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Evaluation of a New Super‐Long‐Pulsed 810 nm Diode Laser for the Removal of Unwanted Hair: The Concept of Thermal Damage Time
Abstract
Laser hair removal is based on the dual concepts of selective photothermolysis and thermal relaxation time. In most laser hair removal systems, light with emitted pulse durations of 2-50 msec targets hair follicles. A novel concept of laser hair removal uses the thermal damage time rather than the thermal relaxation time of the hair follicle. The follicle's thermal damage time is the amount of time required for diffusion of delivered laser energy from the treated hair to follicular-associated hair stem cells. This can range from 170 to 1000 msec.
To investigate the theory of thermal damage time, we performed a pilot study to evaluate the clinical efficacy and side effect profile of a modified 810 nm diode laser device operating in a super-long-pulse mode (200-1000 msec).
Ten female subjects with Fitzpatrick skin types I-VI received either one or two laser treatments at eight test sites. Super-long pulse durations of 200-1000 msec were evaluated with delivered fluences ranging from 23 to 115 J/cm2. Subjects were followed for 6 months after the first treatment. Subjects were evaluated for hair removal efficiency, optimal pulse duration and delivered fluence, and associated complication rate.
The clinical results show that safe hair removal in all skin types can be accomplished with an 810 nm diode laser delivering super-long pulse durations. Pain and complications were greatest at the highest pulse duration (1000 msec) and the highest fluence (115 J/cm2). Optimal hair reduction at 6 months (31%) was achieved at a thermal diffusion time of 400 msec (46 J/cm2).
The super-long pulsed 810 nm diode laser can safely remove unwanted hair in a full variety of skin types. Pain and increased risk of complications may preclude the use of the laser at very high fluences and pulse duration in the range of 1000 msec.
... It has been shown that such intervention does improve patient understanding and recall of their treatments and its related complications [38][39][40][41][42]. Other studies have established the presence of lower anxiety levels in patients undergoing surgical procedures and improved overall satisfaction with their management with the use of written material [43,44]. ...
... • Stimulation of cellular turnover [40] • Reactive flaking In addition, the caustics stimulate the synthesis of growth factors [41], stress proteins and cytokines [42][43][44], which cover a fundamental role both in dermal remodeling and in the control of the acneic process. ...
... "Diffusion" occurs over several days as the toxin passively moves away from the injection site [42]. Generally Azzalure ® /Dysport ® has a larger area of action, and there has been ongoing debate regarding the difference in onset between Botox Cosmetic ® /Vistabex ® and Azzalure ® /Dysport ® [43]. Based on the concept of diffusion and spread it has to be kept in mind that the mimic muscles of the face are in a very intimate relationship in between themselves, therefore, to achieve the most accurate effect on the targeted muscle we should use highly concentrated doses of the drug, injected by means of very small volumes of solution [44]. ...
... The previous reports on the efficacy of long-pulsed alexandrite laser were 74% to 78% hair reduction, 10-12 and the reported hair reduction of long-pulsed diode lasers ranged between 22% and 59%. 3,[13][14][15] Five of our patients underwent laser therapy with different laser systems. The treatment outcome in this group was the best; however, we did not find similar studies in this regard, and we do not know whether this method of treatment is scientifically prudent. ...
... After these, treatment pain is the most frequently reported side effect. 15,24 Hyperpigmentation rate has also reported to be 8% to 30%, and its prevalence in our study (10%) is compatible with Nanni et al., Eremia et al., and Rogachefsky et al. studies. 10,15,24 There is not much work done on the comparison of side effects between laser systems. ...
... 15,24 Hyperpigmentation rate has also reported to be 8% to 30%, and its prevalence in our study (10%) is compatible with Nanni et al., Eremia et al., and Rogachefsky et al. studies. 10,15,24 There is not much work done on the comparison of side effects between laser systems. However, in a study that compared the side effects of 1-ns Q-switched Nd:YAG, alexandrite, and ruby, the side-effect profiles were similar, although there were some differences; for example, postoperative pigmentary alterations were less common in Nd:YAG, whereas folliculitis was more common in that laser system. ...
BACKGROUND: Advances in laser technology over the past several years have led to the development of numerous lasers for the treatment of unwanted hair. Laser wavelength is a key factor influencing treatment efficacy and complication rates. OBJECTIVE: To compare the efficacy and safety of laser hair removal using three different laser systems. METHODS: A retrospective study of 805 consecutive laser-assisted hair removal treatments, conducted on 75 patients by means of either a long-pulsed Nd:YAG, a long-pulsed alexandrite, or a long-pulsed diode laser is reported. All patients were evaluated at least 3 months after the last treatment, and their present conditions were compared with the 1st-day photographs. RESULTS: The mean hair reduction was 42.4%, 65.6%, and 46.9% in Nd:YAG, alexandrite, and diode lasers, respectively. When the number of treatment sessions was taken into account, the efficacy of alexandrite and diode lasers was not significantly different, whereas both systems were more efficacious than Nd:YAG. Neither of the laser systems showed better results for a particular skin type. The occurrence of side effects was not significantly different between three laser systems. CONCLUSION: Both long-pulsed alexandrite and long-pulsed diode laser systems are effective in the treatment of unwanted hair, and they are more efficacious than Nd:YAG laser.
... The previous reports on the efficacy of long-pulsed alexandrite laser were 74% to 78% hair reduction, 10-12 and the reported hair reduction of long-pulsed diode lasers ranged between 22% and 59%. 3,[13][14][15] Five of our patients underwent laser therapy with different laser systems. The treatment outcome in this group was the best; however, we did not find similar studies in this regard, and we do not know whether this method of treatment is scientifically prudent. ...
... After these, treatment pain is the most frequently reported side effect. 15,24 Hyperpigmentation rate has also reported to be 8% to 30%, and its prevalence in our study (10%) is compatible with Nanni et al., Eremia et al., and Rogachefsky et al. studies. 10,15,24 There is not much work done on the comparison of side effects between laser systems. ...
... 15,24 Hyperpigmentation rate has also reported to be 8% to 30%, and its prevalence in our study (10%) is compatible with Nanni et al., Eremia et al., and Rogachefsky et al. studies. 10,15,24 There is not much work done on the comparison of side effects between laser systems. However, in a study that compared the side effects of 1-ns Q-switched Nd:YAG, alexandrite, and ruby, the side-effect profiles were similar, although there were some differences; for example, postoperative pigmentary alterations were less common in Nd:YAG, whereas folliculitis was more common in that laser system. ...
... The pain caused by laser treatment may be influenced by many factors, such as the laser parameters (fluence, wavelength, and pulse duration), treatment site, and skin cooling technique. Rogachefsky et al. [19] reported that pain was directly related to longer pulse duration and higher fluence, and that complications were most severe in patients treated with the highest pulse duration and fluence. However, in our study, the pain score of the highfluence is similar to that of the low-fluence groups in other studies [17,19], and long-term complications were not investigated. ...
... Rogachefsky et al. [19] reported that pain was directly related to longer pulse duration and higher fluence, and that complications were most severe in patients treated with the highest pulse duration and fluence. However, in our study, the pain score of the highfluence is similar to that of the low-fluence groups in other studies [17,19], and long-term complications were not investigated. Another difference is that we used a small number of pass technique, whereas the low fluence treatments in other studies used a multiple pass technique; a small number of pass technique was used in this study in order to reduce the time required for the treatment. ...
Background Diode lasers are the gold standard for removing unwanted hair. Lowering the energy should result in less pain and could theoretically affect therapeutic efficacy. This study evaluated the efficacy of an 808-nm diode laser at different fluences for permanent axillary hair removal in Korean women. Methods Twenty-four Korean women were divided into two groups. Each patient received laser treatment at both axillae, which were divided into upper and lower parts. Each part received different fluence from an HR808 prototype diode at 1-month intervals: 8, 10, 12, and 14 J/cm2. Hair count and thickness were recorded at each follow-up visit and at a 3-month follow-up after the final laser treatment by photography and using a folliscope. At the final visit, pain and patient satisfaction were surveyed. Three plastic surgeons assessed the results on photographs. Results The mean hair follicle density reduction was 62.18%, 65.28%, 73.08%, and 78.29% on the right upper side, right lower side, left upper side, and left lower side, respectively. The mean hair follicle thickness reduction was 45%, 48%, 54%, and 59% on the right upper side, right lower side, left upper side, and left lower side, respectively. In the plastic surgeons’ assessment, the left upper and lower sides scored 2.71. The right upper and lower sides scored 2.38 and 2.04, respectively. Conclusions High-fluence (14 J/cm2) treatment with an HR 808 prototype diode laser efficiently removed unwanted hair. No significant difference in comfort was reported compared to the low-fluence mode (8–10 J/cm2).
... The pain generated from the procedure may be influenced by many factors, such as the laser parameters (fluence, wavelength and pulse duration), skin cooling, treatment site and the quantity and quality of hair. Rogachefsky et al. 14 have reported that the pain was directly related to longer pulse duration and higher fluence, and complications were greatest at the highest pulse duration and fluence. But in our study, high fluence group's pain score in our study is similar with other study's low fluence group 10,14 and there are no complications. ...
... Rogachefsky et al. 14 have reported that the pain was directly related to longer pulse duration and higher fluence, and complications were greatest at the highest pulse duration and fluence. But in our study, high fluence group's pain score in our study is similar with other study's low fluence group 10,14 and there are no complications. Also other study's low fluence treatment use multiple pass, but we use single pass technique. ...
... Compared with the ruby (694.3 nm) or alexandrite (755 nm) lasers, the LPDL is less absorbed by melanin in the epidermis, making it effective for hair removal even in the darker skin types [6][7][8][9][10][11] . The efficacy of LPDL in hair removal is determined with various physical parameters, including the wavelength, pulse duration, fluence, spot size, treatment interval, and number of treatment sessions, as well as by the patient's individual characteristics, such as skin color, hair color, hair thickness, and the treated site 6,10,[12][13][14][15] . LPDLs have thus far only been available with a small spot size (around 1 cm in diameter) 4,7,8,11,[13][14][15] , which is associated with large energy loss due to scattering and with a high demand of time and operators' efforts for hair removal in large areas. ...
... Unlike most previous studies that measured hair density per unit area, we measured the total hair count over the whole armpit to reduce measurement error and faithfully reflect the clinical significance. The mechanism of laser hair removal can be explained by the selective photothermolysis and heat transfer theories 12,[16][17][18] . A selective damaging of target tissue can be achieved with pulse durations shorter than the thermal relaxation time of that tissue by minimizing heat transfer to the surrounding tissues 16 . ...
Background:
The efficacy of the long-pulsed diode laser (LPDL) in hair removal is determined with various physical parameters. Recently, LPDLs with a larger spot size are commercially available; however, the independent effect of spot size on hair removal has not been studied.
Objective:
This study aimed to compare the efficacy of the LPDL in hair removal depending on the spot size.
Methods:
A randomized, evaluators-blind, intrapatient comparison (left vs. right) trial was designed. Ten healthy Korean women received three hair removal treatment sessions on both armpits with the 805-nm LPDL and followed for 3 months. A 10×10 mm handpiece (D1) or a 10×30 mm handpiece (D3) was randomly assigned to the right or left axilla. The fluence, pulse duration, and epidermal cooling temperature were identical for both armpits. Hair clearance was quantified with high-resolution photos taken at each visit. Postprocedural pain was quantified on a visual analogue scale. Adverse events were evaluated by physical examination and the patients' self-report.
Results:
The mean hair clearance at 3 months after three treatment sessions was 38.7% and 50.1% on the armpits treated with D1 and D3, respectively (p=0.028). Procedural pain was significantly greater in the side treated with D3 (p=0.009). Serious adverse events were not observed.
Conclusion:
Given that the pulse duration, fluence, and epidermal cooling were identical, the 805-nm LPDL at the three times larger spot size showed an efficacy improvement of 29.5% in axillary hair removal without serious adverse events.
... In other words, a larger amount of melanin in the epidermis causes an increase in superficial absorption of laser beam in the epidermis, leading to epi- dermal thermal damage. 6 To optimize the hair removal process, it is necessary to understand the basic underlying principles of tissue optics; light delivery into tissue; and resultant heat production, heat distribution, and thermal damage. 7 Optimal laser treatment parameters have been proposed based on mathematical analysis of light propagation in human skin using thermal and optical properties of the follicle and its adjacent 1 Research Center for Science and Technology in Medicine (RCSTIM), Tehran University of Medical Sciences, Tehran, Iran. ...
... Additionally, the thermal properties of tissue were estimated depending on the water content of the tissue (w) according to the literature. 6,13,16 We assumed that w = 0.50 for the epidermis and hair and w = 0.75 for the dermis. 11,13 Calculating thermal coefficients k(W/cmK), r(g/cm 3 ), C P (J/gK) resulted in 0.0048, 1.075, and 3.488 for der- mis, respectively. ...
It is important to prevent unwanted side effects of diode hair-removal lasers especially in dark skin tones. This study simulates the thermal damage patterns caused by diode hair-removal lasers in different skin types, hair colors, and hair densities.
LITCIT software has been used with the tissue modeled as two components, the skin and the hair. The absorption coefficients of various skin types (f(mel)=5%, 10%, 15%, and 20%), laser parameters, and optothermal properties of tissue were inputs.
For all skin types there was a significant unwanted thermal damage to the epidermis as a result of fluence increase. Using longer pulse durations is accompanied by effective thermal damage to the hair follicle, while preserving the epidermis in skin types II and III, an effect not achieved in darker skins. Regardless of pulse duration, when the distance between hair follicles is ≤ 0.5 mm, there is a significant increase in thermal damage to interfollicular epidermis with high fluences compared with lower hair densities (interfollicular space ≥ 1 mm). In lighter hairs, while using longer pulse durations, higher fluences are needed in order to obtain the same level of thermal damage in the hair follicle as shorter pulse widths.
In lighter skin types, lengthening the pulse duration of diode lasers (up to 400 ms) increases efficacy while preserving epidermis from unwanted thermal damage. However, it is necessary to use lower fluences while using longer pulse duration to avoid irreversible thermal damage to epidermis in darker tones, as is also true for locations with higher hair densities.
... Pain and discomfort were assessed by asking subjects to quantify their pain level on a visual analog pain scale ranging between no pain (0) and intolerable pain (10). The distance from no pain was recorded for each subject after the first and last treatment. ...
... Published studies of LHR with a varying number (1)(2)(3)(4)(5) of LPDL treatments and at least 6 months of follow-up after the final treatment demonstrate hair clearance ranging between 25 and 91%. [8][9][10][11][12][13] The current study demonstrated hair clearance of 42% at 15 months and 54% at 6 months with three treatments, which falls in the middle range of these previously reported values and number of treatments. The slight decrease in hair clearance from 6-month follow-up to 15-month follow-up supports the long-held notion that not every hair follicle that is damaged undergoes long-term involution. ...
The long-pulsed diode (800-810-nm) laser is one of the most commonly used and effective lasers for hair removal. Limitations of currently available devices include a small treatment spot size, treatment-associated pain, and the need for skin cooling.
To evaluate the long-term hair reduction capabilities of a long-pulsed diode laser with a large spot size and vacuum assisted suction.
Thirty-five subjects were enrolled in a prospective, self-controlled, single-center study of axillary hair removal. The study consisted of three treatments using a long-pulsed diode laser with a large spot size and vacuum-assisted suction at 4- to 6-week intervals with follow-up visits 6 and 15 months after the last treatment. Hair clearance was quantified using macro hair-count photographs taken at baseline and at 6- and 15-month follow-up visits. Changes in hair thickness and color, levels of treatment-associated pain, and adverse events were additional study endpoints.
There was statistically significant hair clearance at the 6 (54%) and 15-month (42%) follow-up visits. Remaining hairs were thinner and lighter at the 15-month follow-up visit, and the majority of subjects reported feeling up to mild to moderate pain during treatment without the use of pretreatment anesthesia or skin cooling.
A long-pulsed diode laser with a large spot size and vacuum-assisted suction is safe and effective for long-term hair removal. This is the largest prospective study to evaluate long-term hair removal and the first to quantify decreases in hair thickness and darkness with treatment.
... Significantly lower hair counts were observed in follow up in both the groups. However, significant difference was not noted between the two modes in terms of hair counts and pain severity [12]. ...
Background: Hair forms an important appendage of the body playing a significant role in an individual’s psychosocial personality. Hirsutism is the presence of terminal hair at androgen-dependent sites in a female. Hypertrichosis is excessive hair growth all over the body in a non-androgen dependent manner. Increased terminal facial hair growth leads to cosmetic embarrassment, psychological distress and a low self-esteem in women. Currently, the most effective and advanced procedure for unwanted hair removal is laser epilation. Diode laser (800-855nm) are the most frequently used for this purpose and can be used in two different modes FDP (Fast delivery pulse) and DP (delivery pulse). With this study we aim to compare the efficacy of these two modes of diode laser for facial hair reduction. Objectives: 1.To study the clinical presentation of unwanted facial hair in patients visiting the department. 2. To study the trichoscopic features of facial hair in patients. 3.To study the correlation between the endocrinal abnormalities and clinical presentation in patients with increased facial hair. 4. To study the effectiveness of two different modes of diode laser on facial hair. Methods: It is a prospective randomized control study with a total of 20 female patients in the age group of 18-50 years with complaints of unwanted facial hair. VIKINI Diode laser of wavelength 808nm will be used for treatment. Post randomization the participants will be divided into two groups, one of them will be treated with FDP (Fast delivery pulse) mode and the other with DP (delivery pulse) mode. A total of six sittings will be performed at an interval of 4 weeks. Baseline trichoscopy findings as well as trichoscopy at follow up visits at one, three and six months will be recorded. Post procedure patient satisfaction and pain assessment will be also be recorded. Expected Results: The result would be undertaken in SPSS software. This study will help in understanding which technique is superior for laser hair reduction for facial hair. Conclusion: The conclusion will be based on findings for study protocol.
... Durch Verwendung von Pulsdauern, die länger sind als die TRT der Haare, kann die Schädigung der Stammzellen im Haarschaft noch verstärkt werden (sog. Superlang gepulste Laser) [4]. ...
Zusammenfassung
Die Fotoepilation zählt zu den meistgefragten nichtchirurgischen Eingriffen in der ästhetischen Dermatologie. Haarlose, glatte Beine gelten dabei als Schönheitsideal.
Fotoepilation mittels Laser oder hochenergetischer Blitzlampen (sog. Intensed-Pulsed-Light-Geräte) stellt ein sicheres und effektives Verfahren dar. Der Wirkmechanismus beruht auf dem Prinzip der selektiven Fotothermolyse, wobei eine gezielte thermische Schädigung pigmentierter Haarfollikel unter Schonung des umliegenden Gewebes erfolgt. Melaninpigment des Haarschaftes absorbiert als Zielchromophor Licht eines speziellen Wellenlängenspektrums und führt durch Wärmediffusion zur Schädigung der für das Haarwachstum wichtigen Stammzellen im äußeren Haarwurzelschaft.
Patienten müssen über die Notwendigkeit wiederholter Behandlungen sowie den häufig nur partiellen und temporären Haarverlust aufgeklärt werden. Dunkle Terminalhaare bei hellen Hauttypen lassen sich effektiv entfernen. Bei dunklen Hauttypen besteht aufgrund des erhöhten epidermalen Melaninvorkommens ein erhöhtes Risiko für Nebenwirkungen wie Verbrennungen, Dyspigmentierungen und Narben. Sehr feine, helle oder rote Haare lassen sich kaum mit konventionellen Fotoepilationsverfahren entfernen. Haarentfernungsgeräte für den Heimgebrauch sind eine kostengünstige, einfach anzuwendende Alternative, weisen aber im Vergleich zur professionellen Fotoepilation eine geringere Effektivität auf.
... Several IPL:s has default settings for dark skin and separate hand pieces as well. Diode laser has been reported to reduce hair count with 22% to 59% [61,[67][68][69][70][71][72]. Alexandrite and diode lasers are said to be slightly more efficacious than IPL in some studies but not to the point of statistical significance [53]. ...
Hirsutism, excessive hair growth in women in a male pattern distribution, is the most common endocrine disorder in women and approximately 5 to 15% of the general population of women is reported to be hirsute. It causes profound stress in women. Polycystic ovary syndrome is the most common cause. However a woman could have normal menses, normal androgen levels but be hirsute (idiopathic hirsutism). Ferriman- Gallwey scale (F-G) is used for assessment of hairiness. The maximum score is 36 and a score over 8 is considered as a hirsuid state. As hirsutism is a symptom and not a disease it is important to find the underlying cause and exclude uncommon but serious causes. The aim of the medical treatment is to correct the hormonal imbalance and thereby stop further progress. Oral contraceptives (OCP) are recommended as first line treatment. Spironolactone is the first choice if there is indication for antiandrogen therapy. Antiandrogens should be combined with an OCP in women in child bearing age as antiandrogens are teratogenic. Photo-epilation or electrolysis is mostly needed in order to reduce the amount of hair. Multiple treatments are needed. Hair reduction with each session with photo-epilation is estimated to 15% to 30%. Medical therapy and laser or IPL should be combined for best result.
... Diode laser has been reported to reduce hair count with 22% to 59% [86][87][88][89][90]. High fluence diode lasers with contact cooling have been the state of the art for hair removal. ...
Hirsutism, excessive hair growth in women in a male pattern distribution, is an international issue and approximately 5 to 15% of the general population of women is reported to be hirsute. It causes profound stress in women. As hirsutism is a symptom and not a disease it is important to find the underlying cause. Polycystic ovary syndrome is the most common cause but other not so common endocrinology disorders must be excluded. Mild hirsutism could be seen in a woman with normal menses and normal androgen levels (idiopathic hirsutism). Ferriman-Gallwey scale (F-G) is used for assessment of hairiness. The maximum score is 36 and a score over 8 is considered as a hirsuid state. The aim of the medical treatment is to correct the hormonal imbalance and stop further progress. Oral contraceptives (OCP) are recommended as first line treatment. Spironolactone is the first choice if there is indication for antiandrogen therapy. Antiandrogens should be combined with an OCP as antiandrogens are teratogenic. Photo-epilation or electrolysis is mostly needed in order to reduce the amount of hair. Multiple treatments are required. Hair reduction with each session with photo-epilation is estimated to 15% to 30%. Medical therapy and laser or IPL should be combined for best result.
... We also observed that with a 500 ms pulse duration and a fluence of 57 J/cm 2 , or a pulse duration of 1000 ms and a fluence of 115 J/cm 2 (power ¼ 90 W), there was a considerable increase in thermal damage to the adjacent dermis. 14 Similar clinical studies have confirmed such an outcome. For example, a clinical trial was conducted to evaluate the safety and effectiveness of a new 400-ms extended-pulse lightsheer diode hair-removal laser in 2003. ...
... 112 Permanent hair reduction without significant adverse effects has been achieved despite the use of prolonged pulse durations. 113 LP ruby (694 nm), alexandrite (755 nm), diode (800 nm), and Nd:YAG (1,064 nm) lasers as well as IPL (590-1,200 nm) have been shown, through numerous published studies, to achieve long-lasting hair reduction with a low incidence of adverse effects. 110,[114][115][116][117][118][119][120][121][122][123][124][125][126][127][128] The optimal laser or IPL selection is determined by the patient's skin type. ...
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.
... The hair count reduction reported with the longpulse 810-nm diode laser ranges from 22% to 59%. 15,[24][25][26][27][28] In skin treated with the diode laser, histologic analysis showed a statistically significant reduction in hair density and thickness. 29 Lasers with longer wavelengths such as the diode and the 1,064-nm Nd:YAG lasers are preferred when treating darker skin types because they result in fewer side effects such as pain and postinflammatory hyperpigmentation than lasers with shorter wavelengths. ...
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.
... We also observed that with a 500 ms pulse duration and a fluence of 57 J/cm 2 , or a pulse duration of 1000 ms and a fluence of 115 J/cm 2 (power ¼ 90 W), there was a considerable increase in thermal damage to the adjacent dermis. 14 Similar clinical studies have confirmed such an outcome. For example, a clinical trial was conducted to evaluate the safety and effectiveness of a new 400-ms extended-pulse lightsheer diode hair-removal laser in 2003. ...
We simulated the heat distribution and thermal damage patterns of diode hair-removal lasers for different spot sizes, pulse durations, and fluences as a guide for optimization. Background: Recently, the concept of thermal damage time as a reference for pulse duration has become a subject of debate.
Laser-Induced-Temperature-Calculation-In-Tissue (LITCIT) was used for the simulations. Skin was modeled as two homogenous layers of epidermis/dermis and two coaxial cylinders as the hair shaft/ follicle. Opto-thermal coefficients of the components and the radiant parameters of the laser (diode, 810 nm) were defined.
At constant fluences and pulse durations, the damage occurred deeper when larger spot sizes were used. At constant pulse duration, high fluences caused significant damage to the hair follicle and epidermis. By using longer pulse durations (≤ 400 ms) at constant fluences, there was more effective damage to the hair follicle while sparing the adjacent epidermis and dermis. Because of the time-dependent temperature profiles, an increased pulse duration creates a moderate, gradual rise in the target's temperature. Pulse durations > 400 ms are accompanied by unwanted dermis damage.
Our results show that using very long pulse durations near the tissue damage time (≤ 400 ms) creates better efficacy in treating unwanted hairs while avoiding unwanted damage.
Zusammenfassung
Die Fotoepilation zählt zu den meistgefragten nichtchirurgischen Eingriffen in der ästhetischen Dermatologie. Haarlose, glatte Beine gelten dabei als Schönheitsideal.
Fotoepilation mittels Laser oder hochenergetischer Blitzlampen (sog. Intensed-Pulsed-Light-Geräte) stellt ein sicheres und effektives Verfahren dar. Der Wirkmechanismus beruht auf dem Prinzip der selektiven Fotothermolyse, wobei eine gezielte thermische Schädigung pigmentierter Haarfollikel unter Schonung des umliegenden Gewebes erfolgt. Melaninpigment des Haarschaftes absorbiert als Zielchromophor Licht eines speziellen Wellenlängenspektrums und führt durch Wärmediffusion zur Schädigung der für das Haarwachstum wichtigen Stammzellen im äußeren Haarwurzelschaft.
Patienten müssen über die Notwendigkeit wiederholter Behandlungen sowie den häufig nur partiellen und temporären Haarverlust aufgeklärt werden. Dunkle Terminalhaare bei hellen Hauttypen lassen sich effektiv entfernen. Bei dunklen Hauttypen besteht aufgrund des erhöhten epidermalen Melaninvorkommens ein erhöhtes Risiko für Nebenwirkungen wie Verbrennungen, Dyspigmentierungen und Narben. Sehr feine, helle oder rote Haare lassen sich kaum mit konventionellen Fotoepilationsverfahren entfernen. Haarentfernungsgeräte für den Heimgebrauch sind eine kostengünstige, einfach anzuwendende Alternative, weisen aber im Vergleich zur professionellen Fotoepilation eine geringere Effektivität auf.
Background: Various light based technologies like Diode, long pulsed Nd:Yag and Intense Pulsed Light are used commonly for long-term hair reduction. The commonest indication is hirsutism.
Aim: 1. To evaluate efficacy and safety of 810 nm Diode laser in Fitzpatrick skin types III, IV and V.
2. To assess percentage of cases on the basis of indications, average number of sessions, fluence required, the long-term results and complications using diode laser in darker skin types.
Methods: A prospective observational study of 55 consecutive patients who came for laser hair reduction by 810 nm Light Sheer Diode laser with Chill tip technology was carried out. The sessions were conducted at an interval of 4–6 weeks and the patients were followed up over a period of 2 years. Data was analyzed using software SPSS (Statistical Package for Social Science. Ver.12, Inc. Chicago, USA).
Results: Fifty-five patients (51 females and 4 males) were studied. 67.3% (n = 37) had skin type IV. The most common area treated was chin (n = 23). The average growth reduction of terminal hair at the end of three sessions was 61.25%. Only 8% (n = 4) had short-term side effects.
Conclusion: Diode laser is highly effective for long-term hair reduction of terminal hair growth in Fitzpatrick skin type III, IV and V with no permanent side effects.
Abbreviations: LHR (Laser Hair Reduction)
Background: Photoepilation has become a very popular epilation procedure in esthetic and cosmetic practice. There are some types of lasers and other light sources used for epilation.
Aims: The purpose of our study was to compare a IPL device with an IPL plus RF in one device, using a within-patient, right-left controlled study design.
Patients/Methods: Thirty-three patients completed four treatment sessions and the follow-up period of the study.
Results: Hair reduction was effective after the first treatment, but similar results were achieved using the IPL system alone, and with IPL combined with RF. The degree of hair reduction increased after the following treatments, but the two methods yielded similar effects. 3 months after the last treatment, some hair had regrown in both treatments, the combined IPL with RF treatment gave significantly better results than the IPL treatment alone.
Conclusions: In conclusion, IPL and IPL-RF are effective hair reduction therapies, yielding similar effects in patients with skin phototypes II or III. However, IPL-RF can be more effective in long-term observations. These therapies are also safe and regarded be quite comfortable in this population.
Lasers for hair removal are a fast-growing area in cosmetic dermatology. Selective photothermolysis allows for targeting of specific chromophores while minimizing cutaneous damage. Treatment of individuals should be individualized based on anatomical area, skin and hair color, by varying the wavelength, fluence, pulse duration, spot size, and cooling technique of the laser.
Incidence, clinical presentation, and treatment of skin disorders show prominent differences in individuals with pigmented ethnic skin compared to Caucasians with white skin. This is primarily due to decisive differences in the cutaneous structure and function of the skin and hair. For example, the use of pore-clogging substances by Caucasians may result in predominant clinical inflammation with papules and pustules that develop over a period of 2–3 weeks. On the other hand, non-Caucasian skin responds by rupturing the follicular wall early in the process [1]. Patients with pigmented or black skin have unique cosmetic concerns and necessitate particular consideration when it comes to apply cosmeceuticals and/or receive aesthetic procedures, such as laser and chemical peels. In particular, ethnic skin individuals are easily susceptible to trauma which can lead to permanent pigmentary changes. Recent advances in this area resulted in the development of safer technology and products. Consequently, there is an increased demand of the number of patients requesting cosmetic procedures to attain even skin color, reduce the signs of aging, and remove unwanted hair [2]. Dermatologists are required to administer cosmeceuticals in their biologically active form to the skin and ensure the use of sufficient amounts of the appropriate agent in order to obtain desirable effects. It is also crucial that specialists inform their patients on possible side effects individuals with pigmented ethnic skin are more susceptible to a unique profile of complications.
Background:
High-fluence diode lasers with contact cooling have emerged as the gold standard to remove unwanted hair. Lowering the energy should result in less pain and could theoretically affect the efficacy of the therapy.
Objective:
To compare the safety and efficacy of a low-fluence high-repetition rate 810-nm diode laser to those of a high-fluence low-repetition rate diode laser for permanent axillary hair removal in Chinese women.
Methods:
Ninety-two Chinese women received four axillae laser hair removal treatments at 4-week intervals using the low-fluence, high-repetition 810-nm diode laser in SHR mode on one side and the high-fluence, low-repetition diode laser in HR mode on the other side. Hair counts were done at each follow-up visit and 6-month follow up after the final laser treatment using a 'Hi Quality Hair Analysis Program System' , the immediate pain score after each treatment session was recorded by a visual analog scale.
Results:
The overall median reduction of hair was 90.2% with the 810-nm diode laser in SHR mode and 87% with the same laser in HR mode at 6-month follow-up. The median pain scores in SHR mode and in HR mode were 2.75 and 6.75 respectively.
Conclusion:
Low-fluence high repetition rate diode laser can efficiently remove unwanted hair but also significantly improve tolerability and reduce adverse events during course of treatment.
Die Entwicklung von medizinischen Lasergeräten brachte auf dem Gebiet der Epilation große Fortschritte. Hypertrichose und Hirsutismus werden tabuisiert und führen oft zu einer erheblichen psychischen Belastung. Für die Betroffenen ist die neue Entwicklung von großer Bedeutung, können doch dank Lasertechnik nun auch große Flächen schnell, sicher und effektiv epiliert werden. Der Wirkungsmechanismus der Laserepilation beruht auf einem photothermischen Prinzip. Das Melaninpigment des Haarschafts fungiert hierbei als Chromophor und absorbiert das Laserlicht. Somit sprechen dunkle Haare auf heller Haut am besten an. Mit Lasergeräten längerer Pulsdauer und größerer Wellenlänge gelingt es, auch dunklere Hauttypen sicher zu behandeln. Die Laserepilation stellt nicht nur für den Hirsutismus und die Hypertrichose, sondern auch für Pseudofollikulitis, Folliculitis decalvans, behaarte Vollhauttransplantate sowie Pilonidalsinus eine gute Behandlungsmodalität dar. Nach wie vor bleibt es eine Herausforderung, eine effektive Epilationsmethode für helle Haare zu finden.
España El desarrollo de la tecnología ha llevado a la práctica clínica unidades de emisión de luz no coherente de amplio espectro conocida como luz pulsada intensa (" IPL " , de su denominación del inglés, " intense pulse light "). Los efectos de la IPL están basados en la teoría de la fototermólisis selectiva, aprovechando sus características policromáticas que engloban las curvas de absorción de los cromóforos hemoglobina y melanina. Esto ha permitido ampliar el campo de sus aplicaciones clínicas, desde la fotodepilación al tratamiento de lesiones vasculares, pigmentadas, y al fotorejuvenecimiento no ablativo, gracias a que emite longitudes de onda comprendidas entre 515 a 1200 nm, (dentro del espectro visible e infrarrojo cercano). 1 Esta luz policromática es filtrada mediante cristales de cuarzo o zafiro para limitar sus rangos de emisión y optimizar sus efectos. Es así que un mismo equipo puede tener dos o más filtros de corte que serán según las características del fabricante, de 515, 530, 560, 585, 640, 690, 755 nm, etc. Además de poder utilizar varias longitudes de onda, los sistemas de IPL permiten modificar otros
Die Behandlung mit dem Laser wird vom Patienten nach wie vor intensiv nachgefragt. Obwohl die meisten überwiegend kosmetischen Eingriffe das Hautorgan betreffen, bieten inzwischen beinahe sämtliche Fachdisziplinen dermatologische Laserleistungen an. Der Dermatologe kann sich in dieser Situation nur durch überzeugende Darstellung seiner Fachkompetenz behaupten. Da gerade in der Lasertherapie praktisches Anwenderwissen wesentlich ist, wurde auf der 18. Fortbildungswoche erstmals ein Kurs angeboten, der auf theoretische Darstellung des gegenwärtigen Wissensstands verzichtet und sich statt dessen in interaktiver Form am Patienten mit konkreten Fragen und Problemen der Laserbehandlung auseinandersetzt. Komplementär hierzu sind die zum Thema Laser gehaltenen Plenarvorträge zu sehen. Der potenziellen Laseranwender kann somit einmal im Rahmen praktischer Kurse am Patienten aus eigener Anschauung und durch vorgetragene oder publizierte Studienergebnisse verwertbares Wissen gewinnen.
Die Haarentfernung mit dem Laser war ursprünglich eine Zufallsentdeckung bei der Behandlung von pigmentierten Hautveränderungen und Tätowierungen. Die Laserepilation beruht auf dem Prinzip der selektiven Photother-molyse [1]. Weil sich ein dunkel pigmentiertes Haar von seiner helleren Umgebung unterscheidet, kann die Haarwurzel das Laserlicht selektiv absorbieren.
Laser (Ruby, Nd Yag, Alexandrite, Diode) or intense pulse light are the different light-/Laser-based systems used for hair removal; each have its advantages and disadvantages. Laser parameters vary with area, type of hair, and the machine used. Full knowledge about the device and cooling system is important to improve the treatment performance.
Lasers for hair removal are a fast-growing area in cosmetic dermatology.
Selective photothermolysis allows for targeting of specific chromophores while minimizing cutaneous damage.
Treatment of individuals should be individualized based on anatomical area, skin and hair color, by varying the wavelength, fluence, pulse duration, spot size, and cooling technique of the laser.
Introduction Acne scars Acne Photorejuvenation Laser-assisted hair reduction Skin tightening Lipolysis with energy-based devices Most common complications Conclusion References
This chapter discusses the synergy of light and radiofrequency energy for hair removal. Hair removal using lasers and light-based methodologies are limited by the chromophore dependence on melanin located in the hair shaft, creating a small window of efficacy and safety for the treatment of light hair hues and darker skin phenotypes. More recently, using an alternative source of energy, RF, and synthesizing its use with current light and laser modalities have eliminated this dependence on the melanin chromophore. The combination of optical and RF has proven to be a safe and effective method for the permanent removal of unwanted hair, and has shown promising effects in both those individuals with darker skin types as well as in those with blond or white hair, while also creating a high safety profile with minimal patient discomfort. Further investigation with more long-term studies and comparison trials are needed to further elucidate the integrated RF and optical energy technology, especially in the earlier refractory group of photoepilatory individuals.
While the current gold standard for the laser treatment of vascular lesions is the pulsed dye laser (577-595 nm), laser systems with longer wavelengths have been employed in an effort to maintain vascular selectivity and achieve greater depths of penetration while minimizing adverse effects. This chapter will discuss the safety and efficacy of the 755-nm alexandrite laser, the 810-nm and 940-nm diode lasers, and the 1,470-nm diode laser used in endovenous laser ablation for the treatment of vascular lesions.
Introduction: Diode laser and intense pulsed light are among the most frequently used technologies for epilation. Objective: To compare diode laser with intense pulsed light in axillary epilation. Methods: Patients with phototypes II and III (n = 15) were subjected to 3 regular sessions of intense pulsed light (695 nm) - Quantum HR® Platform (Lumenis, Yokneam, Israel) in the right axilla and diode laser (810 nm) - Light Sheer® (Lumenis, Yokneam, Israel) in the left axilla. The number of axillary hairs were counted before and after treatment, and patients were administered a questionnaire about adverse effects, pain and satisfaction. Results: Both techniques provided a similar and significant reduction in hair density. The pain score and degree of inflammation were significantly higher for intense pulsed light (p < 0.01 and p = 0.03, respectively). There was a significant correlation between the fluence employed, the severity of pain, and the degree of inflammation for the two techniques (p < 0.05). The patients considered the final results to be similar, however more side effects were attributed to intense pulsed light. There was no difference in the proportion of preference between the two methods (p = 0.80). Conclusion: The two techniques produced similar results, but the diode laser caused less pain and fewer side effects compared to intense pulsed light.
Publisher Summary
This chapter discusses the different techniques for the treatment of pseudofolliculitis barbae. Pseudofolliculitis barbae (PFB) is a condition of the beard area occurring in black men and other people with curly hair. Highly-curved hair can grow back into the skin, causing inflammation and a foreign-body reaction surrounding the site of the ingrown hair. A variety of treatment options exist for managing PFB, and a judicious use of a combination of treatment options may offer the best opportunity for controlling the formation of ingrown hair that results in shaving bumps and inflammation. The magnitude of improvement resulting from compliance with a daily shaving regimen to provide a very safe, effective, economical, and convenient method to manage PFB can, in some subjects, equal that of professional lasers. The use of appropriate topical treatments such as glycolic acid may enhance the ability to comply with daily shaving, as well as alter superficial skin topography to minimize the occurrence of ingrown hair and maximize shaving efficiency. Topically applied hair-growth retardants such as Eflornithine HCl have been demonstrated to slow hair growth, modify the morphology of the hair follicle and the hair shafts in a manner that can reduce ingrown hair, and also improve compliance with a daily-shave regimen.
RESUMEN Antecedentes El crecimiento de vellos no deseados es un reto terapéutico y se emplean considerables recursos en busca de una apariencia libre de vellos. Frecuentemente se usa la depilación con dispositivos láser (alexandrita, diodo, neodymium:YAG y láser de rubí) y con luz pulsada intensa, aunque el efecto a largo plazo es incierto. Objetivos Evaluar los efectos de la depilación con láser y con fuentes de luz.
Introduction: To improve laser hair removal (LHR) for dark skin, the fluence rate reaching the hair follicle in LHR is important. This paper presents the results of a comparative study examining the function of wavelength on dark skin types using 755 nm alexandrite and 810 nm diode lasers.
Methods: The structure of the skin was created using a realistic skin model by the Advanced Systems Analysis Program.
Result: In this study, the alexandrite laser (755 nm) and diode laser (810 nm) beam–skin tissue interactions were simulated. The simulation results for both lasers differed. The transmission ratio of the diode laser to the dark skin dermis was approximately 4% more than that of the alexandrite laser for the same skin type. For the diode laser at skin depth z = 0.67 mm, the average transmission ratios of both samples were 36% and 27.5%, but those for the alexandrite laser at the same skin depth were 32% and 25%.
Conclusion: Both lasers were suitable in LHR for dark skin types, but the diode laser was better than the alexandrite laser because the former could penetrate deeper into the dermis layer.
Keywords
lasers; simulation; skin; diode laser
Laser hair removal has become an increasingly popular method to remove unwanted or excessive hair. We have assessed the relative efficacy and discomfort associated with competing hair removal techniques, namely a high average power 810 nm diode laser using an "in-motion" technique with a market-leading 810 nm device with a single-pass vacuum-assisted technique. This study has determined the long-term (6-12 months) hair reduction efficacy and the relative pain induction intensities of these devices.
Prospective, randomized, side-by-side comparison of either the legs or axillae was performed comparing the Soprano XL 810 nm diode in super hair removal (SHR) mode (Alma Lasers, Buffalo Grove, IL) hereafter known as the "in-motion" device vs. the LightSheer Duet 810 nm diode laser (Lumenis) hereafter known as the "single pass" device. Five laser treatments were performed 6 to 8 weeks apart with 1, 6, and 12 months follow-ups for hair counts. Pain was assessed in a subjective manner by the patients on a 10-point grading scale. Hair count analysis was performed in a blinded fashion.
There was a 33.5% (SD 46.8%) and 40.7% (SD 41.8%) reduction in hair counts at 6 months for the single pass and in-motion devices respectively (P = 0.2879). The average pain rating for the single pass treatment (mean 3.6, 95% CI: 2.8 to 4.5) was significantly (P = 0.0007) greater than the in-motion treatment (mean 2.7, 95% CI 1.8 to 3.5).
This data supports the hypothesis that using diode lasers at low fluences and high average power with a multiple pass in-motion technique is an effective method for hair removal, with less pain and discomfort, while maintaining good efficacy. The 6 month results were maintained at 12 month for both devices. Lasers Surg. Med. © 2014 Wiley Periodicals, Inc.
To compare the success, complication, and patient discomfort rates of transcanalicular diode laser dacryocystorhinostomy (TCDL-DCR) and external dacryocystorhinostomy (EX-DCR) surgeries performed in patients with primary acquired nasolacrimal duct obstruction.
Eighty consecutive patients were included in the study, and groups were assigned according to DCR technique. Thirty-four (42.5%) patients received TCDL-DCR (Group A) and 46 (57.5%) patients (Group B) received EX-DCR with temporary silicone stent intubation. The success of surgery was determined by the relief of epiphora, patient satisfaction, endoscopic evaluation of ostium patency, and lacrimal system syringing. Pearson Chi-Square test, Fisher's Exact test, and Student's t-test were used for statistical analyses.
Group A included 22 females and 12 males with a mean age of 49.1 ± 15.1 years, Group B included 35 females and 11 males with a mean age of 50.8 ± 11.7 years. There was no difference between groups in terms of age and gender (P = 0.905 and P = 0.167, respectively). The duration of the operation was 22.2 ± 4.8 minutes for Group A, while it was 56.3 ± 15.7 minutes for group B (P = 0.0001). In two patients in Group A, injury in the medial turbinate was recorded, and in Group B, 14 patients experienced mild to severe perioperative bleeding. The perioperative complication rate was significantly different between the groups (P = 0.004). Success in relieving symptoms was 79.4% for Group A and 89.1% for Group B. The difference in the success rates was not statistically significant (P = 0.229).
Although EX-DCR success rate was higher than that achieved with TCDL-DCR, the latter, with its shorter duration of surgery, lower perioperative complication rate, and a similar success rate, may be a good and acceptable surgical alternative in treatment of primary acquired nasolacrimal duct obstruction. Lasers Surg. Med. © 2014 Wiley Periodicals, Inc.
Unwanted hair is a common problem for which different types of light therapy have been developed as the treatment of choice. Since 1996, when the American Food and Drug Administration approved the first laser therapy for depilation, much progress has been made in light-based technology and lasers. Lasers and intense pulsed light sources with red or near infrared wavelengths (600 to 1200 nm) are the most widely used for removing hair as they target the melanin of the hair shaft, hair follicle epithelium, and hair matrix. The aim of this review is to describe and compare the different photodepilation methods currently available.
The efficacy, safety, and treatment time of a new, high-speed, very long-pulsed (90-200 ms) 810-nm diode laser have been evaluated for the rapid removal of bikini hair. Study participants (n520) received 5 treatments at 6-week intervals. Hairs were counted from pretreatment and posttreatment photo- graphs. Among the 16 people who completed the study, the median hair count at 6 months after the fifth treatment was significantly lower than the median pretreatment hair count (P,.0001). The median hair count reduction fractions increased after the second treatment and continued to increase at 3- and at 6-month follow-up visits, indicating continual improvement. Hair count reduction fractions achieved a median of 87.6% (mean584.4%) at 6 months after the final treatment. Adverse effects were not observed, and treatment time was short. The 810-nm diode laser has been observed to safely and efficiently remove unwanted hair from the bikini area.
All the standard light-based techniques for permanent hair reduction, like laser and intense pulsed light (IPL) employ the highest tolerable fluence with a single pass. As opposed to standard techniques, a new diode laser technique employs low fluence with multiple passes. Here we evaluate and compare the efficacy, treatment time, comfort and safety of the low fluence multiple pass diode laser with high fluence single pass IPL for permanent hair reduction in Type III to IV Asian patients.
Thirty Asian patients with Type III to IV black hair were enrolled and received three sessions of treatments at 6-weekly to 8-weekly intervals. A split-leg study was performed in which the IPL was applied to one leg of each patient while the laser was applied to the other. The patients were followed up for 12 months.
All patients were satisfied with the results of the long-term hair reduction without long-term side effects. There was no statistically significant difference in hair reduction and treatment time between the laser (76.85%, 21.39 min) and the IPL (74.53%, 22.17 min) (P > 0.05). The visual analogue scale (VAS) pain score of the IPL (5.96) was higher than that of the laser (3.10) (P < 0.01).
A series of high fluence single pass IPL and low fluence multiple pass diode laser treatments were performed with similar efficacy, speed and safety for permanent hair reduction. However, low fluence multiple pass diode laser treatment was less painful than high fluence single pass IPL.
This study compares the efficacy, safety, and side-effect profile of three different firing modes in a single laser emitting both dual-wavelength multiplexed laser pulses and single-wavelength pulses for removing unwanted axillary hair in subjects with Fitzpatrick skin types II-V.
Subjects received four laser treatments at 4-6 week intervals. One axilla was treated with the alexandrite laser alone while the contralateral axilla was treated with multiplexed pulses delivering either a 755 nm/1064 nm pulse or a 1064 nm/755 nm pulse. Efficacy was evaluated through blinded hair counts performed on digital photographs taken two and six months following the final treatment.
Mean hair clearance percentages were 83%, 81%, and 86% for the alexandrite, alexandrite/YAG sequence, and YAG/alexandrite sequence, respectively. Side effects were minimal and did not differ by treatment.
Muliplexed 755 nm/1064 nm and 1,064 nm/755 nm pulses compared favorably with the 755 nm pulses for efficacy and side-effect profile, all being highly efficacious. Further study of the multiplexed pulses in various clinical settings, including refractory hair removal, are indicated.
This article provides a systematic overview of laser, light, and other energy devices for patients of African descent. It also reviews complications in skin of color and some treatment options for these adverse events.
A handpiece with a 35 × 22-mm treatment window that uses vacuum technology has been designed for the diode laser system. Vacuum suction stretches the skin and brings the hair follicle closer to the surface with the intent to damage the hair follicle at a lower surface fluence. The objective of this study was to compare the degree of follicular thermal damage between the sapphire-cooled smaller handpiece at a higher fluence versus the larger vacuum-assisted handpiece at a lower fluence.
Five male patients with Fitzpatrick skin types I-IV were enrolled in the study. Three test spots on the right back were treated with the vacuum-assisted laser handpiece at a setting of 10-12 J/cm², and 61-ms pulse duration. Three test spots on the left back were treated with the sapphire-cooled handpiece with a setting of 30-34 J/cm² and a pulse duration of 14-16 ms. A punch biopsy was obtained from one treated area for each handpiece type. The biopsies were sectioned horizontally and examined for the degree of thermal damage to the hair follicle at the level of the isthmus and the bulb. Immediate treatment response, pain score, and total treatment time were recorded.
Biopsies from the skin treated with the sapphire-cooled handpiece and the vacuum-assisted handpiece showed the mean hair follicle diameter was 258.3 µm (SE [standard error] 41.7) and 225.1 µm (SE 17.1), respectively. The mean thermal damage diameter to hair diameter ratio was 0.91 (SE 0.10) and 0.72 (SE 0.12), respectively. The mean immediate treatment response, the mean pain severity, and the mean total treatment time were all lower for the vacuum-assisted handpiece.
Treatment with the vacuum-assisted handpiece is faster and has a tendency to be more comfortable. Thermal damage to the hair follicle was greater with the sapphire-cooled handpiece.
Introdução: Laser de diodo e luz intensa pulsada estão entre as tecnologias mais uti-lizadas para fins epilatórios.Objetivo: Comparação entre essas técnicas na epilação axilar.Métodos: 15 pacientes de fototipos II e III foram submetidas a três sessões regulares deluz intensa pulsada (695nm) – Plataforma Quantum HR® (Lumenis,Yokneam, Israel) naaxila direita e Laser de diodo (810nm) – Light Sheer® (Lumenis,Yokneam, Israel) na axilaesquerda. Foi realizada contagem de pelos pré e pós-tratamento, além de aplicado ques-tionário sobre efeitos adversos, dor e satisfação das pacientes.Resultados: O escore de dor foi significativamente maior para a luz intensa pulsada,assim como o grau de inflamação (p<0,01 e p=0,03).Houve correlação significativa entrea fluência utilizada, a dor atribuída e o grau de inflamação para as duas técnicas (p<0,05).Ambas as técnicas proporcionaram redução significativa e semelhante na densidade depelos. As pacientes consideraram o resultado final similar, porém à luz intensa pulsadaforam atribuídos maiores efeitos colaterais. Não houve diferença na proporção de prefe-rência entre os diferentes métodos (p=0,80).Conclusão: Na amostra estudada, com os parâmetros descritos, houve menor dor eincidência de efeitos colaterais com o uso do Laser de diodo em comparação à luz inten-sa pulsada, e eficácia semelhante entre as duas técnicas.
The 800 nm diode laser and the 1064 nm Nd:YAG laser have been used successfully for hair removal for many years. Objective: To compare the efficacy of a diode laser with a Nd:YAG laser regarding axillary fossa hair removal in Chinese women.
Twenty-nine Chinese women underwent three treatment sessions at 4-week intervals with a diode laser (34-38 J/cm(2)) on one side and a Nd:YAG laser (34-40 J/cm(2)) on the other side. Assessments included the reduction of hair diameter following treatment, the regrowth rate in hair length, total hair reduction and the immediate pain associated with the treatments.
At follow-up visit number 1 (4 weeks after the first session), the average reduction in hair diameter on the diode laser side and the Nd:YAG laser side was 2.44 μm and -0.6 μm, respectively. The regrowth rates of the hair were 61.93 μm/day and 59.84 μm/day, respectively, which were not statistically significant (p > 0.05). At follow-up visit number 1, hair reduction was 60.09% and 41.44%, respectively. At follow-up visit number 2 (4 weeks after the second session), hair reduction was noted to be 78.56% and 64.50%, respectively, which were both statistically significant (p < 0.05). Immediate pain scores at the first session were 6.97 and 6.17, respectively; at the second session were 5.48 and 6.69, respectively; and at the third session were 5.76 and 7.45, respectively; all statistically significant (p < 0.05).
The diode laser showed more efficacy and was found to be more comfortable than the Nd:YAG laser for axillary fossa hair removal in Chinese women.
Unwanted hair is a common problem for which different types of light therapy have been developed as the treatment of choice. Since 1996, when the American Food and Drug Administration approved the first laser therapy for depilation, much progress has been made in light-based technology and lasers. Lasers and intense pulsed light sources with red or near infrared wavelengths (600 to 1200 nm) are the most widely used for removing hair as they target the melanin of the hair shaft, hair follicle epithelium, and hair matrix. The aim of this review is to describe and compare the different photodepilation methods currently available.
Lasers have revolutionized the practice of modern dermatology. Our understanding of laser physics and selective photothermolysis has expanded greatly over the last 20 years. In the last 2 years, we have looked beyond the traditional lasers and explored new concepts. This article will look at five of these new concepts. A strong understanding of these new techniques will allow dermatologists to use them either primarily or in combination with more conventional methods.
Unlabelled:
Laser-assisted hair removal, Laser hair removal, Laser and light-assisted hair removal, Laser and light-assisted, long-term hair reduction, IPL photodepilation, LHE photodepilation; all these are acceptable synonyms. Laser (Ruby, Nd Yag, Alexandrite, Diode), intense pulse light, light and heat energy system are the different light-/Laser-based systems used for hair removal; each have its advantages and disadvantages. The word "LONG-TERM HAIR REDUCTION" should be used rather than permanent hair removal. Patient counseling is essential about the need for multiple sessions. PHYSICIANS' QUALIFICATIONS: Laser hair removal may be practiced by any dermatologist, who has received adequate background training during postgraduation or later at a centre that provides education and training in Lasers or in focused workshops providing such training. The dermatologist should have adequate knowledge of the machines, the parameters and aftercare. The physician may allow the actual procedure to be performed under his/her direct supervision by a trained nurse assistant/junior doctor. However, the final responsibility for the procedure would lie with the physician.
Facility:
The procedure may be performed in the physician's minor procedure room. Investigations to rule out any underlying cause for hair growth are important; concurrent drug therapy may be needed. Laser parameters vary with area, type of hair, and the machine used. Full knowledge about the machine and cooling system is important. Future maintenance treatments may be needed.
Background and Objective
Although several studies on laser-assisted hair removal have been published, data on long-term follow-up are few. The present study investigated the long-term efficacy and safety of normal-mode ruby laser pulses on hair removal.Study Design/Materials and Methods
The normal-mode ruby laser (Epilaser; 694 nm, 3 msec) was used to treat a wide range of body sites in 51 volunteers. The mean follow-up after the last treatment was 8.37 months.ResultsSixty-three percent of the patients had sparse regrowth. The mean fluence used was 46.5 J/cm2 in patients who had sparse hair regrowth and 39.3 J/cm2 in patients who had moderate hair regrowth (P = 0.0127). Transient pigmentary changes occurred most frequently in patients with skin type 4.Conclusion
The normal-mode ruby laser is an efficient and safe method for long-term hair reduction, especially in fair-skinned individuals with dark hair. Higher fluences produce greater long-term efficacy. Adverse effects are minimal and transient. Lasers Surg. Med. 26:177–185, 2000. © 2000 Wiley-Liss, Inc.
Background:
Multiple laser systems are available for the purpose of hair removal.
Objective:
The purpose of this study was to determine the safety and long-term efficacy of the 800 nm, pulsed diode laser at reducing hair count.
Methods:
Fifty volunteers, primarily Fitzpatrick skin types II and III, with dark brown or black hair, were treated with a diode laser (800 nm, 10-40 J/cm2, 5-30 msec, 9 mm 9 mm, 5 degrees C chilled handpiece). Each subject had eight treatment sites at varying fluences and pulse durations, as well as a varying number of treatments and pulses. Hair counts were obtained at each site at baseline, 1, 3, 6, 9, and an average of 20 months after treatment.
Results:
After one treatment, hair regrowths ranged from 22 to 31% at the 1-month follow-up visit, then remained stable between 65 and 75% from the 3-month to the averaged 20-month follow-up. After two treatments there were relatively longer growth delays, with hair regrowths plateauing beginning at 6 months after treatment and ranging from 47 to 66% for the remainder of the follow-up evaluations. Side effects were limited to pigmentary changes, transient in subjects with skin types II and III.
Conclusions:
This 800 nm diode laser with a chilled sapphire tip and variable pulse duration is safe and effective for long-term hair reduction in individuals with skin types II and III.
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.
Laser hair removal is a popular treatment method for removing unwanted hair. Several laser systems are available for laser hair removal. The gallium aluminum arsenide semiconductor diode (GAASD) laser is one of the newer laser modalities to be studied.
To evaluate the efficacy of the GAASD laser system in removing unwanted hair.
Twenty-six patients with brown or black hair growth were treated with the GAASD laser at fluences of 20-80 J/cm2. Hair regrowth was measured 4 weeks after the first treatment, 4 weeks after the second treatment, 4 weeks after the third treatment, and 4 weeks, 8 weeks, and 8 months after the fourth treatment.
GAASD laser treatment resulted in hair growth delay in all treated regions. Repeated laser treatments did not produce an increased number of vellus hairs. The percentage of hair reduction fluctuated between 5% and 13% with the second or third treatment averaging the highest percent reduction. In all cases, the percentage of hair reduction of the treatment sites evaluated at 8 months after the fourth treatment was less than both the second and third treatments (highest average percent reduction) and the fourth (last) treatment.
Laser-assisted hair removal with the long pulsed ruby laser is a promising new technique based on selectively targeting melanin in hair follicles.
The purpose of this study was to evaluate the efficacy and safety of the long pulsed ruby laser (EpiTouch) for hair removal.
The Epitouch laser was used for hair removal of the arms of 20 patients. The areas were evaluated immediately post-treatment, and at 1, 4, 8, and 12 weeks, for efficacy and complications.
Postoperative results showed 40-80% regrowth after 12 weeks.
Selective melanin-based photothermolysis with a free running pulsed ruby laser seems to be a promising, noninvasive technique for long-term hair removal. More than one treatment is necessary since only anagen hair will be affected.
Laser dermatology, a long-time model for laser tissue interactions, will play an important part in the future of research, diagnostics, and therapeutics.
Laser research continues in photobiology, especially in molecular reactions, and it continues at the cellular level in melanocyte and Langerhans cells.
Laser diagnostics in the development of opto-electronics concern new developments in imagery. Some studies include new types of microscopes for living skin and vary from the portable illuminated skin microscopes, the current dermatoscopes, to the coaxial polarizing microscope and the new scanning confocal microscope of Gmitro for living tissues. The regular confocal microscope for fixed tissue slides will revolutionize dermatopathology. The other research microscopes include the ultrasonic biomedical microscope and the IR microscope and the holographic microscope of optical phase conjugation used for living tissues.
New lasers for therapy include micromedical lasers, economical junction diode lasers alone and for pumping solid-state lasers, FEL of the future, and multiwavelength laser units. These later units include seven-wavelength units of barium, copper vapor and ruby, and are available for other heavy metal laser heads, ds gold-628 nm and lead-722 nm. Copper vapor can pump also Ti sapphire. The MOPO series (200 nm in the UV to > 4,500 in the IR) is the most extensive modern multiwavelength laser box type.
Laser hair removal is rapidly becoming a widely used modality. Clinical studies are needed to assess these hair removal systems. The long-pulsed ruby laser is one such modality for the removal of unwanted hair.
To evaluate the efficacy of the long-pulsed ruby laser (694 nm, 3-msec pulsewidth, 7- or 10-mm spot size) in removing unwanted hair, and to provide treatment guidelines for the proper utilization of this laser system.
Forty-eight areas of unwanted facial and body hair from 25 patients with blonde, brown, or black hair were treated with the long-pulsed ruby laser at fluences between 10 and 40 J/cm2. Hair regrowth was measured at 4 weeks after the first treatment, 4 weeks after the second treatment, 4 weeks after the third treatment, and 16 weeks after the third treatment by counting the number of terminal hairs compared with baseline pretreatment values. All complications and treatment outcomes were documented.
The mean percent of regrowth after the first treatment was 65.5%, 41% after the second treatment, and 34% after the third treatment. Overall, regardless of skin type or targeted body region, patients who underwent three treatment sessions demonstrated an average 35% regrowth in terminal hair count compared with baseline pretreatment values 6 months after initial therapy.
Long-pulsed ruby laser treatment resulted in significant hair growth delay in most cases. Repeated laser treatments produced an increased number of vellus hairs, an increase in growth delay, and a decreased percentage of hair regrowth.
Traditional methods of hair removal have proven unsatisfactory for many individuals with excessive or unwanted hair. In the last few years, several lasers and xenon flashlamps have been developed that promise to fulfill the need for a practical, safe, and long-lasting method of hair removal. Aggressive marketing of these has contributed to their popularity among patients and physicians. However, significant controversy and confusion surrounds this field. This article provides a detailed explanation of the scientific underpinnings for optical hair removal and explores the advantages and disadvantages of the various devices currently available (Nd:YAG, ruby, alexandrite, diode lasers, and xenon flashlamp). Treatment and safety guidelines are provided to assist the practitioner in the use of these devices. Although the field of optical hair removal is still in its infancy, initial reports of long-term efficacy are encouraging.
There are a variety of different laser hair removal systems currently available. There are also systems with identical emitted wavelengths; yet their emitted pulse durations vary. There are few data comparing these systems in an objective manner.
Fourteen subjects received three treatments with two different pulse duration 755-nm alexandrite lasers. Paired anatomic sites were treated three times with both a 2-msec and a 10-msec system. Subjects were evaluated prior to laser treatment and 6 months after the three treatments with manual hair counts and incidence of complications.
The average percentage of hair reduction was 33.1% for the 2-msec-pulse duration and 33.9% for the 10-msec-pulse duration alexandrite laser. No cutaneous pigmentary changes or scarring was noted 6 months after the final treatment.
The alexandrite laser is effective in removing unwanted hair. There was no difference in response between a 2-msec and a 10-msec alexandrite laser.
The use of lasers for removal of unwanted hair has been shown to be effective in temporarily controlling hair growth. Several lasers are currently utilized for this purpose.
This study evaluates the short-term effectiveness and discomfort levels of the long-pulsed alexandrite laser and the topical suspension-assisted Q-switched Nd:YAG laser in a side-by-side comparison.
Fifteen subjects were treated in the bilateral hair-bearing axilla, using one treatment with the alexandrite laser for the right and two treatments with the topical suspension-assisted Nd:YAG laser for the left. Reduction in hair regrowth was measured at 2 and 3 months following the first treatment by comparing the terminal hair count to the baseline values. Patients rated their pain on a scale of 0-10 immediately following the first treatment at each site.
The mean percentage reduction in hair regrowth 2 months following alexandrite laser treatment was 55% and 73% for the Nd:YAG laser-treated regions. After 3 months, alexandrite laser-treated patients showed a reduction of 19%, while Nd:YAG laser-treated patients showed a 27% reduction. Patients reported average pain values of 8 and 4 for the long-pulsed alexandrite and Nd:YAG laser sites, respectively. All differences were significant.
While the design of this study makes it difficult to compare the relative effectiveness of the lasers, both systems evaluated were shown to delay hair growth and provide patients with a satisfactory treatment.
Hirsutism and hypertrichosis are common problems for which a permanent solution has been elusive. Laser-assisted hair removal is a promising technique. However, the optimal wavelength, pulse duration, and fluence continue to require further investigation.
To determine if the long-pulse Q-switched Nd:YAG laser is safe and effective in reducing facial and non-facial trunk hair.
Fifteen patients were treated with a 30 msec pulsed Q-switched Nd:YAG laser at fluences between 125 and 150 J/cm2. The reduction of hair density was assessed at baseline and at 7, 30, and 90 days after treatment. Potential complications were also evaluated.
The average hair reduction was 36% at 7 days, 52% at 30 days, and 59% at 90 days. No significant complications or adverse events were reported.
The long-pulse Q-switched Nd:YAG laser provides a safe and effective means of hair removal.
Ruby laser hair re-Figure 3. Postinflammatory hyperpigmentation occurring after treatment with the highest parameters, 100 msec and 115 J/cm 2 . 414 rogachefsky et al.: thermal damage time moval. Evaluation of long-term efficacy and side effects
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Campos VB, Dierickx CC, Farinelli WA, et al. Ruby laser hair re-Figure 3. Postinflammatory hyperpigmentation occurring after treatment with the highest parameters, 100 msec and 115 J/cm 2. 414 rogachefsky et al.: thermal damage time Dermatol Surg 28:5:May 2002 moval. Evaluation of long-term efficacy and side effects. Lasers Surg Med 2000;26:177–85.