Guidelines for laser hair removal

Requests for removal of unwanted body hair are common in dermatologic and surgical practices. Technology continues to improve the achievement of a more permanent reduction through the use of lasers. Despite the increased use of lasers, to date, few guidelines exist in terms of how to approach laser hair removal. Specifically, one must understand the mechanism of hair growth and how lasers work to target the hair follicle. There is significant variation among practitioners in pre‐and post‐laser recommendations to patients as well as intervals between treatment sessions. We performed a thorough review of the literature in order to determine evidence for the ideal interval between treatment sessions and the ideal number of sessions. We also sought to establish, based on published reports, the recommendations for shaving, plucking, waxing or other hair removal methods prior to laser hair removal and the guidelines for sun exposure before and after laser treatments. Finally, we searched the literature to find out whether there are areas that should not be treated with laser hair removal. The evidence and recommendations in this article aim to help guide practitioners in their approach to laser hair removal.     

In vivo hair growth-stimulating effect of medicinal plant extract on BALB/c nude mice

Abstract

Context: Chrysanthemum zawadskii var. latilobum (Asteraceae) (CZ) and Polygonum multiflorum Thunb. (Polygonaceae) (PM) have been used traditionally to treat different systemic diseases and acclaimed for various biological activities including hair growth.

Objective: This study investigates the hair restoration efficacy of selected medicinal plant extracts on nude mice.

Materials and methods: Nude mice genetically predisposed to pattern balding were used in this study. Topical methanol extracts of CZ and PM (10?mg/mouse/d) with standardized vehicle formulation, only vehicle (propylene glycol:ethanol:dimethyl sulfoxide, 67:30:3% v/v) and Minoxidil (2%) were applied daily for 40 consecutive days.

Results: In our study, the maximum hair score (2.5?±?0.29) was obtained in the CZ-treated group. Histological observation revealed a significant increase (p?<?0.001) in the number of hair follicles (HF) in CZ-treated mice (58.66?±?3.72) and Minoxidil-treated mice (40?±?2.71). Subsequently, immunohistochemical analysis also confirmed the follicular keratinocyte proliferation by detection of BrdU-labeling, S-phase cells in Minoxidil and CZ-treated mouse follicular bulb and outer root sheaths.

Conclusion: Our study revealed the underlying mechanism of stimulating hair growth in athymic nude mice by repair the nu/nu follicular keratin differentiation defect. Thus, the topical application of CZ may represent a novel strategy for the management and therapy of certain forms of alopecia.     

Deletion of mouse Porcn blocks Wnt ligand secretion and reveals an ectodermal etiology of human focal dermal hypoplasia/Goltz syndrome

The Drosophila porcupine gene is required for secretion of wingless and other Wnt proteins, and sporadic mutations in its unique human ortholog, PORCN, cause a pleiotropic X-linked dominant disorder, focal dermal hypoplasia (FDH, also known as Goltz syndrome). We generated a conditional allele of the X-linked mouse Porcn gene and analyzed its requirement in Wnt signaling and embryonic development. We find that Porcn-deficient cells exhibit a cell-autonomous defect in Wnt ligand secretion but remain responsive to exogenous Wnts. Consistent with the female-specific inheritance pattern of FDH, Porcn hemizygous male embryos arrest during early embryogenesis and fail to generate mesoderm, a phenotype previously associated with loss of Wnt activity. Heterozygous Porcn mutant females exhibit a spectrum of limb, skin, and body patterning abnormalities resembling those observed in human patients with FDH. Many of these defects are recapitulated by ectoderm-specific deletion of Porcn, substantiating a long-standing hypothesis regarding the etiology of human FDH and extending previous studies that have focused on downstream elements of Wnt signaling, such as β-catenin. Conditional deletion of Porcn thus provides an experimental model of FDH, as well as a valuable tool to probe Wnt ligand function in vivo.     

A cluster of childhood leukaemias near two neighbouring nuclear installations in Northern Germany: prevalence of chromosomal aberrations in peripheral blood lymphocytes

Purpose : Between 1990 and 1991 a leukaemia cluster was observed in children living close to the combined site of a nuclear power plant and a nuclear research facility in Elbmarsch, a region in Lower Saxony (Germany). We aim to investigate the prevalence of presumably radiation-induced chromosomal aberrations in peripheral blood lymphocytes of children in Elbmarsch and children of a control region in order to find out whether there was an uncontrolled release of radioactive material which resulted in a substantial exposure. Materials and methods : The frequency of dicentric and ring chromosomes in lymphocytes of the peripheral blood in 42 children in Elbmarsch and 30 children in Plön was investigated. Children in both groups had been permanent residents of the study area. Results : The mean frequency of dicentric and ring chromosomes in Elbmarsch was 14/32580 cells (=0.430 ×10 -3 ; 95% CI 0.24-0.70 ×10 -3 cells), and in Plön it was 17/24065 cells (=0.706 ×10 -3 ; 95% CI 0.42-1.10 ×10 -3 cells). Conclusions : No difference in the frequency of dicentric and ring chromosomes was observed between children in Elbmarsch living close to a combined site of a nuclear power plant and a nuclear research facility and children living in the control area Plön. The power of the study to detect a threefold or higher increase in the aberration frequency was at least 0.86.     

Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

Pigmented facial macules are common on sun damage skin. The diagnosis of early stage lentigo maligna (LM) and lentigo maligna melanoma (LMM) is challenging. Reflectance confocal microscopy (RCM) has been proven to increase diagnostic accuracy of facial lesions. A total of 154 pigmented facial macules, retrospectively collected, were evaluated for the presence of already‐described RCM features and new parameters depicting aspects of the follicle. Melanocytic nests, roundish pagetoid cells, follicular infiltration, bulgings from the follicles and many bright dendrites and infiltration of the hair follicle (ie, folliculotropism) were found to be indicative of LM/LMM compared to non‐melanocytic skin neoplasms (NMSNs), with an overall sensitivity of 96% and specificity of 83%. Concerning NMSNs, solar lentigo and lichen planus‐like keratosis resulted better distinguishable from LM/LMM because usually lacking malignant features and presenting characteristic diagnostic parameters, such as epidermal cobblestone pattern and polycyclic papillary contours. On the other hand, distinction of pigmented actinic keratosis (PAK) resulted more difficult, and needing evaluation of hair follicle infiltration and bulging structures, due to the frequent observation of few bright dendrites in the epidermis, but predominantly not infiltrating the hair follicle (estimated specificity for PAK 53%). A detailed evaluation of the components of the folliculotropism may help to improve the diagnostic accuracy. The classification of the type, distribution and amount of cells, and the presence of bulging around the follicles seem to represent important tools for the differentiation between PAK and LM/LMM at RCM analysis.     

Determination of testosterone esters in the hair of male greyhound dogs using liquid chromatography–high resolution mass spectrometry

The doping of greyhound dogs with testosterone is done in an attempt to improve their athletic performance, but such doping cannot easily be confirmed, especially in male dogs owing to the natural presence of endogenous testosterone. As testosterone is usually administered as its esters, their direct detection in hair would provide confirmatory evidence of the administration of a pharmaceutical product. This article demonstrates that the use of a liquid chromatography–high resolution mass spectrometry method with heated electrospray ionisation (HESI) combined with the use of amino solid‐phase extraction (SPE) cartridges for sample clean‐up, is suitable for the sensitive determination of propionate, phenyl propionate, isocaproate, decanoate, and enanthate esters of testosterone in greyhound hair. The method is linear over the range, 0.1 μg/kg–10 μg/kg, for all the testosterone esters analysed. The limits of detection (LOD) are 0.05 μg/kg for testosterone phenyl propionate, isocaproate, and decanoate, 0.025 μg/kg for testosterone propionate, and 0.25 μg/kg for testosterone enanthate. This method was applied to hair samples collected from male greyhounds before and after a single administration of a product containing several testosterone esters, each of which could be detected up to 100 days post‐administration. The study also demonstrates that tail hair is the specimen of choice for the analysis of testosterone in dog hair and that washing of dogs does not impact the analysis of testosterone esters in hair. This method may be useful in racing regulation for the detection of illegitimate use of testosterone in all species.     

Hair removal with a novel,low fluence,home-use intense pulsed light device

Objective: To evaluate the reduction in unwanted body and facial hair at various body sites of Fitzpatrick skin types I–III and the efficacy, comfort and safety of this treatment intended for home-use by the general public. Methods: In this non-randomized study, 29 individuals were given three sequential weekly treatments on a total of 31 body and facial areas including the axilla, bikini area, abdomen, neck, chin and upper lip using a novel intense pulsed light device. All participants completed a simple self-assessment questionnaire, as well as an evaluation of pain/discomfort. Results: The mean reduction in terminal hair counts was 47% at 4 weeks' follow-up and 41% at 6 months' follow-up after completing three sequential weekly treatments. Overall, 84% of participants showed a significant percentage of hair reduction (p<0.01) at the 6-month follow-up, with a mean of 51% (range 25–86%). No treatment-related side effects were reported, with little or no discomfort reported during the treatment. Only mild erythema was noted immediately post-treatment. In total, 85% of the participants were either pleased or very pleased with the results 1 month after the third treatment. Conclusions: In simulated consumer use, this home-use IPL demonstrated a significant, quantifiable and sustainable reduction in unwanted body and facial hair with minimal side effects.