of this prospective case series were performed on women aged 29–68 years, receiving either tamoxifen (n = 17) or chemotherapy (n = 17) prior to (T1) and after (T2) treatment. Each time, 20 hairs from two different sites of the scalp (frontal, occipital) were examined by OCT. The hair parameters were characterized by cross section (CS) and form factor (FF). The ratio of maximal to minimal hair diameters determined the FF. Results After chemotherapy, the CS of hairs was significantly lower compared with hairs taken at T1. The FF did not vary between T1 and T2 for the frontal area, but it did for the occipital area. In patients treated with tamoxifen, changes were observed neither in CS nor in FF. However, comparing both therapeutic groups, there were significant differences in CS and FF for T2, but not for T1. Conclusions Reported changes in hair structure after chemotherapy may be due to reduction of hair shaft calibre and increase of FF in regrowing hair. The OCT technique is a promising method to gain more insight into chemotherapy‐induced changes of hair morphology.     

800 nanometer diode laser hair removal in African American patients: a clinical and histologic study

BACKGROUND : Although numerous lasers are available for laser assisted hair removal, their use in individuals with a dark skin type presents many challenges due to competition from epidermal melanin. OBJECTIVE : Our aim was to evaluate two 800 nm diode lasers (Lightsheer®) with 30 msec and 100 msec pulse durations in the treatment of African American patients with skin types V and VI. Histologic studies, efficacy and side effects were examined in an effort to optimize laser hair removal procedures in this patient population. METHODS : Facial, neck and axillary areas were treated using 800 nm diode lasers at 30 and 100 msec pulse durations with fluences between 15 J/cm 2 and 40 J/cm 2 . RESULTS : Both lasers could be used safely in skin type V and VI African American patients. Longer pulse durations enabled the delivery of higher fluences with minor and acceptable postoperative complication profiles. CONCLUSION : The Lightsheer® diode laser (Coherent Medical, Santa Clara, CA, USA) operating at 30 msec and 100 msec can be safely used in hair removal procedures in African American patients.     

长脉冲半导体激光脱毛的长期疗效和安全性评价

目的 评价长脉冲半导体激光对于Ⅲ－Ⅴ型皮肤多毛患者脱毛的长期疗效和安全性。方法 用长脉宽半导体激光（波长800 nm，脉宽30 ms，光斑大小9 mm × 9 mm）对350例多毛患者进行多次治疗。治疗结束后22.5个月，回顾性分析了脱毛的疗效和不良反应，每个部位根据治疗次数分2组： < 6次组和≥6次组（腋窝分为 ＜ 4次组和≥4次组），比较不同部位这2组脱毛的疗效。结果 随访到并进行评价的多毛患者235例共375处部位。经2 ~ 18次脱毛治疗后，有效302处，总有效率为80.53%。不同部位2个治疗次数组疗效有一定差异，唇部≥6次组治疗部位38处，有效33处，有效率86.84%， ＜ 6次组治疗部位20处，有效7处，有效率35.00%；面颈（唇以外）≥6次组治疗部位38处，有效26处，有效率68.42%， ＜ 6次组治疗部位13处，有效4处，有效率30.77%；下肢≥6次组治疗部位50处，有效46处，有效率92.00%， ＜ 6次组治疗部位9处，有效5处；躯干≥6次组治疗部位23处，有效20处，有效率86.96%， ＜ 6次组治疗部位8处，有效4处；以上各部位≥6次组疗效均优于 ＜ 6次组（P < 0.05）。腋窝≥4次组治疗部位97处，有效91处，有效率93.81%， ＜ 4次组治疗部位9处，有效5处，两组疗效比较，P < 0.01。上肢部两组疗效比较，差异无统计学意义（P ＞ 0.05）。235例患者中有6例出现不良反应，包括色素沉着、毛囊性丘疹、瘙痒、水疱、白色毛发，未见色素减退及瘢痕形成。结论 长脉冲半导体激光对Ⅲ－Ⅴ型皮肤多毛患者脱毛安全有效。疗效与脱毛部位、治疗次数相关。     

Laser-assisted hair removal for facial hirsutism in women: A review of evidence

Poly cystic ovarian syndrome (PCOS) has been described as the common diagnosis for hirsutism in women. Facial hirsutism is by far the most distressing symptom of hyperandrogenism in women with PCOS. A statistically significant improvement in psychological well-being has been reported in patients with PCOS allocated for laser-assisted hair removal. The theory of selective photothermolysis has revolutionized laser hair removal in that it is effective and safe, when operated by sufficiently trained and experienced professionals. Long-pulsed ruby (694 nm), long-pulsed alexandrite (755 nm), diode (800–980 nm), and long-pulsed Nd:YAG (1064 nm) are commercially available laser devices for hair removal most widely studied. This article will introduce the fundamentals and mechanism of action of lasers in hair removal, in a contemporary literature review looking at medium to long term efficacy and safety profiles of various laser hair removal modalities most widely commercially available to date.     

Hair shaft abnormalities in alopecia areata evaluated by optical coherence tomography

Background/purpose: Optical coherence tomography (OCT) is able to provide highly reproducible measurements of hair shaft thickness, including hair shaft diameter, cross‐sectional surface area and hair shape, similar to histology but in vivo. Variations in the caliber of hair shafts have been described in patchy hair loss like alopecia areata (AA) using electron microscopy. The aim of this study was to evaluate whether OCT is useful for the evaluation of hair shaft abnormalities in AA. Methods: The measurements were performed on patients with AA (n=9), aged 2–66 years. Fifty hairs from the border of an alopecic area and 50 hairs from an unaffected area without hair loss were examined using the OCT technique. The hair parameters were characterized by the cross‐section (CS) and the form factor. The ratio of the maximal and minimal diameters of the hair at a fixed measuring distance from the scalp surface determined the form factor (d_max/d_min). Results: In all cases, the CS of hairs from an AA patch was significantly lower compared with hairs of an unaffected area. However, the form factor did not indicate any disturbances in hair growth. Conclusions: The results demonstrate that structural abnormalities of hair shafts are found in active lesions of AA, but not in clinically unaffected hairs. The OCT technique is a promising method to gain more insight into the pathogenesis of AA in a non‐invasive way.     

Dry dermoscopy in clinical treatment of alopecia areata

Although dermoscopy is conventionally utilized with immersion gel for diagnosis of pigmented tumor, we utilized dry dermoscopy, which is dermoscopy without immersion gel, for clinical treatment of alopecia areata (AA). The scalp skin and hair of a 38-year-old Japanese male, and 23-, 22- and 47-year-old Japanese females with AA, whose normal hair color was black, were examined by dry dermoscopy. Exclamation mark hairs, short hairs, fractured hairs and black dots, all characteristic of AA, were detected by dry dermoscopy of the scalp of the 23-year-old female with ophiasis type AA. In the case of the 47-year-old female with round hair loss on the occipital scalp and diffuse hair loss over the fronto-vertical region, dry dermoscopy was useful for diagnosis of AA based on hair characteristic of AA. After she received corticosteroid pulse therapy with 500 mg of i.v. methylprednisolone on 3 successive days, her hair showed apparent regrowth and disappearance of the abnormal hairs characteristic of AA, evidenced by dry dermoscopy 1 month later. In a case of long-lasting AA in the 23-year-old female, we found a follicular plaque-like appearance at the opened hair follicle pores by dry dermoscopy. Histopathologically, the incompletely differentiated remnant hair shaft was packed in the follicular infundibulum. In addition, regrowing vellus hairs, which were difficult to clinically recognize, were detected by dry dermoscopy. Dry dermoscopy is therefore useful for both diagnosis and follow up of AA.     

Claves diagnósticas en displasias pilosas I

Hair shaft disorders, involving dysplastic abnormalities in the shaft, may be either congenital or acquired. Two large categories have been defined according to the presence or not of hair fragility. A diagnosis can usually be made after taking a thorough medical history and performing a physical examination. Trichoscopy has become a useful, cost-effective tool in recent years, particularly for examining the hair of children, because it facilitates inspection without removal of hairs. Structural abnormalities in the hair shaft are sometimes clues to the diagnosis of more complex diseases in which early treatment can improve prognosis. This review describes key features that enable the diagnosis of the most common hair shaft disorders and discusses the various treatments currently available.     

Histological hair removal study by ruby or alexandrite laser with comparative study on the effects of wavelength and fluence.

BACKGROUND: Several different laser systems are currently used to remove unwanted hairs. In this study, we studied follicular changes following hair removal with ruby or alexandrite lasers at different fluences. METHODS: Unwanted hairs were treated with a ruby laser (Chromos 694, ICN PhotonIcs, UK) at 10, 14 or 18 J/cm2 or with an alexandrite laser (LPIR, Cynosure, USA) at 11, 14 or 17 J/cm2. A 3 mm skin punch biopsy was taken immediately after each laser exposure and also 1 month later. Specimens were stained for histological observation. They were observed using immunohistochemistry with antibodies recognizing factor VIII related antigen or PCNA, and also by the TUNEL method. Similarly, electron microscopic observation was examined. RESULTS: Immediately after the laser exposure, moderate follicular damage was observed following treatment with either type of laser. One month later, cystic formation of hair follicles and foreign body giant cells were observed in skin treated with either type of laser. A similar fluence with either laser treatment resulted in similar histological changes. CONCLUSION: In this study, the histological changes following treatment with a ruby or an alexandrite laser at the same fluence are similar.