Nanni, 1999  Title: Laser-assisted hair removal: side effects
of Q-switched Nd:YAG, long-pulsed ruby, and alexandrite lasers.
Authors: Nanni CA, Alster TS
Journal: J Am Acad Dermatol 1999 Aug;41(2 Pt
1):165-71
PMID: 10426883, UI: 99355835
Affiliated institution: Washington
Institute of Dermatologic Laser Surgery, Washington, DC 20037,
USA.
Cited in:
BACKGROUND: Laser-assisted hair removal has become popularized
using wavelengths in both the red and infrared regions of the
electromagnetic spectrum. These photoepilation devices target
follicular melanin or an exogenous pigment placed within the follicle
resulting in thermal damage to the hair follicle and shaft. However,
melanocytes and keratinocytes located within the superficial layers
of the skin also absorb red and infrared laser radiation. This
may result in unwanted epidermal injury during the hair removal
process.
OBJECTIVE: The purpose of this study was to examine a large patient
population to determine the frequency of side effects using 3
different hair removal laser systems with various wavelengths,
pulse durations, and treatment protocols.
METHODS: A retrospective chart review and digital photographic
analysis of the side effects resulting from 900 consecutive laser-assisted
hair removal treatments delivered over a 24-month study period,
by means of either a Q-switched Nd:YAG laser with pretreatment
wax-epilation and topical carbon solution, a long-pulse ruby laser
with a contact cooling tip, or a long-pulse alexandrite laser
are reported.
RESULTS: Treatment pain, erythema, edema, hypopigmentation and
hyperpigmentation, blistering, crusting, erosions, purpura, and
folliculitis were observed. The majority of undesirable tissue
effects occurred on tanned skin or in Fitzpatrick skin phototypes
III and higher. The ruby and alexandrite laser systems resulted
in the majority of side effects seen. The effects of seasonal
variations, anatomic treatment location, and sun exposure were
striking within the ruby and alexandrite laser groups. No infections,
scarring, or long-term complications occurred.
CONCLUSION: Laser-assisted hair removal is a safe procedure when
patient characteristics such as skin type, anatomic location,
and sun-exposed or tanned skin are considered during selection
of laser treatment parameters. Lasers emitting wavelengths with
high melanin absorption capabilities should be used in a conservative
manner when treating patients with dark skin phototypes or suntans.
No long-term complications, infections, or scarring occurred in
this study population.
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