Overview of Clinical Studies Overview of Clinical Studies On Laser Hair RemovalOn Laser Hair Removal

By: Vickie L. Mickey, By: Vickie L. Mickey, CT,CLHRPCT,CLHRP

Simulated Consumer Use of a Simulated Consumer Use of a Battery Hand-Held Portable Diode Battery Hand-Held Portable Diode

Laser for Hair RemovalLaser for Hair Removal Conducted by Ronald Wheeland, MDConducted by Ronald Wheeland, MD University of Missouri – ColumbiaUniversity of Missouri – Columbia Study was designed to determine Study was designed to determine

safety, efficacy and ease of use safety, efficacy and ease of use Study designed with a treatment Study designed with a treatment

groupgroup

of 77 appropriate users and 44 of 77 appropriate users and 44 inappropriate users inappropriate users

Results:Results:

61% hair reduction after 3 weeks first 61% hair reduction after 3 weeks first treatmenttreatment

70% hair reduction after second 70% hair reduction after second treatmenttreatment

60% hair reduction 1 month after third 60% hair reduction 1 month after third treatmenttreatment

41% hair reduction third treatment41% hair reduction third treatment 31% hair reduction 9 months after 31% hair reduction 9 months after

third treatment third treatment

ConclusionsConclusions

Laser highly effective at hair removalLaser highly effective at hair removal Minimal side effects w/appropriate Minimal side effects w/appropriate

useuse Contract sponsor : Spectra Genics, Contract sponsor : Spectra Genics,

Inc.Inc. Published July 23, 2007 Wiley Published July 23, 2007 Wiley

InterscienceInterscience

Hair Removal With 755 nm Lasers: Hair Removal With 755 nm Lasers: Long Term Results 8.5 YearsLong Term Results 8.5 Years

Study conducted by: Gabriel Study conducted by: Gabriel Buendia, Eva Ciscar, Katharina Usse-Buendia, Eva Ciscar, Katharina Usse-WilfingerWilfinger

Method – Study 668 patients treated Method – Study 668 patients treated in 2 cities in Barcelona, Spain and in 2 cities in Barcelona, Spain and Innsbruck, AustriaInnsbruck, Austria

Method Cont:Method Cont:

1 – 2 body parts treated including 1 – 2 body parts treated including axilla, bikini, legs, backaxilla, bikini, legs, back

755 nm Alexandrite laser755 nm Alexandrite laser 16 – 25 J/cm216 – 25 J/cm2 7 – 15 mm spot size7 – 15 mm spot size 10 – 40 ms pulse duration10 – 40 ms pulse duration Epidermal cooling on all proceduresEpidermal cooling on all procedures

Results:Results:

1009 sites treated1009 sites treated 100% reduction in 899 sites100% reduction in 899 sites 98 sites presented less hair reduction98 sites presented less hair reduction 12 patients did not respond12 patients did not respond 82% reduction in facial areas82% reduction in facial areas 17% unstable reduction17% unstable reduction 1% did not respond1% did not respond

Results cont.Results cont.

93% reduction in bikini area 93% reduction in bikini area 5% unstable5% unstable 2% did not respond2% did not respond

ConclusionsConclusions

The alexandrite long pulsed 755nm The alexandrite long pulsed 755nm lasers are effective in long term hair lasers are effective in long term hair reduction or even permanent hair reduction or even permanent hair removal.removal.

Clinical Comparison of Four Hair Clinical Comparison of Four Hair Removal Lasers and Light SourcesRemoval Lasers and Light Sources Shehal P. Amin & David J. GoldbergShehal P. Amin & David J. Goldberg Skin Laser and Surgery Specialist of Skin Laser and Surgery Specialist of

NY & NJNY & NJ The Mount Sinai School of Medicine, The Mount Sinai School of Medicine,

New York, NY USANew York, NY USA

Abstract/ Background and Abstract/ Background and Objectives:Objectives:

There are few clinical studies that There are few clinical studies that directly compare the efficacy of directly compare the efficacy of multiple hair removal system in the multiple hair removal system in the same individual. This study same individual. This study comparison evaluates the efficacy of comparison evaluates the efficacy of four highly popular systems for laser four highly popular systems for laser hair removal.hair removal.

Method:Method:

10 subjects underwent unwanted hair 10 subjects underwent unwanted hair removal on back & thighsremoval on back & thighs

Skin types I- IIISkin types I- III Ages 18 – 55 yearsAges 18 – 55 years Treated twice with:Treated twice with: Intense pulsed light with red filterIntense pulsed light with red filter Intense pulsed light with yellow filterIntense pulsed light with yellow filter 810 nm diode810 nm diode 755nm alexandrite laser755nm alexandrite laser

Method Cont:Method Cont:

4 treatment areas 4 treatment areas Commonly accepted parameters for Commonly accepted parameters for

permanent hair reductionpermanent hair reduction Non-treated areas/Marked treatment Non-treated areas/Marked treatment

areasareas Hair count camera used @ 1, 3, & 6 Hair count camera used @ 1, 3, & 6

months, after second treatmentmonths, after second treatment Clinical results & adverse events were Clinical results & adverse events were

notednoted

Methods Cont:Methods Cont:

All light sources/lasers were FDA All light sources/lasers were FDA approvedapproved

Results:Results:

Photographs revealed significant Photographs revealed significant decrease in hair counts (-50%) and (-decrease in hair counts (-50%) and (-55%) hair coverage55%) hair coverage

Remaining hair after two treatments Remaining hair after two treatments presented no statistical difference in presented no statistical difference in hair length or diameterhair length or diameter

No statistical difference in efficacy No statistical difference in efficacy between the four different light between the four different light devicesdevices

Results cont:Results cont:

Minimal transient effects were noted Minimal transient effects were noted from all systemsfrom all systems

Cryogen spray-based alexandrite Cryogen spray-based alexandrite laser showed highest pain scoreslaser showed highest pain scores

Conclusion:Conclusion:

Hair removal with the commonly Hair removal with the commonly used systems is as expected highly used systems is as expected highly effectiveeffective

Treatment with light-based devices Treatment with light-based devices can cause less pain, yet show can cause less pain, yet show efficacy similar to laser systemsefficacy similar to laser systems

Patient Reported Pain ScoresPatient Reported Pain Scores

IPL I PalomarIPL I Palomar Mean pain score Mean pain score 3.43.4

IPL II Palomar Mean pain score 2.1IPL II Palomar Mean pain score 2.1 810 nm Lumenis diode laser- Mean 810 nm Lumenis diode laser- Mean

pain score 2.3pain score 2.3 755 nm Candela alexandrite laser-755 nm Candela alexandrite laser-

Mean pain score 4.1Mean pain score 4.1

Blond Hair Removal Using ELOS Blond Hair Removal Using ELOS SystemsSystems

Careen A. Schroeter, Sapna Sharma, Ngozi Careen A. Schroeter, Sapna Sharma, Ngozi C. Mbonu, Thorsten Reineke & Herman A. M. C. Mbonu, Thorsten Reineke & Herman A. M. NeumannNeumann

Department of Lasertherapy, Medical Center Department of Lasertherapy, Medical Center Maastricht, The Netherlands, Department of Maastricht, The Netherlands, Department of Medical Statistics, Informatics and Medical Statistics, Informatics and Epidemiology, University of Cologne, Epidemiology, University of Cologne, Cologne, Germany, & Department of Cologne, Germany, & Department of Dermatology and Verereology Erasmus Dermatology and Verereology Erasmus Medical Center, Rotterdam, The NetherlandsMedical Center, Rotterdam, The Netherlands

Abstract/Objective:Abstract/Objective:

Study was conducted to test blond Study was conducted to test blond hair removal using the ELOS system, hair removal using the ELOS system, which is optical energy and radio-which is optical energy and radio-frequency combinedfrequency combined

Study Date December 2005: Study Date December 2005: accepted January 26, 2006accepted January 26, 2006

Methods:Methods:

17 patients with blond hair were 17 patients with blond hair were randomly selected from the randomly selected from the Department of Lasertherapy, Medical Department of Lasertherapy, Medical Center Maastrichtm The Netherlands.Center Maastrichtm The Netherlands.

Mean age was 57.4 yearsMean age was 57.4 years Mean energy used per patient was Mean energy used per patient was

23.2 j/cm2 with mean radio-23.2 j/cm2 with mean radio-frequency 18.6 j/cm2frequency 18.6 j/cm2

Results:Results:

57.4% hair reduction obtained with 57.4% hair reduction obtained with mean 8.5 treatmentsmean 8.5 treatments

A trend was found between hair A trend was found between hair removal and the number of removal and the number of treatmentstreatments

No correlation between the No correlation between the percentage of hair removal and age percentage of hair removal and age and technical data of deviceand technical data of device

No major side effects observed No major side effects observed postoperatively postoperatively

IntroductionIntroduction

Hair removal options vary in efficacy, Hair removal options vary in efficacy, degree of discomfort, and costdegree of discomfort, and cost

Common methods are: plucking, shaving, Common methods are: plucking, shaving, mechanical and chemical dermabrasionmechanical and chemical dermabrasion

Methods are less expensive yet Methods are less expensive yet temporarytemporary

Long term methods are: needle epilation, Long term methods are: needle epilation, surgical epilation, laser epilation and surgical epilation, laser epilation and intense pulse light sourceintense pulse light source

Introduction Cont.:Introduction Cont.:

Management of hirsutism remains Management of hirsutism remains challenging to dermatologists & challenging to dermatologists & cosmetic surgeons world widecosmetic surgeons world wide

Search for a method that will give Search for a method that will give enduring results with minimum side enduring results with minimum side effects has been on going for yearseffects has been on going for years

Hair growth cycles, stages of growth, Hair growth cycles, stages of growth, color or hair, areas of hair growth are color or hair, areas of hair growth are all factors in resolving this dilemmaall factors in resolving this dilemma

Introduction cont.:Introduction cont.: Methods of hair removal all have their distinct set Methods of hair removal all have their distinct set

of advantages and disadvantagesof advantages and disadvantages Increased demand for safe and effective hair Increased demand for safe and effective hair

removalremoval IPL and laser technology promise rapid results and IPL and laser technology promise rapid results and

is effectiveis effective Lasers can treat hundreds of hairs simultaneously Lasers can treat hundreds of hairs simultaneously

in comparison to electrolysis in comparison to electrolysis Gorgu et al concluded that laser hair removal is Gorgu et al concluded that laser hair removal is

more expensive than electrolysis but 60 times more expensive than electrolysis but 60 times faster and less painfulfaster and less painful

Fewer sessions are needed with laser vs. Fewer sessions are needed with laser vs. electrolysis with better results electrolysis with better results

Introduction cont.:Introduction cont.:

Light skin with dark hair responds best Light skin with dark hair responds best to laser or light based hair removalto laser or light based hair removal

Light colored hair is more difficult to Light colored hair is more difficult to treat with lasers or LPLtreat with lasers or LPL

Laser hair removal is based on photo-Laser hair removal is based on photo-thermolysis and thermal relaxation timethermolysis and thermal relaxation time

Initial studies indicated that all lasers Initial studies indicated that all lasers caused a delay in growth of hair after a caused a delay in growth of hair after a single treatmentsingle treatment

Introduction cont.:Introduction cont.:

The concept of photo-thermolysis with laser The concept of photo-thermolysis with laser light was first described by Kuriloff in 1988 light was first described by Kuriloff in 1988 for pharyngo-oesophageal hair growthfor pharyngo-oesophageal hair growth

The argon laser was used for photo-epilation The argon laser was used for photo-epilation in the treatment of trachomatous trichiasisin the treatment of trachomatous trichiasis

Nd:Yag laser for epilaton of hair bearing Nd:Yag laser for epilaton of hair bearing urethral grafts in 1992 & 1994urethral grafts in 1992 & 1994

Dr. Jeffrey used the ruby laser for epilation of Dr. Jeffrey used the ruby laser for epilation of the hair follicle in 1989 the hair follicle in 1989

Introduction cont.:Introduction cont.:

Dr. Zaias proposed the concept of a Dr. Zaias proposed the concept of a pulsed laser for hair removal in 1991pulsed laser for hair removal in 1991

Increasing numbers of published Increasing numbers of published studies confirm the long-term studies confirm the long-term efficacy of laser and flashlamp efficacy of laser and flashlamp technologytechnology

Laser and ILP still have limitations in Laser and ILP still have limitations in regards to the hair removal with regards to the hair removal with concerns to lighter hairconcerns to lighter hair

Introduction cont.:Introduction cont.:

The side effects of the ILP and laser The side effects of the ILP and laser remain constant today in regards to pain remain constant today in regards to pain and complications.and complications.

The second generations of the IPL are The second generations of the IPL are more effective in hair removal however more effective in hair removal however use by a skilled practitioners is necessary use by a skilled practitioners is necessary as to the difficulty in the use of the deviceas to the difficulty in the use of the device

A novel method to surmount the A novel method to surmount the restrictions of light-based hair removal is restrictions of light-based hair removal is the ELOS technology or Electro-Optical the ELOS technology or Electro-Optical Synergy Synergy

ELOS – The Aurora DSELOS – The Aurora DS Delivers a combination of radio-frequency and a pulse Delivers a combination of radio-frequency and a pulse

of red to infrared light to achieve the heating required of red to infrared light to achieve the heating required for selective thermal energyfor selective thermal energy

Energy delivered to the skin from the RF is Energy delivered to the skin from the RF is independent of skin color and there is no epidermal independent of skin color and there is no epidermal barrier to absorption as with optical energybarrier to absorption as with optical energy

This deliver prevents overheating of surrounding This deliver prevents overheating of surrounding tissues. tissues.

Skin is pre-cooled and the target is selectively pre-Skin is pre-cooled and the target is selectively pre-heated by application of a low-fluence optical pulse.heated by application of a low-fluence optical pulse.

The RF energy increases the difference in The RF energy increases the difference in temperature between the epidermis and the target, temperature between the epidermis and the target, this combination of RF and optical enables this combination of RF and optical enables coagulation level with low riskcoagulation level with low risk

ELOS – Cont.:ELOS – Cont.:

Few studies have been conducted Few studies have been conducted regarding the ELOSregarding the ELOS

Dr. Neil Sadick conducted a studies Dr. Neil Sadick conducted a studies in 2004 using the ELOS system in 2004 using the ELOS system observed an average of 48% hair observed an average of 48% hair removal in 18 monthsremoval in 18 months

Slightly higher results with blond hair Slightly higher results with blond hair (52%) vs. (44%) white hair(52%) vs. (44%) white hair

Discussion of StudyDiscussion of Study

This study found consistent results This study found consistent results with Dr. Sadick’s studieswith Dr. Sadick’s studies

RF has been used for over a century RF has been used for over a century to treat the hair follicle, however the to treat the hair follicle, however the thermal effect is not conducted well thermal effect is not conducted well in the hair shaftin the hair shaft

Electrical current created between Electrical current created between the electrodes streams is the electrodes streams is concentrate in layer of 20 – 40 concentrate in layer of 20 – 40 microns around the hair microns around the hair

Discussion Cont.:Discussion Cont.:

The bulge area is important as well as the The bulge area is important as well as the hair follicle in regards to hair regrowthhair follicle in regards to hair regrowth

Studies have shown that hair can Studies have shown that hair can regenerate from totally follicle-free skinregenerate from totally follicle-free skin

RF does not need a chromophore to RF does not need a chromophore to effectively treat the hair follicleeffectively treat the hair follicle

RF properties permit negligible reflection RF properties permit negligible reflection or scattering of energy or scattering of energy

Light energies require a chromophore in Light energies require a chromophore in the skin and permits scattering of the skin and permits scattering of energies.energies.

Discussion cont.:Discussion cont.:

RF requires a conductive media RF requires a conductive media (water) to(water) to

RF enables a direct measure of the RF enables a direct measure of the current and voltage on the current and voltage on the electrodes delivered to the skinelectrodes delivered to the skin

This study shows advances in This study shows advances in technology for hair removal, however technology for hair removal, however further research with greater further research with greater numbers is advisednumbers is advised

ConclusionConclusion

The ELOS system can be effectively The ELOS system can be effectively used in reduction of blond hair.used in reduction of blond hair.