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.     

Uncommonly reported side effects of hair removal by long pulsed‐alexandrite laser

Objective To provide retrospective clinical review of some uncommonly reported side effects of long‐pulsed alexandrite laser treatment for hair removal. Material and methods Two hundred and fifty female patients suffering from hirsutism of the face were subjected to treatment by long pulse alexandrite laser for a maximum of 15 sessions per patient at 5‐ to 7‐week intervals. Results Apart from the commonly reported side effects of pigmentary changes, occasional blistering and rare scarring, other untoward effects have been observed. These include – among others – de‐novo growth of hair outside the area treated by laser, potentiation of co‐existing vellus hair in the treatment area, induction or aggravation of acne, rosacea‐like rash, premature grayness of hair, tunneling of hair under the skin, prolonged diffuse redness and edema of the face, focal hypopigmentation of the lip, angular cheilitis, allergic reaction to the cooling gas, and inflammatory and pigmentary changes of pre‐existing nevi. Conclusion Although the efficacy of long‐pulsed alexandrite laser seems unmistakable, the short‐ and long‐term untoward effects of such treatment have yet to be carefully delineated and the underlying mechanisms are yet to be adequately clarified.     

A giant melanocytic nevus treated with combined use of normal mode ruby laser and Q-switched alexandrite laser

We report a combination procedure that can improve the effectiveness of laser removal of giant congenital melanocytic nevi (CMN). A 2-year-old girl with a giant CMN was seen in our outpatient clinic. Histological findings showed a compound nevus without any evidence of malignancy or dysplastic changes. The patient was treated with the normal mode ruby laser and Q-switched alexandrite laser. The lesion was significantly improved in color and cosmetic appearance. Partial hypopigmentation and texture changes were observed. Histological findings showed a marked decrease in the number of junctional melanocytes and the nests in the papillary and reticular dermis. The combined laser treatment is an effective method for the treatment of giant CMN, but further study is warranted to follow-up questions of recurrence and malignant change.     

Patient satisfaction with laser hair removal

Background Laser hair removal (LHR) is a widely used treatment for unwanted hair. Aim To determine patient satisfaction with LHR. Methods The clinic offered LHR by long pulse ruby, alexandrite and Nd:YAG. Patients attending the LHR clinic completed a patient satisfaction questionnaire. Satisfaction with LHR treatment was recorded on a linear analogue scale (LAS 0 = laser very much worse than alternative method; 10 = laser very much better than the alternative method). Results In terms of hair removal, 71% of patients were satisfied with their treatment. Laser treatment compared favourably with electrolysis and waxing. LHR scored 8.6 when compared with electrolysis and 7.7 when compared with waxing. During LHR treatments, 61% of patients used fewer ancillary methods than before. Most patients would recommend LHR to other persons with unwanted hair. Conclusions Most patients were satisfied with LHR.     

长脉冲紫翠宝石激光脱毛1386例疗效及安全性评价

目的：评价激光技术睨毛的疗效和安全性。方法：采用755nm的紫翠宝石激光对l386例FitzpatrickⅢ～Ⅴ型患者的l922个部位进行了脱毛,对经过2次及2次以上治疗的1122个部位的脱毛效果进行评价。结果：1122处皮损中的322处接受了2次治疗,有效率为8．39％;264处接受了3次治疗,有效率为17．42％;202处接受了4次治疗,有效率为27．23％,;136处接受了5次治疗,有效率为36．76％;198处接受了6次及以上治疗,有效率为81．31％。治疗次数与脱毛疗效呈正相关。1386例中13例(0．93％)出现色素沉着。结论：紫翠宝石激光是一种安全、有效的脱毛方法。     

Safety and efficacy of low fluence,high repetition rate versus high fluence,low repetition rate 810-nm diode laser for axillary hair removal in Chinese women

Background: High-fluence diode lasers with contact cooling have emerged as the gold standard to remove unwanted hair. Lowering the energy should result in less pain and could theoretically affect the efficacy of the therapy. Objective: To compare the safety and efficacy of a low fluence high repetition rate 810-nm diode laser to those of a high fluence, low repetition rate diode laser for permanent axillary hair removal in Chinese women. Methods: Ninety-two Chinese women received four axillae laser hair removal treatments at 4-week intervals using the low fluence, high repetition rate 810-nm diode laser in super hair removal (SHR) mode on one side and the high fluence, low repetition rate diode laser in hair removal (HR) mode on the other side. Hair counts were done at each follow-up visit and 6-month follow-up after the final laser treatment using a “Hi Quality Hair Analysis Program System”; the immediate pain score after each treatment session was recorded by a visual analog scale. Results: The overall median reduction of hair was 90.2% with the 810-nm diode laser in SHR mode and 87% with the same laser in HR mode at 6-month follow-up. The median pain scores in SHR mode and in HR mode were 2.75 and 6.75, respectively. Conclusion: Low fluence, high repetition rate diode laser can efficiently remove unwanted hair but also significantly improve tolerability and reduce adverse events during the course of treatment.     

A split-face comparison of facial hair removal with the long-pulsed alexandrite laser and intense pulsed light system

Background: Undesirable hair growth presents a significant problem for many patients. Photoepilation has become a very popular procedure in esthetic and cosmetic practice. Among the systems used are the long-pulsed alexandrite laser (755 nm) (ALX) and intense pulsed light (IPL). Objective: To compare the safety and efficacy of long-pulsed ALX and IPL for hair removal. Patients and methods: This comparative study was carried out in the outpatient Department of Dermatology and Venereology, Al-Sadir Teaching Hospital, Al Najaf City during the period from June 2009 to July 2010. Thirty-five patients were included; thirty of them completed the study. They received six treatment sessions with the ALX on the left side of the face and IPL on the right side of face with 4-week intervals between sessions. Response to treatment on both sides of the face was assessed at 1, 3, and 6 treatment sessions. Hair-free intervals and patient's satisfaction were recorded in each visit. Results: After six treatment sessions, IPL-treated sides showed longer median hair-free intervals compared with ALX-treated sides. Reduction in hair counts was significantly larger on the IPL compared with that on the ALX-treated sides at 1, 3, and 6 sessions. Three patients (10%) developed postinflammatory hyperpigmentation, one of them on the left side and the others on the right side. It was more severe on the right side and both the patients were of skin type IV. Slight stinging and burning sensation at time of the treatment were recorded in all patients. All reported side effects were transient and tolerated by the patients except postinflammatory hyperpigmentation which persisted and was decreasing gradually toward the end of the study. Conclusions: The results of this study suggested that IPL is more effective in reducing excessive facial hair growth, with longer hair-free intervals and greater patient satisfaction than the ALX.     

Long-pulsed ruby laser-assisted hair removal in male-to-female transsexuals

Background Unwanted male‐pattern pilosity is a heavy psychological burden and can cause distress for male‐to‐female transsexuals. Orchidectomy and oestrogen supplementation combined with antiandrogens fail to make hair disappear. Aims To study the effect of long‐pulsed ruby laser treatment. Results Hair density was successfully abated on the beard and chest of three male‐to‐female transsexuals. A lingering effect over 6 months with a 50–90% hair density reduction was obtained. Conclusion Photothermolysis using the long‐pulsed ruby laser is a promising, well‐tolerated method of hair removal in male‐to‐female transsexuals under oestrogen supplementation and antiandrogens.     

Pili bigemini complicating diode laser hair removal

After two diode laser treatments for hair removal, a 39-year-old woman was noted to have pili bigemini within the treated areas. It resolved after a third treatment. Pili bigemini, the appearance of two hairs coming from the same follicular opening, can be induced by intermediate doses of laser energy. It follows sublethal damage to the hair follicule apparatus.     

Effect of hair removal by Nd:YAG laser on the recurrence of pilonidal sinus

Background  Pilonidal sinus (PNS) is chronic inflammatory process of the skin in the natal cleft. Management of PNS is mainly surgical. Although different types of surgery have been performed, the recurrence rate is still high.
Objective  To evaluate the effectiveness of laser hair removal (LHR) in the natal cleft area on the recurrence rate of PNS as an adjuvant therapy after surgical treatment.
Methods  Twenty five patients with PNS were included in this study. Fifteen patients underwent LHR treatment using Nd:YAG laser after surgical excision of PNS (Patients group) while ten subjects with PNS did not do LHR and served as a control group.
Results  All of the patients were male patients. Their age ranged from 17 to 29 years with a mean of 21.60 ± 3.13 years. They had Fitzpatrick skin type III, IV and V. The patients have got 3 to 8 sessions of LHR (mean 4.87 ± 1.64). Follow up period lasted between 12 to 23 months. None of the patients, who underwent LHR, has required further surgical treatment to date. Seven patients out of ten in the control group have developed recurrent PNS. Pain was the most frequent side effect and it was seen in 6 patients (40%).
Conclusion  LHR can prevent the recurrence of PNS. LHR should be advised as an essential adjuvant treatment after surgical excision of PNS. In non-complicated recurrent PNS, LHR is strongly advocated to be started before and continued after doing surgical treatment.     

Novel 755-nm diode laser vs. conventional 755-nm scanned alexandrite laser: Side-by-side comparison pilot study for thorax and axillary hair removal

Background: Alexandrite (755 nm) and diode lasers (800–810 nm) are commonly used for hair removal. The alexandrite laser technology is somewhat cumbersome whereas new diode lasers are more robust. Recently, alexandrite-like 755 nm wavelength diodes became available. Objectives: To compare the efficacy, tolerability, and subject satisfaction of a 755 nm diode laser operated in conventional (HR) and non-conventional in-motion (SHR) modes with a conventional scanned alexandrite 755 nm laser for chest and axillary hair removal. Materials and methods: A prospective, single-center, proof of principle study was designed to evaluate the safety, efficacy and handling of a 755 nm diode laser system in comparison to a standard alexandrite 755 nm scanning hair removal laser. Results: The new 755 nm diode is suitable to be used in SHR and HR mode and has been tested for its safety, efficacy and handling in a volunteer with success. Overall, both systems showed a high efficacy in hair reduction (88.8% 755 nm diode laser vs. 77.7% 755 nm alexandrite laser). Also, during the study period, no severe adverse effects were reported. Conclusion: The new 755 nm diode laser is as effective and safe as the traditional 755 nm alexandrite laser. Additionally, treatment with the 755 nm diode laser with HR and SHR modes was found to be less painful.     

Split-leg comparison of low fluence diode laser and high fluence intense pulsed light in permanent hair reduction in skin types III to IV

Background/Objectives: All the standard light‐based techniques for permanent hair reduction, like laser and intense pulsed light (IPL) employ the highest tolerable fluence with a single pass. As opposed to standard techniques, a new diode laser technique employs low fluence with multiple passes. Here we evaluate and compare the efficacy, treatment time, comfort and safety of the low fluence multiple pass diode laser with high fluence single pass IPL for permanent hair reduction in Type III to IV Asian patients. Methods: Thirty Asian patients with Type III to IV black hair were enrolled and received three sessions of treatments at 6‐weekly to 8‐weekly intervals. A split‐leg study was performed in which the IPL was applied to one leg of each patient while the laser was applied to the other. The patients were followed up for 12 months. Results: All patients were satisfied with the results of the long‐term hair reduction without long‐term side effects. There was no statistically significant difference in hair reduction and treatment time between the laser (76.85%, 21.39 min) and the IPL (74.53%, 22.17 min) (P > 0.05). The visual analogue scale (VAS) pain score of the IPL (5.96) was higher than that of the laser (3.10) (P < 0.01). Conclusions: A series of high fluence single pass IPL and low fluence multiple pass diode laser treatments were performed with similar efficacy, speed and safety for permanent hair reduction. However, low fluence multiple pass diode laser treatment was less painful than high fluence single pass IPL.     

Novel laser hair removal in all skin types

Background

Laser has been long accepted as a solution for excess or unwanted hair growth yet traditional lasers are not always ideal for safe and effective outcome for all skin types and hair characteristics. A diode laser module combining three wavelengths (755, 810, and 1064 nm) in a single pulse was developed to provide a fast and long-term solution for subjects with various profiles.

Aims

To evaluate the safety and efficacy of a Triple wavelength diode laser module for hair removal treatment in all skin types (Fitzpatrick I–VI).

Subjects and methods

This was a prospective, dual centered, single-arm study. Subjects were treated with a novel diode laser module. Thirty-six subjects were enrolled, sixteen with Fitzpatrick skin types I–IV (46%) and twenty with Fitzpatrick skin types V–VI (54%). Treatment areas were axilla and bikini lines. Subjects underwent 4 treatment sessions at 6 weeks ± 5 days intervals and attended a follow-up visit 3 months after the last treatment session. 2D digital photographs were taken at baseline and at the follow-up visit, and a hair count was conducted by three blinded evaluators.

Results

A significant reduction in hair count between baseline and the 3-month follow-up visit was observed in both axilla and bikini lines for all skin types. The mean hair reduction was 41.5 ± 19.4% and 48.1 ± 20.9% in the axilla and bikini line, respectively. A significant hair reduction was also observed within skin type groups; mean hair reduction 45.5 ± 16.9% and 40.3 ± 17.2% in skin types I–IV and V–VI, respectively, indicating similar efficacy for both light and dark skin types. No serious adverse events were reported.

Conclusions

This study demonstrates that the Soprano Titanium laser platform is safe and effective for hair removal treatment in all skin types.     

Effects of ambient room temperature on cold air cooling during laser hair removal

Forced air cooling is a well-established technique that protects the epidermis during laser heating of deeper structures, thereby allowing for increased laser fluences. The goal of this prospective study was to identify whether an elevation in ambient room temperature influences the efficacy of forced air cooling. Skin surface temperatures were measured on 24 sites (12 subjects) during cold air exposure in examination rooms with ambient temperatures of 72 degrees F (22.2 degrees C) and 82 degrees F (27.8 degrees C), respectively. Before cooling, mean skin surface temperature was 9 degrees F (5 degrees C) higher in the warmer room (P < 0.01). Immediately after exposure to forced air cooling (within 1 s), the skin surface temperature remained considerably higher (10.75 degrees F, or 5.8 degrees C, P < 0.01) in the warmer room. We conclude that forced air cooling in a room with an ambient temperature of 82 degrees F (27.8 degrees C) is not as effective as in a room that is at 72 degrees F (22.2 degrees C).     

A 12-month follow-up of hypopigmentation after laser hair removal

Abstract

Introduction: Laser hair removal is becoming an increasingly popular alternative to traditional methods such as shaving, waxing, among other methods. Semiconductor diode lasers are considered the most efficient light sources available and are especially well suited for clinical applications including hair reduction. The effectiveness of laser hair reduction depends on many variables, including the skin type of the patient. Material and Methods: A patient with Fitzpatrick Skin Type IV was submitted to laser hair removal of the arms with a high-power diode laser system with long pulses with a wavelength of 800 nm, a fluence of 40 J/cm² and a pulse width of 20 ms. A 12-month follow-up assessment was performed and included photography and questionnaire. Results: Hypopigmentation was observed after a single laser hair removal section. After 6 months with the area totally covered, a gradual suntan with a sun screen lotion with an SPF of 15 was prescribed by the dermatologist. After 12 months of the initial treatment, a complete recovery of the hypopigmentation was achieved. Conclusion: Although a safe procedure, lasers for hair removal may be associated with adverse side effects including undesired pigment alterations. Before starting a laser hair removal treatment, patients seeking the eradication of hair should be informed that temporary, and possibly permanent, pigmentary changes may occur.     

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。     

From flint razors to lasers: a timeline of hair removal methods

Today, most do not go a day without practicing or hearing about new hair removal methods. However, little is discussed about the history of hair removal and the development of most hair removal methods since the period of cavemen. Avoiding decapitation and fitting in with society are two of many reasons for the development of this now normative practice. Knowledge of the hair growth cycle is vital in understanding the efficacy of various hair removal methods as well as the difference between epilation and depilation. While laser hair removal (LHR) is one of the most common cosmetic procedures practiced in the world, according to the FDA, the only current permanent form of hair removal is electrolysis. These two methods as well as various other ones are discussed in this article. Further developments are being made every day to better treat the removal of blonde and white hair as well as to diminish the pain of hair removal. With these developments, dermatologists will better understand the advancement of hair removal methods and the reasons why patients may seek treatment.