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Before and After
Laser and IPL hair removal, the Treatment Results
What kind of results can you expect from Laser and SPL Epilation?
Most technicians can expect up to a 90% improvement rate. This
means 9 of 10 hairs will be destroyed after treatment (1-5
applications). The few hair follicles which do not respond to the
first treatments will almost certainly be destroyed from additional
applications.
Are there any side effects to the treatment? No, the procedure is very safe. Most clients will report an overall improvement in the texture, feel and condition of their skin. This is primarily due to the discontinuation of the chronic irritation (dermatitis) caused by the constant shaving and plucking that normally accompanies the condition of unwanted hair.
Empirical Evidence/Clinical Study Introduction. This
study reports treatment using the semiconductor diode laser system,
a high power, long pulsed diode with a wavelength of 808nm for laser
hair reduction. Laser hair reduction operates on the
principles of selective photothermolysis. This process combines the
selective absorption of light energy by the melanin in the hair
follicle with suitable fluences and pulse durations to allow
selective injury to the hair follicle while sparing skin(1).
The major
'absorber' of radiation in the skin between 300 and 1200nm is
melanin(2), which is found primarily in the epidermis, hair shaft,
and hair follicle. This study was conducted using the 808nm
wavelength diode laser for its increased tissue penetration,
optimized melanin absorption and safety for treating a wide range of
hair diameters/colors and skin types.
The 808nm wavelength penetrates deeply to reach the germinative
cells of the hair bulb and the bulge in even the deepest follicles.
The 808nm wavelength appears to be the correct balance, offering
safety on darker skin types while providing enough absorption to
effectively treat finer and/or lighter hairs.
To achieve selectivity, the laser energy is applied in a pulse
duration that approximately equals the thermal relaxation time of
the hair shaft, but exceeds the thermal relaxation time of the
epidermal melanin. This causes injury to the hair shaft resulting in
growth delay and reduction, but allows the heat to dissipate away
from the epidermis without causing injury. The semiconductor diode
laser system can deliver short pulses or pulse durations up to
100msec. The thermal relaxation time for the hair follicle is
dependent upon its diameter; thus longer pulse durations are
theoretically best suited for medium to coarse hairs(3) while finer
hairs may require shorter pulses.
Clinical studies have shown that aggressive skin cooling allows the
use of higher fluences and results in a greater margin of safety for
all and especially for darker skin types(4). Contact with the
patient's skin after each laser pulse provides a thermal quenching
effect and additional epidermal protection.
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Methods and Variations of Laser
Application.
This prospective study looked at hair reduction in 36
healthy subjects (33 women and 3 men) between the ages of 28 and 78
years old. All subjects had tried various hair removal methods in
the past without satisfactory results. These methods included
shaving, tweezing/plucking, waxing, electrolysis, prescription
medications and other hair laser machines. Eligible subjects had
black or brown hair, Fitzpatrick skin type I - IV and lacked
exclusion criteria. The exclusion criteria included active herpes
infection, history of accutane use in the last 12 months, keloid or
hypertrophic scarring, photosensivity disorders, severe lentiginous
photoaging, compromised skin integrity or HIV infection.
Once the initial screening was completed, the subjects were educated
on the potential risks and side effects of laser hair reduction and
pre-and post-treatment care. Informed consent was then obtained.
Subjects were instructed not to use any other method of hair
removal, except shaving or trimming if needed, during the study
period. Subjects were asked to return for four sessions, four to
eight weeks apart.
Prior to each treatment session, a photograph and hair count was
performed on a section marked in a 1cm x 1cm or larger square. The
treatment area was cleansed with alcohol and trimmed of any
excessively long hairs.
All patients were treated with the semiconductor diode laser system
at 808nm wavelength setting. The energy density (J/cm2) and pulse
duration (msec) were adjusted according to the subject's Fitzpatrick
skin type classification, hair count/hair reduction and skin
response. The system is capable of cooling from -2 to 5 degrees
Celsius, pulse durations up to 100msec, fluences up to 50J/cm2 and
repetition rate up to 4Hz. The area was treated with sufficient
energy to elicit follicular edema and erythema within 2 - 5 minutes
after laser irradiation. The settings were adjusted with each
subsequent treatment if adequate reduction was not evident in the
hair count or verbalized by the subject. Topical steroids (class III
- V) were applied to the treatment area immediately after each
session, with samples provided if needed. Prior to each session, the
area was evaluated for skin/hair response and potential
complications.
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Treatment Efficacy and Overall Results. Eighteen
subjects completed three treatment sessions, eight subjects
completed two treatment sessions and ten subjects completed only one
treatment session. Only one subject had 2 different sites treated
(i.e. neck and upper lip). The remaining subjects had only one
treatment site, although two hair count measurements were obtained
(i.e. both right and left side of the chin or right and left axilla,
etc). The average hair reduction of all sites was 41% after the
first treatment, 55% after the second treatment and 68% after the
third treatment. Hair reduction varied by both treatment site (axilla,
face, legs, back, neck, arms, abdomen, and bikini) and number of
treatment sessions (1-3). Hair reduction continued to improve with
each subsequent treatment. The chin treatment sites appeared to show
consistently higher hair reduction measurements than other areas of
the face and overall.
References
1. Anderson RR, Parish JA. Selective photothermolysis: precise
microsurgery by selective absorption of pulsed radiation. Science
1983; 220: 524-527.
2 Anderson RR, Parkish JA. The optics of human skin. J. Invest.
Dermatol 1981;77:13-9.
3. Adrian RM, Tanghetti E. Clinical evaluation of a high energy
long-pulse ruby laser for the treatment of unwanted body hair.
Lasers Med Surg 1997; supp 9:36.
4. Grossman MC, Dierickx CC, Farinelli WA, Flotte TJ, Anderson RR.
Damage to hair follicles by normal-mode ruby laser pulses. J AM Acad
Dermatol 1996;35:889.
5. Battle EF. Study of very long-pulsed (100 ms) high powered diode
laser for hair reduction on all skin types. Coherent Medical, Santa
Clara, CA 2000.
6. Handrick, C., Alster, T. Comparison of long pulsed diode and long
pulsed alexandrite lasers for hair removal; A long-term clinical and
histologic study Derm Surgery, 2001;27:622-626.
7. Anderson, RR., Laser-tissue interactions. In: Goldman MP,
Fitzpatrick RE, editors. Cutaneous laser surgery: the art and
science of selective photothermolysis. St. Louis (MO): Mosby-Year
Book Inc; 1994. p. 1-18.
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