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Literature Review
Hair Removal
- ... Promoting full hydration may enhance drug bioavailability into skin and hair. Thirdly, the cream may help in softening and swelling the hair (Ramos-e-Silva et al., 2001). Lastly, on the outermost or exposed surface of hair cuticle, a thin proteolipidic membranelike structure forms a hydrophobic barrier (Jones, 2001). ...Histological alterations in the skin and hair follicle of mice were evaluated as a result of the application of gel and cream formulas containing papain as a harmless treatment for hirsutism. Papain is a proteolytic enzyme and it has been used in pharmaceutical, cosmetic and nutrition areas. The purpose of this study was to evaluate the efficacy of a depilatory product, through histological analysis using light microscopy. Gel and cream formulas containing papain were developed and daily applied on the back of two groups of mice for 31 days. The depilatory effect of the gel formula applied on the first group was less evident. The second group treated with the cream formula presented an intensive depilatory effect; the morphometrical analysis showed dilation of about 55% of the hair follicle lumen and an increase of the thickness of epidermis. Papain cream had a significantly higher depilatory effect than the papain gel.
- ... These include acute erythema during and after the procedure, folliculitis, pseudofolliculitis, bullous impetigo, hyperpigmentation and depigmentation. 1,3,4 We have seen a case of unilateral molluscum contagiosum along the threaded eyebrow, and koebnerization of vitiligo after the procedure has also been reported from this clinic. 2 In this paper, we report a series of eight cases from our clinic, showing a new complication of eyebrow threading. ...Koebnerization is a well-known phenomenon in diseases like vitiligo and psoriasis. Eyebrow plucking is a common procedure, which induces some trauma. This is a report of a woman with vitiligo whose vitiligo spread to the eyebrow area after eyebrow plucking by threading in a beauty parlour. This is an example of an unusual koebnerization of vitiligo by a very common cosmetic procedure.
- ... These include acute erythema during and after the procedure, folliculitis, pseudofolliculitis, bullous impetigo, hyperpigmentation and depigmentation. 1,3,4 We have seen a case of unilateral molluscum contagiosum along the threaded eyebrow, and koebnerization of vitiligo after the procedure has also been reported from this clinic. 2 In this paper, we report a series of eight cases from our clinic, showing a new complication of eyebrow threading. ...Removal of eyebrow and facial hair by 'threading' has gained popularity worldwide. Threading is an ancient Eastern method of removing unwanted facial and eyebrow hair by a technique whereby one end of a cotton thread is held in the mouth of the technician and the other end looped around individual hair shafts, which are then pulled out. This is repeated in quick, successive movements. In India, this is used extensively for shaping and removing eyebrow hair. Threading now enjoys immense popularity with women worldwide, irrespective of race or colour, and is an accepted method for removing eyebrow hair and shaping the eyebrows. However, this popular cosmetic procedure has some significant dermatological side-effects and is not familiar to many dermatologists. To our knowledge, this is the first report of verrucae occurring in threaded eyebrows. Other complications include erythema, folliculitis, pseudofolliculitis, hyperpigmentation, and depigmentation, including koebnerization of vitiligo. This report should alert dermatologists to the possible complications that may arise from this popular aesthetic epilatory procedure.
- ... Promoting full hydration may enhance drug bioavailability into skin and hair. Thirdly, the cream may help in softening and swelling the hair (Ramos-e-Silva et al., 2001). Lastly, on the outermost or exposed surface of hair cuticle, a thin proteolipidic membranelike structure forms a hydrophobic barrier (Jones, 2001). ...Cited By (since 1996):1, Export Date: 24 February 2014, Source: Scopus, References: Aubin, G., Experimentação biológica dos produtos cosméticos (1994) Manual de Cosmetologia Dermatológica, pp. 233-243. , PRUNIÉRAS, M. São Paulo: Organização Andrei;
- Laser hair removal (LHR) is increasingly popular for the treatment of unwanted hair. To date, there have been few studies to evaluate patient satisfaction and complications after LHR among people of color. To determine patient satisfaction and complications with long-pulsed Nd:YAG laser assisted hair removal in dark-complexioned skin individuals from the patient's point of view. A survey questionnaire was administered to subjects with Fitzpatrick skin type VI between the ages of 21-70 years who had been treated with long-pulsed Nd:YAG for unwanted hair. Questions were comprised of those related to satisfaction and complications from treatment with LHR. Satisfaction was recorded on a linear analogue scale (LAS=not at all satisfied; 100=extremely satisfied). Fifty patients (female 41, male 9) completed the survey. All patients were satisfied with Nd:YAG LHR treatment with the mean satisfaction score of 84.2. All patients favor LHR treatment as compared to alternative methods. The majority of patients (79.3%) who had completed six or more LHR treatments were removing their hair less frequently than before LHR treatment. Hyperpigmentation after treatment was noted in three patients (6%), which lasted for 3-10 days. No hypopigmentation, blistering, or scarring was observed. All patients completing the study would recommend LHR for patients with unwanted hair with the mean recommendation score of 91.5. Nd:YAG laser-assisted hair removal gives a high rate of patient satisfaction in terms of hair reduction with minimal complication among subjects of color.
- Cosmetic dermatology should be an established part of the practice of dermatology. No ifs, ands, or buts. Patients want to look their best, and they have every right to achieve this goal.
- Approximately 10% of women of childbearing age are hirsute, which is defined as the presence of coarse terminal hairs in androgen-dependent areas on the face and body. It not only is a source of psychological discomfort but also may be a sign of an underlying medical condition. This article reviews the pathophysiology, diagnosis, evaluation, and treatment of hirsutism.
- This study was performed in order to evaluate patient satisfaction with epilation using an intense pulsed light source. Between 1995 and 2000, 416 patients consulted the authors' practice because of unwanted facial and body hair. A total of 309 patients received treatment with a non-coherent, filtered flashlamp intense pulsed light source. In February 2000, a questionnaire was mailed to each patient and 207 replies were obtained. Overall, 45 (22%) of patients were very satisfied, 93 (45%) were satisfied and 69 (33%) remained unsatisfied with the outcome of light-assisted hair removal. The non-coherent, filtered flashlamp intense pulsed light source satisfactorily removed unwanted dark hair. Hair-free periods from weeks to years could be observed. Hair removal by a non-coherent, filtered flashlamp intense pulsed light source is an effective and safe method for long-term epilation of unwanted hair. This technique offers a more reliable and practical solution than any other hair removal method, especially for patients with skin irritation and ingrown hair.
- 1. General Photoepilation is a very new method in dermatology. Therefore possibilities and borders are not known by now. Many doctors are using these devices as comfortable method t reduce hair. This ex-amination should be helpful for the operator in judgment of in some cases contradictory statements in literature. Beyond this investigation should be a guidline to optimize the treatment with photo-epilation systems. 2. Material and Methods Therefore comparison investigations in between different lasers and IPL were performed as well as investigations concerning treatment parameters as energy densitiy and pulse duration and their influ-ence on efficiacy of hair reduction. The parameter that was used for statistical evaluation was the per-cental hair reduction that was ascertained by hair counts before the first and every following treatment as well as during the follow up periods up to twelve months. It was seen to it that countings were per-formed by the same person every time to reduce inaccuracies. Testing areas were located on sym-metric body areas with as homogenous hair as possible. This procedure should avoid diversity in hair density and differences in respond evocated by different body areas. Testing areas were generously extended on skin to guarantee for certain treatment of testing areas. All testing areas were treated in 4 to 8 weekly intervals with the respective method. Treatment parameters were unalterated concerning pulse duration and spot diameter at every repeated treatment, energy densitiy was enhanced at every treatment as far as the protocol of study allowed to do so. 3. Results 3. 1. Hair counting method The hair counting method that was evolved during this investigation was statistically explored and was statistically reliably and convincing. 3. 2. Comparison of two alexandrite lasers in low dose category This investigation was performed with two alexandrite lasers (alexandrite laser 1 and 2) of different firms in low energy ranges. That means within energy densities of 10 J/cm². This comparison showed a better hair reduction of alexandrite laser 1 at the third and fourth repeated treatment. 3. 3. Comparison of two alexandrite lasers at the energy densitiy of 20-25 J/cm² There was another comparison in the energy densitiy of 20-25 J/cm². This investigation showed no statistically significant different result. 3. 4. Analysis of influence on efficiacy of different pulse durations with alexandrite laser 2 A further comparison study with alexandrite laser 2 analysed the influence of pulse duration on efficiacy of hair reduction. This investigation showed no influence during pulse durations of 10 to 40 msec. 3. 5. Comparison of energy densities between 10 and 40 J/cm² by treatment with the alexandrite laser 2 There was another comparison study that investigated the influence of energy density of the range between 10 an 40 J/cm² on hair reduction. Statistical evaluation showed a significant different result after the second treatment in the group 10 and 30 J/cm² and 10 and 40 J/cm². All further results were statistically not significant different. 3. 6. Comparison concerning the efficiacy of hair reduction using lowly energy densities to normal energy densities treating with the alexandrite laser A further comparison study investigated the range of energy densities between 5 and 20 J/cm². The comparison of low energy densities showed statistically significant different results after the second treatment in the group of 5 to 20 J/cm² and after the third treatment in the group of 5 to 10 respectively 15 J/cm². All further results were statistically not significant different. Therefore low energy densities are sucessfull in hair reduction and enlarge the array of this method. 3. 7. Comparison of different cooling methods and their influence on hair reduction treating with an alexandrite laser and a flash lamp A further study investigates the influence of cooling on efficiacy of hair reduction. There were different cooling methods that were related to an uncooled control area. Cooling methods were ultra sonic gel, air cooling and a combination out of air and ultra sonic gel. Treatment parameters in all areas were that settings that were tolerated in the uncooled area. Treatment was performed either with alexandrite laser 1 or a flash lamp. Results of this investigation did not show statistically significant different re-sults in efficiacy concerning the cooling method. Apart from that treatment method was not crucial. 3. 8. Comparison of a diode laser and a flash lamp There was a comparison study between a diode laser and a flash lamp performed. Statistical evalua-tion showed statistical significant different results in five from six treatments. Results treating with the diode laser were better. Follow up after three and sex months showed statistically significant different results only after three months to the advantage of the diode laser. Apart from that there was another investigation concerning the body localisation. Therefore legs, bikini and chin were compared. There was a statistically significant difference after the first treatment in between legs and bikini. All further results were not statistically significant different. 3. 9. Comparison of a diode laser, two flash lamps and an alexandrite laser concerning the efficiacy of hair reduction A further study compared two flash lamps, a diode laser and alexandrite laser 1. This investigation did not show any statistically significant differences between the mentioned epilation systems. 4. Discussion concluding there could be mentioned that there are more investigations with more volunteers neces-sary to get better and more exact results concerning photo-epilation. Apart from that a more precise determination of treatment parameters should help to get better results. Follow up investigations are necessary in a bigger extension to qualify perspectives and
- The authors have indicated no significant interest with commercial supporters.
- Background: In gender minority patients, electrolysis and laser hair removal may be necessary to reduce facial and body hair in individuals seeking a more feminine appearance and/or modified gender expression. These procedures may also be required preoperatively for some gender-affirming surgeries. Aims: To identify (a) the frequency of unwanted facial and body hair, (b) the use of various hair removal methods, and (c) associated barriers to care in gender minority patients. Methods: An online-based patient survey was distributed via social media on Facebook® , YouTube® , and Instagram® in fall 2018. Respondents were at least 18 years old and self-identified as a gender minority. Results: In total, 991 responses were recorded with a completion rate of 77%. Considering excess hair, 84% of transwomen on feminizing hormone therapy (FHT: estrogen and anti-androgen therapy), 100% of transwomen not on FHT, and 100% of nonbinary individuals on FHT reported excess facial/body hair. Laser hair removal (18%) and electrolysis (17%) had similar rates of use in this cohort and were more commonly reported for nonsurgical gender-affirming purposes than preoperative preparation. Cost was the most frequently cited barrier to care. Conclusion: As the majority of transwomen and nonbinary people on feminizing hormone therapy had persistent excess facial/body hair, routine use of gender-affirming hormones is not sufficient to fully eliminate unwanted hair. There remains a critical need to advocate for more comprehensive insurance coverage for laser hair removal and electrolysis in gender minority patients.
- Eyebrow threading is a practice of shaping the eyebrows. Many dermatological complications have been briefly mentioned in various publications. There are scant data regarding the appearance of molluscum in the line of eyebrows after a session of threading. We report a series of eight patients both males (3) and females (5) who had lesions of molluscum in the eyebrow region after threading. The earlier reported cases are only among the females. The present study is highlighting the appearance of molluscum in the region of eyebrow after a session of threading from beauty salon. So, to the best of our knowledge, this is the first report of its kind describing same pathology in males. The rational of reporting this case series is to create awareness among the dermatologists as well as in general population about potential hazards of threading.
- Importance Pubic hair grooming is a common practice that can lead to injury and morbidity. Objective To identify demographic and behavioral risk factors associated with pubic hair grooming–related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices. Design, Setting, and Participants This cross-sectional study conducted a national survey of noninstitutionalized US adults (aged 18-65 years). The web-based survey was conducted through a probability-based web panel designed to be representative of the US population. Data were collected in January 2014 and analyzed from August 1, 2016, through February 1, 2017. Main Outcomes and Measures Grooming-related injury history (yes or no), high-frequency injuries (>5 lifetime injuries), and injury requiring medical attention. Results Among the 7570 participants who completed the survey (4198 men [55.5%] and 3372 women [44.5%]; mean (SD) age, 41.9 [18.9] years), 5674 of 7456 (76.1%) reported a history of grooming (66.5% of men and 85.3% of women [weighted percentages]). Grooming-related injury was reported by 1430 groomers (weighted prevalence, 25.6%), with more women sustaining an injury than men (868 [27.1%] vs 562 [23.7%]; P = .01). Laceration was the most common injury sustained (818 [61.2%]), followed by burn (307 [23.0%]) and rashes (163 [12.2%]). Common areas for grooming-related injury for men were the scrotum (378 [67.2%]), penis (196 [34.8%]), and pubis (162 [28.9%]); for women, the pubis (445 [51.3%]), inner thigh (340 [44.9%]), vagina (369 [42.5%]), and perineum (115 [13.2%]). After adjustment for age, duration of grooming, hairiness, instrument used, and grooming frequency, men who removed all their pubic hair 11 times or more during their lifespan had an increased risk for grooming injury (adjusted odds ratio [AOR], 1.97; 95% CI, 1.28-3.01; P = .002) and were prone to repeated high-frequency injuries (AOR, 3.89; 95% CI, 2.01-7.52; P < .001) compared with groomers who did not remove all their pubic hair. Women who removed all their pubic hair 11 times or more had increased odds of injury (AOR, 2.21; 95% CI, 1.53-3.19; P < .001) and high-frequency injuries (AOR, 2.98; 95% CI, 1.78-5.01; P < .001) compared with groomers who do not remove all their pubic hair. In women, waxing decreased the odds of high-frequency injuries (AOR, 0.11; 95% CI, 0.03-0.43; P = .001) compared with nonelectric blades. In total, 79 injuries among 5674 groomers (1.4%) required medical attention. Conclusions and Relevance Grooming frequency and degree of grooming (ie, removing all pubic hair) are independent risk factors for injury. The present data may help identify injury-prone groomers and lead to safer grooming practices.
- Today, most do not go a day without practicing or hearing about new hair removal methods. However, little is discussed about the history of hair removal and the development of most hair removal methods since the period of cavemen. Avoiding decapitation and fitting in with society are two of many reasons for the development of this now normative practice. Knowledge of the hair growth cycle is vital in understanding the efficacy of various hair removal methods as well as the difference between epilation and depilation. While laser hair removal (LHR) is one of the most common cosmetic procedures practiced in the world, according to the FDA, the only current permanent form of hair removal is electrolysis. These two methods as well as various other ones are discussed in this article. Further developments are being made every day to better treat the removal of blonde and white hair as well as to diminish the pain of hair removal. With these developments, dermatologists will better understand the advancement of hair removal methods and the reasons why patients may seek treatment.
- Hair growth disorders are wide spread around the world. They do affect many men and women, influencing on their psychological wellbeing. Trade segment associated with treatments of hair growth disorders has been increasing in the last 10 years. There are many experiments concerning new agents, a lot of other actives are approved for treatment of hair growth disorders. Current paper shows mechanism of the hair growth cycle as disturbances of which cause hair loss or unwanted hair growth. There are presented information concerning miniaturization of hair follicle - what is connected with androgenetic alopecia, telogen effluvium - another form of hair loss is described as well. Authors collect also data from many studies, experiments published in literature concerning alopecia areata, an autoimmune disorder of cells of the anagen hair bulb attacked by lymphocytes. Apart from listed hair loss disturbances authors try to explain mechanism of unwanted hair growth - hirsutism. There are many approved agents; many others wait for approvement for treatment of hair growth disorders. In last few years many agents are taken into account as potential hair loss inhibitors, or hair growth promoters, among them plant active agents are very interesting. By using many plant extracts is possible to treat almost every hair growth disorders.
- Hair disorders have become a central social and psychological issue with increasing demands and expectations from patients. Written by world-renowned experts, this lavishly illustrated textbook provides the latest scientific aspects of hair biology, up-to-date knowledge on hair diagnosis and treatment options as well as hair removal and restoration techniques. The well-structured content is divided into three sections: * Basic aspects of hair growth * Hair and scalp disorders * Fotoepilation, surgery and hair cosmetics It also contains unique sections on hair at different ages, in art and in forensic investigations as well as ethnic hair.
- Although the loss of scalp hair is distressing and many medical treatments focus on its restoration, the removal of body hair has been adopted since ancient times. Beauty standards, which r eflect the culture of each society, have been presenting the depilated body as absolutely desirable. Through the ages various methods of hair removal have been used depending on the requirements of the individuals. In recent years, Laser and Intense Pulse Light devices have been considered as the most promising solution for excess hair growth, without excluding the efficacy of other methods to induce satisfactory epilatory results. The enzyme-based hair removal method has received little recognition even though experimental and clinical data support its efficacy to provide long term or even permanent epilation. The present review presents these data and examines the likelihood of considering the aforementioned method as ideal.
- • Hypertrichosis is the growth of hair of an excessive amount and thickness on any part of the body. • The term is frequently confused with hirsutism, which should only be applied to women with an excessive development of hair with a male pattern distribution. • Hypertrichosis is classified in generalized, localized, or symptomatic. All types can also be classified according to the age of onset as congenital or acquired. • Generalized, symptomatic, and localized forms of congenital hypertrichosis are present in several genodermatoses. Localized forms may also appear in relation to underlying hamartomas. • Generalized acquired hypertrichosis may be a paraneoplastic syndrome, such as acquired hypertrichosis lanuginosa; it may be localized, the result of association with abnormalities of the fat, muscle, bone or of the underlying hemodynamic system; or it may be related to multiple direct cutaneous traumas. • The most frequent acquired symptomatic forms of hypertrichosis are iatrogenic. • Long-term removal of unwanted hair is the objective.
- Androgen excess (AE) is a key feature of polycystic ovary syndrome (PCOS) and results in or contributes to the clinical phenotype of these patients. While AE will contribute to the ovulatory and menstrual dysfunction of these patients the most recognizable sign of AE includes hirsutism, acne and androgenic alopecia or female pattern hair loss (FPHL). Evaluation not includes scoring facial and body terminal hair growth using the modified Ferriman-Gallwey method, but also recording and possibly scoring acne and alopecia. Assessment of biochemical hyperandrogenism is also necessary, particularly in patients with unclear or absent hirsutism, and will include assessing total and free testosterone (T), and possibly DHEAS and androstenedione, although these latter add a limited amount to the diagnosis. Assessment of T requires use of the highest quality assays available, generally radioimmunoassays with extraction and chromatography, or mass spectrometry preceded by liquid or gas chromatography. Management of clinical hyperandrogenism involves primarily either androgen suppression, with a hormonal combination contraceptive, or androgen blockade, as with an androgen receptor blocker or a 5α-reductase inhibitor, or a combination of the above. Medical treatment should be combined with cosmetic treatment including the use of topical eflornithine hydrochloride, and short-term (shaving, chemical depilation, plucking, threading, waxing, and bleaching) and long-term (electrolysis, laser therapy, and intense pulse light therapy) mechanical treatments. Generally acne responds to therapy relatively rapidly, while hirsutism is slower to respond, with improvements observed as early as three months, but generally only after 6 or 8 months of therapy. Finally, FHLP is the slowest to respond to therapy, if it will at all, and it may take 12 to 18 months of therapy before response is begun to be observed.
- Introduction: Due to hormonal stimulation during puberty, changes occur in hair type and distribution. In both sexes, body and facial unwanted hair may have a negative psychological impact on the teenager. There are several available methods of hair removal, but the choice of the most suitable one for each individual can raise doubts. Objective: To review the main methods of hair removal and clarify their indications, advantages and disadvantages. Development: There are several removal methods currently available. Shaving and depilation with chemicals products are temporary methods, that need frequent repetition, because hair removal is next to the cutaneous surface. The epilating methods in which there is full hair extraction include: epilation with wax, thread, tweezers, epilating machines, laser, intense pulsed light, and electrolysis. Conclusions: The age of beginning hair removal and the method choice must be individualized and take into consideration the skin and hair type, location, dermatological and endocrine problems, removal frequency, cost and personal preferences.
- Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, typically presenting with menstrual irregularities and signs of androgen excess. Approximately 4-10% of reproductive aged women have PCOS. The fact that PCOS often presents in adolescence and the chance of long-term adverse health consequences indicate the need for early diagnosis and intervention. Menstrual dysfunction and hyperandrogenism are key features of the diagnosis of PCOS in reproductive aged women. Diagnosis can be challenging, however, in adolescent girls. The etiology of PCOS is complex and incompletely understood. Therapy should focus on alleviating symptoms and preventing adverse health consequences.
Literature Review
- Cosmetic and medical electrolysis and temporary hair removal
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Richards RN, Meharg GE. Cosmetic and medical electrolysis and temporary hair removal. Toronto: Medric, 1991:9 –14. - Fá usados no tratamento das protozoonoses, tripanosomí, leishmaniose, amebi-ase, giardiase, tricomoní e outras protozoonoses
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Tracy JW, Webster LT. Fá usados no tratamento das protozoonoses, tripanosomí, leishmaniose, amebi-ase, giardiase, tricomoní e outras protozoonoses. In: Hardman JG, Limbird LE, editors. Goodman e Gilman: As bases farmacoló gicas da terapê, 9th ed. Mexico City: Ofgloma. 1997:725– 40. - Manual de terapê dermato-ló gica e cosmetologia
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Fonseca A, Prista LN. Manual de terapê dermato-ló gica e cosmetologia. Sã Paulo, Brazil: Roca, 1993:150 –5. - Use of video imag-ing system to obtain hair measurement data in controlled clinical trails evaluating the safety and efficacy of eflorni-thine 15% cream (BMS-203522) in the treatment of exces-sive facial hair in women. Poster presented at the 58th Annual Meeting
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Altman DJ, Huber F, Schrode K, et al. Use of video imag-ing system to obtain hair measurement data in controlled clinical trails evaluating the safety and efficacy of eflorni-thine 15% cream (BMS-203522) in the treatment of exces-sive facial hair in women. Poster presented at the 58th Annual Meeting; March 10 –15 2000, San Francisco. - Randomized double-blind, vehicle-controlled safety and efficacy eval-uation of eflornithine 15% cream (BMS-203522) in the treatment of women with excessive facial hair
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Altman DJ, Huber F, Schrode K, Staszak J. Randomized double-blind, vehicle-controlled safety and efficacy eval-uation of eflornithine 15% cream (BMS-203522) in the treatment of women with excessive facial hair. Poster presented at the 58th Annual Meeting, USA; March 10 –15 2000 - Adding and subtracting hair Women's derma-tology: From infancy to maturity
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Unger WP, Coterill PC. Adding and subtracting hair. In: Parish LC, Brenner S, Ramos-e-Silva M. Women's derma-tology: From infancy to maturity. New York: Parthenon, 2000;535– 46. - Drug eruption reference manual
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Litt JZ. Drug eruption reference manual 2000. New York: Parthenon, 2000. - Innovative photothermal technology for hair removal
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Moretti M. Innovative photothermal technology for hair removal. Medical Laser Insight 2000;8:1. - Lasers in derma-tology In: Freedberg I
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Grevelink JM, Ross EV, Anderson RR. Lasers in derma-tology In: Freedberg I, Eisen A, Wolff K, et al., editors Fitzpatrick Dermatology in General Medicine. New York: McGraw Hill, 1999:2901– 21. - More than 30 years of experience have resulted in advances of the technology, technique, and therapeutic efficacy of dermatologic lasers. The original lasers have been modified and improved, and new lasers with a more sophisticated technology have been introduced. Laser therapy has provided novel ways of treating difficult conditions and, for several skin diseases, it is now considered the treatment of choice. The goal of this article is to review laser physics and laser-tissue interactions, discuss the various groups of lasers and their clinical uses in dermatology, and to contemplate future developments in laser skin surgery.
- Cosmetics of the hair, skin, and nails represent an area of great importance to the practicing dermatologist because use of these products can enhance the external appearance, create cutaneous disease, or interfere with other treatment modalities. Furthermore, the dermatologist is the physician best suited to aid patients in appropriate cosmetic product selection and use. This article is an overview of the most important cur-rently marketed cosmetics for the hair, skin, and nails. It discusses the use of hair cosmetics to alter the shape, color, thickness, and cosmetic appearance of the hair. Hair-removal techniques are also discussed. Nail polishes and prostheses to alter nail color and length are examined. Finally, skin cosmetics and toiletries for the face and body in the form of cleansers, toners, exfoliants, masks, moisturizers, specialty creams, and antiperspirants/deodorants are evaluated in terms of formulation, as well as therapeutic versus aesthetic benefit.
- 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.
- 26 patients with arseno-resistant Trypanosoma brucei gambiense trypanosomiasis were treated with difluoromethylornithine (eflornithine), an inhibitor of ornithine decarboxylase, given intravenously, then orally. There was rapid disappearance of trypanosomes in the cerebrospinal fluid (CSF), gradual decrease of CSF lymphocytosis, and parallel improvement in central nervous system status. Side-effects, including diarrhoea, anaemia, and hair loss, were common but tolerable and reversible. 5 patients died during or shortly after treatment. None of the 21 patients who completed therapy has had a relapse during the 6-30 month follow-up.
- The effect of repeated shaving on human hair growth was studied. Five healthy young white men each shaved one leg weekly for several months and left the other leg as a control. No significant differences in total weight of hair produced in a measured area, or in width or rate of growth of individual hairs, could be ascribed to shaving.
- The activities of ornithine decarboxylase and S-adenosylmethionine decarboxylase, two of the enzymes involved in the synthesis of the polyamines, were found to be high in follicle-rich homogenates of sheep skin, and to be responsive to the nutrition of the animal. Systemic provision of the inhibitor of ornithine decarboxylase, alpha difluoromethylornithine, markedly altered the length, diameter, and composition of the fiber, the last being accompanied by an increase in the proportion of the fiber occupied by paracortical cells and an increase in the level of mRNA encoding a cysteine-rich family of keratin proteins. The growth of wool follicles cultured in media containing alpha-difluoromethylornithine was not inhibited, even at high concentrations. In contrast, low concentrations of methylglyoxal (bis)guanylhydrazone, the inhibitor of S-adenosylmethionine decarboxylase, completely inhibited fiber growth in culture follicles. Addition of spermidine to the media overcame this inhibition but spermine had no effect. Further evidence that spermine is not required for normal follicle function was provided by incubating follicles with the specific inhibitor of spermine synthase, n-butyl-1,3-diaminopropane. This inhibitor, even at high concentrations, had no effect on fiber growth in vitro. Spermidine partially overcame the growth depression that occurred in follicles cultured in methionine-deficient media, suggesting that part of the requirement for methionine is for spermidine synthesis in the follicle. These investigations provide strong evidence that the polyamines in general , and spermidine in particular, play a major role in hair growth.
- Mice that overexpress a mutated ornithine decarboxylase (ODC) transgene in outer root sheath keratinocytes of the hair follicle were used to study the role of this enzyme in regulating hair follicle structure and function. These transgenic mice have a normal first hair cycle, but lose their hair completely beginning 2-3 wk after birth. Transgene overexpression in follicular keratinocytes is first detected at day 12 after birth, coincident with the development of follicular cysts in the upper portion of the dermis. The onset of keratin 6 expression also begins around day 12; because the promoter/regulatory region of the bovine keratin 6 gene was used to target ODC transgene expression of hair follicle keratinocytes, these data demonstrate the faithful temporal and cell type-specific expression of the K6 -driven transgene. The ODC inhibitor 2-difluoromethylornithine could prevent hair loss and partially normalize skin histology if administered before the onset of ODC overexpression. 2-Difluoromethylornithine could also reactivate hair growth in animals with complete hair loss. Our results suggest that ODC is an important regulatory gene for the mouse hair follicle.
- Khite (also known as fatlah in Egypt) is a manual technique of temporary vellus hair removal that is widely performed in the Middle East. The technique of khite is reviewed as illustrated. Khite is an effective method of removing unwanted vellus hairs. Dermatologists in all parts of the world should be familiar with khite, because the ease of international travel may bring patients to their attention who have khite-association complications such as erythema, folliculitis, and secondary pigmentary changes.
- The use of lasers in the treatment of a number of different skin disorders and diseases has become commonplace. This tremendous acceptance by both physicians and patients is a direct reflection of the high degree of precision and selectivity provided by lasers, which helps to minimize the risk of side effects and complications while simultaneously maximizing the opportunity for obtaining a satisfactory outcome. In an attempt to remove unwanted or excess hair, the principles of selective photothermolysis have been employed with several different laser and light devices that permit the effective treatment of large areas of hair-bearing skin with minimal discomfort and with low risk of scarring or other complications. It is possible using current laser technology to permanently remove some hair and induce a prolonged delay in the regrowth of many hairs. With additional experience and an improved understanding of how light can influence the rate and quality of hair growth, it is anticipated that permanent hair removal will be achieved in the near future.
- Skin diseases have been treated with lasers since the early 1960s. The three principal chromophores in the skin--hemoglobin, melanin, and water--have different absorption spectra that selectively absorb certain wavelengths of electromagnetic radiation. A given wavelength and pulse duration will selectively treat a target containing a chromophore. The wide variety of lasers and their applications are discussed.
- 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. (J Am Acad Dermatol 1999;40:143-55.) Learning objective: At the completion of this learning activity, participants should be cognizant of the different control mechanisms for hair growth and how the different means of hair removal affect these. Readers will also become familiar with the different types of electrolysis and lasers currently used for hair removal and the advantages and disadvantages of each.
- Laser emission from neodymium-doped glass was first produced nearly 40 years ago. Later, a crystal of yttrium, aluminum, and garnet (YAG) was discovered to be a better lasing host for neodymium. The Nd:YAG laser has since been used for a variety of medical applications, more recently, this instrument has been used for the purpose of damaging hair follicles to epilate unwanted hair. This article reviews the background of the Nd:YAG laser with particular application to hair removal, summarizing the clinical and histologic studies presently available. Its current clinical use and possible future modification for elimination of excess hair are discussed.
- 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.
- 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.
- A systematic and logical approach for laser hair removal demands an understanding of its biologic and physical bases. This article presents an overview of hair anatomy and physiology followed by a mathematically nonrigorous review of tissue optics and thermal responses to laser irradiation. The reader is provided with a step by step approach to laser hair removal.
- 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.
- 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.
- The mechanism and permanence of laser-assisted hair removal remains a formidable task in the medical community. 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. 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. 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. 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.
- The hair removal market is evolving rapidly. The goal has always been long-term epilation. Success is dependent on understanding hair biology and physiology and on knowledge of laser physics, skin optics, and tissue preservation with respect to these emerging laser technologies. These topics will be reviewed, as will specific categories of laser systems in the hair removal arena and the clinical aspects of laser hair removal today.
- Difluoromethylornithine (DFMO) is an irreversible inhibitor of ornithine decarboxylase (ODC), the essential enzyme in mammalian polyamine biosynthesis (Pasic et al., 1997, Arch. Otolaryngol. Head Neck Surg. 123[12], 1281-1286). This cancer chemotherapeutic agent has significant ototoxic potential. Because the DFMO enantiomers differ in their ability to block ODC, the present study was designed to compare the ototoxic potential of each enantiomer with the racemic form of this drug for the rat and guinea pig. Determining differential ototoxicity of the enantiomers is one preliminary step in determining the optimal form of DFMO to use in human cancer chemotherapy. Daily intubation with D,L-DFMO does not produce any auditory dysfunction in rats with doses between 200 mg/kg/day and 1. 2 g/kg/day for up to 8 weeks, despite the fact that doses of 800 and 1200 mg/kg/day depressed body weight gain. In contrast to the data observed in rats, substantial ototoxicity was observed when guinea pigs were injected ip with doses of D,L-DFMO between 500 mg/kg/day and 1 g/kg/day. D,L-DFMO produced loss of compound action potential sensitivity, but not of cochlear microphonic amplitude. This finding correlated with histological data revealing loss of both outer and inner hair cells in the cochlea with inner more affected than outer hair cells, particularly in the basal turn. Higher exposure doses (2-3 g/kg/day) resulted in significant general toxicity including impaired growth and some mortality. When the enantiomers were evaluated in the guinea pig, it was found that 1 g/kg/day D-DFMO did not produce any significant hearing impairment, whereas 1 g/kg/day of the L-enantiomer of DFMO generated a threshold shift that surpassed that of 1 g/kg/day of the D,L-DFMO treatment.
- The incidence of skin cancer (both melanoma and non-melanoma) continues to grow at an alarming rate. Our chemoprevention strategies include the development of novel agents evaluated by (1) preclinical mechanistic studies in models of ultraviolet (UV) radiation-induced skin carcinogenesis; (2) clinical studies of immunohistochemical surrogate endpoint biomarkers in high-risk patients; and (3) randomised, placebo-controlled phase I, II and III clinical chemoprevention trials. Recent clinical results validate this development model. Molecular targets of chemopreventive strategies for melanoma and non-melanoma skin cancers include the ras and activator protein-1 (AP-1) signal transduction pathways. A transgenic murine melanoma model has been developed for evaluating potential agents in vivo. Agents at various stages of study include the green tea catechin epigallocatechin gallate (EGCG), the limonene derivative perillyl alcohol, the ornithine decarboxylase inhibitor alpha-difluoromethylornithine (DFMO), selenium, retinoids and salicylates. New chemopreventive agents that can be used to complement sunscreens may result in decreased incidence, morbidity and mortality of skin cancer.
- Squamous cell carcinoma (SCC) of the oral cavity is a multistep process, progressing through a series of discrete, irreversible and complementary alterations in genes that control cell growth, death, and differentiation. In the premalignant state, the oral mucosa progresses through various grades of epithelial dysplasia, with the potential to convert to SCC. Chemopreventive strategies are designed to suppress, reverse, or prevent the formation of premalignant lesions and their subsequent progression to SCC. In the present study, we determined the growth inhibitory effect of 21 chemopreventive agents in a cell culture model using normal, premalignant, and malignant human oral mucosal cell lines. There were significant differences in the growth inhibitory responses of these cell lines to selected retinoids and non-retinoid analogs. Among the retinoids tested, the synthetic retinamides, as a class, showed selective growth inhibition of both premalignant and malignant cells compared to normal human oral epithelial cells in culture. Within the retinamide class, 2CPR exhibited the greatest selectivity in the growth inhibition of premalignant and malignant cells. Among the non-retinoids analyzed, DFMO was a moderate to potent inhibitor of malignant and premalignant oral cell growth, respectively, and stimulated normal oral cell growth at low concentrations. Using this in vitro approach, we have identified several potential chemopreventive agents for oral cancer as selective growth inhibitors of premalignant ahd malignant human oral mucosa cells.
- Laser hair removal is a relatively new procedure. Our purpose was to study the efficacy and safety of a high-power, pulsed diode laser array for removing unwanted hair. A total of 38 subjects were treated with a prototype of the 800-nm diode laser system. Fluences ranging from 10 to 40 J/cm(2) (mean, 33.4 J/cm(2)) were used and 1 to 4 treatments (mean, 2.7) were performed. Evaluation of hair loss was performed at least 4 months after the last treatment (mean, 8.7 months) by a blinded assessment of clinical photographs. A total of 59% of the subjects had only sparse hair regrowth at the final follow-up. Higher fluences and multiple treatments produced greater long-term efficacy. Transient pigmentary changes occurred in 29% of the subjects and were more common in darker skin types IV to VI (P =. 047). The 800-nm diode laser is an efficient and safe technique for hair reduction. Adverse pigmentary effects occur, but are transient.
