34361 Laser hair removal treatment considerations for Ehlers Danlos syndrome

Abstract

EDS is a clinically and genetically heterogenous group of heritable connective tissue disorders involving a pathogenic disruption of collagen fibrils. Here we present a case of laser hair removal in the setting of EDS (type 6a) in a 29-year-old female phototype 2 patient successfully treated with 755-nm alexandrite laser for aesthetic laser hair removal. Our patient was born with a dislocated hip and diagnosed at age 6 with EDS type 6a with genetic confirmation of PLOD1 positive gene mutation, poor wound healing, chronic sacroiliac joint dysfunction, kyphoscoliosis and bilateral hip dysplasia. She also had a myocardial infarction, right renal artery dissection and iliac artery dissection. She was interested in aesthetic laser hair removal and noted a significant scarring history with numerous hypopigmented scars throughout her extremities with shaving leaving her with scarring on occasion. Given her complex connective tissue disease history with significant morbidity particular consideration was given to planning her laser hair removal treatment sessions for the bikini line. Clinically our patient was phototype 2 with the bikini line containing dark brown terminal hair. To clinically identify endpoints and mitigate potential complications including scarring a test spot was initially performed. The test spot was performed with the alexandrite laser 755 nm, fluence 16 J/cm2, 10-ms pulse duration, 18-mm spot size, dynamic cooling device with 4 total pulses in separate areas. No undesirable endpoints, pigmentary alteration, or scarring was observed and full treatment sessions were initiated with 755-nm 16-18 J/cm2, 10-ms pulse duration, 18-mm spot size, dynamic cooling device with excellent clinical response.