Unwanted Hair Research Articles

The evaluation of a new broadband light (BBL) source and a 1,064 nm Nd:YAG laser in the removal of unwanted hair

The evaluation of a new broadband light (BBL) source and a 1,064 nm Nd:YAG laser in the removal of unwanted hair

Hair Depigmentation During Chemotherapy With a Class III/V Receptor Tyrosine Kinase Inhibitor

Hair pigmentation is regulated by several factors including the interaction of the ligand stem cell factor (SCF) with its class III receptor tyrosine kinase, c-kit. An interruption of SCF/c-kit signal transduction results in hair depigmentation. A 69-year-old white woman developed hair depigmentation and fine-textured hair while being treated with the phase I chemotherapeutic agent GW786034, a class III/V receptor tyrosine kinase inhibitor. Discontinuation of therapy resulted in a reversal of these hair changes. Treatment with oral GW786034 resulted in reversible hair depigmentation and change in hair growth rate and texture, which were most likely due to an incomplete inhibition of SCF/c-kit signaling, although the exact mechanism is unknown. It would be intriguing to investigate topical tyrosine kinase inhibitors as a treatment for unwanted body hair.

Laser and photoepilation for unwanted hair growth

Unwanted hair growth is a therapeutic challenge and considerable resources are spent to achieve a hair-free appearance. Epilation with laser devices (alexandrite, diode, neodymium:YAG, and ruby lasers) and intense pulsed light are commonly used although the long-term effect is uncertain. To assess the effects of epilation with lasers and light sources. We searched the Cochrane Skin Group's Specialised Register in February 2004; MEDLINE (from 1966) and EMBASE (from 1980) in April 2005. We searched reference lists of collected trials and contacted trial authors. Randomised controlled trials of laser or photoepilation. Primary outcomes were objective reduction in hair counts, adverse effects and subjective reduction in hairiness. Secondary outcomes were participants satisfaction and personal observations such as softer, finer, or paler hairs. Two authors independently extracted data and assessed trial quality. We included eleven randomised controlled trials involving 444 people, none of which were of high methodological quality. A large number of trials were excluded, mainly because of their non-randomised design. The randomisation procedures were either unclear or inadequate, using coin tossing, alternation, drawing lots or cards, or open tables of random numbers. The interventions and outcomes were too heterogeneous to be entered in a meta-analysis. Most trials examined a short-term effect up to six months after final treatment. There appeared to be a short-term effect of approximately 50% hair reduction with alexandrite and diode lasers up to six months after treatment, whereas little evidence was obtained for an effect of intense pulsed light, neodymium:YAG or ruby lasers. Long-term hair removal was not documented with any treatment. Pain, skin redness, swelling, burned hairs and pigmentary changes were infrequently reported adverse effects. Some treatments lead to temporary short-term hair removal. High quality research is needed on the effect of laser and photoepilation.

Eflornithine Cream Combined with Laser Therapy in the Management of Unwanted Facial Hair Growth in Women: A Randomized Trial

Eflornithine cream is approved for the reduction of unwanted facial hair in women. The mechanism of action for eflornithine is reduction in follicular cell growth rate, while laser photoepilation heats hair and adjacent tissues to suspend growth. The objective was to assess the efficacy and safety of eflornithine or vehicle with laser therapy in the treatment of unwanted facial hair in women. Subjects were randomized to treatment with eflornithine on one side of the face and vehicle on the contralateral side for 34 weeks. Subjects received Nd:YAG or alexandrite laser therapy to both sides of the face at Weeks 2 and 10. Blinded evaluations included left to right comparisons and appearance relative to baseline. Fifty-four women completed the trial. From Weeks 6 through 22, eflornithine-treated sides showed significant reduction in hair growth. By Week 34, no significant differences were seen. Subject grading showed significant and persistent hair reduction through Week 34 for eflornithine-treated sides. The safety profile for combination therapy is similar to eflornithine alone. Eflornithine is safely used in conjunction with laser hair removal treatments and promotes more rapid hair removal when combined with laser treatment. Patients demonstrate a clear preference for treatment with laser and eflornithine.

Eflornithine Cream Combined with Laser Therapy in the Management of Unwanted Facial Hair Growth in Women

Eflornithine Cream Combined with Laser Therapy in the Management of Unwanted Facial Hair Growth in Women

Women living with facial hair: the psychological and behavioral burden

Objective While unwanted facial hair is clearly distressing for women, relatively little is known about its psychological impact. This study reports on the psychological and behavioral burden of facial hair in women with suspected polycystic ovary syndrome. Methods Eighty-eight women (90% participation rate) completed a self-administered questionnaire concerning hair removal practices; the impact of facial hair on social and emotional domains; relationships and daily life; anxiety and depression (Hospital Anxiety and Depression Scale); self-esteem (Rosenberg Self-esteem Scale); and quality of life (WHOQOL-BREF). Results Women spent considerable time on the management of their facial hair (mean, 104 min/week). Two thirds (67%) reported continually checking in mirrors and 76% by touch. Forty percent felt uncomfortable in social situations. High levels of emotional distress and psychological morbidity were detected; 30% had levels of depression above the clinical cut off point, while 75% reported clinical levels of anxiety; 29% reported both. Although overall quality of life was good, scores were low in social and relationship domains—reflecting the impact of unwanted facial hair. Conclusion Unwanted facial hair carries a high psychological burden for women and represents a significant intrusion into their daily lives. Psychological support is a neglected element of care for these women.

The effects of laser-mediated hair removal on immunohistochemical staining properties of hair follicles

The mechanisms involved in laser-mediated hair removal remain unclear. One means of reducing hair growth is alteration of follicular stem cells. We sought to examine the effects of laser hair removal on the immunohistochemical staining properties of human hair follicles, including the putative stem cells of the bulge region. Treatment of unwanted axillary hair was performed on one side using an 800 nm-wavelength diode laser and on the other side using a 1064 nm-wavelength neodymium:yttrium-aluminum-garnet laser. Serial skin samples were obtained at baseline and various times after treatment and stained using immunohistochemical techniques. Hair shafts were thermally altered, but the immunostaining properties of much of the follicle, including the bulge region, remained generally unchanged. This study only addressed the acute immunohistochemical changes found after a single treatment using specific laser parameters. Laser-mediated hair removal does not appear to work by frank destruction of follicular stem cells. Other mechanisms including functional alteration of these cells may underlie the clinical efficacy of the procedure.

A comparison study of the efficacy and side effects of different light sources in hair removal

Unwanted hairs are a common problem in which different light sources were developed as the treatment of choice. Alexandrite laser, diode laser, and intense pulsed light (IPL) were clinically used for this purpose with long-term scarce comparative results. The objective of the study was to compare the clinical efficacy, complications, and long-term hair reduction of alexandrite laser, diode laser, and IPL. Clinical trials on 232 persons using diode, alexandrite, laser and IPL were conducted. The number of sessions to reach optimal result varied between 3 and 7. Then the side effects were evaluated. Six months after the last session, optimal hair reduction was observed with no significant differences between the light sources, but a hair reduction was found to be higher using the diode laser. Side effects were observed with all light sources but more frequently with diode. Our findings indicate that all three light sources tested have similar effects on hair removal and in Iranian patients, using lower wavelengths minimizes the side effects.

Biology of the Hair Follicle: The Basics

The mammalian hair follicle represents a unique, highly regenerative neuroectodermal-mesodermal interaction system that contains numerous stem cells. It is the only organ in the mammalian organism that undergoes life-long cycles of rapid growth (anagen), regression (catagen), and resting periods (telogen). These transformations are controlled by changes in the local signaling milieu, based on changes in expression/activity of a constantly growing number of cytokines, hormones, neurotransmitters, and their cognate receptors as well as of transcription factors and enzymes that have become recognized as key mediators of hair follicle cycling. Transplantation experiments have shown that the driving force of cycling, the "hair cycle clock," is located in the hair follicle itself. However, the exact underlying molecular mechanisms that drive this oscillator system remain unclear. These controls of hair follicle cycling are of great clinical interest because hair loss or unwanted hair growth largely reflect undesired changes in hair follicle cycling. To develop therapeutic agents for the management of these hair cycle abnormalities, it is critical to decipher and pharmacologically target the key molecular controls that underlie the enigmatic "hair cycle clock."

The use of a constant spectrum, uniform temporal profile intense pulsed light source for long‐term hair removal in Asian skin

Phototherapy has become a treatment of choice in many areas of medicine. Light can deliver energy to tissue selectively, targeting specific structures in order to induce the desired therapeutic outcome. For the safe and effective removal of unwanted hair, the key optical parameters are wavelength, pulse duration and energy density, and can vary dependent upon skin and hair color. In recent years, the use of broad spectrum white light sources has proved to be safe and efficacious in the removal of hair with minimal short‐ or long‐term side effects. Whilst these highly flexible devices can achieve the desired results, there is scope for improvement. There are two key limitations to these devices: an inability to produce a ‘true’ long pulse matched to the thermal relaxation time of the hair structure and fluctuations in the output spectrum can lead to ineffective treatment with an increased risk of side effects. This paper describes an alternative approach to producing long pulse, constant spectrum optical pulses and presents clinical data showing improved efficacy in long‐term hair removal.

Clinical comparison of four hair removal lasers and light sources

Background and objective: There are few clinical studies directly comparing the efficacy of multiple hair removal systems in the same individual. This study evaluates the efficacy of four highly popular systems for laser hair removal. Methods: In this prospective comparison study, 10 subjects underwent treatment of unwanted hair on the back or thigh. Subjects were skin types I–III, aged 18–55 years. All were treated twice with (1) an intense pulsed light with a red filter; (2) an intense pulsed light with a yellow filter; (3) an 810 nm diode laser; and (4) a 755 nm alexandrite laser. Four treatment areas, using commonly accepted parameters for permanent hair reduction, as well as a control non‐treated area were selected. Each treatment area was evaluated with a camera system specifically designed for hair counts at 1, 3, and 6 months after the second treatment by a blinded non‐treating physician. Clinical results and adverse events were also noted. Results: Evaluation of photographs at 1, 3, and 6 months revealed a significant decrease in hair counts (∼50%) and hair coverage (∼55%). In the hairs that remained after two treatments, no statistical difference was noted in hair length or diameter. There was no statistical difference in efficacy between the four different light devices. Minimal transient adverse effects were noted from all systems. The cryogen spray‐based alexandrite laser showed the highest pain scores. Conclusion: Although hair removal with commonly used systems is, as expected, highly effective, treatment with light‐based devices can cause less pain, yet show efficacy similar to laser systems.

Epilation Today: Physiology of the Hair Follicle and Clinical Photo-Epilation

Despite the variations of length and type of hair (vellus or terminal), the growth of human hair in all body sites is cyclic. Phases of active hair growth, or anagen, are separated by periods of quiescence, or telogen. The duration of both phases varies greatly depending on the body site. Whether hairs are in anagen/telogen at the time of hair removal is important because only anagen hairs are particularly sensible to physical insults. Photo-epilation is a technique for long-term removal of unwanted hair by thermal destruction of the hair follicle and its reproductive system (stems cells). As melanin is the main chromophor existing in hair follicles the corresponding wavelength spectrum would range from ultraviolet up to infrared light. Furthermore longer wavelengths are preferred as the cromophor lies deep in the skin and the penetration of light is increasing with the wavelength. Thus, in the range of 600-1100 nm melanin absorption may be used for selective photothermolysis of hair follicles. Yet to be resolved questions for permanent destruction are the location of the key follicular target and the possible influence of the hair growth cycle on photothermolysis-induced hair removal. An overview on the individual physiology of the hair follicle is given to discuss the latest strategies for photo-epilation.

Band‐like opacity in the corneas of abattoir‐acquired pig eyes

In the course of an investigation into the distribution of immune cells in the porcine cornea, a band-like lesion on the cornea of two-thirds of the eyes acquired from the local abattoir was noted. Histological investigations revealed an area of corneal epithelium debridement with no obvious other pathological changes. Discussions with abattoir staff soon revealed the cause of the lesions to be the scalding process that all pig carcasses undergo immediately post-mortem that serves to remove unwanted hair and reduce skin-dwelling bacterial contamination. We concluded that the band-like opacity was the result of thermal injury to the anterior surface of the cornea between the open eyelids. It is hoped that this short communication will act as a cautionary note to other investigators who currently use or are considering using porcine eyes in research or as a model in surgical training and who may be unaware of the conventional handling procedures in pig abattoirs.

Prospective, Comparative Evaluation of Three Laser Systems Used Individually and in Combination for Axillary Hair Removal

Using the concept of selective photothermolysis, a variety of laser systems have been developed to remove unwanted hair. To evaluate the relative efficacy, tolerability, and subject satisfaction of three different laser systems used individually and in rotation for axillary hair removal. Twenty female patients (17 with dark-colored hair, 3 with red or light-colored hair) with Fitzpatrick phototype II skin received three treatments performed at 6- to 8-week intervals. Each axilla was divided in half to yield four distinct areas that were treated by the following lasers: (1) three sessions with a long-pulse 755 nm alexandrite laser, (2) three sessions with a long-pulse 810 nm diode laser, (3) three sessions with a long-pulse 1,064 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and (4) rotational treatment consisting of a single session by each of the three laser systems. Percent hair reduction and acute and long-term side effects were evaluated after treatment. Subjects completed questionnaires assessing tolerability and satisfaction. All subjects tolerated the treatments well, with only local, transient side effects seen. At the 3-month follow-up, the greatest average hair reduction was comparably similarly seen after the alexandrite laser at 59.3 +/- 9.7% and the 810 nm diode laser at 58.7 +/- 7.7%. The Nd:YAG laser and rotational regimens were less efficacious, with 31.9 +/- 11.1% and 39.8 +/- 10.1% hair reduction, respectively. Subjects with red or light-colored hair experienced 5 to 15% reduced efficacy with any laser system used. Subjects found the alexandrite and diode lasers to be equally tolerable, with only slight discomfort, and the Nd:YAG laser to be the least comfortable of the three systems. Overall, subject satisfaction of each treated site, in decreasing order, was (1) the 810 nm diode laser, (2) the alexandrite laser, (3) rotational therapy, and (4) the Nd:YAG laser. At the 3-month follow-up, the long-pulse alexandrite and 810 nm diode lasers demonstrated no statistically significant differences in efficacy, comparable efficacy and tolerability, and highest subject satisfaction. Rotational therapy with the three laser systems is not as effective as treatment with the alexandrite laser or diode laser alone but is statistically more effective than use of the long-pulse Nd:YAG system alone. Individuals with red or light-colored hair and Fitzpatrick phototype II skin have decreased efficacy of laser treatment than those with dark-colored hair and the same phototype.

Evidence‐based review of hair removal using lasers and light sources

Unwanted hair growth remains a therapeutic challenge and there is a considerable need for an effective and safe treatment modality. From an evidence-based view to summarize efficacy and adverse effects from hair removal with ruby, alexandrite, diode, and Nd:YAG lasers and intense pulsed light (IPL). Original publications of controlled clinical trials were identified in Medline and the Cochrane Library. A total of 9 randomized controlled (RCTs) and 21 controlled trials (CTs) were identified. The best available evidence was found for the alexandrite (three RCTs, eight CTs) and diode (three RCTs, four CTs) lasers, followed by the ruby (two RCTs, six CTs) and Nd:YAG (two RCTs, four CTs) lasers, whereas limited evidence was available for IPL sources (one RCT, one CT). Based on the present best available evidence we conclude that (i) epilation with lasers and light sources induces a partial short-term hair reduction up to 6 months postoperatively, (ii) efficacy is improved when repeated treatments are given, (iii) efficacy is superior to conventional treatments (shaving, wax epilation, electrolysis), (iv) evidence exists for a partial long-term hair removal efficacy beyond 6 months postoperatively after repetitive treatments with alexandrite and diode lasers and probably after treatment with ruby and Nd:YAG lasers, whereas evidence is lacking for long-term hair removal after IPL treatment, (v) today there is no evidence for a complete and persistent hair removal efficacy, (vi) the occurrence of postoperative side-effects is reported low for all the laser systems. The evidence from controlled clinical trials favours the use of lasers and light sources for removal of unwanted hair. We recommend that patients are pre-operatively informed of the expected treatment outcome.

Hirsutism

Hirsutism is defined as the excessive growth of terminal hair on the face and body of a female in a typical male pattern distribution. Untreated, it can be associated with considerable loss of self-esteem and psychological morbidity. Hyperandrogenaemia is the key trigger for excess hair growth, but the expression and severity are modified by genetic factors. Polycystic ovary syndrome, resulting in excess ovarian androgen production, is the most common cause of hirsutism. A raised serum testosterone level of greater than 5 nmol/l should prompt further investigations to exclude adrenal pathology or an underlying androgen-secreting tumour. The treatment of hirsutism is most effective using combination therapy, including androgen suppression, peripheral androgen blockade and mechanical/cosmetic amelioration and destruction of the unwanted hairs.

Long-Term Toxic Effects of Radiations: Sarcomatoid Carcinoma and Multiple Basal Cell Carcinoma of the Limbs in Chronic Radiodermatitis

A 73-year-old woman was referred to our attention for the presence of severe chronic lymphoedema and neoplastic lesions of the limbs. When she was 19 years old, the patient had undergone X-ray epilation of the limbs to remove unwanted body hair. The neoplastic lesions, observed 2 years before our observation, were excised, and histological examination revealed multiple basal cell carcinomas and a spindle squamous cell carcinoma on the left thigh. The case we observed offers some interesting points of consideration as it shows that in nonexposed areas cutaneous carcinomas can appear many years after irradiation and that the same treatment consequently requires careful follow-up for life. Another point of interest is the particular hystological aspect of neoplastic lesions in the site of radiodermatitis that requires in-depth immunohistochemical investigation for an exact diagnosis. Patients with previous treatment with ionizing radiation also in nonexposed areas need lifelong follow-up to identify cutaneous tumors at an early treatable stage.

Treatment of terminal and vellus non‐pigmented hairs with an optical/bipolar radiofrequency energy source—with and without pre‐treatment using topical aminolevulinic acid

Objective. The present study compares the 6‐month hair removal efficacy of a combined pulsed light bipolar radiofrequency device with and without pre‐treatment using topical aminolevulinic acid.Materials and methods. Fifteen adult females, skin phenotypes II–IV were entered into the study. Ten subjects were determined to have white terminal hairs; an additional five females presented with fine facial vellus hairs. Unwanted facial hair was treated twice at 4–6 week intervals with a combined optical bipolar radiofrequency source. At each treatment half of the treatment area was pre‐treated with topical aminolevulinic acid; the other half was not. Follow‐up visits were undertaken at 6 months after the second treatment. Hair counts were obtained before treatment and 6 months after the final treatment.Results. An average terminal white hair removal of 35% was observed at 6 months after treatment with the combined pulsed light bipolar radiofrequency device. When pre‐treatment with topical aminolevulinic acid was provided the average hair removal of terminal white hairs was found to be 48%. None of the five subjects with vellus hair were noted to respond to either treatment.Conclusions. Combined radiofrequency and optical light treatment leads to effective hair removal of terminal white hairs. This improvement is increased with pre‐treatment use of topical aminolevulinic acid. Vellus nonpigmented hairs did not respond to treatment

Hair removal with the long-pulse alexandrite laser

Background Although laser depilation has been performed for removal or reduction of unwanted and dark-colored hair in recent years, techniques including the appropriate approaches for different skin types and body areas have not yet been optimized. Objective We review the principles of laser hair removal and report a retrospective study of 322 patients who received long-pulse alexandrite laser hair removal for 3 or more sessions between January 2000 and December 2002. Methods Prior to treatment, patients were evaluated by a physician and informed of the mechanism, efficacy, and possible side effects of treatment. Patients were classified by skin type according to the Fitzpatrick classification. Those patients with systemic disease, a history of sun sensitivity, or who had used drugs known to cause photosensitivity were excluded from laser treatment. All treatments were performed with a long-pulse alexandrite laser with a constant spot size (18 mm) and 3-ms pulse width that applied energy of 755 nm. Sessions were repeated at different intervals depending on the body parts to be treated. Results The overall hair reduction rate for all patients, independent of skin type, was estimated as 80.8%. There were 2 cases of hypopigmentation and 8 cases of hyperpigmentation post-treatment. No other complications were reported. Conclusions Treatment with the long-pulse alexandrite laser can meet the expectations of patients who desire permanent hair removal. Careful examination of patients prior to therapy, as well as thorough patient education, are essential to patient compliance and success with this technique.

HAIRY CRICKETS DETECT SNEAKY PREDATORS

![Figure][1] We may spend inordinate amounts of time removing unwanted body hair, but hairy body parts are a matter of life or death if you're a cricket. Perched on the end of a cricket's abdomen is a small pair of hairy appendages called cerci. The cerci's mechanosensory hairs are sensitive