Shorter Pulsed Laser Found Safe for Hair Removal

A new study reports that a laser that delivers energy pulses shorter than those currently considered standard practice is effective and safe for hair removal. The study appears in a recent issue of the Journal of Cosmetic and Laser Therapy.

Laser pulse duration is believed to be an important factor in the safety and efficacy of laser treatments. Studies have generally found that although longer pulses are safer for darker skin, shorter pulses tend to be better at removing hair. Fluence, or energy level, is also important. Generally, the higher a laser’s fluency, which is measured in joules per square centimeter (J/cm2), the longer-lasting the treatment

This new study was designed to evaluate the efficacy of a shorter pulsed, 0.65 ms Nd:YAG laser. Six women were recruited. Using a Nd:YAG laser with a wavelength of 1064 nm and a pulse duration of 0.65 milliseconds, each woman had one-half of each underarm treated. The other half of the underarm was left untreated as a control. The laser fluence used on the treated areas was either 21 J/cm2 or 36 J/cm2. The women received 4 monthly treatment sessions. A manual hair count was conducted before each session and at a 4-month follow-up visit.

The results: At the four-month follow-up, there was a 75% to 100% reduction in hair on the high-fluence treated areas and a 50% to 75% reduction on the low- fluence areas. The average hair count declined 76% on the high-fluence areas and 72% on the low-fluence areas.

“This well-controlled study shows that a 0.65 ms ND:YAG laser is effective and safe for hair removal,” the authors concluded.

Source: Khatri KA, Lee RA, Goldberg LJ, Khatri B, Garcia V. Efficacy and safety of a 0.65 millisecond pulsed portable Nd:YAG laser for hair removal. J Cosmet Laser Ther. 2009. Feb 6:1-6. [Epub ahead of print]

Laser Hair Removal Treatments Well-Tolerated in Children, Study Shows

Using lasers to remove unwanted hair in adults is known to be safe and well tolerated, but what is the safety and tolerability of the procedure in children? Children also have conditions, including hypertrichosis and hirutism, that result in excessive hair, which can lead to significant psychosocial distress. Families often resort to extreme measures to minimize the undesired appearance of unwanted hair, including neonatal shaving, trimming, plucking, bleaching and waxing. Increasingly, parents have turned to laser hair removal treatments for their children, despite the lack of extensive investigations into its safety and efficacy for this age group.

In an article in the journal Clinical and Experimental Dermatology, British researchers describe their experience with laser hair removal in 24 children under the age of 16 years. Depending on their skin type, the children received a minimum of three treatments with a long-pulse alexandrite laser (with either continuous chilled-air cooling or cryogen cooling) or a long-pulse Nd:YAG laser (with either a chilled contact sapphire tip or cryogen cooling).

The mean age of the children was 12.3 years. They were diagnosed with constitutional hirsutism (14 patients), polycystic ovarian syndrome (5), congential melanocytic naevus (2), generalized hypertrichosis (2) and naevoid hypertrichosis (1). Before the treatment, 1 patient required a general anesthetic, 8 required a topical anesthetic, and 15 needed no anesthetic at all.

The results: Only two children experienced discomfort that required adjusting the fluence of the laser. This was the only side effect. No incidences of blistering, infection, dyspigmentaion or scarring occurred.

The authors concluded that “[w]hen administered appropriately, laser hair removal is safe and well tolerated in children aged < 16 years.”

Source: Rajpar SF, Hague JS, Abdullah A, Lanigan SW. Hair removal with the long-pulse alexandrite and long-pulse Nd:YAG lasers is safe and well tolerated in children. Clin Exp Dermatol. 2009. Jan 23. [Epub ahead of print]

Non-Physician Laser Hair Removal Treatments Pose Dangers: A Case Study

The use of lasers for hair removal has exploded in popularity since the technology was first introduced for this purpose in 1996. And with good reason. Laser-assisted hair removal is currently the most efficient long-term method of getting rid of unwanted body hair.

These devices need to be operated by skilled and trained practitioners, however. If used improperly, lasers can result in serious side effects, including burning, scarring, pigmentary changes, damage to the eyes, and severe swelling and pain.

In a recent issue of the Canadian Family Physician, two Spanish dermatologists relate the case of a healthy 28-year-old woman who was referred to them a few hours after undergoing her first laser hair removal treatment with a ruby laser at a neighborhood “aesthetic center.” As a result of the non-physician-supervised treatment, the woman had experienced first-degree burns and hyperpigmentation on her neck. The dermatologists prescribed her a twice-daily application of a topical corticosteroid, but six months later the treated area still showed signs of skin pigmentation and slight scarring.

The authors present the woman’s story as a cautionary tale. They note that they have seen an increasing incidence in their hospital of side effects caused by laser hair removal performed by non-physicians. The authors also want family physicians to be able to recognize the signs of skin-related complications of laser hair removal treatments so that they can correctly diagnose and treat those complications in their patients.

Source: Vano-Galvan S, Jaen P. Complications of nonphysician-supervised laser hair removal: case report and literature review. Can Fam Physician. 2009;55:50-52.

Are Two Lasers Better than One? No, Says a New Study

Researchers have found that using two types of lasers in combination to remove unwanted leg hair offers no additional benefits and may lead to more adverse effects that using either of the lasers alone.

For this single-center, randomized trial, which was published in the Archives of Dermatology, researchers compared the long-pulsed Nd:YAG and alexandrite lasers, individually and in combination. It’s the first study to examine the effect of combining these two lasers in a single treatment session, rather than sequentially.

Twenty people, aged 16 to 50, were enrolled in the trial. The medial and lateral sides of each participant’s legs were randomly assigned to receive one of these four laser treatments:

• A long-pulsed 1064-nm Nd:YAG laser (12-millimeter spot size)
• A long-pulsed 755-nanometer alexandrite laser (12-millimeter spot size)
• A long-pulsed 755-nm alexandrite laser (18-millimeter spot size)
• A combination of both lasers

Identified areas were treated for a total of 4 sessions at 8-week intervals. Fifteen participants finished the trial. (One dropped out due to adverse side effects; the other four were lost to follow-up.). The mean hair reduction (based on hair counting with digital photography) 18 months after the final treatment session was the following:

• 75.9% for the 12-millilmeter spot size alexandrite laser
• 84.3% for the 18-millimeter spot size alexandrite laser
• 73.6% for the Nd:YAG laser
• 77.8% for the combination therapy

The incidence of adverse effects (hyperpigmentation) and severe pain were most likely to occur in areas that received combination therapy. “After 18 months of follow-up, alexandrite and Nd:YAG lasers were efficacious for leg hair removal,” concluded the study’s authors. “Combination therapy did not have any additional benefit and caused more adverse effects.”

Source: Davoudi SM, Behnia F, Gorouhi F, et al. Comparison of long-pulsed alexandrite and Nd:YAG lasers, individually and in combination, for leg hair reduction. Arch Dermatol. 2008;144:1323-1327.

What’s the Future for Home Laser Devices?

In a recent issue of the journal Seminars in Cutaneous Medicine and Surgery, Darryl Shaw Hodson, MD, takes a comprehensive look at home laser and light devices for hair removal. He notes that although all currently available data (both peer- and nonpeer-reviewed) show these devices to be safe and effective, more studies are needed to validate their safety and efficacy.

Most studies to date have been conducted not in the patients’ home, Dr. Hodson observes, but in the artificial setting of the research environment, where someone is readily available to answer the patients’ questions—and to rescue them from mistakenly harming themselves with these devices.

Dr. Hodson writes:

“The true test of knowledge may not be whether a patient can properly discharge laser energy to the skin but whether the individual can recognize pitfalls before a complication occurs. It is not clear from the literature available that patients can do this. As an example, slight graying of the skin can occur if excessive energy or inadequate cooling is used during hair removal. Most laser experts can recognize this change before a large area is treated and adjust accordingly so that any side effects are minimal. Although the color change is typically obvious to laser experts, it remains to be seen whether patients can detect these subtleties.”

Still, Dr. Hodon believes that as these devices become smaller, safer, less expensive and easier to operate, their use by patients will increase—and for purposes other than hair removal. “Results from home use devices are impressive but still inferior to office-based lasers and light devices,” he writes. “It is likely that home lasers and intense pulsed light devices will eventually receive other indications because many of these devices use wavelengths similar to currently available office based equipment.”

Source: Hodson DS. Current and future trends in home laser devices. Semin Cutan Med Surg. 2008:27:292-300.

Home Laser Hair Removal

Since the advent of laser hair removal companies have hoped to offer something for use inside consumers’ homes. Unfortunately the delicate nature and highly sensitive art of lasers has made it very difficult to develop something which can be both affective and safe for use by a consumer. However, news is out that exciting new technologies are in development and being marketed as “laser hair removal” for the home. These new technologies are being launched by some of the premier names in laser technology.

Companies such as Spectragenics, Palomar, Radiancy, Gillette, and Phillips are getting into the development and marketing of laser/light based devices for home use. This exciting turn of events could lead to “lasers” being used by average people within the privacy of their own homes in a matter of a few years. Technologies not only for hair removal but also for skin rejuvenation and acne are in the works.

Some devices are already being sold to US consumers. The No!No! by Radiancy retails for $250 and is marketed as a “Professional Hair Removal System”. The Silk’n hair remover uses intense pulsed light technology. It retails for $800, but comes with a life of 750 pulses. Once the pulses run out, you must replace it with a lamp cartridge which retails for $80.

The Tria device has been cleared by the FDA for the neck down. This device is a laser, and is therefore skin-color dependent. In order to ensure that dark skinned people do not use the Tria, it comes with an activator which will either turn green or red depending on your skin tone. If green, it will activate the Tria device and allow for treatment. If red, it will lock the Tria to prevent use to safeguard the consumer. The reason for this precaution is that patients who are darker-skinned are more complex to treat with lasers as lasers can target the melanin pigment in the skin. This may cause damage if not properly treated by a physician. The Tria is now selling for $995.

As these products gain wider acceptance and usage rates around the US, it is expected that the cost for these devices will decrease over time. In addition increased competition should lower cost as new devices continue to enter the market.

Laser Innovation, Part 5,

In this articles we cover Cynosure, the last of the medical laser companies we are covering. They also produce lasers for hair removal and many of the top laser hair removal clinics are using their technologies.

Cynosure

Established in 1991, Cynosure is a developer and manufacturer of a broad array of light-based aesthetic treatment systems. Cynosure holds a number of U.S. patents and currently offers 15 different aesthetic treatment systems targeting a variety of non-invasive treatments including hair removal, skin rejuvenation and the temporary reduction in the appearance of cellulite. Cynosure is headquartered in Westford, MA.

The market for aesthetic procedures has grown significantly over the past several years. The American Society of Plastic Surgeons estimates that its members treated approximately 2 million people in 2002, a 95% increase since 1998. According to industry analysts, an estimated $1 billion is spent each year on cosmetic laser procedures in the United States alone. As more and more laser technologies are developed with higher utility and efficacy, the more popular procedures are likely to gain in popularity increasing demand for lasers and greater technologies.