Advances in laser hair removal in skin of color

Laser hair removal, previously contraindicated in patients with ethnically dark (phototypes IV-VI) or sun-tanned skin, is now recognized as a safe and effective method of permanent hair reduction in all patients. Longer wavelengths, conservative fluences, longer pulse durations and appropriate cooling methods are necessary to minimize untoward side effects and maximize efficacy. The longer wavelength Nd:YAG laser is considered safest in treating darker skin of color. An added benefit of laser epilation is that side effects of conventional hair removal such as pseudo-folliculitis barbae and post inflammatory dyspigmentation, more commonly seen in skin of color, may also respond favorably to the laser, thus increasing the potential for patient satisfaction.     

Excess salt and pepper hair treated with a combination of laser hair removal and topical eflornithine HCl

A common problem among aging women, salt and pepper facial hair poses a significant psychosocial impact as well as a challenge for treatment. Various laser therapies or topical eflornithine HCl 13.9% cream are commonly used to reduce the rate of hair growth. We report a case of a woman with salt and pepper hair in the beard distribution. A combination of laser hair removal with concurrent use of topical eflornithine was used in the treatment.     

Comparison between sequentional treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism

Laser systems that are commonly used for the treatment of hirsutism include the ruby laser (694 nm), the diode laser (800 nm), the alexandrite laser (755 nm) and the Nd:YAG laser (1084 nm). The diode laser and alexandrite laser are considered effective in treatment of hirsutism in dark-skinned patients. The response of hairs to these laser systems is variable and not complete. In this study, we compared the efficacy of these two laser systems for permanent hair removal. This was a randomized, controlled clinical trial that was performed with women of the age range 15-45 years old. After obtaining informed consent, the samples were randomized into two groups using random allocation software. The first group was treated with alexandrite laser alone (four sessions, two months apart). The second group was treated sequentially with diode laser for the first two sessions and alexandrite laser for the next two sessions. Overall, 111 patients (57 patients in the alexandrite laser group and 54 patients in the sequential diode-alexandrite laser group) were evaluated. There was no significant difference regarding mean of hair reduction between the two groups during the courses of treatment. Except for the first session, there was no significant difference regarding percent of patient satisfaction between the two groups (P value >0.05). Comparison between the two groups showed no significant difference one month, three months and six months after the last treatment (P value >0.05). Regarding the results of our study, there is no significant difference between sequential treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism. We suggest that in further studies, the efficacy of sequential treatment with other laser systems is evaluated against single treatment methods.     

Comparison of adverse events of laser and light-assisted hair removal systems in skin types IV-VI

Photoepilation, utilizing lasers and noncoherent light sources, is designed to irradiate as much of the follicular unit as possible, with melanin as the target chromophore. Wavelength absorption should generate energy sufficient to heat and destroy the hair follicle, while preserving the surrounding tissue. When performing photoepilation on African-American skin (Fitzpatrick skin types IV-VI) a greater risk of potential epidermal adverse events, such as dyspigmentation, blistering, crusting, edema, and subsequent scarring, is possible. To reduce epidermal melanin absorption of energy longer wavelengths are considered safer for use on Fitzpatrick skin types IV to VI. This article reviews and compares the reported incidences of adverse events in African-American skin, utilizing lasers and noncoherent light sources for assisted hair removal.     

激光焊接技术在口腔修复中的临床应用分析

目的：分析激光焊接技术在口腔修复中的应用。方法抽选本院口腔科需要进行口腔修复的患者180例,其中由于全冠龈边缘较短行激光焊接的90例,焊接铸造支架连接杆55例和修理卡环的患者35例。通过观察患者口腔修复后牢固情况、腐蚀折断及牙龈健康状况,来分析激光焊接技术的临床应用。结果观察患者口腔修复后记录,90件中不牢固的3例（占3.33%）,牙龈炎的4例（占4.44%）;修理的支架连接体的55件中不牢固和折断的各1例（占1.81%）;修理卡环的35件中不牢固只有1例（占2.85%）,而其他不良问题均未发现。结论激光焊接因其本身的独特性和优越性,在口腔修复中有着不可替代的作用,对口腔修复的质量有很大提高,临床应用可信赖。     

Clinical evaluation of a handheld self-treatment device for hair removal

BACKGROUND AND OBJECTIVES: Laser- and light-based methods for hair removal, though effective, are expensive and may be associated with adverse effects. Our objective was to evaluate the efficacy and safety of a thermal, handheld self-treatment device (no!no! Thermicon, Radiancy Inc, Orangeburg, NY) for removing unwanted hair. METHODS: Twelve of the 20 enrolled subjects underwent 6 supervised and 6 unsupervised self-treatments of their lower legs and umbilicus-bikini areas at twice-weekly intervals for 6 weeks. Follow-up visits were scheduled at 2, 6, and 12 weeks after the final treatment. Results were evaluated by pretreatment, post-treatment, and follow-up hair counts. RESULTS: For legs, the median clearance percentages were 48% post-treatment and 43.5% at 12 weeks. For the umbilicus-bikini area, the median clearance percentage was 15% at 12 weeks. CONCLUSIONS: The efficacy and safety of the no!no! Thermicon device for hair removal of the legs appear to be comparable to those of laser devices.     

Case reports: clearance of lentigines in Japanese men with the long-pulsed alexandrite laser

Benign pigmented lesions can be effectively treated with multiple modalities including lasers. The treatment of pigmented lesions in phototype IV skin is more complicated and challenging given the risk of pigmentation changes and scarring. We present the novel use of the long-pulsed Alexandrite 755 nm laser for the treatment of solar lentigines in sun-reactive phototype IV skin of patients of Japanese decent. Our Japanese patients cleared with one treatment with no pigmentary changes or scarring. No recurrences were noted to date. The long-pulsed Alexandrite 755-nm laser is a novel, safe, and effective treatment of solar lentigines in Japanese patients.     

长脉冲可调脉宽1064nm Nd∶YAG激光在脱毛上的临床应用

目的研究长脉冲可调脉宽1064nm Nd∶YAG激光脱毛的临床应用,并比较光斑垂直照射与光斑倾斜照射两种治疗方法的疗效。方法通过分组治疗,比较治疗部位毛发平均清除率、治疗后12个月毛发再发生率及不良反应。结果采用光斑倾斜照射治疗组比光斑垂直照射治疗组的平均清除率高出8%～12%,毛发再发生率低2%～6%。结论让光斑朝着皮肤毛发的生长方向作用,探头与皮肤成一定倾角,相对于光斑垂直作用于皮肤,疗效更好。     

The role of hormones and hormonal treatments in premenstrual syndrome

Premenstrual syndrome (PMS) is a menstrual cycle-linked condition with both mental and physical symptoms. Most women of fertile age experience cyclical changes but consider them normal and not requiring treatment. Up to 30% of women feel a need for treatment. The aetiology is still unclear, but sex steroids produced by the corpus luteum of the ovary are thought to be symptom provoking, as the cyclicity disappears in anovulatory cycles when a corpus luteum is not formed. Progestogens and progesterone together with estrogen are able to induce similar symptoms as seen in PMS. Symptom severity is sensitive to the dosage of estrogen. The response systems within the brain known to be involved in PMS symptoms are the serotonin and GABA systems. Progesterone metabolites, especially allopregnanolone, are neuroactive, acting via the GABA system in the brain. Allopregnanolone has similar effects as benzodiazepines, barbiturates and alcohol; all these substances are known to induce adverse mood effects at low dosages in humans and animals. SSRIs and substances inhibiting ovulation, such as gonadotrophin-releasing hormone (GnRH) agonists, have proven to be effective treatments. To avoid adverse effects when high dosages of GnRH agonists are used, add-back hormone replacement therapy is recommended. Spironolactone also has a beneficial effect, although not as much as SSRIs and GnRH agonists.     

The role of hair follicles in the percutaneous absorption of caffeine

Aims

The skin and its appendages are our protective shield against the environment and are necessary for the maintenance of homeostasis. Hypotheses concerning the penetration of substances into the skin have assumed diffusion through the lipid domains of the stratum corneum. It is believed that while hair follicles represent a weakness in the shield, they play a subordinate role in the percutaneous penetration processes. Previous investigation of follicular penetration has mostly addressed methodical and technical problems. Our study utilized a selective closure technique of hair follicle orifices in vivo, for the comparison of interfollicular and follicular absorption rates of caffeine in humans.

Methods

Every single hair follicle within a delimited area of skin was blocked with a microdrop of a special varnish-wax-mixture in vivo. Caffeine in solution was topically applied and transcutaneous absorption into the blood was measured by a new surface ionization mass spectrometry (SI/MS) technique, which enabled a clear distinction to be made between interfollicular and follicular penetration of a topically applied substance.

Results

Caffeine (3.75 ng ml⁻¹) was detected in blood samples, 5 min after topical application, when the follicles remained open. When the follicles were blocked, caffeine was detectable after 20 min (2.45 ng ml⁻¹). Highest values (11.75 ng caffeine ml⁻¹) were found 1 h after application when the follicles were open.

Conclusions

Our findings demonstrate that hair follicles are considerable weak spots in our protective sheath against certain hydrophilic drugs and may allow a fast delivery of topically applied substances.

What is already known about this subject

• In recent years, it has been suggested that hair follicles represent important shunt routes into the skin for drugs and chemicals [1–3].
• In vitro studies have shown the importance of skin appendages for skin penetration by hydrophilic compounds [4]. Investigation of follicular penetration in vivo has been difficult due to the absence of appropriate analytical methods or suitable animal model systems.
• Recently, a new method was described that quantifies follicular penetration in vivo by using selective closure of hair follicles [5].
• Caffeine is frequently used in skin penetration experiments as a model for highly water-soluble compounds. Occlusion [6] and skin thickness [7] seem to have little influence on the penetration of caffeine. However, percutaneous absorption rates for caffeine exhibit regional skin differences in humans in vivo[1].

What this study adds

• The results of the present study demonstrate that a fast drug delivery of caffeine occurs through shunt routes. Therefore, hair follicles are considerable weak spots in our protective sheath against penetration into the body by hydrophilic substances.
• We showed that there is a quantitative distinction between follicular penetration and interfollicular diffusion of caffeine in vivo.
• These findings are of importance for the development and optimization of topically applied drugs and cosmetics. In addition, such properties must be considered in the development of skin protection measures.

     

Detection of stimulants in hair by laser microscopy

In order to detect methamphetamine, a common stimulant, laser microscopy and immuno-histochemical staining, which uses anti-methamphetamine labeled with colloidal gold, were employed. The intensity of reflection of colloidal gold at a 488- and 514-nm line of Ar laser was measured with a laser microscope equipped with a computerized image processing system. Microtomed hair samples from five drug users who died from methamphetamine intoxication were used. The drug distribution in the hair was quite different in these five cases, but the levels of drug concentration in two different hair samples from the same abuser were correlated. The results from two hair samples with roots showed a correlation between drug concentration in hair roots and plasma samples. The proposed method needs no melanin bleaching and is simple and sensitive enough to estimate the drug concentration using only a segment of hair.     

皮秒755 nm激光与Q开关1064 nm激光治疗颧部褐青色痣的有效性及安全性比较

目的 比较755 nm皮秒激光与Q开关激光1 064 nm治疗颧部褐青色痣的有效性及安全性。方法 选择2020年1月至2021年1月在东莞台心医院就诊的180例颧部褐青色痣病人作为研究对象,按随机数字表法分为皮秒激光组(n=90)和Q开关激光组(n=90)。皮秒激光组采用755 nm皮秒激光治疗,Q开关激光组采用Q开关激光1 064 nm治疗,两组病人均每隔2.5个月治疗1次,连续治疗5次,比较两组病人每次治疗后的显效率、最终痊愈率,不良反应情况及病人满意率。结果 第1、2、3、4、5次治疗后,皮秒激光组病人的显效率为0、14.44%、43.33%、71.76%、93.33%,Q开关激光组病人的显效率为0、21.11%、47.73%、78.82%、94.37%,两组病人每次治疗后的显效率比较均差异无统计学意义(均P>0.05);Q开关激光组病人的最终痊愈率84.44%明显高于皮秒激光组的71.11%(P<0.05)。Q开关激光组患的色素沉着发生率25.56%明显低于皮秒激光组病人的40.00%(P<0.05);Q开关激光组患的病人满意率84.44%与皮秒激光组病人的8...     

The role of serotonergic agents as treatments for alcoholism

Serotonergic agents remain an important area of pharmacologic study as treatments for alcoholism. Selective serotonin reuptake inhibitors (SSRIs) do not appear to be efficacious at treating a heterogeneous alcoholic group. SSRIs may, however, possess utility in treating later-onset alcoholics and alcoholism that is complicated by co-morbid major depression. The 5-HT(1A) partial agonist, buspirone, does not appear to be an efficacious treatment for alcoholics without co-morbid disease. Buspirone may, however, possess some utility in treating alcoholics with co-morbid anxiety disorder. Ritanserin, a 5-HT(2) antagonist, does not appear to be an efficacious treatment for alcoholism at pharmacologically relevant clinical doses. Ondansetron, a 5-HT(3) antagonist, is an efficacious and promising medication for the treatment of earlier-onset alcoholism. The differential treatment effect of SSRIs and ondansetron among various subtypes of alcoholics is intriguing. Future research is needed to more clearly understand the biopsychosocial differences that typify a particular alcoholic subtype. This type of understanding could develop our ability to make reasonable predictions as to what alcoholic subtype would respond best to a particular serotonergic agent, which could then be provided.     

The use of 308-nm excimer laser for dermatoses: experience with 34 patients

Targeted phototherapy has been utilized in the past few years for the treatment of various dermatoses. In this article, we summarize the experience of using 308-nm excimer laser at Henry Ford Hospital, Detroit, MI, for the treatment of psoriasis, vitiligo, palmoplantar psoriasis, and hand dermatitis. A total of 34 patients were treated between January 2003 and February 2005. Of the 28 patients with psoriasis, over 80% had greater than 75% improvement after an average of 12 treatments. While the number of patients was small, excimer laser showed promising results for palmoplantar psoriasis. Possibly due to patient selection bias, we have not had the same success as other studies for the treatment of vitiligo with this modality.     

Nonablative skin tightening with a variable depth heating 1310-nm wavelength laser in combination with surface cooling

A near-infrared laser with the ability to target different depths within skin has been developed and evaluated for the application of facial and neck skin tightening in a pilot clinical study. The device consists of a combination of a 1310-nm wavelength and sapphire contact cooling. Cooling temperature and laser pulse duration were varied to target different dermal depths in various subgroups of the subject population. Quantitative changes in various categories characterizing the aging skin employing a comprehensive grading scale as well as subject satisfaction were calculated. A mean improvement of 7.9% (95% CI [confidence interval] 3.6-12.3) in laxity and 10.6% (95% CI 5.8-15.4) in rhytides was determined by quantitative grading at one month after the treatment regimen. These values were 11.0% (5.5-16.5) and 11.7% (5.8-17.7) at 3 months after the treatment regimen. The percent of patients reporting mild or better improvement in laxity of the face and neck was 78% and 61% at one month, and 63% and 61% at 3 months, respectively. The discomfort was minimal. Side effects were limited to short-term erythema and edema. In summary, a variable depth heating laser can achieve skin tightening and wrinkle reduction with high subject satisfaction.