Lasers in the military for cutaneous disease and wound healing

Comparative evaluation of long pulse Alexandrite laser and intense pulsed light systems for pseudofolliculitis barbae treatment with one year of follow up

Background:

Existing remedies for controlling pseudofolliculitis barbae (PFB) are sometimes helpful; however the positive effects are often short lived. The only definitive cure for PFB is permanent removal of the hair follicle.

Aims:

Our aim was to compare the efficacy of the Alexandrite laser with the intense pulsed light system in the treatment of PFB and to follow up the recurrence.

Methods:

Twenty male patients seeking laser hair removal for the treatment of PFB were enrolled in this study. One half of the face was treated with the long-pulse Alexandrite laser and the other half was treated with the IPL system randomly. The treatment outcome and any complications were observed and followed up for one year.

Results:

All patients exhibited a statistically significant decrease in the numbers of papules. Our results showed that the Alexandrite-treated side needed seven sessions to reach about 80% improvement, while the IPL-treated side needed 10-12 sessions to reach about 50% improvement. During the one year follow up period, the Alexandrite-treated side showed recurrence in very minimal areas, while the IPL-treated side showed recurrence in bigger areas.

Conclusions:

Our results showed that both systems might improve PFB but Alexandrite laser was more effective at reducing PFB than IPL.

Treatment of pseudofolliculitis barbae in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser

BACKGROUND

Pseudofolliculitis barbae affects a large number of individuals with coarse curly hair, and present treatment options are suboptimal.

OBJECTIVE

We evaluated the safety and efficacy of a long-pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser in the treatment of pseudofolliculitis barbae.

METHODS

This was a two-phase observational study conducted at a military tertiary medical facility. The study group included 37 patients (skin types IV, V, and VI) referred from primary care physicians with a diagnosis of pseudofolliculitis barbae refractory to conservative therapy. In phase I, one treatment with a Nd:YAG laser was performed on a tattooed area of the thigh with 3 light doses. Epidermal tolerance was evaluated, and hair counts were performed 3 months after treatment for each light dose. In phase II, the highest dose tolerated by the epidermis from phase I was applied to a small submental region of skin with an adjacent site as a control. Subsequently, papule counts were performed 90 days after treatment in the laser-irradiated and control areas.

RESULTS

Phase I: When normalized for controls, there was 33%, 43%, and 40% hair reduction on the thigh for the 50, 80, and 100 J/cm(2) fluences, respectively, after 90 days. Overall, the highest doses tolerated by the epidermis were 50, 100, and 100 J/cm(2) for type VI, V, and IV skin, respectively. Phase II: Mean papule counts after 90 days were 6.95 and 1.0 for the control and treatment sites, respectively.

CONCLUSION

Nd:YAG laser treatment may represent a safe and effective option for reducing hair and subsequent papule formation in patients with pseudofolliculitis barbae.

Treatment of pseudofolliculitis barbae using the Q-switched Nd:YAG laser with topical carbon suspension

BACKGROUND

Pseudofolliculitis barbae (PFB) is a condition caused by ingrown hairs of the face. No treatment to date has shown long-term effectiveness without risk of side effects or ease of treatment.

OBJECTIVE

The goal of this pilot study was to evaluate the use of the topical suspension-assisted Q-switched Nd:YAG laser in the treatment of PFB.

METHODS

Nine patients were given two treatments 1 month apart and assessed by objective papule/pustule counts at 1 and 2 months after final treatment. Treatment sites were 9 cm2 regions on the mandible and neck, with contralateral controls. Patients also performed subjective evaluations.

RESULTS

Reduction in the quantity of papules and pustules when compared with baseline was statistically significant for treatment of the mandibular region and combined sites at 1- and 2-month evaluations, as well as the neck region at the 2-month evaluation.

CONCLUSION

Use of the Q-switched Nd:YAG laser with topical carbon suspension is an effective means of treating PFB, with results persisting at least 2 months after treatment.