Treatment of trichostasis spinulosa with 0.5-millisecond pulsed 755-nm alexandrite laser

Abstract

Trichostasis spinulosa (TS) is a follicular disorder in which multiple hairs in a keratinous sheath project above the skin surface. Current treatments provide temporary relief and side effects are common. We report the successful treatment of TS in 20 patients using a short-pulsed 755-nm alexandrite laser. The 20 patients (skin types II-V) presented with TS lesions on the tip of their nose. All patients received a single treatment (one to three passes) with the laser with cold air cooling but without anaesthesia or analgesia. Treatment parameters were as follows: pulse duration 0.5ms, fluence 15-17J/cm(2), and spot size 5mm. The entire procedure required less than 5min to perform. The patients were followed up for 3months for any adverse effects or recurrence. In all patients the lesions disappeared immediately after treatment with minimal or no pain. Erythema was minimal and lasted 5-20min in all patients. Patients were very satisfied. The treated areas were still clear 4 to 5weeks later, and a second treatment was not considered necessary. There were adverse effects other than the erythema and there was no recurrence within the follow-up period of 3months. A single treatment with a short-pulsed 755-nm alexandrite laser appears to be a rapid, minimally painful, and effective treatment for TS in patients of skin types II to V.