Overview of Clinical Studies On Laser Hair Removal By: Vickie L. Mickey, CT,CLHRP

Simulated Consumer Use of a Battery Hand-Held Portable Diode Laser for Hair Removal Conducted by Ronald Wheeland, MD University of Missouri – Columbia Study was designed to determine safety, efficacy and ease of use Study designed with a treatment group of 77 appropriate users and 44 inappropriate users

Results: 61% hair reduction after 3 weeks first treatment 70% hair reduction after second treatment 60% hair reduction 1 month after third treatment 41% hair reduction third treatment 31% hair reduction 9 months after third treatment

Conclusions Laser highly effective at hair removal Minimal side effects w/appropriate use Contract sponsor : Spectra Genics, Inc. Published July 23, 2007 Wiley Interscience

Hair Removal With 755 nm Lasers: Long Term Results 8.5 Years Study conducted by: Gabriel Buendia, Eva Ciscar, Katharina Usse-Wilfinger Method – Study 668 patients treated in 2 cities in Barcelona, Spain and Innsbruck, Austria

Method Cont: 1 – 2 body parts treated including axilla, bikini, legs, back 755 nm Alexandrite laser 16 – 25 J/cm2 7 – 15 mm spot size 10 – 40 ms pulse duration Epidermal cooling on all procedures

Results: 1009 sites treated 100% reduction in 899 sites 98 sites presented less hair reduction 12 patients did not respond 82% reduction in facial areas 17% unstable reduction 1% did not respond

Results cont. 93% reduction in bikini area 5% unstable 2% did not respond

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

Clinical Comparison of Four Hair Removal Lasers and Light Sources Shehal P. Amin & David J. Goldberg Skin Laser and Surgery Specialist of NY & NJ The Mount Sinai School of Medicine, New York, NY USA

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

Method: 10 subjects underwent unwanted hair removal on back & thighs Skin types I- III Ages 18 – 55 years Treated twice with: Intense pulsed light with red filter Intense pulsed light with yellow filter 810 nm diode 755nm alexandrite laser

Method Cont: 4 treatment areas Commonly accepted parameters for permanent hair reduction Non-treated areas/Marked treatment areas Hair count camera used @ 1, 3, & 6 months, after second treatment Clinical results & adverse events were noted

Methods Cont: All light sources/lasers were FDA approved

Results: Photographs revealed significant decrease in hair counts (-50%) and (-55%) hair coverage Remaining hair after two treatments presented no statistical difference in hair length or diameter No statistical difference in efficacy between the four different light devices

Results cont: Minimal transient effects were noted from all systems Cryogen spray-based alexandrite laser showed highest pain scores

Conclusion: Hair removal with the commonly used systems is as expected highly effective Treatment with light-based devices can cause less pain, yet show efficacy similar to laser systems

Patient Reported Pain Scores IPL I Palomar Mean pain score 3.4 IPL II Palomar Mean pain score 2.1 810 nm Lumenis diode laser- Mean pain score 2.3 755 nm Candela alexandrite laser-Mean pain score 4.1

Blond Hair Removal Using ELOS Systems Careen A. Schroeter, Sapna Sharma, Ngozi C. Mbonu, Thorsten Reineke & Herman A. M. Neumann Department of Lasertherapy, Medical Center Maastricht, The Netherlands, Department of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany, & Department of Dermatology and Verereology Erasmus Medical Center, Rotterdam, The Netherlands

Abstract/Objective: Study was conducted to test blond hair removal using the ELOS system, which is optical energy and radio-frequency combined Study Date December 2005: accepted January 26, 2006

Methods: 17 patients with blond hair were randomly selected from the Department of Lasertherapy, Medical Center Maastrichtm The Netherlands. Mean age was 57.4 years Mean energy used per patient was 23.2 j/cm2 with mean radio-frequency 18.6 j/cm2

Results: 57.4% hair reduction obtained with mean 8.5 treatments A trend was found between hair removal and the number of treatments No correlation between the percentage of hair removal and age and technical data of device No major side effects observed postoperatively

Introduction Hair removal options vary in efficacy, degree of discomfort, and cost Common methods are: plucking, shaving, mechanical and chemical dermabrasion Methods are less expensive yet temporary Long term methods are: needle epilation, surgical epilation, laser epilation and intense pulse light source

Introduction Cont.: Management of hirsutism remains challenging to dermatologists & cosmetic surgeons world wide Search for a method that will give enduring results with minimum side effects has been on going for years Hair growth cycles, stages of growth, color or hair, areas of hair growth are all factors in resolving this dilemma

Introduction cont.: Methods of hair removal all have their distinct set of advantages and disadvantages Increased demand for safe and effective hair removal IPL and laser technology promise rapid results and is effective Lasers can treat hundreds of hairs simultaneously in comparison to electrolysis Gorgu et al concluded that laser hair removal is more expensive than electrolysis but 60 times faster and less painful Fewer sessions are needed with laser vs. electrolysis with better results

Introduction cont.: Light skin with dark hair responds best to laser or light based hair removal Light colored hair is more difficult to treat with lasers or LPL Laser hair removal is based on photo-thermolysis and thermal relaxation time Initial studies indicated that all lasers caused a delay in growth of hair after a single treatment

Introduction cont.: The concept of photo-thermolysis with laser light was first described by Kuriloff in 1988 for pharyngo-oesophageal hair growth The argon laser was used for photo-epilation in the treatment of trachomatous trichiasis Nd:Yag laser for epilaton of hair bearing urethral grafts in 1992 & 1994 Dr. Jeffrey used the ruby laser for epilation of the hair follicle in 1989

Introduction cont.: Dr. Zaias proposed the concept of a pulsed laser for hair removal in 1991 Increasing numbers of published studies confirm the long-term efficacy of laser and flashlamp technology Laser and ILP still have limitations in regards to the hair removal with concerns to lighter hair

Introduction cont.: The side effects of the ILP and laser remain constant today in regards to pain and complications. The second generations of the IPL are more effective in hair removal however use by a skilled practitioners is necessary as to the difficulty in the use of the device A novel method to surmount the restrictions of light-based hair removal is the ELOS technology or Electro-Optical Synergy

ELOS – The Aurora DS Delivers a combination of radio-frequency and a pulse of red to infrared light to achieve the heating required for selective thermal energy Energy delivered to the skin from the RF is independent of skin color and there is no epidermal barrier to absorption as with optical energy This deliver prevents overheating of surrounding tissues. Skin is pre-cooled and the target is selectively pre-heated by application of a low-fluence optical pulse. The RF energy increases the difference in temperature between the epidermis and the target, this combination of RF and optical enables coagulation level with low risk

ELOS – Cont.: Few studies have been conducted regarding the ELOS Dr. Neil Sadick conducted a studies in 2004 using the ELOS system observed an average of 48% hair removal in 18 months Slightly higher results with blond hair (52%) vs. (44%) white hair

Discussion of Study This study found consistent results with Dr. Sadick’s studies RF has been used for over a century to treat the hair follicle, however the thermal effect is not conducted well in the hair shaft Electrical current created between the electrodes streams is concentrate in layer of 20 – 40 microns around the hair

Discussion Cont.: The bulge area is important as well as the hair follicle in regards to hair regrowth Studies have shown that hair can regenerate from totally follicle-free skin RF does not need a chromophore to effectively treat the hair follicle RF properties permit negligible reflection or scattering of energy Light energies require a chromophore in the skin and permits scattering of energies.

Discussion cont.: RF requires a conductive media (water) to RF enables a direct measure of the current and voltage on the electrodes delivered to the skin This study shows advances in technology for hair removal, however further research with greater numbers is advised

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