Excess or unwanted hair is a common problem affecting both genders. Over time, this problem has been dealt with in various ways, including plucking, threading, shaving, waxing, and electrolysis. Although effective for short-term control of hair growth, most of these methods are associated with significant pain and prolonged treatment times, making them fairly impractical for larger areas such as the human trunk.
First introduced in the mid-1990’s, laser hair removal has become an accepted treatment modality for patients seeking to reduce unwanted hair and has been found to improve quality of life for many patients. Lasers currently in use for hair removal include the normal-mode ruby, normal-mode alexandrite, diode, and neodymium: yttrium-aluminum-garnet (Nd:YAG) lasers, as well as intense pulsed light devices.
The majority of laser procedures aimed at hair removal in both genders are not performed for medically excessive hair growth, but rather for unwanted hair. Patient preferences may be influenced by social or personal perceptions of normal hair distribution and density. Thus, clear understanding of the patient’s specific expectations and of the actual capabilities of laser hair removal is a must for anyone undertaking such procedures.
Attempts to correlate effective hair removal with targeting various hair cycles have, in general, failed. Further research in this area is needed; in the meantime, most laser sessions for hair removal are currently carried out in 4- to 8-week intervals, with small, if any, regard as to the body site. There is, however, an apparent difference in response to laser treatment based on location. The upper lip, chin, scalp, and back are generally associated with the weakest response, whereas the remainder of the face, chest, back legs, and axillae typically demonstrate higher clearance rates.
Most published studies with any laser hair removal systems do not distinguish response rates between different anatomic areas. In one study non-facial skin, such as the trunk, did show somewhat better clearance rates compared to facial sites when treated with a long-pulsed Nd:YAG laser. Conversely, paradoxical increase in hair growth, a rare complication of laser hair removal, has also been reported on the trunk after alexandrite laser hair removal.
In general, the goals of laser hair removal must be realistic. It is rare to see 100% total clearance of all treated hairs in this area. In general patients need to understand that the purpose of treatment is to decrease the amount and thickness of hair in the treated sites. Younger treated patients must also understand that they will continue to grow “new” hairs for decades. Thus periodic re-treatments will be required.
(Updated June 3, 2010)
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