Williams,
1998
 Title: A clinical study of hair removal using
the long-pulsed ruby laser.
Authors: Williams R, Havoonjian H, Isagholian
K, Menaker G, Moy R
Journal: Dermatologic Surgery 1998 Aug;24(8):837-42
PMID: 9723047, UI: 98390305
Affiliated institution:
Cited in: Williams overview
Purpose: To evaluate ruby
laser efficacy and provide treatment guidelines.
Equipment data
| Equipment type |
Lomg-pulsed ruby |
| Brand name |
EpiLaser |
| Manufacturer |
Spectrum/Palomar |
| Wavelength |
694 nm |
| Pulsewidth |
3 msec |
| Handpiece size |
7 or 10 mm |
| Fluence(s) used in study |
10 - 32 J/cm2 |
| Number of pulses used in study |
|
Test subject data
| Number of subjects |
25
|
| Sex of subjects |
13 males, 12
females
|
| Areas treated |
48
|
| Skin color in treated areas |
|
|
Hair color in treated areas |
|
| - Fitzpatrick I |
12
|
|
white/gray |
excluded
|
| - Fitzpatrick I/II |
18
|
|
blonde |
X
|
| - Fitzpatrick II |
10
|
|
red |
-
|
| - Fitzpatrick II/III |
8
|
|
brown |
X
|
| - Fitzpatrick III |
excluded
|
|
black |
X
|
| - Fitzpatrick III/IV |
excluded
|
|
|
|
| - Fitzpatrick IV |
excluded
|
|
|
|
| - Fitzpatrick IV/V |
excluded
|
|
|
|
| - Fitzpatrick V |
excluded
|
|
|
|
| - Fitzpatrick V/VI |
excluded
|
|
|
|
| - Fitzpatrick VI |
excluded
|
|
|
|
Areas treated (48 total):
upper lip
chin
jawline/under chin: 10
upper back/shoulders: 10
thighs/lower legs: 10
armpits: 9
bikini line: 9
arms
scalp
total
Number of treatments: Variable
("treatment was repeated at monthly
intervals if there was any evidence of hair
regrowth")
Length of study: 12 weeks
Interval between final treatment
and assessment: variable (minimum 4 weeks)
Test patch
Shaved
photographed
Experiment 2
Number of subjects: 12
Skin color: white (all)
Hair color: dark (all)
Fluence: 11 J/cm2
Area treated: Lower legs
Length of study: 12 weeks
Interval between final treatment
and assessment: 12 weeks
0 1 2 3 4 5 6 7 8
9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
about one-third (8 of 25)
reported mild to moderate discomfort following
treatment. Two requested EMLA
* * * * * * * * * * * * * * * * *
* * * * * * * *
Results
Side effects mentioned: "one
case of crusting of skin was seen after
treatment, and it resolved completely without
scarring in 4 weeks."
No correlation was seen between
efficacy and
Author's conclusions
Shaving prior to treatment is not
necessary
Treatment should be equally
effective on the face or on the legs *
Regrowing hairs are simply from
follicles that received inadequate treatment.
Factors other than or in addition
to melanin content may be important in laser hair
removal.
The proportion of hair in the
growth phase and the melanin content of hair do
not contribute solely to the efficacy of ruby
laser hair removal.
Increasing the fluence beyond the
effective threshold over the range tested does
not confer any extra benefit.
* I disagree with this
assumption, since leg hair and facial hair are
different types of hair
Quotes:
"The Q-switched Nd:YAG laser
(1064 nm) is used in conjunction with a
carbon-mineral oil suspension... This system has
shown minimal effectiveness."
Many patients required the 7-mm
handpiece with its hiugher fluence capabilities,
as the lower energy levels were not adequate for
effective follicular injury.
This process of irradiating the
skin with increasing fluences followed by an
observation period was repeated until a Nikolsky
sign was recorded.
Standard wound care instructions
included sun avoidance in treated areas for one
week posttreatment, use of Bacitracin ointment
and sunscreen, use of antibacterial soap and
loofa sponge after erythema subsided and use of a
low-medium potency steroid cream if erythema
persisted for more than 48 hours posttreatment
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2.
Nanni CA, Alster TS. Optimizing treatment
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carbon-based solution and 1064-nm Q-switched
neodymium:YAG laser energy. Arch Dermatol
1997;133:1546-9
3. Connolly CS, Paolini L. Study reveals
successful removal of unwanted hair with LPIR
laser. Cosmet Dermatol 1997;10:38-40
4.
Grossman MC, Dierickx C, Farinelli W, Flotte T,
Anderson RR. Damage to the hair follicles by
normal-mode ruby laser pulses. J Am Acad Dermatol
1996;35:889-95
5.
Dierickx C, Grossman M, Farinelli W et al.
Long-pulsed ruby laser hair removal. Lasers Surg
Med 1997;9(Suppl):36-7.
6. Anderson RR, Parrish JA.
Selective photothermolysis: precise microsurgery
by selective absorption of pulsed radiation.
Science 1983;220:524-7.
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reside in the bulge area of pilosebaceous unit: implications for
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8. Anderson RR, Parrish JA. The optics of
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