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.     

Effects of the 810-nm diode laser on hair and on the biophysical properties of skin

Abstract

Introduction: Laser therapy is clinically effective in hair removal; however, despite the development of various strategies, laser procedures still present a risk of adverse effects due to the overheating of the skin. Objective: To investigate the effects of 810-nm diode laser treatment on hair and on the biophysical properties of skin by using various non-invasive techniques on various parameters, including hair analysis, surface color changes, integrity of skin barrier, sebum production rate and pH level. Methods: In this randomized, right–left comparison study, 35 women with axillary hair received single-session diode laser therapy. Hair analysis and biophysical properties of the skin were assessed before treatment and at weeks 2, 4 and 6 after the therapy. Results: Hair density and thicknesses statistically significantly decreased after the first post-treatment evaluation. Regarding comparison of the biophysical properties of the skin, there was no statistically significant difference in the assessments, except for the increase determined during the second week in the erythema index in the laser-treated areas. Conclusion: The findings of this study showed that the diode laser can perform a significant reduction in the hair amount without significant epidermal damage, at least for a short period.     

A randomized,single-blind,study evaluating a 755-nm picosecond pulsed Alexandrite laser vs. a non-ablative 1927-nm fractionated thulium laser for the treatment of facial photopigmentation and aging

Background: Laser toning is one of the most popular strategies to treat facial photopigmentation and aging. Several laser modalities, including fractional non-ablative, Q-switched (QS) lasers and new generation picosecond lasers have been used for this indication. However, there is paucity of head to head comparisons of older generation of lasers with new ones.

Objective: To compare a 755 nm picosecond pulsed alexandrite laser with a non-ablative 1927 nm fractionated thulium laser for the treatment of facial photopigmentation and aging through a randomized, single-blind study.

Materials and methods: 20 subjects (skin types I–IV) were randomized to receive either four 755-nm picosecond alexandrite laser treatments, spaced 3 weeks apart, or two dual wavelength thulium fiber fractionated 1550/1927 nm laser treatments, spaced 6 weeks apart. Follow-up assessment visits occurred 4 and 12 weeks after the last study treatment.

Results: At the 4- and 12-week follow-up, both groups showed significant improvement of photoaging, pigmentation, skin quality according to the investigator and subjects assessments. When comparing the two groups, subjects in 755 nm group had statistically significant greater improvement in investigator assessments of photoaging/skin quality and subject satisfaction than those in the 1927 nm group.

Conclusion: Both the non-ablative 1927 and 755 nm picosecond laser can improve facial photopigmentation, but the latter can yield superior results with less pain and side effects according to patient and investigator assessments.     

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.     

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.     

Combined laser assisted treatment for permanent hair removal for skin types I‐V with Alexandrite 755 nm and ND:YAG 1064 nm lasers

This retrospective cohort study regarding hair removal procedures considers all the data collected in three different clinical centers from 2017 to 2019. The device used to perform the treatments was composed of an Alexandrite 755 nm and an Nd:YAG 1064 nm laser, that delivered both wavelengths in a blended simultaneous emission (Thunder MT, Quanta System, Samarate, Italy). The improvement evaluated after five sessions of treatment by an external referee was: 83.0% for armpits, 82.1% for the bikini line, 82.2% for legs, 79.6% for thorax, and 81.6% for the back. The collected temporary skin reaction data reported in this study were all acceptable and transitory resolving in less than 1 week. The level of erythema and perifollicular edema were all signs of the reached treatment endpoint. First degree burns, hyper, and hypopigmentation were also reported in a few cases but these, all resolved before the follow‐up visit without any permanent skin effects. No adverse effects were thus reported to have happened. This retrospective study demonstrates the efficacy of combining Alexandrite and Nd:YAG lasers in a mixed modality with simultaneous emission. This technology permitted to treat patients with skin types I‐V without any reported permanent side effects and with a high pain tolerability compared to the use of Nd:YAG in single mode.     

Effect of piroxicam gel for pain control and inflammation in Nd:YAG 1064-nm laser hair removal

Background Laser‐assisted hair removal is a variably uncomfortable and painful procedure. Objective The aim of this study was to investigate the efficacy of piroxicam gel on pain control and subsequent inflammation in Nd:YAG 1064 nm laser hair removal in women volunteers. Methods Fifty women volunteers were enrolled in this prospective, randomised, placebo‐controlled study over a 6‐month period. Subjects were randomly assigned to receive piroxicam gel as Group P or saline as a control group. Topical analgesic and saline were applied to the treatment sites for 45 minutes. The pain scores (VAS) and side effects were recorded before the hair removal, during the hair removal, at the end of the hair removal, and after 1 hour, 2 hours and 24 hours after the hair removal. Results Subject characteristics and treatment settings in Nd:YAG 1064 nm laser were similar in both groups. The pain scores (VAS) were significantly lower in the Group P than those of the control group during the hair removal (p < 0.001). Inflammatory side effects such as erythema, edema, and folliculitis, were more frequent in the control group than those of Group P during the procedure (p < 0.001). Conclusion This study showed that piroxicam gel provided adequate pain relief after Nd:YAG 1064 nm laser hair removal in women volunteers. Piroxicam gel was associated with lesser inflammatory side effects when compared to placebo because of its anti‐inflammatory effect after the procedure.     

Evaluation of the vacuum-assisted handpiece compared with the sapphire-cooled handpiece of the 800-nm diode laser system for the use of hair removal and reduction

Abstract

Background: A handpiece with a 35 × 22-mm treatment window that uses vacuum technology has been designed for the diode laser system. Vacuum suction stretches the skin and brings the hair follicle closer to the surface with the intent to damage the hair follicle at a lower surface fluence. The objective of this study was to compare the degree of follicular thermal damage between the sapphire-cooled smaller handpiece at a higher fluence versus the larger vacuum-assisted handpiece at a lower fluence. Methods: Five male patients with Fitzpatrick skin types I–IV were enrolled in the study. Three test spots on the right back were treated with the vacuum-assisted laser handpiece at a setting of 10–12 J/cm², and 61-ms pulse duration. Three test spots on the left back were treated with the sapphire-cooled handpiece with a setting of 30–34 J/cm² and a pulse duration of 14–16 ms. A punch biopsy was obtained from one treated area for each handpiece type. The biopsies were sectioned horizontally and examined for the degree of thermal damage to the hair follicle at the level of the isthmus and the bulb. Immediate treatment response, pain score, and total treatment time were recorded. Results: Biopsies from the skin treated with the sapphire-cooled handpiece and the vacuum-assisted handpiece showed the mean hair follicle diameter was 258.3 µm (SE [standard error] 41.7) and 225.1 µm (SE 17.1), respectively. The mean thermal damage diameter to hair diameter ratio was 0.91 (SE 0.10) and 0.72 (SE 0.12), respectively. The mean immediate treatment response, the mean pain severity, and the mean total treatment time were all lower for the vacuum-assisted handpiece. Conclusion: Treatment with the vacuum-assisted handpiece is faster and has a tendency to be more comfortable. Thermal damage to the hair follicle was greater with the sapphire-cooled handpiece.     

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。     

Combination of 595-nm pulsed dye laser,long-pulsed 755-nm alexandrite laser,and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients

Abstract

Keratosis pilaris (KP) has beenpresented as small keratotic follicular papules with or without surrounding erythema. Various treatments with laser or light therapy have been used for the management of KP with various clinical outcomes. In the present study, we investigated the efficacy and safety of a combination therapy for KP. A total of 29 anatomical sites with KP in 26 patients were treated using a 595-nm pulsed dye laser (PDL) with nonpurpuragenic fluences, a long-pulsed 755-nm alexandrite laser, and microdermabrasion. Clinical improvement was assessed by comparing preand posttreatment clinical photographs and patient satisfaction rates. Evaluation of the clinical results three months after the treatments showed that 12 of the 29 anatomical sites (41.4%) demonstrated Grade 3 clinical improvement, ten (34.5%) had Grade 2 clinical improvement, four (13.8%) showed Grade 1 improvement, and three (10.3%) showed Grade 4 improvement. We observed that KP lesions improved not only in erythema and skin texture, but also in brownish dyschromias. Potential adverse events were not observed, except prolonged posttherapy scaling. Our observations demonstrate that combination therapy using a 595-nm PDL, a long-pulsed 755-nm alexandrite laser, and microdermabrasion can have a positive therapeutic effect on KP.     

Comparison of hair reduction with three lasers and light sources: Prospective,blinded and controlled study

Abstract

Objective: The main goal of this study was to compare the hair removal efficacy of three methods: intense pulsed light (IPL), a combination of IPL and radio frequency (RF) and diode laser (810 nm). Methods: Forty participants were treated within three standardized squares on lateral sites on their legs. Each of these squares was treated twice with an interval of 4–6 weeks. The fourth square was left as a control. A blinded physician counted the hairs in each square before the first treatment and 8 months after the second treatment. Immediate and delayed side effects as well as pain scores were recorded. Results: The mean hair count reduction achieved by the diode laser, IPL and IPL+RF was 49.90%, 39.16% and 47.15%, respectively. This study did not show any serious side effects and the number of side effects was minimal. The mean pain scores for the first and second treatments by diode laser, IPL and IPL+RF were 4.65 and 4.58, 2.43 and 2.53, and 3.95 and 4.03, respectively. At the end of the study, a free hair removal treatment for both legs was chosen by patients in the proportion 20 diode laser, 10 IPL and eight IPL+RF. Conclusions: The combination of RF and optical energies proved its safety and efficacy for hair removal, which is comparable with diode lasers and approximately 20% more efficient than ‘pure’ IPL.     

Hair removal utilizing the LightSheer Duet HS hand piece and the LightSheer ET: A comparative study of two diode laser systems in Chinese women

Abstract

Objective: To compare the clinical efficacy, safety and pain associated with the use of the LightSheer Duet HS as compared to the original LightSheer ET diode Laser for axillae hair removal in Chinese women. Methods: Thirty-six Chinese women received three axillae laser hair removal treatments using the LightSheer Duet HS on one side and the LightSheer ET on the other side. Subjects were evaluated for hair removal efficiency. The immediate pain associated with the treatments was noted. Results: At 1 month following the final laser treatment, hair reduction on the LightSheer Duet HS side and on the LightSheer ET side was 81 ± 13% and 85 ± 9% respectively. There was no statistical difference. Immediate pain scores at the first session on the LightSheer Duet HS sites and LightSheer ET sites was 5.71 ± 1.74 and 6.86 ± 1.80 respectively, which was statistically significant (p < 0.05). Following the second and third sessions, immediate pain scores of the LightSheer Duet HS sites were both less than those of the LightSheer ET sites, but the differences were not statistically significant. Conclusions: The LightSheer Duet HS laser is a safe and effective method of hair removal in Chinese women. Treatment with the LightSheer Duet HS causes less pain.     

Efficacy and safety of mascara dyeing as an adjunct to Alexandrite and Nd:YAG laser applications for removing thin and white-colored facial and axillary hair

Introduction: There is no satisfactory and efficient method for long-term removal of white-colored and thin hair. Methods: We conducted a randomised clinical trial of hirsute patients with excessive white and/or thin hair on the face and/or axilla. In Group I (n: 16), the facial hair on one side of the face was painted with a black eyelash mascara immediately before Nd:YAG laser and the other half was only treated by Nd:YAG. In Group II (n: 20), the axillary hair on one side was painted with the mascara before the Alexandrite laser with the other side being only treated by Alexandrite. Results: The terminal hair counts on the painted facial and axillary sides were significantly lower than those on the control sides throughout the study except for the first month. The decrease in the terminal hair count was significant from the beginning of treatment to the second and sixth months on the painted and control facial sides and to the first and sixth months on the axillary sides. Conclusion: Hair coloring with black eyelash mascara is a simple, efficient and safe adjunct to Alexandrite and Nd:YAG laser applications to enhance their clinical efficacy in eliminating white and thin facial or axillary hair.     

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.     

A split axilla comparison study of axillary hair removal with low fluence high repetition rate 810 nm diode laser vs. high fluence low repetition rate 1064 nm Nd:YAG laser

Background A low fluence, high repetition rate 810 nm diode laser using constant motion technique has been recently introduced with advantages of less treatment discomfort and fewer side effects compared with traditional laser hair removal. Objective To compare hair reduction and side effects of low fluence high repetition rate 810 nm diode with high fluence low repetition rate 1064 nm Nd:YAG lasers. Methods Forty‐nine subjects were randomly received five monthly treatments with diode laser on one side of their axilla and long‐pulsed Nd:YAG laser on the other side. Hair count was recorded at baseline, 1‐ and 6‐month follow‐up visits. Results Percentage of axillary hair reduction at 1‐month follow‐up visit after receiving diode and Nd:YAG laser treatment were 71.0% and 82.3%, respectively, and at 6‐month follow‐up were 35.7% and 54.2%, respectively. There were significant differences in hair reduction between both laser systems at 1‐ and 6‐month follow‐ups (P < 0.001 and P < 0.001, respectively). Patients reported lower pain on the diode laser side (P < 0.001). Side effects of both laser systems were mild and transient erythema and swelling. Conclusions High fluence low repetition rate Nd:YAG laser was superior in hair reduction and provided higher patient satisfaction. However, low fluence high repetition rate diode laser was less painful.     

810 nm diode laser for hair reduction with Chill-tip technology: prospective observational analysis of 55 patients of Fitzpatrick skin types III,IV,V

ABSTRACT

Background: Various light based technologies like Diode, long pulsed Nd:Yag and Intense Pulsed Light are used commonly for long-term hair reduction. The commonest indication is hirsutism.

Aim: 1. To evaluate efficacy and safety of 810 nm Diode laser in Fitzpatrick skin types III, IV and V.

2. To assess percentage of cases on the basis of indications, average number of sessions, fluence required, the long-term results and complications using diode laser in darker skin types.

Methods: A prospective observational study of 55 consecutive patients who came for laser hair reduction by 810 nm Light Sheer Diode laser with Chill tip technology was carried out. The sessions were conducted at an interval of 4–6 weeks and the patients were followed up over a period of 2 years. Data was analyzed using software SPSS (Statistical Package for Social Science. Ver.12, Inc. Chicago, USA).

Results: Fifty-five patients (51 females and 4 males) were studied. 67.3% (n = 37) had skin type IV. The most common area treated was chin (n = 23). The average growth reduction of terminal hair at the end of three sessions was 61.25%. Only 8% (n = 4) had short-term side effects.

Conclusion: Diode laser is highly effective for long-term hair reduction of terminal hair growth in Fitzpatrick skin type III, IV and V with no permanent side effects.

Abbreviations: LHR (Laser Hair Reduction)     

Hair removal in hirsute women with normal testosterone levels: a randomized controlled trial of long‐pulsed diode laser vs. intense pulsed light

Background Hirsutism is a common disorder in women of reproductive age, and androgen disturbances may aggravate the condition. Limited evidence exists regarding efficacy of hair removal in this specific population and no data are available for patients with verified normal testosterone levels. Objectives To compare efficacy and safety of intense pulsed light (IPL) vs. long‐pulsed diode laser (LPDL) in a well‐defined group of hirsute women with normal testosterone levels. Methods Thirty‐one hirsute women received six allocated split‐face treatments with IPL (525–1200 nm; Palomar Starlux IPL system) and LPDL (810 nm; Asclepion MeDioStar XT diode laser). Testosterone levels were measured three times during the study period. Patients with intrinsically normal or medically normalized testosterone levels throughout the study were included in efficacy assessments (n = 23). Endpoints were reduction in hair counts assessed by blinded photoevaluations at baseline and 1, 3 and 6 months after final treatment, patient‐evaluated reduction in hairiness, patient satisfaction, treatment‐related pain and adverse effects. Results IPL and LPDL reduced hair counts significantly, with median reductions from baseline of 77%, 53% and 40% for IPL and 68%, 60% and 34% for LDPL at 1, 3 and 6 months, respectively. At 6 months follow‐up, there was no significant difference between treatments in terms of hair reduction (P = 0·427), patient assessment of hairiness (P = 0·250) and patient satisfaction (P = 0·125). Pain scores were consistently higher for IPL [median 6, interquartile range (IQR) 4–7] than LPDL (median 3, IQR 2–5) (P < 0·001). Conclusion Hirsute women with normal or medically normalized testosterone levels responded equally well to IPL and LPDL treatments of facial hairiness, but the efficacy declined over 6 months.