Unwanted Hair Research Articles

Laser therapy is a safe and effective treatment for unwanted hair in adults undergoing male to female sex reassignment.

Reduction in unwanted facial and body hair is an important goal in the process of sex reassignment. Laser treatment is a popular, well-established safe and effective method of reducing unwanted hair growth. In the UK a limited number of laser treatment and electrolysis sessions are publically funded for people undergoing sex reassignment. To date, published evidence on efficacy and adverse effects (AEs) has focused on treatment of women and men not undergoing sex reassignment. In the current study, data were collected prospectively from 2015 to 2020 at a UK regional laser centre. Patients were included if they were transgender women aged >16years old and seeking laser treatment for unwanted hair at any body site. The study demonstrated significant reductions in hair growth and significant patient satisfaction, with no AEs. Laser treatment is a safe and effective method of managing unwanted hair growth in the transgender transfeminine population.

A paradoxical phenomenon: Intense pulsed light‐induced hypertrichosis, a brief review

AbstractThe advancement of laser and light therapies have allowed patients of all races and ethnicities access to different methods for removing unwanted hairs that can cause emotional distress and impact one's quality of life. Despite their effectiveness, these technologies are not without their risks, such as the well‐known side effects of blister formation, erythema, crusting, and postinflammatory hypo‐ and hyperpigmentation. However, one adverse effect that seems to remain a clinical mystery is paradoxical hypertrichosis. Paradoxical hypertrichosis is the growth of fine, dark hair in treated areas or untreated areas close to the area treated on the face and neck, more frequently affecting those with darker skin (Fitzpatrick III‐VI) and darker hair color, and most associated with those having undergone the intense pulsed laser and long‐pulse alexandrite laser, although, this adverse reaction is likely common to all current and laser and light hair removal devices, despite the unknown prevalence and varying incidence rates. This phenomenon is not well understood, although explanations include the activation of dormant hair follicles by the intense pulse light flashlamp's suboptimal fluences and the synchronization of hair growth cycles caused by direct light stimulation.

Using the Hair Removal Laser in the Axillary Region and its Effect on Normal Microbial Flora.

Introduction: The axillary hair removal laser is one of the most often used procedures to treat unwanted hairs in that region. Employing this technology can be helpful in decreasing the bromhidrosis. Methods: In the present research, a clinical trial study over the effect of the hair removal laser on normal microbial flora at the axillary region is presented. The intervention group consisted of 30 women referred to the dermatologic clinic for the purpose of removing axillary hair by the alexandrite 755 nm laser and the control group consisted of 30 women referred to the same clinic for any other reasons. Both groups were evaluated for the type of bacterial strains on the first visit and after three and six months. Results: The results showed that the sense of sweat smell improved by about 63% after the last laser session. The frequency of all bacterial strains decreased in the intervention group except Staphylococcus epidermidis which was significant. In the control group, there was no significant decrement in any bacterial strains and even the prevalence of more strains including Staphylococcus aureus and S. epidermidis increased. Counting the mean bacterial colon showed a slight decrement of the bacterial count following the laser. Conclusion: The use of laser radiation, even with the aim of hair removal, can alter the microbial flora, and it can be accompanied by the improvement of the smell of sweat. The effect of the laser on different bacterial strains is quite different, which can depend on the amount of energy, the wavelength, the characteristics of the area under the laser, and also the structural properties of the membrane of the microorganism itself.

Routine circumcision? The role of prepuce in syndactyly repair

Circumcisions are among the most commonly performed procedures in the pediatric population, but the value of the preputial skin often goes unrecognized as a potential graft (Ehrlichman et al., 2018). We highlight three patients who underwent coordinated circumcision and use of the excised preputial skin as a graft for syndactyly repair. Syndactyly, a condition where fingers are fused together, is often repaired utilizing skin from the groin region, which can result in unwanted hair growth and subcutaneous fat growth. The utilization of the prepuce is a convenient alternative that may have fewer undesirable qualities.

Laser Treatment in Hirsutism: An Update.

Unwanted hair growth, which is a common aesthetic problem, has traditionally been treated using various techniques such as shaving, waxing, and epilation, but most of these provide only a temporary solution. Laser and light-based technology for hair removal has become one of the fastest growing procedures in modern cosmetic dermatology in the last decade. Clinical experience suggests that in the ideal subject with fair skin and dark hair, laser treatment can reduce hair growth significantly. This article reviews the various laser and light-based devices used for hair removal along with the various laser and patient parameters that affect the outcome of laser treatment for hair removal. Photoepilation, when properly used, offers clear advantages when compared with older, traditional techniques.

Efficacy and Safety of Long-Pulsed Nd-Yag Laser in Treatment of Hirsutism

Introduction: Hirsutism is a condition of unwanted malepattern hair growth in women. Perception of hirsutism is subjective and it is a common condition affecting 5-10% of unselected women.
 Objectives: To find out the efficacy and safety of long-pulsed Nd-YAG laser in the treatment of hirsutism.
 Materials and Methods: Fifty females of age between 18- 50 years with dark terminal facial hair and normal hormonal profile were treated with long-pulsed Nd-YAG laser (1064nm, 10mm spot size, pulse duration of 25-30 minutes and fluence of 25-40J/cm2). Six consecutive sessions of laser treatment were delivered to all the patients at 4 to 6 weeks’ interval. Photographic evaluations and percentage of hair reduction were done before each session and final assessment noted at the end ofninemonths.
 Results: All the patients completed the study. Good hair reduction (50-75%) was seen in 52% of patients after the first treatment session. After six consecutive treatment sessions at the end of nine-month excellent hair reduction (>75%) was noted in 86% of patients and good hair reduction (50-75%) seen in 12% patients. Side effects in our study were post-operative erythema in 40% and perifollicular oedema in 33.33%.
 Conclusion: The study supportslong-pulsed Nd-YAG laser with multiple six sessionsis safe and effective in the treatment of hirsutism.
 Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 169-172

Skin cancer detection and classification using machine learning

Skin cancer is considered as one of the most dangerous types of cancers and there is a drastic increase in the rate of deaths due to lack of knowledge on the symptoms and their prevention. Thus, early detection at premature stage is necessary so that one can prevent the spreading of cancer. Skin cancer is further divided into various types out of which the most hazardous ones are Melanoma, Basal cell carcinoma and Squamous cell carcinoma. This project is about detection and classification of various types of skin cancer using machine learning and image processing tools. In the pre-processing stage, dermoscopic images are considered as input. Dull razor method is used to remove all the unwanted hair particles on the skin lesion, then Gaussian filter is used for image smoothing. For noise filtering and to preserve the edges of the lesion, Median filter is used. Since color is an important feature in analyzing the type of cancer, color-based k-means clustering is performed in segmentation phase. The statistical and texture feature extraction is implemented using Asymmetry, Border, Color, Diameter, (ABCD) and Gray Level Co-occurrence Matrix (GLCM). The experimental analysis is conduted on ISIC 2019 Challenge dataset consisting of 8 different types of dermoscopic images. For classification purpose, Multi-class Support Vector Machine (MSVM) was implemented and the accuracy obtained is about 96.25.

The effects of 755 nm alexandrite laser on skin dryness and pruritus.

IntroductionThe alexandrite laser (AL) is a very safe and effective treatment used for unwanted hair removal with a reported success rate of 40% to 80% at 6 months and after several treatment sessions. Although a diffuse variety of side effects has been observed during laser treatment, changes in skin dryness and pruritus before and after AL epilation have not been reported yet to the best of our knowledge.AimTo investigate the effects of 755 nm alexandrite laser on skin dryness and pruritus at the beginning and in the third and the sixth month after the treatment.Material and methodsForty three patients with Fitzpatrick skin types of II–IV aged 18–45 with leg hair were included in this prospective study. Patients were treated with 755 nm alexandrite laser with 10–12 mm spot size. According to the skin phototype, the settings of the laser were as follows: 12–22 J/cm² and pulse width of 3 ms. For self-assessment by the patient, the visual analogue scale (VAS) was used before, at the third and sixth month of the treatment as to skin dryness and pruritus. The patients were evaluated by the same dermatologist with the same VAS. The values were compared between before-at the third month, before-at the sixth month and at the third and at the sixth month of the treatment.ResultsPruritus scores were statistically lower at the third month when compared with the baseline scores (p < 0.01). However, there was no difference between the third and sixth month of the treatment as to pruritus scores (p > 0.05). There was a statistically significant difference between the scores before the treatment and the scores at the third month and at the sixth month as to skin dryness (p < 0.001). However, the difference was not prominent between the third and sixth month scores of skin dryness (p > 0.05).ConclusionsTo the best of our knowledge, this is the first study researching the effects of AL on pruritus and skin dryness. Further studies with larger samples and longer follow-up periods will be able to better clarify the association.

Intraoperative Electrosurgical Depilation of a Skin Graft.

Full-thickness skin grafts harvested from hair-bearing areas may negatively impact cosmetic outcomes if the recipient site is hairless. Intraoperative depilation of unwanted hair follicles using an electrosurgical device can permanently remove hair with a single treatment and improve overall cosmesis.

Hypopigmented macules following quality-switched 1064 nm laser hair removal: A retrospective study

Introduction: Laser hair removal (LHR) is a common procedure in dermatology. LHR using quality-switched (QS) 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) is very popular in our community despite lack of sufficient evidence on its efficacy and safety. Purpose: We report the characteristics of nine patients who developed hypopigmented macules after being treated with QS 1064 nm laser for hair removal. Methods: This was a retrospective study at a laser center in Saudi Arabia conducted between June 2014 and September 2018. Patients who developed white macules following treatment with QS 1064 nm Nd:YAG laser for removal of unwanted hair were included in the study. Results: All patients were Saudi females with a mean age of 28.8 years (range: 25–37 years). Well-defined hypopigmented to depigmented 1–3 mm macules developed after being treated with QS 1064 nm Nd:YAG laser for hair removal. The most commonly affected area was the face. Majority of patients had skin phototype IV. Hypopigmented macules developed after an average of 22 laser sessions (range: 4–48 sessions). None of the patients had either personal or family history of vitiligo. Lesions seem to be difficult to treat, with only two patients responding to topical tacrolimus and excimer laser. Conclusion: Hypopigmented macules might develop after QS 1064 nm LHR. Those macules appear to be resistant to treatment. Further prospective controlled studies needed to elaborate more on the safety profile of this procedure.

Lasers for reduction of unwanted hair in skin of colour: a systematic review and meta-analysis.

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.

An osteopontin-derived peptide inhibits human hair growth at least in part by decreasing fibroblast growth factor-7 production in outer root sheath keratinocytes.

Given that unwanted hair growth (hirsutism, hypertrichosis) can cause major psychological distress, new pharmacological treatment strategies with safe and effective hair growth inhibitors that do not destroy the hair follicle (HF) and its stem cells need to be developed. To establish if osteopontin-derived fragments may modulate human hair growth given that human HFs express the multifunctional, immunomodulatory glycoprotein, osteopontin. Our hypothesis was tested exvivo and invivo by using a newly generated, toxicologically well-characterized, modified osteopontin-derived peptide (FOL-005), which binds to the HF. In organ-cultured human HFs and scalp skin, and in human scalp skin xenotransplants onto SCID mice, FOL-005 treatment (60 nmol L-1 to 3 μmol L-1 ) significantly promoted premature catagen development without reducing the number of keratin 15-positive HF stem cells or showing signs of drug toxicity. Genome-wide DNA microarray, quantitative reverse-transcriptase polymerase chain reaction and immunohistochemistry revealed decreased expression of the hair growth promoter, fibroblast growth factor-7 (FGF7) by FOL-005, while cotreatment of HFs with recombinant FGF7 partially abrogated FOL-005-induced catagen promotion. With caveats in mind, our study identifies this osteopontin-derived peptide as an effective, novel inhibitory principle for human hair growth exvivo and invivo, which deserves systematic clinical testing in hirsutism and hypertrichosis. What's already known about this topic? The treatment of unwanted hair growth (hypertrichosis, hirsutism) lacks pharmacological intervention, with only few and often unsatisfactory treatments available. Osteopontin is prominently expressed in human HFs and has been reported to be elevated during catagen in the murine hair cycle. What does this study add? We tested the effects on hair growth of a novel, osteopontin-derived fragment (FOL-005) exvivo and invivo. In human hair follicles, high-dose FOL-005 significantly reduces hair growth both exvivo and invivo. What is the translational message? High-dose FOL-005 may provide a new therapeutic opportunity as a treatment for unwanted hair growth.

Evaluation of subject response following treatment for pigmentation or wrinkles using a diode laser.

Pulsed diode array laser systems are utilized extensively for various aesthetic indications such as removal of unwanted hair, treatment of vascular and pigmented lesions, and wrinkle reduction. The purpose of this study was to report and assess the experience of using a diode laser system delivering pulsed infrared laser light at the near-infrared (NIR) spectrum at wavelengths of 805 and 1060nm. The study was a retrospective analysis of treatment outcomes in adult subjects treated at the clinic between January 2017 and April 2018 for wrinkles and pigmentation with a noninvasive aesthetic diode laser system. Subjects were treated at nominal wavelengths of 805nm for pigmentation and 1060nm for wrinkles reduction. Improvement in pigmentation and wrinkles, adverse events, and patient tolerability to treatment and satisfaction were evaluated. Of 44 subjects with Fitzpatrick skin types II-IV, eight were treated for pigmentation and 36 for wrinkles. For both treatments, subjects reported tolerable pain levels. All immediate responses resolved within 48hours post-treatment. Evaluation of treatment outcomes by two blinded evaluators demonstrated significant pigmentation clearance mean of 2.50±0.15, (P<.05) in subjects treated for pigmentation, as well as significant improvement mean of 0.46±0.12 (P=.005) in wrinkles in 13 subjects (41%) whose "before" and "after treatment" photographs were correctly identified by both blinded evaluators. Subjects were satisfied with the treatments. Use of the Diode laser effectively resulted in improvement in pigmentation and wrinkles, while maintaining a high safety profile with limited downtime.

Evaluation of Safety and Efficacy of Laser Hair Removal With the Long-Pulsed 755 nm Wavelength Laser: A Two-Center Study With 948 Patients.

Laser hair removal is the most common laser therapy and the third most commonly performed procedure with more than one million treatments in United States in 2016. This retrospective study was conducted to assess long-term efficacy and safety of the 755 nm laser for hair removal. Nearly, 3,606 laser treatments were performed with the long-pulsed 755 nm wavelength laser equipped with an epidermal cooling device between 1997 and 2005 and were followed till 2013. Standardized assessments were conducted by two treating physicians and patients at two follow-up intervals. At first follow-up, clearance was assessed by two physicians and clearance and satisfaction by patients. At the second follow-up, patients were assessed if hair clearance sustained compared with the first follow-up. Nine hundred and forty-eight patients with Fitzpatrick skin types I-IV were treated with a total of 3,606 laser treatments in this study. The mean age at the beginning of the study was 35 years (±11), 95.1% of patients were female (n = 902) and 4.9% male (n = 46). Five hundred and seventy-four patients received a minimum of three treatments and an average of 5.31 (3-16) treatments on axilla, back, bikini, breast, abdomen, face, lower extremity, or upper extremity region. First, follow-up was conducted 3.9 (±1.5) years after the final laser treatment. Seventy-four percent of these patients received 75-100% clearance as reported by the physician and 48% clearance as reported by the patient. Fifty-two percent of patients reported slower hair growth and 42% change in hair texture. Ninety percent of patients treated on axilla, 82% treated on the bikini area, and 79% treated on lower extremities experienced 75% or more clearance after three treatments. Facial, as well as breast and abdomen treatments, only showed a 66% and 62%, respectively, after three treatments. For these locations, five and more treatments were needed to achieve a quote of 79% (face) or 80% (breast and abdomen) for a 75-100% clearance. Upper extremity and back treatments did not have enough physician ratings to draw conclusions. Long-term adverse events were minimal and were all located on the face (one patient scar, four patients herpes infection). Second follow-up of 173 patients was conducted after 11.5 years (±2.0) and 87.9% of patients reported that their improvement sustained. The long-pulsed 755 nm alexandrite laser is a safe and efficacious treatment for the reduction of unwanted body hair with permanent results and high patient satisfaction. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Excess hair, hair removal methods, and barriers to care in gender minority patients: A survey study.

In gender minority patients, electrolysis and laser hair removal may be necessary to reduce facial and body hair in individuals seeking a more feminine appearance and/or modified gender expression. These procedures may also be required preoperatively for some gender-affirming surgeries. To identify (a) the frequency of unwanted facial and body hair, (b) the use of various hair removal methods, and (c) associated barriers to care in gender minority patients. An online-based patient survey was distributed via social media on Facebook® , YouTube® , and Instagram® in fall 2018. Respondents were at least 18years old and self-identified as a gender minority. In total, 991 responses were recorded with a completion rate of 77%. Considering excess hair, 84% of transwomen on feminizing hormone therapy (FHT: estrogen and anti-androgen therapy), 100% of transwomen not on FHT, and 100% of nonbinary individuals on FHT reported excess facial/body hair. Laser hair removal (18%) and electrolysis (17%) had similar rates of use in this cohort and were more commonly reported for nonsurgical gender-affirming purposes than preoperative preparation. Cost was the most frequently cited barrier to care. As the majority of transwomen and nonbinary people on feminizing hormone therapy had persistent excess facial/body hair, routine use of gender-affirming hormones is not sufficient to fully eliminate unwanted hair. There remains a critical need to advocate for more comprehensive insurance coverage for laser hair removal and electrolysis in gender minority patients.

A cut above the rest: Trimming as a painless depilatory

Shaving and other modes of epilation can cause undue anxiety, pain, or skin irritation in children. Here, we present hair trimming as a safe, painless, and cost-effective alternative for patients with unwanted hair which may be performed indefinitely or until the child is old enough to direct management. In select cases, removing unwanted hair using this technique may facilitate dermatologic surveillance.

Hair removal treatment using 1,064 nm long-pulsed Nd:YAG laser in auricular post reconstruction of microtia patient: two case reports

Microtia is a congenital anomaly of the external and middle ear with various degrees of severity. The hair growth on the reconstructed auricle causes aesthetic problems. We describe two cases about the successful epilation of unwanted hair in postauricular reconstruction of microtia patients using 1,064 nm long-pulsed neodymium: ytrium-alumunium-garnet (LP Nd:YAG) laser in Fitzpatrick skin type IV patients, using 6x6 mm tip, 35 J/cm2 fluence, 10 ms pulse, and 1 Hz frequency with burnt of hair as an endpoint. On the follow up day 11 of case one and day 7 of case two, the hair reductions on treated auricles were 46% and 58%, respectively, with no adverse effects. Minimal 6 repeated sessions are recommended for optimal result. In these case reports, LP Nd:YAG laser treatment is considered effective for the unwanted hair growth on the reconstructed auricle in dark skin type patients with minimal risk of adverse effect.

Clinical Evaluation of a Novel Blended Mode Diode Laser for Hair Removal

Introduction: Photoepilation by lasers is a popular procedure in aesthetic dermatology for removing unwanted body and facial hair. The use of the most appropriate laser wavelength is crucial as it affects treatment depth and melanin absorption. The three commonly used hair removal lasers are of specific wavelengths: 755 nm, 810 nm, and 1064 nm, each preferred certain types of skin and hair characteristics. The current evaluation reports the safety and efficacy of unique blended modes 755/810 nm and 810/1064 nm diode lasers for hair removal. Methods: Hair removal results from 50 patients treated with the 755/810 nm handpiece and 50 patients treated with the 810/1064 nm handpiece were gathered from a few clinics. 3 treatments on various body areas were conducted 6 weeks apart and patients were followed up with 6 months after the last treatment. Results were evaluated by baseline, follow-up photographs, and hair counts. Results: Treatment area photos demonstrated hair reduction in the treated body and facial areas. Average hair count reduction at 6 months follow-up was 84% for the 755/810 nm handpiece and 81% for the 810/1064 nm handpiece. No significant or unexpected adverse events were detected in any of the patients. Conclusions: The novel blended mode hair removal diode lasers are proven to be safe and effective for hair removal in facial and body areas for patients of various skin types and hair characteristics.

Endocrinology of Hirsutism: From Androgens to Androgen Excess Disorders.

Unwanted sexual hair growth has a considerable negative impact on a woman's self-esteem and quality of life. Excessive growth of terminal hair in women in a man-like pattern is defined as hirsutism and affects up to 1 in 7 women. Androgens secreted by the ovary and adrenal are the main regulator of physiological and pathological alterations of skin hair. Hirsutism is the result of the interaction between circulating serum androgens and hair follicles. Hirsutism is the most commonly used clinical diagnostic criterion of hyperandrogenism and majority of hirsutism cases are due to androgen excess. Over 80% of women with hirsutism will have polycystic ovary syndrome, about 10% will have idiopathic hirsutism, and the remaining will have rare disorders including non-classical congenital adrenal hyperplasia, hyperandrogenism with insulin resistance and acanthosis nigricans, and androgen-secreting neoplasms. Cushing's syndrome, acromegaly, thyroid dysfunction and hyperprolactinemia might be associated with hirsutism as well as the use of androgens, anabolic steroids and valproate. This paper provides an overview of the principal endocrinological aspects of hirsutism including the role of androgens in excessive hair growth and associated androgen excess disorders. Clinical evaluation and management of hirsutism are also discussed.

Effectiveness of short-pulse width Nd:YAG in laser hair reduction.

Laser hair reduction (LHR) is a safe and effective way of reducing unwanted hairs over body. Long-pulse Nd:YAG laser has over the years, been proven to be particularly safe and effective in darker skin types. While conventionally, long-pulse Nd:YAG laser has been used, recently short-pulse width Nd:YAG laser of 0.6-1.6ms which is 10-50 times less than the standard method (long-pulse) of Nd:YAG LHR, has become available. To study the effectiveness of short-pulse width Nd:YAG laser in LHR in Indian patients. This was a prospective observational study conducted over a period of 1year. Fifty female patients with fitzpatrick skin type 3-5 were included. Patients underwent four sessions of LHR, with an interval of 6weeks and then follow up was done for 6months after the last session. The mean age of patient was 29.92years ranging from 17 to 48years. After finishing four sessions of LHR procedure 58%, 34%, 6%, and 2% of the patients showed excellent, good, moderate, and poor improvement respectively. No complications were seen during the treatment and after follow-up. Statistical analysis by paired t test showed the results to be statistically significant. Hair reduction using unique short-pulse width Nd:YAG laser is easy to use, safe, and effective in Indian skin.