Evaluation of combination triple wavelength diode laser for facial hair reduction

Introduction: Women these days have fine hair above their lips and on their chin, chest, abdomen, or back. The growth of coarse dark hair in these areas resemble more typical of male- pattern hair growth which is called hirsutism. Which make the body produce low levels of male hormones like androgens. The body produces too much of this hormone, which may result in unwanted hair growth. In most of cases, the exact cause is unknown. This condition often runs in families. A common causes of hirsutism is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormone conditions cause unwanted hair growth which may also be associated with acne, trouble losing weight, problems with menstrual periods, Diabetes. Other, less common causes of unwanted hair growth Include: Thyroid disorders tumour or cancer of the adrenal gland, tumour or cancer of the ovary, Cushing syndrome, congenital adrenal hyperplasia.

Hypertrichosis is a condition in which the ovaries produce too much male hormones where certain medicines will also result in unwanted hair growth, which include: Testosterone, danzol, anabolic steroids, DHEA, glucocroticoids, cyclosporine, minoxidil, phenytoin. Female body builders may take male hormones like anabolic steroids, which may result in excessive hair growth. In rare conditions, women with hirsutism have normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified. Laser hair reduction (LHR) is one of the most common laser procedures in dermatology which helps in the removal of the unwanted hair. Based on the theory of selective photo- thermolysis, laser energy of a particular wavelength is selectively absorbed by the pigmented target that gets converted into heat. In LHR, the chromophore is melanin in the hair shaft, but the intended target is cluster of follicular stem cells within the hair bulb and bulge located at a subtle distance away from the chromophore. The denaturation of the stem cells and resultant hair reduction can be explained by the extended theory of photothermolysis where the laser induced heat diffuses from the hair shaft melanin to the bulge and bulb. The selective nature of laser energy absorption allows the hair destruction while leaving the surrounding tissues unharmed. Laser systems developed over the past two decades encompass various wavelengths and light spectrums for hair removal including long pulse ruby at 694 nanometer (nm), long pulse alexandrite (755 nm), long pulse diode (810 nm), and long pulse Nd:YAG (1064 nm). The challenges of effective hair removal treatments, such as skin melanin content that acts as a competing chromophore for light absorption, affect both the hair reduction and efficacy and increases the risk of adverse events such as blistering and hyperpigmentation, especially for the skin types IV-VI. The shorter alexandrite 755 nm wavelength penetrates moderately and has been shown to effectively target hair with relatively low levels of melanin, usually found in lighter skin types. The 810 nm diode and 1064 Nd:YAG wavelengths penetrate deeper into the dermis, effectively targeting deeper hair with minimal treatment- related risks. LHR is preferred for skin types IV-VI.

Aim: To assess the efficacy and safety of combination triple wavelength diode laser for facial hair reduction in skin types IV and V.

Type of study: Hospital based observational study.

Materials &Methods:
Diode laser hair removal machine: The cooling gel is applied before the laser therapy which helps to reduce painful skin discomfort during the treatment by absorbing the minimum level, the energy of laser beams. Use of eye protection for both the operator and the patient.

Methods: 30 patients in the age group between 18-50 years of age were enrolled for the study and subjected to laser hair removal after use of 4 sessions of laser hair removal each with interval of 4 weeks for 4 months. (Frequency 4, Fluency 20, Pulse 40). All the patients were advised sunscreens for 2 weeks after the procedure.

Results: In 18 patients hair reduction was observed after use of 4 sessions of laser hair removal each with interval of 4 weeks for 4 months. (Frequency 4, Fluency 20, Pulse 40)

Patient satisfaction was between 4 and 5 points in 20 patients on the GAIS scale, indicating that the treatment was very well received and tolerated. No adverse side effects were observed.

In 8 patients hair reduction of was observed after use of 4 sessions of laser hair removal each with interval of 4 weeks for 4 months (Frequency 4, fluency 20, pulse 40). Patient satisfaction was 3-4 points on GAIS scale indicating that the treatment was improved and unchanged.

In 2 patients hair reduction of was observed after use of 4 sessions of laser hair removal each with interval of 4 weeks for 6 months (Frequency 4, fluency 20, pulse 40). Patient satisfaction was 2-3 points on GAIS scale indicating that the treatment was improved and much improved.

Conclusion: It can be concluded that use of a triple wavelength diode hair removal laser is safe and effective treatment for skin types III, IV, V. A triple wavelength diode hair removal 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. Choosing the optimal treatment protocol for LHR is based on skin type and hair characteristics such as density, thickness, color (melanin content), and depth. Recently, devices presenting a combination of wavelengths have shown to produce high effective hair reduction with no related risk.