Laser Hair Reduction and Removal

Comparison of Permanent Hair Removal Procedures before Gender-Affirming Vaginoplasty: Why We Should Consider Laser Hair Removal as a First-Line Treatment for Patients Who Meet Criteria

Introduction

Permanent genital hair removal is required before gender-affirming vaginoplasty to prevent hair-related complications. No previous studies have directly compared the relative efficacy, costs, and patient experiences with laser hair removal (LHR) vs electrolysis treatments. Food and Drug Administration (FDA) oversight of medical devices is poorly understood and commonly misrepresented, adversely affecting patient care.

Aim

This study compares treatment outcomes of electrolysis and LHR for genital hair removal and investigates FDA regulation of electrolysis and LHR devices.

Methods

Penile-inversion vaginoplasty and shallow-depth vaginoplasty patients completed surveys about their preoperative hair removal, including procedure type, number/frequency of sessions, cost, and discomfort. Publicly available FDA-review documents and databases were reviewed.

Main Outcomes Measure

Compared to electrolysis, LHR was associated with greater efficiency, decreased cost, decreased pain, and improved patient satisfaction.

Results

Of 52 total (44 full-depth and 8 shallow-depth) vaginoplasty patients, 22 of 52 underwent electrolysis only, 15 of 52 underwent laser only, and 15 of 52 used both techniques. Compared to patients that underwent LHR only, patients that underwent only electrolysis required a significantly greater number of treatment sessions (mean 24.3 electrolysis vs 8.1 LHR sessions, P < .01) and more frequent sessions (every 2.4 weeks for electrolysis vs 5.3 weeks for LHR, P < .01) to complete treatment (defined as absence of re-growth over 2 months). Electrolysis sessions were significantly longer than LHR sessions (152 minutes vs 26 minutes, P < .01). Total treatment costs for electrolysis ($5,161) were significantly greater than for laser ($981, P < .01). Electrolysis was associated with greater pain and significantly increased need for pretreatment analgesia, which further contributed to higher net costs for treatment with electrolysis vs laser. Many LHR and electrolysis devices have been FDA-cleared for safety, but the FDA does not assess or compare clinical efficacy or efficiency.

Clinical Implications

For patients with dark-pigmented hair, providers should consider LHR as the first-line treatment option for preoperative hair removal before gender-affirming vaginoplasty.

Strength and Limitations

This is the first study to compare electrolysis and LHR for genital hair removal. The discussion addresses FDA review/oversight of devices, which is commonly misrepresented. Limitations include the survey format for data collection.

Conclusion

When compared with electrolysis, LHR showed greater treatment efficiency (shorter and fewer treatment sessions to complete treatment), less pain, greater tolerability, and lower total cost. Our data suggests that, for patients with dark genital hair, providers should consider recommending laser as the first-line treatment for permanent genital hair removal before vaginoplasty.

Yuan N, Feldman A, Chin P, et al. Comparison of Permanent Hair Removal Procedures before Gender-Affirming Vaginoplasty: Why We Should Consider Laser Hair Removal as a First-Line Treatment for Patients Who Meet Criteria. Sex Med 2022;10:100545.

Prescription Skin Care Products and Skin Rejuvenation

Beauty of the face is dependent on many factors, measurable and intangible. The concept of a beautiful face varies from era to era and culture to culture. Maintenance, improvement, and creation of beautiful skin benefit from procedures, prescriptive topicals, cosmeceuticals, and cosmetics. Current science and art are children of the efforts of previous practitioners of past generations. A thorough understanding of how the skin ages is necessary for choosing the appropriate therapeutic approach to halt and reverse signs of aging. The concept of beauty, history of skin treatments, skin anatomy, aging process of skin, and prescriptive skin care products are examined herein.

Topical Cyperus rotundus oil: a new therapeutic modality with comparable efficacy to Alexandrite laser photo-epilation

BACKGROUND

Topical Cyperus rotundus oil is an effective and safe method to decrease hair growth. The oil's flavonoids have antiandrogenic activity on androgenic hair. To date, there have been no randomized controlled trials comparing topical C rotundus oil to the available allopathic modalities, such as laser-assisted hair removal.

OBJECTIVES

In an open-label pilot study, the author prospectively evaluated the efficacy of C rotundus essential oil, compared with the Alexandrite laser (GentleLase; Candela Laser Corp, Wayland, Massachusetts) and saline, for reducing unwanted axillary hair.

METHODS

Eligible participants (n=65) with unwanted axillary hair were assigned randomly to 1 of 3 study groups: topical C rotundus oil (group 1), saline (group 2), and Alexandrite laser (group 3). Sixty patients completed the entire study. Three methods were used to evaluate the results: hair counts, observations of independent professionals, and patient self-assessments.

RESULTS

Overall results did not differ significantly between C rotundus oil and the Alexandrite laser (P>.05). However, statistically significant differences were noted with respect to decreased growth of white hair (P<.05), favoring the oil. This finding was evident by all 3 methods of assessment. No side effects were detected.

CONCLUSIONS

Cyperus rotundus essential oil is as effective as the Alexandrite laser for decreasing the growth of axillary hair (both dark and white).

LEVEL OF EVIDENCE

3.