Lasers Surg Med 2002;30(2):127-34

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Click here to read Hair removal with the long pulsed Nd:YAG laser: a prospective study with one year follow-up. Lorenz S, Brunnberg S, Landthaler M, Hohenleutner U. Department for Dermatology, University of Regensburg, 93053 Regensburg, Germany. Lorenz@rkdernw1.ngate.uni-regensburg.de BACKGROUND AND OBJECTIVE: The aim was to investigate the efficacy, side effects, and the long-term results of a long pulsed Nd:YAG-Laser for hair removal in different hair colors and skin types. STUDY DESIGN/MATERIALS AND METHODS: We performed a prospective clinical study with 29 volunteers. Treatment was performed on the lower leg with a long pulsed Nd:YAG-Laser. Five test areas were treated 1-5 times in monthly intervals; one served as control. Follow-up investigations were performed at each session, and 3, 6, and 12 months after the last therapy. No depilatory treatment except shaving was allowed during the time of follow-up. Percentual hair loss, short- and long-term side effects, and pain during the treatment were evaluated. RESULTS: After one month, a hair loss of greater than 50% was found in 44.9% of the areas treated once. With up to five treatments, this percentage increased up to 71.5%. One year after therapy, a greater than 50% hair reduction was still present in 40% of the five-treatment-areas and in 0% of the areas treated only once. There were no permanent side effects despite one small scar after a folliculitis. CONCLUSIONS: The long pulsed Nd:YAG is suitable to remove hair for more than 12 months effectively, although 4-5 sessions are necessary for these results. Blond hair can also be removed, although much less effective. No lasting side effects could be seen. Darker skin types or tanned skin can also be treated without side effects. A cooling may be advisable due to the pain reported by the volunteers. Copyright 2002 Wiley-Liss, Inc. Publication Types:

• Clinical Trial

PMID: 11870792 [PubMed - indexed for MEDLINE]

Dermatol Surg 1999 Mar;25(3):175-8

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Click here to read Long-term epilation with long-pulsed neodimium:YAG laser. Bencini PL, Luci A, Galimberti M, Ferranti G. Servizio di Dermatologia, Ospedale S. Raffaele, Milan, Italy. BACKGROUND: Unwanted body hair can represent a severe cosmetic disturbance. The traditional methods used to epilate often have limitations, side effects, and unsatisfactory results. In recent years, various light sources (lasers and others) have been developed for long-term epilation of unwanted hair. OBJECTIVE: This study evaluates, on a large number of patients, the efficiency and safety of a long-pulsed low-potency Nd-Yag laser invented specifically for long-term hair removal. METHODS: Some 208 subjects needing epilation were divided into three groups and treated during an 11-month period. Group A included 79 patients with a normal distribution of unwanted hair; Group B 67 patients with constitutional hypertrichosis; and Group C 62 patients with hirsutism. Treatment sessions were performed with a fluence of 23-56 J/cm2 at 1-month intervals until obtaining desirable results. Follow-ups ranged from 1 to 6 months. In 3 patients 4-mm diameter punch biopsy specimens were obtained before the first session and again after 6 hours. A third biopsy was performed after 3 months. RESULTS: Every session resulted in a 20-40% hair loss, depending on the color of hair. Complete epilation was obtained in 4 to 6 sessions. Only white hair was not receptive to laser light, and its growth was not modified. No patients, including dark-complexioned patients, had blistering, hypo-or hyperpigmentation. No pain was present during treatment except for the axillary area. In the specimen obtained after 6 hours, very extensive necrosis of the hair follicular and sebaceous gland epithelium was evident. Histologic findings of the biopsies taken after three months showed complete disappearance of hair and moderate fibrosis. CONCLUSION: This study proves that the long-pulsed Nd:Yag laser treatment produces an excellent prolonged epilation with no relevant side effects. This laser light, having a 1064 nm wavelength, is minimally absorbed in superficial skin layers, and pronounced scattering up to 5 mm occurs targeting the deeper follicles. Publication Types:

• Clinical Trial

PMID: 10193962 [PubMed - indexed for MEDLINE]

Dermatol Surg 2001 May;27(5):434-6

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Click here to read Hair removal using a long-pulsed Nd:YAG Laser: comparison at fluences of 50, 80, and 100 J/cm. Goldberg DJ, Silapunt S. Skin Laser and Surgery Specialists of New York and New Jersey, Mount Sinai School of Medicine, New York, New York, USA. BACKGROUND: Unwanted hair is a widespread cosmetic problem. Many temporary methods of hair removal have proved unsatisfactory. A variety of laser systems with varying wavelengths, pulse durations, and energy fluences are currently utilized for hair removal. Optimal laser parameters continue to require further investigation. OBJECTIVE: To evaluate the efficacy and safety of a long-pulse millisecond Nd:YAG hair removal laser utilizing fluences of either 50, 80, or 100 J/cm2. METHODS: Fifteen subjects were treated with a contact cooled 50 msec Nd:YAG laser at fluences 30, 50, or 100 J/cm2. Reduction in hair regrowth was measured at 3 months after treatment by comparing the terminal hair count to the baseline values. Potential complications were also evaluated. RESULTS: Average hair reduction at 3 months after treatment was 29%, 29%, and 27% in areas treated with a 50-msec Nd:YAG laser at fluences of 50, 80, and 100 J/cm2, respectively. Although short-term blistering was noted in two subjects, no hyperpimentation, hypopigmentation, or scarring was observed at 3 months after treatment. CONCLUSION: Long-pulse millisecond Nd:YAG laser hair removal with fluences of either 50, 80, or 100 J/cm2 leads to similar efficacy with no significant adverse effects. PMID: 11359488 [PubMed - indexed for MEDLINE

Dermatol Surg 2002 Oct;28(10):932-6

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Click here to read Evaluation of a Long-Pulsed Nd:YAG Laser at Different Parameters: An Analysis of Both Fluence and Pulse Duration. Rogachefsky AS, Becker K, Weiss G, Goldberg DJ. Skin Laser & Surgery Specialists of New York and New Jersey, Hackensack, NJ. BACKGROUND: Effective hair removal continues to pose a challenge to the physician. The use of lasers represents a significant advance in epilation, but still requires further refinement. The long-pulsed Nd:YAG laser may offer advantages over other systems because of its significant depth of penetration and minimal absorption by epidermal melanin, but ideal parameters need to be determined. OBJECTIVE: To evaluate the efficacy of a long-pulsed Nd:YAG laser system and determine the optimal parameters for hair removal. METHODS: Twenty-two subjects were treated with a cryogen spray-cooled long-pulsed Nd:YAG laser. Four adjacent sites were assigned to each subject, where the following sets of parameters were utilized: 50 J/cm2 with a 25-msec pulse duration, 60 J/cm2 with a 50-msec pulse duration, 80 J/cm2 with a 50-msec pulse duration, and control. Hair counts were obtained immediately, 1 week, 1 month, and 3 months after treatment, and multivariate regression analysis was used to determine the significance of hair reduction. Acute reactions and adverse events were also evaluated. RESULTS: Treatment at all three sets of parameters resulted in significant mean hair reductions immediately, at 1 week, and at 1 month (P <.001). At 3 months, the higher settings of 60 J/cm2 and 50 msec and 80 J/cm2 and 50 msec were statistically significant for reduced mean hair counts (P =.014, P =.042, respectively), while the lowest setting at 50 J/cm2 and 25 msec was not significant (P =.079). Patient and physician assessments suggested optimal hair reduction at the highest fluence (80 J/cm2) and longest pulse duration (50 msec). The most common acute reactions were pain during treatment, erythema, and perifollicular edema, all of which were more severe with higher fluences. CONCLUSION: The long-pulsed Nd:YAG laser is a safe and effective method of hair removal. Increased fluence (60-80 J/cm2) and longer pulse duration (50 msec) settings were generally correlated with reduced hair counts and improved clinical outcome. PMID: 12410678 [PubMed - in process]

http://archderm.ama-assn.org/issues/v137n7/abs/dst00091.html

Long-Pulsed Nd:YAG Laser-Assisted Hair Removal in Pigmented Skin A Clinical and Histological Evaluation Author Information Tina S. Alster, MD; Holly Bryan, BS; Carmen M. Williams, MD

Objective To determine the safety and effectiveness of a long-pulsed Nd:YAG laser at 1064 nm in effecting long-term hair reduction in patients with darkly pigmented skin.

Design Nonrandomized before-after clinical and histological trial.

Setting Private practice, ambulatory care facility.

Patients Twenty women with skin phototypes IV through VI and dark brown to black terminal hair on the face, axillae, or legs.

Intervention A series of 3 long-pulsed (50-millisecond) 1064-nm Nd:YAG laser treatments at fluences ranging from 40 to 50 J/cm2 were delivered to the identified treatment areas on a monthly basis by a single operator.

Main Outcome Measures Global clinical grading scores of comparable before-after treatment photographs were determined by 2 independent medical assessors during each laser session and 1, 3, 6, and 12 months postoperatively. A dermatopathologist reviewed unmarked histological specimens obtained at baseline, immediately after the initial laser treatment, and at 1 and 6 months after the final laser session.

Results Substantial hair reduction was seen after each of the 3 treatment sessions. Prolonged hair loss was observed 12 months after the final laser treatment (70%-90% hair reduction). Axillary hair was substantially more responsive to laser irradiation than was hair located on the legs and face. Adverse effects included mild to moderate treatment pain and rare occurrences of vesiculation and transient pigmentary alteration without fibrosis or scarring. Histological tissue changes mirrored clinical response rates, with evidence of selective follicular injury without epidermal disruption.

Conclusion The long-pulsed 1064-nm Nd:YAG laser is a safe and effective method of long-term hair reduction in patients with darkly pigmented skin.

Arch Dermatol. 2001;137:885-889

View Full Text Author/Article Information From the Washington Institute of Dermatologic Laser Surgery, Washington, DC. Corresponding author and reprints: Tina S. Alster, MD, 2311 M St NW, Suite 200, Washington, DC 20037.

Accepted for publication December 27, 2000.