Study on the efficacy and safety of a high-power triple wavelength diode laser (810, 940, 1060 nm) for removing fine and less pigmented facial hair on Asian skin.

INTRODUCTION: Performing laser hair removal treatments on dark skin is limited by the quantity of melanin within the skin. To minimize side effects, lower values of fluence are selected when using standard 755 or 810 nm diode lasers. However, this approach may limit the effectiveness of the procedure, particularly when treating areas with thin and less pigmented hair, which is often the case in facial regions. To improve results, high-power triple wavelength diode lasers can be used. This study aims to assess the efficacy, safety, and comfort of treatments that remove facial hair with a high-power triple wavelength diode laser (810, 940, and 1060 nm) in static mode on Asian patients with thin and less pigmented hair. MATERIALS AND METHODS: A single-center retrospective cohort study was carried out using a high-power triple wavelength diode laser (810, 940, and 1060 nm), with a 2.7 cm2 spot size, on faces with thin and less pigmented hair. The study comprised 23 subjects with Fitzpatrick skin types IV and V. Effectiveness was measured by counting the hairs that appeared in high-resolution photos taken prior to and following the procedure, in addition to the Global Aesthetic Improvement Scale (GAIS). Furthermore, mathematical 3D simulations were created on the COMSOL Multiphysics® software to allow for comparisons to be made with regard to thermal damage sustained by the hair follicles and epidermal heating. Assessments were also made in relation to side effects. RESULTS: An average of 66% hair reduction was observed. Patient satisfaction was between 4 and 5 points on the GAIS scale, indicating that the treatment was very well received and tolerated. Adverse side effects were not observed. CONCLUSION: It can be concluded that the use of a high-power triple wavelength diode laser (810, 940, and 1060 nm) is safe and effective for the treatment of very fine and less pigmented facial hair on Asian skin. Furthermore, a triple wavelength (810, 940, and 1060 nm) laser is absorbed less by the melanin in the skin, enabling the use of higher fluences in stamping mode, with greater efficacy and safety for darker skin.

What are the Factors That Induce Paradoxical Hypertrichosis After Laser Hair Removal?

BACKGROUND: Laser hair removal (LHR) is one of the most requested cosmetic procedures worldwide. A rare side effect is the appearance of excess hair around previously treated areas, known as paradoxical hypertrichosis. OBJECTIVES: The aim of this study was to retrospectively identify the cause of this side effect. METHODS: This study included all patients who underwent LHR at our center between November 2018 and November 2020. Alexandrite laser hair removal (HR) or diode laser super hair removal (SHR) was performed in 70% and 30% of cases, respectively. Clinical features and daily habits of patients with and without postlaser hypertrichosis were compared. RESULTS: Of the 7381 patients who received LHR, 25 patients (0.34%) demonstrated an increase in hair growth compared to baseline. Of these 25 patients, 24 had been treated with alexandrite laser HR (P < .01). The most common site was the upper arm, followed by the periareolar area. Daily sun protection was associated with a significantly lower incidence of hypertrichosis (P < .05), as was confirmed and shown to be independent of Fitzpatrick skin type by binary logistic regression analysis (odds ratio = 0.41, P < .05). CONCLUSIONS: In our clinic, we observed paradoxical hypertrichosis after laser hair removal in a small minority of cases, as described by others. We did not observe differences in incidence related to skin type, but daily sun protection and LHR with diode laser SHR were associated with significant reductions in incidence rates. In addition to previously reported common sites, we also identified the periareolar area as a high-risk region.

Multispectral near-infrared spectroscopy study evaluating the effect of razor design on shaving-induced erythema.

BACKGROUND: While shaving-induced erythema is a common inflammatory skin issue, there is a lack of quantitative information on how well a shaving product performs in this regard. In this study, multispectral near-infrared spectroscopy (NIRS) imaging was used to quantitatively and qualitatively measure the extent of shaving-induced erythema. The research compares a safety razor and a cartridge razor to evaluate their impact on skin irritation. MATERIALS AND METHODS: Fifty-nine healthy male volunteers without pre-existing skin conditions were enrolled. Basic demographics were recorded, and participants' faces or necks were imaged before shaving. Shaving was conducted on the right side of the face/neck with the safety razor and on the left side of the face/neck using the 3-blade cartridge razor. Images were captured immediately after shaving, at 5 and 10 min post-shaving. RESULTS: Tissue oxygen saturation (StO2) measurements demonstrated that the safety razor induced significantly less erythema than the cartridge razor. Immediately after shaving, 40.3% of skin shaved with the safety razor had erythema compared to 57.6% for the cartridge razor. At 5 min post-shaving, 36.5% of skin shaved with the safety razor had erythema, compared to 53.8% of cartridge razor. CONCLUSIONS: Multispectral NIRS revealed significant differences in shaving-induced erythema between safety and cartridge razors. Safety razors demonstrated a lower incidence of erythema, suggesting a potential advantage for individuals prone to skin irritation. This study contributes valuable insights into skin irritation and highlights the potential of multispectral NIRS in dermatology research.

Laser Hair Removal for Intraoral Flaps: A Review.

Importance: Laser hair removal is a noninvasive technique that has been used for patients with oropharyngolaryngeal hair growth related to surgical flap reconstruction after head and neck cancer resection. The purpose of this work was to perform a rapid review of the literature to determine the therapeutic relevance of laser hair removal and identify laser parameters. Observations: A total of 10 publications addressing depilation of the head and neck sphere were selected and analyzed. Conclusions and Relevance: Laser therapy appears to be a promising treatment for hair removal from flaps with few side effects. However, there is no scientific basis for a standardized protocol or determination of the superiority of laser hair removal over another treatment.

Laser Epilation as an Adjunct to Standard Care in Reducing Pilonidal Disease Recurrence in Adolescents and Young Adults: A Randomized Clinical Trial.

Importance: Recurrence continues to be a significant challenge in the treatment and management of pilonidal disease. Objective: To compare the effectiveness of laser epilation (LE) as an adjunct to standard care vs standard care alone in preventing recurrence of pilonidal disease in adolescents and young adults. Design, Setting, and Participants: This was a single-institution, randomized clinical trial with 1-year follow-up conducted from September 2017 to September 2022. Patients aged 11 to 21 years with pilonidal disease were recruited from a single tertiary children's hospital. Intervention: LE and standard care (improved hygiene and mechanical or chemical depilation) or standard care alone. Main Outcomes and Measures: The primary outcome was the rate of recurrence of pilonidal disease at 1 year. Secondary outcomes assessed during the 1-year follow-up included disability days, health-related quality of life (HRQOL), health care satisfaction, disease-related attitudes and perceived stigma, and rates of procedures, surgical excisions, and postoperative complications. Results: A total of 302 participants (median [IQR] age, 17 [15-18] years; 157 male [56.1%]) with pilonidal disease were enrolled; 151 participants were randomly assigned to each intervention group. One-year follow-up was available for 96 patients (63.6%) in the LE group and 134 (88.7%) in the standard care group. The proportion of patients who experienced a recurrence within 1 year was significantly lower in the LE treatment arm than in the standard care arm (-23.2%; 95% CI, -33.2 to -13.1; P < .001). Over 1 year, there were no differences between groups in either patient or caregiver disability days, or patient- or caregiver-reported HRQOL, health care satisfaction, or perceived stigma at any time point. The LE group had significantly higher Child Attitude Toward Illness Scores (CATIS) at 6 months (median [IQR], 3.8 [3.4-4.2] vs 3.6 [3.2-4.1]; P = .01). There were no differences between groups in disease-related health care utilization, disease-related procedures, or postoperative complications. Conclusions and Relevance: LE as an adjunct to standard care significantly reduced 1-year recurrence rates of pilonidal disease compared with standard care alone. These results provide further evidence that LE is safe and well tolerated in patients with pilonidal disease. LE should be considered a standard treatment modality for patients with pilonidal disease and should be available as an initial treatment option or adjunct treatment modality for all eligible patients. Trial Registration: ClinicalTrials.gov Identifier: NCT03276065.

Hair follicle extraction combined with an expanded scalp flap for facial organ reconstruction.

BACKGROUND: Use of scalp skin for facial organ reconstruction represents a mainstream procedure for organ reconstruction. In most cases, adequate amounts of skin can be obtained by using tissue expanders, but harvesting sufficient scalp tissue in patients with low hairlines is challenging. Hair follicular unit extraction (FUE) is one approach to resolve this problem. With FUE, hair follicles are removed from the scalp skin, which can then be prepared as a donor site to obtain sufficient amounts of hairless skin. OBJECTIVES: To evaluate the safety and efficacy of FUE when combined with an expanded scalp flap for facial organ reconstruction. MATERIAL AND METHODS: Patients with low hairlines requiring facial organ reconstruction were selected for this study. The area of skin extension and hair removal were determined prior to surgery, a process which was performed in three stages. Stage I consisted of hair follicle removal using the FUE technique at the donor site. Stage II involved expander implantation using water injections. In Stage III facial organ reconstruction was completed. RESULTS: With the use of the FUE technique, hair follicles from the donor scalp were thoroughly removed and the donor scalp tissue was successfully expanded. Postoperatively, no evident scar formation at the reconstruction site or contracture of the expanded flap was observed. All patients were satisfied with the outcome of their reconstruction procedure. CONCLUSION: FUE provides a means for hair follicle removal from the donor site and can be employed to achieve a safe and effective procedure for facial reconstruction in patients with low hairlines.

Efficacy of Laser in Hair Removal: A Network Meta-analysis.

BACKGROUND: Laser hair removal is an increasingly prevalent trend of cosmetic procedures. The purpose of this study was to assess the effectiveness of hair reduction among several types of laser interventions. METHODS: The selected studies searched in PubMed and EMBASE were assessed for quality of evidence, and extracted data on absolute hair count and hair reduction rate. Qualitative data were synthesized using standardized mean difference (SMD) in frequentist network meta-analysis because various measurement units were used among selected studies. Inconsistency and small study effects were examined by design-by-treatment interaction model and comparison-adjusted funnel plot. RESULTS: A total of 13 randomized controlled trials (RCTs) (n = 652) were contributed to network meta-analysis. Pooled results revealed that diode laser showed significantly lower absolute hair count within three-month (SMD = -13.21, 95% confidence interval [CI]: -22.25 to -4.17) and around six months follow-up (SMD = -11.01, 95% CI: -18.24 to -3.77) as compared with those in control group, but no significant difference among laser interventions. All side effects observed were transient without leaving any permanent scars. CONCLUSION: Eliminating unwanted hair with lasers or intense pulsed light is safe and effective; however, which type of intervention is more beneficial in the long-term process should be studied with a longer follow-up time.

Changes in melanocytic nevi treated with laser hair removal: A systematic review.

BACKGROUND: Incidental treatment of melanocytic nevi during laser hair removal (LHR) has been noted to cause clinical and dermoscopic changes that may appear similar to findings seen in atypical or neoplastic melanocytic lesions. The rate and characteristics of these changes has not been well-studied. OBJECTIVES: The objective of this review article is to assess the literature for reported changes in melanocytic nevi following LHR to guide clinical practice. METHODS: PubMed was searched December 5, 2022 for articles evaluating changes in melanocytic nevi after LHR treatment using the following search terms: "nevi laser hair removal," "nevi diode," "nevi long pulse alexandrite," "nevi long pulse neodymium doped yttrium aluminum garnet," and "melanoma laser hair removal." All English language patient-based reports discussing incidental treatment of melanocytic nevi while undergoing LHR with a laser were eligible for inclusion, while reports of changes following hair removal with non-laser devices such as intense pulsed light were excluded. Studies evaluating non-melanocytic nevi such as Becker's nevus or nevus of Ota were excluded as were those evaluating the intentional ablation or removal of melanocytic lesions. RESULTS: Ten relevant studies were included, consisting of seven case reports or series and three observational trials, two of which were prospective and one retrospective. Among the seven case reports or series there were a total of 11 patients, six of which had multiple affected nevi. Clinical and dermoscopic changes to nevi following LHR appear to be common in clinical practice, though not well studied. Clinical and dermoscopic changes have been noted to present as early as 15 days after treatment and persist to the maximum time of follow up at 3 years. Commonly reported changes include regression, decreased size, laser induced asymmetry, bleaching, darkening, and altered pattern on dermoscopy. Histologic changes include mild atypia, thermal damage, scar formation, and regression. Although some of the clinical and dermoscopic alterations may be concerning for malignancy, to our knowledge, there are no documented cases of malignant transformation of nevi following treatment with LHR. LIMITATIONS: This study is limited by the low number of relevant reports and their generally small sample size, many of which is limited to single cases. Additionally, comparison of available data was limited by variable reporting of treatment regimens and outcomes. CONCLUSIONS: Changes to nevi treated during LHR are not uncommon. Modifications to nevi may occur and look similar to changes seen in dysplastic or neoplastic melanocytic lesions. Notably, despite the widespread use of LHR since the first device was Food and Drug Administration approved in 1995, a time span of nearly three decades, there have been no reported cases of melanoma or severe dysplastic changes within treated nevi. However, dermatologists should be aware that morphologic and dermoscopic alterations can occur after LHR to prevent unnecessary surgical procedures. Although melanoma has not been reported to occur in nevi treated with LHR nor with any other laser exposures, further long-term data is needed to fully elucidate this concern. Optimally, nevi should be examined by a dermatologist before LHR to determine a baseline clinical and dermoscopic morphology. If there is concern for potential atypia, laser should be avoided over such nevi to avoid confusion at future follow up visits.

Laser and light therapy for pediatric hair removal: a systematic review.

Hair removal with lasers and intense pulsed light (IPL) is considered safe. However, data on the efficacy and safety of these procedures specifically in the pediatric population remain sparse. To determine the efficacy and safety of lasers and IPL for hair reduction in children and adolescents, a systematic review was conducted of original studies evaluating hair removal with lasers or IPL in patients aged less than 18 years. Primary outcome measures were efficacy and safety of treatment. The literature review yielded 2 retrospective cohort studies and 11 case reports/case series including a total of 71 patients aged 9 months to 17 years. Diagnoses ranged from localized lumbosacral to generalized hypertrichosis. Six treatment modalities were evaluated: alexandrite, Nd:YAG, Q-switched Nd:YAG, ruby, and diode lasers and IPL. Only one of the cohort studies (n = 28), using the ruby laser, provided efficacy data. The results showed a 63% hair loss in 89% of patients after completion of treatment, although partial regrowth was evident during 6 to 32 weeks of follow-up. Most of the case reports and case series (10/11) reported significant hair reduction following laser and IPL treatments. None of the patients experienced scarring or dyspigmentation. Some kind of pain management was necessary in 65% of patients; 25% required general anesthesia. On the basis of the limited available data which consisted primary of case reports and case series, lasers and IPL might be effective for pediatric hair reduction. Recurrence following treatment may be higher in children than adults, and pain control may be a limiting factor.

Handheld dermatoscope versus digital camera for hair counts in laser facial hair removal.

The lack of uniform and objective techniques to evaluate treatment efficacy in photo-epilation studies leads to contradictory results. Thus, there is an urgent need to explore commonly accepted assessment tools. One of the most common methods uses hair counts via digital photography. However, macrophotography may not be able to depict the vellus-like hair induced by photo-epilation. On the other hand, handheld dermatoscopy is practical, affordable and offers high-quality magnification. Hair counts from a handheld dermatoscope and a digital camera were compared in 73 women who underwent 6 sessions with the Alexandrite 755 nm laser. Significantly more hairs were counted using the dermatoscope than using the digital camera (76.9 ± 41.3 vs. 58.6 ± 31.4, p < .005), independently of hair thickness and hair density. The difference in hair counts between the two instruments was inversely related to hair thickness and directly related to hair density. The handheld dermatoscope may be a more effective tool than the widely used digital camera in evaluating the response to laser hair removal treatment.

Effectiveness of Light-Emitting Diode Epilation on Different Skin Types: A Pilot Study.

Objective: This study analyzed the histological and immunohistochemical changes in hair follicles submitted to epilation with light-emitting diode (LED). Background: The use of specific wavelengths of LED leads to the absorption of photons by chromophore tissues, enabling different photophysical and photochemical events, bringing therapeutic benefits such as removing body hair. Methods: The sample included five participants, with phototypes II-V, divided into two groups. The volunteers received a session of epilation with the Holonyak® device on the pubic region and right groin, whereas the contralateral side was kept as a control. An energy of 10 J and a cooling temperature of -5°C were used, after which the pain provoked by the equipment was questioned using the analogue pain scale. After 45 days, the punching procedure was performed in the region where skin samples were taken for histological and immunohistochemical analysis. Results: For all phototypes, in the treated area, the follicles and sebaceous glands were in a stage of involution, showing perifollicular inflammatory infiltrate with changes suggestive of apoptosis. The apoptosis process was confirmed by the increase in markers cytokeratin-18 and cleaved caspase 3, in addition to the reduced expression of Blc-2, and the lower cell proliferation (Ki67), reinforcing the action of LED based on the definite involution and resorption of the follicle, through macrophages (CD68) triggered by the inflammatory process. Conclusions: The preliminary results of this study found relevant histological changes and immunohistochemical markers in the epilation process, which may indicate the efficacy of LED in permanent hair removal.

Utilization of intense pulsed light for hair removal in pediatric auricular reconstruction using tissue expander: A retrospective cohort study.

This study aimed to investigate the safety and efficacy of depilation with intense pulsed light (IPL) in congenital microtia patients during their reconstruction treatment. The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695 to 1200 mm. A contact prob with a window of 15 cm × 35 mm or 8 cm × 15 mm was used at a radiant setting of 14 to 15 J/cm2 in the non-expander group and 13 to 14 J/cm2 in the expander group, both in a single pulse mode. The efficiency index of hair removal was classified based on the percentage of hair density reduction as excellent (>75%), good (50-75%), fair (25-50%), poor (<25%). The depilation effect was compared between the 2 groups, and any adverse effects were evaluated. A total of 159 patients were included, with 93 patients in the expander group and 66 in the non-expander group. The reduction of the hair density in the expander group after 3 treatments was higher than that in the non-expander group [82.98 (73.47-89.09)% vs 77.84 (71.50-85.34)%; P < .05, Wilcoxon rank-sum test], as well as the efficiency [excellent cases 68 (73.12%) vs 37 (56.06%); P < .05, Chi-square test]. Four cases of folliculitis, 3 cases of blisters, and no instance of expander exposure and cartilage absorption were observed in this study. Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. Depilation in the skin expansion period resulted in better outcomes after 3 treatments, although after 5 treatments no difference between the 2 groups was observed.

Reasonable Accommodation and Disparate Impact: Clean Shave Policy Discrimination in Today's Workplace.

This article examines Bey v. City of New York - a recent Second Circuit case where four Black firefights suffering from Pseudofolliculitis Barbae (a skin condition causing irritation when shaving which mostly affects Black men) challenged the New York City Fire Department's Clean Shave Policy - with an intersectional approach utilizing legal theories of racial, disability, and religious discrimination.

Epilation and depilation in the genital area - motivation, methods, risks and recommendations from a dermatological point of view.

Pubic hair removal is a body modification practice done worldwide for different socio-cultural reasons, which is more common in women than in men, more common in younger than in older people, and more common in sexually active people than in abstinent individuals. Since there is no medical indication for genital epilation and depilation, with a few exceptions, there is only very limited evidence in the literature about the methods used and their risks. In order to provide users with guidance from a dermatological perspective on the use of different procedures and associated risks, the existing data were collected, analyzed and evaluated in a systematic literature search. For this purpose, a total of 290 articles in the English- and German-language scientific literature were identified in databases (PubMed, Google Scholar) according to defined search strategies, and 61 publications with scientific significance were identified after assessing relevance. It became clear that depilation methods (shaving, trimming, chemical depilation) are used more frequently compared to epilation methods (waxing, sugaring, mechanical epilation, electro-epilation, laser, intense pulsed light, drug epilation). The different risks and undesirable effects were analyzed in a method-associated manner and prophylactic strategies to avoid complications were developed.

Effects of Depilatory Cream Formulation and Contact Time on Mouse Skin.

Depilatory creams are widely used in research to remove hair in preparation for surgery, imaging, and other procedures. However, few studies have evaluated the effects of these creams on mouse skin. We sought to determine the cutaneous effects of 2 different depilatory formulations of a widely used brand as related to the duration of exposure. We compared a standard body formula [BF] and a facial formula [FF] that is marketed as being more gentle on skin. The cream was applied to one flank for 15, 30, 60, or 120 s; hair on the contralateral flank was clipped and used as a control. Treatment and control skin were scored for gross lesions (erythema, ulceration, and edema), degree of depilation, and histopathologic changes. C57BL/6J (B6) and Crl:CD-1(ICR) (CD-1) mice were used to allow comparison of an inbred/pigmented strain to an outbred/albino strain. BF caused significant cutaneous injury to both strains of mice, whereas FF produced significant cutaneous injury only in CD-1 mice. Both strains showed gross skin erythema, with the most severe erythema seen in CD-1 mice treated with BF. Contact time did not affect histopathologic changes or gross erythema. Both formulations produced depilation comparable to clipping in both strains when left on for a sufficient duration. In CD-1, mice, BF required at least 15 s of exposure, whereas FF required at least 120 s. In B6 mice, BF required at least 30 s of exposure, whereas FF required at least 120 s. The 2 mouse strains did not show statistically significant differences in erythema or histopathologic lesions. Overall, these depilatory creams were comparable to clippers for hair removal from mice but they produce cutaneous injury that may affect research outcomes.

Review of treatments for pseudofolliculitis barbae.

Pseudofolliculitis barbae (PFB) is a chronic inflammatory condition characterized by follicular and perifollicular papules and pustules primarily affecting the beard and neck area. PFB is a condition that predominantly affects patients with skin of colour. The objective of this paper is to review the epidemiology, pathogenesis and presentation of PFB, and assess the most recent evidence-based treatment options and recommendations for PFB. This is important to increase the quality of care given to target patient populations and to address the prominent disparity in healthcare management of patients with skin of colour. A literature review was conducted utilizing PubMed and Cochrane Library. The key term 'pseudofolliculitis barbae' was used. Search parameters were set to search from 1987 to the present. Results were further narrowed by limiting the literature review to published observational studies, case studies, case series, randomized control trials and case-control studies. Effective treatment for PFB requires a multifaceted approach that targets various aspects of the pathogenesis. Current treatments include preventive measures, antibiotics, corticosteroids, keratolytics, chemical depilatories and/or laser treatments. Topical therapies are currently the mainstay treatment. However, laser hair removal has become a potential long-term treatment option, and additional studies are warranted to understand its long-term efficacy and permanency.

Novel laser hair removal in all skin types.

BACKGROUND: Laser has been long accepted as a solution for excess or unwanted hair growth yet traditional lasers are not always ideal for safe and effective outcome for all skin types and hair characteristics. A diode laser module combining three wavelengths (755, 810, and 1064 nm) in a single pulse was developed to provide a fast and long-term solution for subjects with various profiles. AIMS: To evaluate the safety and efficacy of a Triple wavelength diode laser module for hair removal treatment in all skin types (Fitzpatrick I-VI). SUBJECTS AND METHODS: This was a prospective, dual centered, single-arm study. Subjects were treated with a novel diode laser module. Thirty-six subjects were enrolled, sixteen with Fitzpatrick skin types I-IV (46%) and twenty with Fitzpatrick skin types V-VI (54%). Treatment areas were axilla and bikini lines. Subjects underwent 4 treatment sessions at 6 weeks ± 5 days intervals and attended a follow-up visit 3 months after the last treatment session. 2D digital photographs were taken at baseline and at the follow-up visit, and a hair count was conducted by three blinded evaluators. RESULTS: A significant reduction in hair count between baseline and the 3-month follow-up visit was observed in both axilla and bikini lines for all skin types. The mean hair reduction was 41.5 ± 19.4% and 48.1 ± 20.9% in the axilla and bikini line, respectively. A significant hair reduction was also observed within skin type groups; mean hair reduction 45.5 ± 16.9% and 40.3 ± 17.2% in skin types I-IV and V-VI, respectively, indicating similar efficacy for both light and dark skin types. No serious adverse events were reported. CONCLUSIONS: This study demonstrates that the Soprano Titanium laser platform is safe and effective for hair removal treatment in all skin types.