Long-pulsed Nd:YAG laser vs. intense pulsed light for hair removal in dark skin: a randomized controlled trial

Background Although several lasers meet the wavelength criteria for selective follicular destruction, the treatment of darker skin phototypes is particularly challenging because absorption of laser energy by the targeted hairs is compromised by an increased concentration of epidermal melanin. Objectives To compare satisfaction level, safety and effectiveness of a long‐pulsed Nd:YAG laser and intense pulsed light (IPL) in axillary hair reduction in subjects with dark skin. Methods The study design was a within‐patient, right‐left, assessor‐blinded, comparison of long‐pulsed Nd:YAG laser and IPL. Fifty women (skin phototypes IV–VI) volunteered for removal of axillary hair. Five sessions at 4‐ to 6‐week intervals were performed. Hair counts at both sides were compared at baseline and 6 months after the last session. Final overall evaluations were performed by subjects and clinician at the end of the study. Satisfaction was scored for both devices. Results Thirty‐nine women completed the study. At 6 months, the decrease in hair counts on the laser side (79·4%, P < 0·001 vs. pretreatment) was significantly (P < 0·01) greater than that on the IPL side (54·4%, P < 0·01 vs. pretreatment). Only temporary adverse effects were reported at both sides. Higher pain scores and more inflammation were reported with Nd:YAG laser; however, it was preferred by 29 volunteers (74%). Volunteers reported higher satisfaction score with Nd:YAG laser (P < 0·01). Conclusions Dark skin can be treated by both systems safely and effectively; however, long‐pulsed (1064 nm) Nd:YAG laser is more effective as reported by both subjects and clinician.