Hair Reduction

Hair Reduction

The desire to look good is probably as old as the human being itself. It is this desire that drives the billion dollar cosmetic industry. Where on one hand there is an industry which promises to increase hair growth, parallel to it is another which pledges to remove the unwanted hair. Removal of unwanted hair probably first started with the use of a sharp stone and since then as ideas emerged and technology advanced, we have come a long way from the stone aged razors to the modern day lasers.

Shaving was first started by men for their face, to look clean and groomed. It is said that Alexander the Great had ordered his men to shave their beards so that the enemy is not able to grab them by their long hairs or beard in a hand to hand combat. Since then there have been various ways used for hair removal from sharp clams by Native Americans, sugaring by Egyptians, pumice stones by Greeks, threading by Arabians and many depilatories like starch, arsenic, quicklime, and so on. MECHANISM
OF ACTION

Principle for hair reduction

The word LASER is an acronym for “Light Amplified by Stimulated Emission of Radiation.”  for hair reduction.

Selective Photothermolysis – The laser for skin treatment works on the ­concept of “selective photothermolysis” (photo: light, thermo: heat, lysis: destruction). The term selective photothermolysis describes site-specific, thermally mediated injury of microscopic tissue targets by selectively absorbed pulses of radiation,3 where the target and the chromophore occupy the same area, the natural or artificial chromophore is heated by absorption of monochromatic or broadband electromagnetic radiation. For example, heating of a chromophore may result in destruction of tattoo.

The aim of selective photothermolysis is to cause permanent thermal damage to the target tissue with no or minimal damage to the surrounding

 INDICATIONS

 1. Hirsutism and hypertrichosis: Unwanted facial hair in women in androgen or non androgen dependent areas may ­warrant treatment in areas like upper lip, chest, and chin.

2. Cosmetic: Many individuals have hair distribution which would be considered ­normal, however, they may be considered for hair removal for cosmetic or social indications.

3. Therapeutic: for treatment of pseudofolliculitis barbae, pilonidal sinus, acne keloidalis nuchae.

4. Grafted hair bearing flaps used for reconstruction may require hair removal for cosmetic or medical purpose.

CONTRAINDICATIONS 

1. Age less than 15 years.

2. Patients with history of hypertrophic and keloidal scarring. This is a relative contraindication and patients may be treated carefully with lesser fluence.

3. Infections. Herpes simplex and staphylococcal infection in the local site. Patients with a history of herpes simplex may be given prophylactic therapy prior to the procedure.

4. Drugs: patients on aspirin or other anticoagulant therapy. They may be treated cautiously by stopping the therapy 10 days prior to the procedure.

5. Patients with too high expectations and unwilling to cooperate.

6. Superficial wounds in the procedure area.

7. Patients with psoriasis and vitiligo for

 Adverse Effects

Local side effects may be seen postprocedure which includes

1. Burning

2. Scarring

3. Pigmentary changes

4. Post treatment erythema

5. Pain

6. Purpura

7. Ocular complications due to accidental injury and

8. Paradoxical hypertrichosis increase in hair growth has been noted at sites previously treated with laser. It has been reported that this effect is more in skin types III and higher and more common with Intense Pulse Light laser (IPL).

Many of these complications can be prevented with adjustment of parameters like fluence, spot size, wavelength, and use of appropriate ­cooling methods. Burning, pigmentary changes, ­erythema, and edema can be treated with topical steroids.