The effect of Centella Asiatica cream on scar development in patients who underwent open carpal tunnel release surgery.

AIM: To evaluate the efficacy of the Centella asiatica extract in a cream preparation for the prevention of scar tenderness formation in patients who underwent conventional open carpal tunnel release (CTR) surgery. MATERIAL AND METHODS: A total of 280 patients with carpal tunnel syndrome who underwent CTR surgery were individually randomized into the intervention (n = 140) and control (n = 140) groups. In the intervention group, a petroleum cream mixture consisting of 1% Centella asiatica extract was applied to the patients' wrist for 6 months after the sutures were removed. In the control group, no intervention was applied. The Vancouver Scar Scale (VSS), Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) functional score, and Visual Analog Scale (VAS) satisfaction scores were assessed preoperatively and postoperatively. Follow-up evaluations were scheduled at 1, 3 and 6 months after CTR surgery. RESULTS: The overall VSS score of the intervention group significantly improved at 3-6 months (-1.260, p = .040). At 6 months after surgery, the mean QuickDASH functional score was 18.54 (range 0.00-63.64, SD 17.4) in the intervention group and 28.70 ± 12 (range: 2.27-40.91) in the control group (p < .04). At 6 months after surgery, the mean VAS satisfaction score was 1.46 ± 1.95 (range: 0-4) in the intervention group and 2.48 ± 1.02 (range: 0-4) in the control group (p < .03). CONCLUSION: The Centella asiatica cream applied to the wrist after CTR surgery was found to be beneficial in preventing scar tenderness in the thenar and hypothenar regions of the hand.

Investigation of coenzyme Q10 levels and predisposing factors in patients with striae gravidarum.

BACKGROUND: Striae gravidarum (SG) can cause pregnant women severe psychological stress. OBJECTIVE: This study aimed to compare primigravidas with and without SG concerning fasting blood coenzyme Q10 (CoQ10), age, skin type, family history, gestational weight gain, pre- and post-pregnancy BMI, daily water consumption during pregnancy, gender and weight of baby, and the educational level. METHODS: The study included 79 primigravidas in the gestational week of 36 or above. The patients were divided into two groups based on the presence of SG. The fasting blood CoQ10 levels and other associated parameters were compared between the groups. RESULTS: Of the 79 primigravidas, 35 (44.3%) had SG. There was no statistically significant relationship between striae and CoQ10 (P = 0.144 and P = 0.189, respectively). Predisposing factors for striae were young pregnancy, light skin color, family history, high pre- and post-pregnancy BMI, increased gestational weight gain, and increased newborn weight. There was no significant relationship between striae development and educational level or water consumption during pregnancy. CONCLUSION: This is the first study to show that CoQ10 did not significantly differ between women with and without SG. Further studies with a larger case series are needed to elucidate predisposing factors for striae and involvement of CoQ10 in this condition.

Is there any Correlation between Red Cell Distribution Width, Mean Platelet Volume Neutrophil Count, Lymphocyte Count, and Psoriasis Area Severity Index in Patients Under Treatment for Psoriasis?

Psoriasis vulgaris is a well-known systemic inflammatory disease accompanied by many cardiac, renal, and metabolic manifestations. In recent years, hematological parameters have been studied in different systemic diseases as markers for inflammation. In this study, we investigated the possible association between the hematological parameters, namely neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), and Psoriasis Area Severity Index (PASI) scores, in patients under treatment for psoriasis. Forty-five patients with moderate to severe psoriasis and PASI values of 7 or greater were included in the study. Patients with other inflammatory diseases were excluded. All the patients were treated according to the severity of the disease. Hematological parameters and PASI were examined at baseline and at month 3, 6, 9, and 12. Twenty-seven patients (60%) were women, and the mean age was 42.2 years. No statistically significant association was found between PASI values and NLR, PLR, or RDW at months 0 and 12. The mean platelet volumes increased only at month 3, and lymphocyte counts increased significantly at all months. However, platelet counts decreased significantly only at month 6, 9, and 12, while RDW decreased significantly only at month 3. All the remaining parameters such as: neutrophils count, lymphocyte count, and erythrocyte sedimentation rate decreased significantly. The decrease in RDW and the increase in the mean platelet volume accompanied by a decrease in PASI values may represent contributing prognostic hematologic parameters to predict clinical progress and treatment response of patients with moderate-severe psoriasis during the first 3 months of treatment.

The efficacy and safety of omalizumab in refractory chronic spontaneous urticaria: real-life experience in Turkey.

INTRODUCTION: This study used real-world data to evaluate the effectiveness and reliability of omalizumab in treating recalcitrant chronic spontaneous urticaria in Turkish patients. METHODS: Study data were collected retrospectively from eight tertiary-care hospitals in Turkey. This study included 132 patients with chronic spontaneous urticaria that were resistant to H1 antihistamine treatment in a dose up to four times the licensed dose and were treated with 300 mg/month of omalizumab for 6 months. RESULTS: The mean weekly urticarial activity score (UAS7) after omalizumab treatment improved significantly compared to the pre-treatment score (p < 0.001). Treatment response was detected primarily in the 1st and 2nd months after treatment. No significant association was observed between omalizumab's treatment effectiveness and disease-related parameters or laboratory data. The mean dermatology life quality index was 23.12 ± 6.15 before treatment and decreased to 3.55 ± 3.60 6 months after treatment (p < 0.001). No side effects were reported in 89.4% (118) of the patients. CONCLUSIONS: This study showed that UAS7 decreased significantly and quality of life improved in omalizumab-treated patients. Moreover, treatment effectiveness was mainly observed in the first 2 months after treatment. However, no association was observed between omalizumab treatment effectiveness and disease-related parameters or laboratory data.

Dry Eye Assessment in Patients With Vitiligo.

PURPOSE: To evaluate tear osmolarity and tear film parameters in patients with vitiligo. METHODS: A total of 25 eyes of 25 patients with vitiligo with periocular involvement (group 1), 30 eyes of 30 patients with vitiligo without periocular involvement (group 2), and 20 eyes of 20 controls (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film breakup time, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity. RESULTS: Mean tear osmolarity was 332 ± 16.3 mOsm/L in group 1, 308.8 ± 19.5 mOsm/L in group 2, and 286.3 ± 23.4 mOsm/L in group 3 (P < 0.001). There was no significant difference in Schirmer I test results among the 3 groups (16.5 ± 3.2 mm in group 1, 16.3 ± 4.7 mm in group 2, and 17.4 ± 4.2 mm in group 3) (P = 0.175). Tear film breakup time measurements in groups 1 (9.8 ± 3.5 seconds) and 2 (10.1 ± 4.3 seconds) were significantly lower than those in group 3 (18.5 ± 4.0 seconds) (P < 0.001). There was no significant difference among the 3 groups on the Oxford scale (0.04 ± 0.70 in group 1, 0.03 ± 0.33 in group 2, and 0.03 ± 0.20 in group 3) (P = 0.865). The mean Ocular Surface Disease Index score was significantly higher in groups 1 and 2 than in group 3 (42.1 ± 16.5 in group 1, 39.9 ± 17.3 in group 2, and 12.3 ± 11.6 in group 3) (P < 0.001). CONCLUSIONS: This study showed that vitiligo is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitiligo with periocular involvement may be more prone to dry eye than those without ocular involvement.

The assessment of macular electrophysiology and macular morphology in patients with vitiligo.

PURPOSE: We aimed to analyze the electrophysiologic function and morphology of macula in vitiligo patients. METHODS: Seventeen patients with vitiligo and 11 healthy subjects were studied. All participants underwent multifocal electroretinography (mfERG) and spectral domain optical coherence tomography (SD-OCT) evaluations. The mfERG (P1 mfERG responses central and peripheral) and retinal layer segmentation parameters (nine ETDRS subfields) were compared in vitiligo and control groups. RESULTS: The mean P1 response amplitudes were significantly decreased in central and peripheral rings of the fovea in patients with vitiligo compared with controls (p = 0.002 and p = 0.006, respectively). There was a tendency toward a prolonged mean implicit time for both central and peripheral in patients with vitiligo compared to controls, however, with no statistical significance (p = 0.453 and p = 0.05, respectively). There was no statistically significant difference in all retinal layers thickness between two groups. CONCLUSION: In patients with vitiligo, while photoreceptor segment preserved in SD-OCT, mfERG reduced showing potential decline in central retinal function. This study showed a potential decline in central retinal function in patients with vitiligo even if they have normal fundus appearance and SD-OCT findings.

Narrow-band UV-B phototherapy: an effective and reliable treatment alternative for extensive and recurrent pityriasis versicolor.

PURPOSE: In the previous studies, positive effect of sunlight on seborrheic dermatitis may well be explained by the direct influence of UV-light on the yeasts. Narrow-band ultraviolet-B phototherapy appears to be a very effective and safe treatment option for patients with severe seborrheic dermatitis. We aimed to investigate the efficacy of narrow-band ultraviolet-B phototherapy as an alternative treatment for pityriasis versicolor. MATERIAL AND METHODS: A total of 38 patients diagnosed with disseminated pityriasis versicolor having more than four relapsing episodes within 12 months were treated with narrow-band ultraviolet-B phototherapy given three times weekly. Clinical assessment on the basis of the severity of pruritus, erythema/hyperpigmentation and scaling and mycological examination were made at Weeks 0, 4, 8, 12 and 16. RESULTS: Of the remaining 30 patients, 20 (66.7%) achieved excellent results and four patients (14%) had mild residual disease. The decrease in the clinical scores calculated at 4th week, 8th week, 12th week and 16th week were statistically significant. CONCLUSION: Narrow-band ultraviolet-B presumably may have an immunomodulatory and inhibitory effect on Malassezia growth. Narrowband ultraviolet-B is an effective and safe alternative tool for the management of extensive and recurrent pityriasis versicolor for patients who are unresponsive to conventional treatments.

A split-face, investigator-blinded comparative study on the efficacy and safety of Q-switched Nd:YAG laser plus microneedling with vitamin C versus Q-switched Nd:YAG laser for the treatment of recalcitrant melasma.

BACKGROUND: High recurrence has previously been reported in the treatment of melasma with low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminium garnet (QS-Nd:YAG) laser. On the other hand, the efficacy and safety of the QS-Nd:YAG laser plus microneedling with vitamin C have not been evaluated in patients with mixed-type melasma. MATERIAL AND METHODS: Sixteen patients with recalcitrant dermal- or mixed-type melasma were included in the study. One side of patients' face was treated with QS-Nd:YAG laser plus microneedling with vitamin C (Group A) and the other side with QS-Nd:YAG laser alone (Group B) for four sessions at four-week intervals. Melasma Area Severity Index (MASI) scores and clinician's evaluation of clinical response were assessed monthly. RESULTS: Group A had a significantly lower mean MASI score and better treatment response than Group B according to clinician's evaluation. According to MASI scores, in Group B, two patients had a good response while 12 were unresponsive to treatment. Good or very good improvement was reported by 10 patients in Group A and three patients in Group B. Adverse effects and recurrence rates were similar in Groups A and B (31.3 and 43.8%, respectively). DISCUSSION: QS-Nd:YAG increases the blood circulation in the dermis, thereby enhancing the mechanical effect of microneedling to promote the penetration of vitamin C. CONCLUSION: Vitamin C application with microneedling immediately after treatment with QS-Nd:YAG laser is a promising adjunctive method for the treatment of recalcitrant melasma.

Best dilution of the best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults.

PURPOSE: To evaluate and compare the clinical efficacy, dermoscopic results and safety of triamcinolone acetonide (TA) and betamethasone dipropionate (BD) injections at different concentrations in localized scalp and beard alopecia. METHODS: Intralesional injection of BD or TA in three different dilutions; 1/4, 1/8, 1/12 (BD1, BD2, BD3, TA1, TA2, TA3) and Saline (control) was randomly applied to a total of 231 alopecia patches in 83 patients every four weeks in a maximum of six sessions until a hair regrowth score of 4 was achieved. The number of required sessions, sixth-month hair regrowth scores, treatment success rates and dermoscopic data were investigated. RESULTS: The mean number of required sessions were similar and significantly lower in BD1 and TA1 being 4.21 ± 1.12 and 3.74 ± 0.99, respectively. Dermoscopic examinations revealed similar terminal hair growth rations in Saline (30.3%), BD1 (44.4%) and TA1 (42.9%). However, sixth-month hair regrowth scores, overall treatment success rates and percentage of terminal hair regrowth were similar in BD1 and TA1. However, adverse effects were more common in TA groups (24.3%) than in BD groups (10.6%) at the sixth month. CONCLUSIONS: BD » dilution (1.25 mg/dL) seems best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults.

Salicylic acid peeling combined with vitamin C mesotherapy versus salicylic acid peeling alone in the treatment of mixed type melasma: A comparative study.

INTRODUCTION: Melasma is a distressing condition for both dermatologists and patients. We evaluated the effectiveness of salicylic acid (SA) peel and vitamin C mesotherapy in the treatment of melasma. MATERIALS AND METHODS: Fifty female patients were divided into two groups. All patients were treated with 30% SA peel every two weeks for two months. In addition, after SA peeling Group A was intradermally administered 10 vitamin C on the melasma lesion at 1-cm intervals. All patients were followed up for 6 months, during which the recurrence rates were evaluated. Digital photographs of the melasma site were taken and patients' Melasma Area and Severity Index (MASI) scores were assessed. After the treatment, the patients were asked to complete the melasma quality of life questionnaire (MelasQoL) to evaluate their satisfaction with the treatment. All the adverse effects were noted. RESULTS: The MelasQoL and MASI scores of patients in both groups significantly decreased after the treatment. Apart from a burning sensation, no adverse event was observed and all patients tolerated the treatment well. DISCUSSION: SA peel combined with vitamin C mesotherapy is a safe and effective alternative for the treatment of melasma with no significant side effects and minimal downtime.

Tear osmolarity and ocular surface parameters in patients with psoriasis.

PURPOSE:: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. METHODS:: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. RESULTS:: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). CONCLUSIONS:: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.

Successful Treatment of Classic Kaposi Sarcoma With Long-Pulse Neodymium-Doped Yttrium Aluminum Garnet Laser: A Preliminary Study.

BACKGROUND: Kaposi sarcoma (KS) is a systemic disease that can present with cutaneous lesions with or without internal involvement, mostly caused by infection with human herpesvirus-8. The treatment options include surgical excision, cryotherapy, radiotherapy, intralesional chemotherapy, laser, and elastic stockings for the prevention of lymphedema. OBJECTIVE: This article presents 7 cases with classic KS treated with the long-pulse neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. METHODS: Forty-nine lesions of 7 KS patients (5 stage 1, 2 stage 2A) were treated with Nd:YAG laser with a spot size of 4 to 6 mm and a fluence of 180 J/cm increased by 10 J/cm in the neighboring area to a maximum of 260 J/cm. The pulse sequencing was 1.5, and delay time was 5 milliseconds. Sessions were continued at 4-week intervals for 2 to 4 sessions. RESULTS: All patients exhibited clinical and histological improvement. One session was sufficient for small lesions, whereas coalescing and multicentric lesions required up to 4 sessions. All the lesions healed in 2 to 4 weeks, with the only complication being mild atrophic scars. CONCLUSION: With the advantage of penetrating into deeper sites than other lasers, long-pulse Nd:YAG is an efficient and safe local treatment alternative especially for papulonodular and deeper lesions located on bony structures.

Bilateral Half-Head Comparison of 1% Anthralin Ointment in Children with Alopecia Areata.

BACKGROUND/OBJECTIVES: Alopecia areata (AA) is one of the most difficult skin diseases to manage well. In children, anthralin is commonly used for the treatment of AA. Available research consists of a limited number of uncontrolled trials that assessed the effectiveness of anthralin in promoting hair growth in patients with AA. The objective of this study was to validate the clinical effectiveness of short-contact anthralin 1% ointment in children with AA. METHODS: Thirty children with chronic, severe, treatment-refractory, extensive AA were treated with 1% anthralin ointment. One side of the scalp was treated with anthralin for 12 months and the other side was left untreated. Outcomes were evaluated according to the Severity of Alopecia Tool (SALT) score. RESULTS: The mean time to first response in terms of new hair growth was 3 months and the mean time to maximal response was 9 months. In the first 12-month period, 10 patients (33.4%) achieved complete response to treatment and 11 patients (36.6%) had a partial response. Of the 11 patients with partial response at the end of the first year, 6 achieved a complete response before the end of the study. Total SALT scores for the entire scalp decreased from the end of the first year to the end of the 2-year period. No serious adverse events were observed. CONCLUSION: Anthralin 1% is an effective therapy for AA and should be continued at least 9 months. At 9 months of topical anthralin therapy, the patients with at least a 50% reduction in their pretreatment SALT scores should continue the same treatment for at least 1 year. Anthralin is safe in children with chronic, severe, treatment-refractory, extensive AA.

Tear osmolarity and ocular surface parameters in patients with psoriasis / Parâmetros de osmolaridade lacrimal e da superfície ocular em pacientes com psoríase

ABSTRACT Purpose: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. Methods: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. Results: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). Conclusions: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.

RESUMO Objetivo: O objetivo deste estudo foi avaliar a osmolaridade da lágrima, função do filme lacrimal e alterações da superfície ocular em pacientes com psoríase. Método: Em um único centro, 30 olhos de 30 pacientes com psoríase (grupo 1) e 30 olhos de 30 indivíduos saudáveis (grupo 2) foram avaliados pelo questionário do Índice de Doença da Superfície Ocular (OSDI), teste de Schirmer tipo I, tempo de ruptura do filme lacrimal (TBUT), coloração por fluoresceína da superfície ocular utilizando a escala de Oxford modificada e osmolaridade lacrimal. Resultados: Os valores de osmolaridade lacrimal, OSDI e escores da escala de Oxford foram significativamente maiores no grupo 1 (309,8 ± 9,4 mOsm, 38,9 ± 1,1 e 0,7 ± 1,1, respectivamente) em comparação com o grupo 2 (292,7 ± 7,7 mOsm, 4,2 ± 0,3 e 0,1 ± 0,3, respectivamente) (p<0,01 para todos). TBUT no grupo 1 (8,7 ± 3,6 s) foi significativamente menor em comparação com o grupo 2 (18,1 ± 2,8 s) (p<0,001). Não foram detectadas diferenças significativas nos valores de teste de Schirmer (16,2 ± 2,5 mm no grupo 1 e 16,6 ± 2,3 mm no grupo 2, p=0,629). Conclusões: Este estudo mostrou que a psoríase pode influenciar osmolaridade lágrima e função do filme lacrimal. Os pacientes com psoríase apresentaram hiperosmolaridade lágrima e disfunção do filme lacrimal.

Erbium:yttrium aluminum garnet laser versus Q-switched neodymium:yttrium aluminum garnet laser for the treatment of xanthelasma palpebrarum.

BACKGROUND: Several lasers have been used for the treatment of xanthelasma palpebrarum (XP), such as Q-switched neodymium:yttrium aluminum garnet (QSNd:YAG) and erbium:yttrium aluminum garnet (Er:YAG) laser. Up to now, a comparative study among these laser options in the treatment of XP has not been reported. OBJECTIVE: The aim of this study was to compare the clinical efficacy and response rates of QSNd:YAG and Er:YAG in the treatment of XP. METHODS: Sixty patients with a total of 102 XP lesions were randomly and equally divided into two groups. The first group was treated with QSNd:YAG at a fluence of 10 joule/cm2, 10 Hz and 2 mm spot size, and the second group was treated with Er:YAG at 200-300 millijoule, 4 Hz and 2 mm spot size. RESULTS: In the Er:YAG group, the percentage of patients who required 3 or 4 sessions and wound healing time were higher compared to those of the QSNd:YAG group. Furthermore, the percentage of patients who had an improvement score of 4 was higher in the Er:YAG than that in the QSNd:YAG group. CONCLUSION: Er:YAG is an efficient, successful and minimally invasive method without long-lasting adverse effects.

Use of Er:YAG for the treatment of recalcitrant facial verruca plana.

BACKGROUND: Recalcitrant facial verruca plana (FVP) may persist for years and full remission is not always achieved with conventional therapies. The clinical success rates reported for different lasers are highly variable and only one study evaluated the Er:YAG laser for the treatment of FVP. OBJECTIVE: To determine whether Er:YAG is safe and effective for the treatment of recalcitrant FVP. METHODS: Forty-six patients with recalcitrant FVP were treated by Er:YAG at four-week intervals. The patients' clinical response, adverse effects such as scarring and pigment change, recurrence and patient satisfaction were assessed. Patients were clinically evaluated after each session over a six-month follow-up. RESULTS: A total of 550 lesions of 46 participants were treated with 1-3 passes. The patients received 1-4 laser sessions with one session on average. Thirty-two patients (62.5%) achieved a complete response with 458 lesions (83.3%) being completely and 30 (5.5%) being partially healed. The post-treatment side effects were post-inflammatory hyperpigmentation and mild scar formation. FVP recurred in 12 patients (26.0%). Twenty-six patients (56.5%) were completely satisfied and nine (19.5%) were mostly satisfied with the treatment. CONCLUSIONS: Er:YAG laser is a good treatment option in patients with recalcitrant FVP, particularly for cosmetically sensitive areas.

Efficacy and safety of mascara dyeing as an adjunct to Alexandrite and Nd:YAG laser applications for removing thin and white-colored facial and axillary hair.

INTRODUCTION: There is no satisfactory and efficient method for long-term removal of white-colored and thin hair. METHODS: We conducted a randomised clinical trial of hirsute patients with excessive white and/or thin hair on the face and/or axilla. In Group I (n: 16), the facial hair on one side of the face was painted with a black eyelash mascara immediately before Nd:YAG laser and the other half was only treated by Nd:YAG. In Group II (n: 20), the axillary hair on one side was painted with the mascara before the Alexandrite laser with the other side being only treated by Alexandrite. RESULTS: The terminal hair counts on the painted facial and axillary sides were significantly lower than those on the control sides throughout the study except for the first month. The decrease in the terminal hair count was significant from the beginning of treatment to the second and sixth months on the painted and control facial sides and to the first and sixth months on the axillary sides. CONCLUSION: Hair coloring with black eyelash mascara is a simple, efficient and safe adjunct to Alexandrite and Nd:YAG laser applications to enhance their clinical efficacy in eliminating white and thin facial or axillary hair.