Laser-assisted hair removal by selective photothermolysis. Preliminary results

The effect of long-pulsed 1064 nm Nd:YAG laser-assisted hair removal on some skin flora and pathogens: an in vivo study

Background The effect of NDYag on normal skin flora and pathogenic microbes has not been studied. Objectives Evaluation of immediate (before versus after each session) and delayed (pre-first session versus pre-fourth session) antimicrobial effect of Nd:YAG laser-assisted hair removal. Methods Thirty females scheduled for axillary Nd:YAG laser hair removal were included. Skin swabs were collected from the vault of the dominant axilla before and after each of the four sessions. Bacteriological cultures were performed to record the counts of total aerobes, total anaerobes, lipophilic bacteria, total staphylococci, Staphylococcus epidermidis (S. epidermidis), S. saprophyticus, S. hominis, and S. aureus. Reported changes in sweat odour and folliculitis (if present) were recorded. Results S.hominis was the predominant species in all subjects before and after all sessions. Counts of total aerobes, total anaerobes, lipophilic bacteria, total staphylococci, and S.hominis significantly decreased after all 4 sessions. A significant reduction was noted in the median colony counts before the fourth session as compared to the baseline count before the first session in total aerobes (278.9 versus 126.3 × 105 CFU/cm2, p = 0.003), total anaerobes (338.7 versus 103.7 × 105 CFU/cm2, p = 0.002) and total staphylococci (248.5 versus 105.0 × 105 CFU/cm2, p = 0.004). Most subjects reported worsened or unchanged axillary sweat odour. There was a statistically significant positive correlation between sweat odour and the counts of total aerobes (r = 0.433, p = 0.017), total anaerobes (r = 0.377, p = 0.040), total staphylococci (r = 0.383, p = 0.036) and S.hominis (r = 0.497, p = 0.005) ; lower counts were associated with a worsened odour. Limitations Small sample size; few laser sessions; short follow-up; subjective assessment of sweat odor and quantity. Conclusions Laser caused an immediate and delayed reduction in axillary aerobes, anaerobes, lipophilic bacteria, and staphylococci. This form of dysbiosis might lead to sweat odour changes.

Using blend wavelengths in order to improve the safety and efficacy of laser hair removal

BACKGROUND

As the pursuit for a safe and effective device for laser hair removal continues, the use of simultaneous multiple wavelengths in a single device requires further exploration.

AIM

To evaluate the safety and efficacy of a novel multi-wavelength laser device for hair removal.

PATIENTS AND METHODS

This retrospective cohort study included adult participants of both sexes with Fitzpatrick skin types of III and IV. Hairy sites were treated by a multiple wavelength (810nm, 940nm, and 1064nm) laser device (Primelase, Coccoon medical, Barcelona, Spain). Laser parameters included: fluence of 14-20 J/cm² , pulse duration of 7-30 ms, and spot size of 20*9 mm² . Participants underwent up to 7 treatments at 6-8 weeks intervals and were followed for 6 months after the last treatment session. "Before" and "after" clinical photographs were acquired and were used to evaluate efficacy by 2 independent dermatologists. They employed the Global Aesthetic Improvement Scale (GAIS; scale of 0 [no improvement] to 4 [excellent improvement; Over 75% hair reduction]). Participants' satisfaction was rated on a scale of 1 (not satisfied) to 5 (very satisfied). Pain perception and adverse events were recorded as well.

RESULTS

Eighteen participants (6 men, 12 women) were included with a total of 49 treatment sites. Mean hair reduction was 3.6 out of 4 in the GAIS. Participants' satisfaction rate was high (mean 4.5). Beside mild transient discomfort during the procedure, no adverse events were recorded.

CONCLUSION

The use of a multiple wavelengths' laser device is safe and effective for hair removal.

Review of human hair optical properties in possible relation to melanoma development

Immigration and epidemiological studies provide evidence indicating the correlation of high ultraviolet exposure during childhood and increased risks of melanoma in later life. While the explanation of this phenomenon has not been found in the skin, a class of hair has been hypothesized to be involved in this process by transmitting sufficient ultraviolet rays along the hair shaft to possibly cause damage to the stem cells in the hair follicle, ultimately resulting in melanoma in later life. First, the anatomy of hair and its possible contribution to melanoma development, and the tissue optical properties are briefly introduced to provide the necessary background. This paper emphasizes on the review of the experimental studies of the optical properties of human hair, which include the sample preparation, measurement techniques, results, and statistical analysis. The Monte Carlo photon simulation of human hair is next outlined. Finally, current knowledge of the optical studies of hair is discussed in the light of their possible contribution to melanoma development; the necessary future work needed to support this hypothesis is suggested.

Precise Spatially Selective Photothermolysis Using Modulated Femtosecond Lasers and Real-time Multimodal Microscopy Monitoring

The successful application of lasers in the treatment of skin diseases and cosmetic surgery is largely based on the principle of conventional selective photothermolysis which relies strongly on the difference in the absorption between the therapeutic target and its surroundings. However, when the differentiation in absorption is not sufficient, collateral damage would occur due to indiscriminate and nonspecific tissue heating. To deal with such cases, we introduce a novel spatially selective photothermolysis method based on multiphoton absorption in which the radiant energy of a tightly focused near-infrared femtosecond laser beam can be directed spatially by aiming the laser focal point to the target of interest. We construct a multimodal optical microscope to perform and monitor the spatially selective photothermolysis. We demonstrate that precise alteration of the targeted tissue is achieved while leaving surrounding tissue intact by choosing appropriate femtosecond laser exposure with multimodal optical microscopy monitoring in real time.

The role of lasers and intense pulsed light technology in dermatology

The role of light-based technologies in dermatology has expanded dramatically in recent years. Lasers and intense pulsed light have been used to safely and effectively treat a diverse array of cutaneous conditions, including vascular and pigmented lesions, tattoos, scars, and undesired hair, while also providing extensive therapeutic options for cosmetic rejuvenation and other dermatologic conditions. Dermatologic laser procedures are becoming increasingly popular worldwide, and demand for them has fueled new innovations and clinical applications. These systems continue to evolve and provide enhanced therapeutic outcomes with improved safety profiles. This review highlights the important roles and varied clinical applications that lasers and intense pulsed light play in the dermatologic practice.

Laser hair removal: a review

BACKGROUND

Unwanted hair growth is a common aesthetic problem. Laser hair removal has emerged as a leading treatment option for long-term depilation.

OBJECTIVES

To extensively review the literature on laser hair removal pertaining to its theoretical basis, current laser and light-based devices, and their complications. Special treatment recommendations for darker skin types were considered.

MATERIALS AND METHODS

A comprehensive literature search related to the long-pulse alexandrite (755 nm), long-pulse diode (810 nm), long-pulse neodymium-doped yttrium aluminum garnet (Nd:YAG; 1,064 nm), and intense pulsed light (IPL) system, as well as newer home-use devices, was conducted.

RESULTS

The literature supports the use of the alexandrite, diode, Nd:YAG and IPL devices for long-term hair removal. Because of its longer wavelength, the Nd:YAG is the best laser system to use for pigmented skin. Further research is needed regarding the safety and efficacy of home-use devices.

CONCLUSION

Current in-office laser hair removal devices effectively provide a durable solution for unwanted hair removal.

Low-fluence vs. standard fluence hair removal: a contralateral control non-inferiority study

Introduction

Laser hair removal at lower fluences, delivered under certain conditions, may retain the efficacy of high-fluence lasers while improving tolerability. We performed a pilot study comparing the efficacy, safety and tolerability of laser hair removal using traditional settings compared to lower fluences, delivered from a larger handpiece and under vacuum.

Material and methods

Fourteen healthy participants underwent 5 axillary hair removal treatments with an 800 nm diode laser at 1-month intervals, with follow-up 1 and 3 months after the 5th treatment. In all patients, one side was treated with standard parameters using a 9 × 9 mm chilled tip and gel, while the contralateral side was treated using a 22 × 35 mm vacuum-assisted handpiece at fluences up to 12 J/cm². Follow-up assessments were performed after each treatment and at each follow-up visit, and included photography and questionnaires.

Results

Eleven participants completed the study and follow-up. All experienced significant hair removal in all treated areas. At the 3-month follow-up visit, the high-fluence and low-fluence treated axillae demonstrated comparable hair reduction. Participants found the lower fluence treatments to be more tolerable. No adverse events were reported.

Conclusion

Lower fluence diode laser, delivered under conditions of vacuum and using larger spot sizes, can provide significant hair reduction.

Evaluation of Long-pulsed 1064 nm Nd:YAG Laser-assisted Hair Removal vs Multiple Treatment Sessions and Different Hair Types in Indian Patients

Background:

Longer wavelength lasers such as Nd: YAG are considered to be the best for darker skin phototypes.

Objectives:

The aim of this study was to investigate the safety and efficacy of long-pulsed, 1064 nm Nd:YAG laser-assisted hair removal in relation to multiple treatment sessions and different hair types in Indian patients.

Method:

Fifty-nine adult women with skin phototypes IV and V were treated with a long-pulsed Nd: YAG laser (1064 nm, 10 mm spot size, fluence of 30–50 J/cm², pulse duration 15–30 ms). Six consecutive treatment sessions were given at 4–6 week intervals. The modified Ferriman Gallway system of scoring was used to grade the hairs before each treatment session and six weeks after the last therapy. Based on this grading, three main hair types were recognised: thin vellus (Grade 1), intermediate (Grade 2), and terminal hair (Grades 3 and 4). Patients were divided into three groups: achievers who converted to thin vellus hair (Grade I), responders who shifted to a lower grade but were short of reaching grade 1, and failures who did not show any change throughout the six laser sessions.

Results:

Six weeks after six laser treatment sessions, the achievers totaled 56%, responders 23%, and failures 20% of the patient population. At the end of the 3^rd, 4^th, 5^th, and 6^th sessions, achievers were 5, 15, 25, and 56% respectively of all the patients (P < 0.001, which was statistically significant). Achievers for terminal hair were 57.5% while it was 53.8% for intermediate hair (P = 0.9, nonsignificant). There were no permanent side effects. There were no failures in the terminal group while nearly 50% of the patients were failures in the intermediate group.

Conclusion:

Six multiple laser treatment sessions with a long-pulsed, 1064 nm Nd: YAG laser with contact cooling were found to be safe and effective for hair reduction in Indian patients with both terminal and intermediate hair. The success rate was found to improve with successive sessions. However, terminal hairs responded better than intermediate hairs.

Lasers and optical technologies in facial plastic surgery

Lasers and optical technologies play a significant role in aesthetic and reconstructive surgery. The unique ability of optical technologies to target specific structures and layers in tissues to effect chemical, mechanical, or thermal changes makes them a powerful tool in cutaneous rejuvenation, hair removal, fat removal, and treatment of vascular lesions such as port-wine stains, among many other procedures. With the development of adjunct techniques such as epidermal cooling, lasers and optical technologies have become more versatile and safe. The constant improvement of existing applications and the emergence of novel applications such as photodynamic therapy, nanoparticles, spectroscopy, and noninvasive imaging continue to revolutionize aesthetic medicine by offering a minimally invasive alternative to traditional surgery. In the future, therapies will be based on individualized, maximum, safe radiant exposure to deliver optimal dosimetry. Lasers and optical technologies are headed toward safer, easier, more quantifiable, and more individualized therapy.

Masers to magic bullets: an updated history of lasers in dermatology

Laser therapy is one of the fastest expanding and most exciting fields in dermatology. From its theoretical beginnings in Einstein's imagination, lasers have come to be used in treatments for conditions ranging from skin malignancy and acne to hirsutism and photoaging. We will briefly review the evolution of laser treatment, with a focus on the recent developments surrounding the new millennium.

Dermatologic manifestations of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects 5-10% of reproductive-aged women and is one of the most common endocrine disorders in women. The disorder is commonly characterized by elevated levels of androgen and insulin. Women with PCOS may present with a range of signs and symptoms, and face increased risks of reproductive, metabolic, cardiovascular, psychologic, and neoplastic sequelae, particularly if the condition is left unrecognized or untreated. The clinical definition of PCOS has changed in recent years and includes as one of its cardinal criteria the dermatologic manifestations of hyperandrogenism, chiefly hirsutism, acne vulgaris, and androgenetic alopecia. Acanthosis nigricans, a cutaneous sign of hyperinsulinemia, may also be present. These dermatologic features may provide early clinical clues to recognition of PCOS, and treatment of these cutaneous conditions may improve the patient's quality of life and psychologic well-being. The effects of androgen on pilosebaceous units in the skin can vary by anatomic location, producing pathophysiologic effects on hair growth and differentiation, sebaceous gland size and activity, and follicular keratinization. Treatment modalities may include hormonal therapy intended to modulate androgen production and action as well as non-hormonal therapies directed toward specific dermatologic conditions.

Prospective, Comparative Evaluation of Three Laser Systems Used Individually and in Combination for Axillary Hair Removal

BACKGROUND

Using the concept of selective photothermolysis, a variety of laser systems have been developed to remove unwanted hair.

OBJECTIVE

To evaluate the relative efficacy, tolerability, and subject satisfaction of three different laser systems used individually and in rotation for axillary hair removal.

METHODS

Twenty female patients (17 with dark-colored hair, 3 with red or light-colored hair) with Fitzpatrick phototype II skin received three treatments performed at 6- to 8-week intervals. Each axilla was divided in half to yield four distinct areas that were treated by the following lasers: (1) three sessions with a long-pulse 755 nm alexandrite laser, (2) three sessions with a long-pulse 810 nm diode laser, (3) three sessions with a long-pulse 1,064 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and (4) rotational treatment consisting of a single session by each of the three laser systems. Percent hair reduction and acute and long-term side effects were evaluated after treatment. Subjects completed questionnaires assessing tolerability and satisfaction.

RESULTS

All subjects tolerated the treatments well, with only local, transient side effects seen. At the 3-month follow-up, the greatest average hair reduction was comparably similarly seen after the alexandrite laser at 59.3 +/- 9.7% and the 810 nm diode laser at 58.7 +/- 7.7%. The Nd:YAG laser and rotational regimens were less efficacious, with 31.9 +/- 11.1% and 39.8 +/- 10.1% hair reduction, respectively. Subjects with red or light-colored hair experienced 5 to 15% reduced efficacy with any laser system used. Subjects found the alexandrite and diode lasers to be equally tolerable, with only slight discomfort, and the Nd:YAG laser to be the least comfortable of the three systems. Overall, subject satisfaction of each treated site, in decreasing order, was (1) the 810 nm diode laser, (2) the alexandrite laser, (3) rotational therapy, and (4) the Nd:YAG laser.

CONCLUSION

At the 3-month follow-up, the long-pulse alexandrite and 810 nm diode lasers demonstrated no statistically significant differences in efficacy, comparable efficacy and tolerability, and highest subject satisfaction. Rotational therapy with the three laser systems is not as effective as treatment with the alexandrite laser or diode laser alone but is statistically more effective than use of the long-pulse Nd:YAG system alone. Individuals with red or light-colored hair and Fitzpatrick phototype II skin have decreased efficacy of laser treatment than those with dark-colored hair and the same phototype.

Combination Radiofrequency and Light Energies: Electro-optical Synergy Technology in Esthetic Medicine

BACKGROUND

In the past decade, there has been an astonishing insurgence in the number and variety of commercially available nonablative resurfacing devices. This is related in part to a continually increasing market demand for noninvasive cosmetic procedures that are associated with minimal recovery time and fewer complications than the traditional carbon dioxide (CO2) laser.

OBJECTIVE

The goal of nonablative devices is to selectively heat the target tissues without injuring surrounding tissue. This article reviews the mechanism, results of clinical studies, and treatment parameters for a combination optical and radiofrequency (RF) energies system.

METHODS AND MATERIALS

To see modest clinical improvement, the patient often requires a series of treatments over the course of several months (sometimes up to 18 months).

RESULTS

Preliminary studies with combination optical and RF energies have shown promising results in different dermatologic applications, including skin rejuvenation, hair removal, and leg vein treatment.

CONCLUSION

A new technology that integrates bipolar RF and optical energies, ELOS (Syneron Medical Ltd, Yokneam, Israel), is based on the premise of a synergistic activity between the two forms of energy. The bipolar RF component enables the use of lower levels of the optical component, reducing the risk from optical energy and potentially improving its use across different skin types and hair colors. The optical component is believed to drive the bipolar RF energy to concentrate where the optical energy has selectively heated the target.

Long-pulsed ruby laser-assisted hair removal in male-to-female transsexuals

BACKGROUND

Unwanted male-pattern pilosity is a heavy psychological burden and can cause distress for male-to-female transsexuals. Orchidectomy and oestrogen supplementation combined with antiandrogens fail to make hair disappear.

AIMS

To study the effect of long-pulsed ruby laser treatment.

RESULTS

Hair density was successfully abated on the beard and chest of three male-to-female transsexuals. A lingering effect over 6 months with a 50-90% hair density reduction was obtained.

CONCLUSION

Photothermolysis using the long-pulsed ruby laser is a promising, well-tolerated method of hair removal in male-to-female transsexuals under oestrogen supplementation and antiandrogens.

Successful reduction in skin damage resulting from exposure to the normal-mode ruby laser in an animal model

Normal-mode ruby laser (NMRL) irradiation of skin has now become an acceptable method of producing depilation. However, side effects, which include superficial burning and changes in skin pigmentation, still occur and, although temporary, can be distressing to the patient. This paper reports a method by which the skin can be protected (or preconditioned) from damage during NMRL treatment by pre-heating to a lower, non-damaging level prior to irradiation. Using the black-haired mouse (C57B1/10) as an animal model, an appropriate 'preconditioning' temperature was established by exposing the mouse skin to a range of temperatures, taking biopsies and staining the skin immunohistochemically for heat shock protein 70 (HSP 70) expression within the keratinocyte cells. Increased HSP 70 expression is stimulated by exposure to environmental stressors such as heat, so it was hypothesised that its increased expression conveyed increased cellular protection. The appropriate temperature (45 degrees C for 15 min) allowed for the superficial skin cells to be protected (as assessed by maximal HSP 70 staining) but undamaged (as assessed by haematoxylin and eosin staining), leaving the target hair-producing cells unprotected. Eight mice (16 flanks) were then exposed to this preconditioning temperature (eight of the flanks being growing-hair sites and eight resting-hair sites) and 5 h later exposed to a laser fluence known to cause mild skin damage and depilation (6J/cm2). This exposure was to both the preconditioned and the adjacent non-preconditioned sites. A statistically significant reduction in skin damage (P <0.001), as measured by the time taken to heal and noted both clinically and histologically, was seen in the preconditioned sites in resting-hair regions but not in growing-hair regions. Depilation, established over an 8 week period, was successful in growing-hair regions within both preconditioned and non-preconditioned sites, but complete hair regrowth had occurred in preconditioned and non-preconditioned sites within resting-hair regions by 5 weeks. The latter finding was consistent with work already reported suggesting that NMRL-assisted depilation in this animal model is not successful for hairs in the telogen phase. Successful preconditioning of mouse skin prior to laser exposure appears to reduce NMRL-induced skin side effects. In addition, the technique does not appear to adversely affect successful depilation.

Hair removal using a 5-msec long-pulsed ruby laser

BACKGROUND

Unwanted hair is a widespread cosmetic problem. Many temporary methods of hair removal exist, with laser hair removal rapidly becoming the most widely used modality.

OBJECTIVES

Our objective was to evaluate the efficacy and side effects of a long-pulsed ruby laser for epilation in patients with varying skin types and hair color 6 weeks and 6 months after treatment.

METHODS

Seventy-four patients received one to four treatments with a long-pulsed ruby laser (694 nm, 5-msec pulse length, 6 mm spot size, 17.5-32 J/cm2) in different body areas.

RESULTS

After a mean number of treatments of 1.98 (range 1-4) the mean clearance was 51-75% after 6 weeks and less than 25% after 6 months. A lower percentage of hair regrowth was observed in the facial region than on the trunk or legs and in dark hair compared to blond hair.

CONCLUSION

Laser epilation provides a quick and relatively comfortable, but nonpermanent modality for hair removal with few side effects.

Comparison of alexandrite laser and electrolysis for hair removal

BACKGROUND

Different techniques have been used for hair removal. Electrolytic epilation is a widely accepted method for this purpose. Recently laser hair removal was introduced.

OBJECTIVE

To evaluate and compare the effectiveness of long-pulse alexandrite laser hair removal with electrolytic epilation.

METHODS

Twenty-four areas of unwanted axillar hair in 12 patients were included in the study. The right axillar area of the patients was treated by electrolysis with an intensity of 4-8 mA, and the left area was treated with long-pulse alexandrite laser with fluences between 30 and 50 J/cm2. Electrolysis was performed four times at 3-week intervals, and laser treatment was performed three times at 4-week intervals. Before each session, the hairs in a 4 cm2 area centered in the axilla were counted. The last evaluation was done 6 months after the initial treatment. The pain, time, and cost of each procedure are compared.

RESULTS

The average clearance rate of the hairs was 74% by laser and 35% by electrolysis 6 months after the initial treatment.

CONCLUSION

Alexandrite laser hair removal is a more reliable and practical solution than electrolysis. Laser hair removal is more expensive than electrolysis, but is 60 times faster and less painful than electrolysis; also fewer sessions are needed with the laser with better results.

Ruby laser-assisted hair removal: an ultrastructural evaluation of cutaneous damage

Ruby laser-assisted hair removal is thought to act via selective photothermolysis of melanin in the hair follicles. Although initial clinical trials of permanent hair removal using ruby lasers are promising, the exact mechanisms of hair destruction and the potential damage to other structures of skin are not known. The aim of this study was to evaluate the cutaneous ultrastructural changes following ruby laser hair removal. Nineteen healthy Caucasian patients with dark (brown/black) hair were treated with the ruby laser and biopsies taken after 0, 2, 3, 5, 7, 14 and 21 days. Specimens were examined by light and electron microscopy. Laser-treated specimens showed widespread coagulation and charring of subcutaneous hair shafts. These obviously damaged follicles were randomly dispersed amongst intact follicles within the same treatment sites. Microscopic changes were also seen in the basal epidermis where melanin was concentrated, irrespective of any obvious macroscopic damage. A low level of inflammatory response seen up to 2 weeks after treatment always followed laser treatment. Suprabasal epidermal necrosis was only seen in patients with blister formation after treatment. Ruby laser irradiation results in selective damage to the hair follicles, with microscopic changes to the basal epidermis. The damage is probably compounded by the inflammatory response to the damaged hair. The normal appearance and distribution of collagen in the dermal layer supported the clinical evidence that laser-assisted hair removal, if performed correctly, does not lead to scar formation.

Laser hair removal: a review and report on the use of the long-pulsed alexandrite laser for hair reduction of the upper lip, leg, back, and bikini region

BACKGROUND

The mechanism and permanence of laser-assisted hair removal remains a formidable task in the medical community.

OBJECTIVE

The purpose of this study was to determine the safety and long-term efficacy of the long-pulsed or normal mode alexandrite infrared laser for hair depilation.

METHODS

Beginning in October 1996, a total of 31 anatomic sites on 22 patients ranging in age from 25 to 59 years (mean 42 years) were evaluated to assess hair removal. Treatment sites included 17 upper lips, 9 legs, 2 backs, and 3 bikini regions. Eligible patients were of Fitzpatrick skin types I-III. Patients were treated using the long-pulsed alexandrite infrared laser at 755 nm, single-pulse technique, 10 mm spot size, 10% overlap, pulse durations of 5, 10, and 20 msec, and a fluence of 20 J/cm2. Subjective patient improvement and objective, blinded graded improvement was assessed at 1, 2, 3, and 6 months.

RESULTS

Objective blinded grading at 6 months revealed that hair reduction varied both with the pulse duration and anatomic location. Maximum reductions observed were 40%, 56%, 50%, and 15% for the lip, leg, back, and bikini areas, respectively. Upper lip hair reduction increased from 40% to 54% at 6 months when a second treatment was performed 8 weeks after the initial treatment.

CONCLUSION

The long-pulsed alexandrite laser is safe and effective in reducing hair growth. Treatment efficacy varies with the anatomic location, pulse duration, and number of treatments. A single-pulse technique utilizing a 10 msec pulse duration at 20 J/cm2 produced the greatest hair reduction. No permanent adverse effects occurred on skin types I-III at the parameters tested.

Unwanted body hair and its removal: a review

Despite widespread demand for efficient, reliable methods of eliminating unwanted hair from the face and body, available options were limited until the recent development of laser-assisted hair removal systems. This is a review of the various types of hair removal methods available today with an emphasis on laser-assisted hair removal.

A clinical overview of hair removal using lasers and light sources

The tremendous demand for removal of unwanted hair has led to the development of a wide range of noninvasive, user-friendly laser and light source systems; however, despite considerable advances in this field, these devices still have the potential to cause injury when used improperly. It is important to follow precise treatment guidelines in order to attain optimal results. This article gives an overview of the currently available lasers and light sources. It focuses on the practical aspect of laser hair removal by discussing patient selection, safety precautions, techniques using the different systems, pre- and post-laser treatment care, proper treatment endpoints, expected outcome, and possible side-effects and complications.

Hair removal using a long-pulsed alexandrite laser

The use of lasers for hair depilation has become a common modality for physicians in the recent past. As new lasers are developed, the complex mechanisms affecting this form of treatment are now under close investigation. The long-pulsed alexandrite laser functioning at a wavelength of 755 nm has recently been added to the armamentarium of health care providers to assist patients with unwanted body hair. A review of the embryology and anatomy of the hair follicle are discussed, as well as the findings of recent studies using this form of laser therapy. Using the suggested treatment protocols offered laser assisted depilation may be effectively achieved. The degree and duration of reduction vary with anatomic site and improve with multiple treatments.

Hair removal using a pulsed-intense light source

Many new laser and light sources have been developed for removal of unwanted body and facial hair. A multiple wavelength pulsed-intense light source (Epilight) has been shown to be effective for long-lasting hair removal. This system is most effective on patients with dark hair and light skin. Further studies are needed to fully elucidate the role of the pulsed-intense light source in permanent hair removal.

Long-term epilation with long-pulsed neodimium:YAG laser

BACKGROUND

Unwanted body hair can represent a severe cosmetic disturbance. The traditional methods used to epilate often have limitations, side effects, and unsatisfactory results. In recent years, various light sources (lasers and others) have been developed for long-term epilation of unwanted hair.

OBJECTIVE

This study evaluates, on a large number of patients, the efficiency and safety of a long-pulsed low-potency Nd-Yag laser invented specifically for long-term hair removal.

METHODS

Some 208 subjects needing epilation were divided into three groups and treated during an 11-month period. Group A included 79 patients with a normal distribution of unwanted hair; Group B 67 patients with constitutional hypertrichosis; and Group C 62 patients with hirsutism. Treatment sessions were performed with a fluence of 23-56 J/cm2 at 1-month intervals until obtaining desirable results. Follow-ups ranged from 1 to 6 months. In 3 patients 4-mm diameter punch biopsy specimens were obtained before the first session and again after 6 hours. A third biopsy was performed after 3 months.

RESULTS

Every session resulted in a 20-40% hair loss, depending on the color of hair. Complete epilation was obtained in 4 to 6 sessions. Only white hair was not receptive to laser light, and its growth was not modified. No patients, including dark-complexioned patients, had blistering, hypo-or hyperpigmentation. No pain was present during treatment except for the axillary area. In the specimen obtained after 6 hours, very extensive necrosis of the hair follicular and sebaceous gland epithelium was evident. Histologic findings of the biopsies taken after three months showed complete disappearance of hair and moderate fibrosis.

CONCLUSION

This study proves that the long-pulsed Nd:Yag laser treatment produces an excellent prolonged epilation with no relevant side effects. This laser light, having a 1064 nm wavelength, is minimally absorbed in superficial skin layers, and pronounced scattering up to 5 mm occurs targeting the deeper follicles.

Methods of hair removal

The methods of hair removal vary between simple inexpensive means of home treatment (shaving, plucking, depilatories) to expensive and potentially time-consuming means used by paraprofessionals, nurses, and/or physicians (electrolysis, lasers, x-ray). The ways in which these different methods induce hair removal, the duration of such removal, and the nuances between devices within the same category of methods are discussed.

Recalcitrant scarring follicular disorders treated by laser-assisted hair removal: a preliminary report

BACKGROUND

Recalcitrant scarring follicular disorders have been treated previously by removing hair follicles both surgically by scalp resection with skin grafting and with X-ray epilation. Laser-assisted hair removal may provide an alternate method of hair removal with less associated morbidity.

OBJECTIVE

The goal is to determine whether laser-assisted hair removal can be used to treat follicular inflammatory disorders by destroying hair follicles.

METHODS

Three patients with various scarring follicular disorders (dissecting cellulitis of the scalp, keratosis pilaris spinulosa decalvans, and pseudofolliculitis barbae) were treated with the long-pulse non-Q-switched ruby laser and followed clinically.

RESULTS

The patients tolerated the treatments well without significant side effects and noted improvement of their condition along with decreased hair growth in the treated area.

CONCLUSION

Laser-assisted hair removal may provide a safe, effective means of treating recalcitrant follicular disorders.