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Mallat F, Chaaya C, Aoun M, Soutou B, Helou J. Adverse Events of Light-Assisted Hair Removal: An Updated Review. J Cutan Med Surg 2023; 27:375-387. [PMID: 37272371 DOI: 10.1177/12034754231174852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND With light-assisted hair removal becoming widely used, reports of adverse effects are increasing. OBJECTIVE To review all the reported optical incidents and cutaneous complications of laser or intense pulse light-assisted hair removal. METHODS A PubMed database systematic search was performed to identify studies reporting such adverse events before July 2022 using the Mesh terms "adverse effects" AND "hair removal" AND ("laser" OR "intense pulse light"). RESULTS Altogether, 358 references were identified. After excluding duplicates, unrelated articles, guidelines, and conference abstracts, then adding references from studies bibliography, 104 publications were included. Ocular incidents consisted of anterior uveitis, iritis and iris atrophy, pupillary distortion, posterior synechiae, anterior chamber pigment, and cataracts in the anterior subcapsular region. Cutaneous complications consisted of pain, burns, folliculitis, leukotrichia, paradoxical hypertrichosis, pigmentary changes, changes in nevi, pili bigemini, herpes infection, hyperhidrosis, bromhidrosis, Fox-Fordyce disease, and frostbite from the cooling system. They were mostly correlated to skin type and body area as well as to light device and set parameters. Intense pulse light devices were found to be less painful than alexandrite laser, yet more painful than diode laser; Nd:YAG laser had the highest pain score. CONCLUSION Optical incidents can be systematically avoided. Cutaneous complications are usually related to professional errors and patient characteristics. Better knowledge of laser physics and adequate training of laser operators are key recommendations to avoid undesirable side effects. Safety recommendations help prevent most of the reported complications.
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Affiliation(s)
- Farid Mallat
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
| | - Céline Chaaya
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
| | - Maroun Aoun
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
| | - Boutros Soutou
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
- Dermatology Department, Hôtel-Dieu de France, Beirut, Lebanon
| | - Josiane Helou
- Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon
- Dermatology Department, Hôtel-Dieu de France, Beirut, Lebanon
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Kao YC, Lin DZ, Kang YN, Chang CJ, Chiu WK, Chen C. Efficacy of Laser in Hair Removal: A Network Meta-analysis. J COSMET LASER THER 2023; 25:7-19. [PMID: 37493187 DOI: 10.1080/14764172.2023.2221838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 08/14/2022] [Accepted: 06/01/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Laser hair removal is an increasingly prevalent trend of cosmetic procedures. The purpose of this study was to assess the effectiveness of hair reduction among several types of laser interventions. METHODS The selected studies searched in PubMed and EMBASE were assessed for quality of evidence, and extracted data on absolute hair count and hair reduction rate. Qualitative data were synthesized using standardized mean difference (SMD) in frequentist network meta-analysis because various measurement units were used among selected studies. Inconsistency and small study effects were examined by design-by-treatment interaction model and comparison-adjusted funnel plot. RESULTS A total of 13 randomized controlled trials (RCTs) (n = 652) were contributed to network meta-analysis. Pooled results revealed that diode laser showed significantly lower absolute hair count within three-month (SMD = -13.21, 95% confidence interval [CI]: -22.25 to -4.17) and around six months follow-up (SMD = -11.01, 95% CI: -18.24 to -3.77) as compared with those in control group, but no significant difference among laser interventions. All side effects observed were transient without leaving any permanent scars. CONCLUSION Eliminating unwanted hair with lasers or intense pulsed light is safe and effective; however, which type of intervention is more beneficial in the long-term process should be studied with a longer follow-up time.
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Affiliation(s)
- Yu-Chien Kao
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Obstetrics and Gynecology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Dai-Zhu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-No Kang
- Center for Evidence-Based Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Cheng-Jen Chang
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Plastic Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wen-Kuan Chiu
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chiehfeng Chen
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Amici JM, Cogrel O, Jourdan M, Raimbault C, Canchy L, Kerob D, Madfes DC, Tian Y, Araviiskaia E. Expert recommendations on supportive skin care for non-surgical and surgical procedures. J Eur Acad Dermatol Venereol 2023; 37 Suppl 3:16-33. [PMID: 36635618 DOI: 10.1111/jdv.18855] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023]
Abstract
A thorough knowledge of non-surgical procedures (laser, peelings, injections, threads) and surgical procedures (combined surgeries and skin grafts), including contraindications and potential risks and side effects, (e.g. infection, hypopigmentation, hyperpigmentation, and scarring) is essential to be able to reduce their incidence and ensure the patient receives the most benefit from the procedure. Individuals with darker skin and of high Fitzpatrick phototype are at higher risk of dyschromias, notably melasma and post-inflammatory hyperpigmentation, which may be treated using aesthetic procedures but may also arise as a complication of some procedures. A group of experts in cosmetic surgery and dermatology reviewed the published literature and discussed recommendations for optimizing outcomes with practical advice on supportive skincare before, during and after non-surgical or surgical procedures. A broad-spectrum sunscreen with a high sun protection factor against UVB and high protection against UVA, especially long UVA, is essential for all treatment modalities for the prevention and potential improvement of pigmentation disorders. Supportive skin care management to prepare, cleanse and protect the skin and post-procedure skin care with healing and anti-inflammatory ingredients are recommended to speed up regeneration and wound healing whilst minimizing scarring and downtime. Additionally, adjunctive skin care to procedures with antioxidant, anti-ageing and lightening properties may enhance skin benefits.
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Affiliation(s)
- Jean-Michel Amici
- Dermatology Department, CHU Bordeaux, Hôpital Saint-André, Bordeaux, France
| | - Olivier Cogrel
- Mohs Surgery and Laser Unit, Dermatology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Marie Jourdan
- Centre Laser International de la Peau-Paris (CLIPP), Paris, France
| | | | - Ludivine Canchy
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | - Delphine Kerob
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | | | - Yan Tian
- Dermatology Department, Air Force Medical Center, PLA, Beijing, China
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Moftah N, Tymour M, Ibrahim SMA. Multipass low fluence, high-frequency 755-nm alexandrite laser versus high fluence, low-frequency 1064-nm long-pulsed Nd: YAG laser in axillary hair reduction of dark skin phototypes: an intra-individual randomized comparative study. J DERMATOL TREAT 2021; 33:2079-2084. [PMID: 33844620 DOI: 10.1080/09546634.2021.1914311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Laser hair removal has become popular means of achieving hair reduction with improved quality of life. OBJECTIVE This study aimed to assess the safety and efficacy of Multipass low fluence, high-frequency 755-nm Alexandrite laser versus the high fluence, low-frequency 1064-nm long-pulsed Nd: YAG laser on axillary hair reduction in women with dark skin phototypes. PATIENTS AND METHODS This study was carried out on 30 adult women [skin type, IV-VI)] who seek axillary hair reduction. These subjects were adjusted to receive 5 laser sessions with a 1-month interval. One side received high fluence, low-frequency 1064-nm laser where the other side received multipass low fluence, high-frequency 755 nm laser. The follow up was done using photographs, folliscope, patients' visual analog pain scale. RESULTS The mean percentage of hair density reduction showed significant improvement in both treated sides being higher in the Alex treated side with corresponding significant decreases in the mean hair thickness. CONCLUSION Multipass low fluence, high-frequency 755-nm Alex laser practice was verified to be safe and effective for hair removal in dark skin phototypes compared to the high fluence, low frequency 1064-nm long pulsed Nd:YAG laser.
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Affiliation(s)
- Nayera Moftah
- Ex. Dean of Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.,Professor of Dermatology & Venereology, Faculty of Medicine for Girls, Al-Azhar University.,Editor in Chief of Journal of the Egyptian Women's Dermatologic Society (JEWDS)
| | - Mai Tymour
- M.B.B.Ch of General Medicine &Surgery, Faculty of Medicine, Cairo University, Giza, Egypt.,Diplomate of Dermatology & Venereology, Al-Azhar university, Cairo, Egypt
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Modena DAO, Miranda ACG, Grecco C, Liebano RE, Cordeiro RCT, Guidi RM. Efficacy and safety of ND:YAG 1064 nm lasers for photoepilation: a systematic review. Lasers Med Sci 2020; 35:797-806. [PMID: 31919681 DOI: 10.1007/s10103-019-02939-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
Using light sources in phototherapy has presented promising results regarding several types of facial and body skin affections for centuries. The neodymium-doped yttrium aluminum garnet (ND:YAG) 1064 nm laser has become a standard treatment in dermatology for dermatological disturbances related to the pilous follicle and the structures surrounding it. Despite the reports of its clinical benefits, few scientific studies show its actual safety and efficacy. To substantiate the effects, benefits, and safety of applying an ND:YAG 1064 laser in the epilation process during esthetic treatment, a systematic review was carried out between October 2018 and January 2019, on studies published in the last 20 years. Randomized clinical trials in humans were considered that evaluated the efficacy, safety, and benefits of ND:YAG laser application at 1064 nm wavelengths for hair removal. A total of 198 articles were identified; 58 articles remained after their titles and abstracts were read; and 21 articles were selected after the removal of duplicates. After the integral reading, 13 of these articles were included in the systematic review (734 patients). The ND:YAG 1064 nm laser presents safety and promising, beneficial effects in epilation. However, further scientific studies with better methodologic quality are necessary to better standardize ND:YAG laser therapy and clarify its parameters for photoepilation.
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Affiliation(s)
- Débora Aparecida Oliveira Modena
- Department of Surgery, Medical Sciences Institute, University of Campinas (Unicamp), Campinas, São Paulo, Brazil. .,Department of Research, Development and Innovation of Ibramed, Study Group in Applied Technologies for Health, Amparo, São Paulo, Brazil. .,Center for Advanced Studies Ibramed (CEFAI), Amparo, São Paulo, Brazil. .,Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
| | - Ana Carolina Godoy Miranda
- Department of Research, Development and Innovation of Ibramed, Study Group in Applied Technologies for Health, Amparo, São Paulo, Brazil.,Center for Advanced Studies Ibramed (CEFAI), Amparo, São Paulo, Brazil.,Department of Tocogynecology, Medical Sciences Institute, University of Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Clovis Grecco
- Department of Research, Development and Innovation of Ibramed, Study Group in Applied Technologies for Health, Amparo, São Paulo, Brazil.,Center for Advanced Studies Ibramed (CEFAI), Amparo, São Paulo, Brazil
| | - Richard Eloin Liebano
- Department of Research, Development and Innovation of Ibramed, Study Group in Applied Technologies for Health, Amparo, São Paulo, Brazil.,Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | | | - Renata Michelini Guidi
- Department of Research, Development and Innovation of Ibramed, Study Group in Applied Technologies for Health, Amparo, São Paulo, Brazil.,Center for Advanced Studies Ibramed (CEFAI), Amparo, São Paulo, Brazil.,Department of Biomedical Engineering, Electrical and Computing Engineering Institute, University of Campinas (Unicamp), Campinas, São Paulo, Brazil
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Dorgham NA, Dorgham DA. Lasers for reduction of unwanted hair in skin of colour: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2019; 34:948-955. [PMID: 31587390 DOI: 10.1111/jdv.15995] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/04/2019] [Indexed: 01/12/2023]
Abstract
Light-based therapies are one of the most effective and widely used strategies for removal of undesired hair, with a broadly favourable safety profile. However, subjects with pigmented skin are found to be more prone to laser-related adverse events. While prolonged pulse-width and longer treatment duration were proposed to minimize adverse events, the optimal treatment option among available phototherapy modalities - long-pulsed (Nd:YAG), pulsed diode and alexandrite lasers as well as intense pulsed light (IPL) - remains unclear, particularly for skin of colour. To determine superiority in terms of effectiveness and tolerability, we conducted a systematic review of literature on different types of in-office laser and IPL for hair removal in subjects with Fitzpatrick skin types III-VI. The meta-analysis was performed using Review Manager (RevMan) version 5.3 and included 12 eligible comparative trials (nine randomized controlled trials and three quasi-randomized). In terms of hair count reduction, pooled effect estimates for long-pulsed ND:YAG laser [OR: 0.26, 95% CI (0.1, 0.78)] and diode laser [standardized mean difference (SMD): -0.11, 95% CI (-0.62, 0.39)] were not statistically significant from those of IPL; in contrast, alexandrite laser was found to be superior to IPL in reducing hair count [SMD: -1.7, 95% CI (-2.6, -0.78)]. In terms of adverse events, the pooled effect estimates favoured long-pulsed Nd:YAG laser to IPL with respect to postinflammatory hyperpigmentation [OR: 0.26, 95% CI: (0.1, 0.78)]. However, both pulsed diode and alexandrite lasers exhibited a comparable safety profile to IPL, despite higher pain scores with lasers. In conclusion, this systematic review suggests that treatment outcomes for different in-office laser devices and IPL in subjects with skin type III-VI are broadly similar; nevertheless, we observed a trend towards greater hair reduction following laser therapy compared with IPL.
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Affiliation(s)
- N A Dorgham
- Dermatology Department, Kasr Al Ainy Hospital, Cairo University, Giza, Egypt
| | - D A Dorgham
- Dermatology Department, Kasr Al Ainy Hospital, Cairo University, Giza, Egypt
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