Diode Laser Hair Removal and Isotretinoin Therapy

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2017

Currently, the isotretinoin (13-cis-retinoic acid) package insert contains language advising the discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. It is common practice to follow this standard because of concerns regarding reports of sporadic adverse events and increased risk of scarring. To develop expert consensus regarding the safety of skin procedures, including resurfacing, energy device treatments, and incisional and excisional procedures, in the setting of concurrent or recent isotretinoin use. The American Society for Dermatologic Surgery authorized a task force of content experts to review the evidence and provide guidance. First, data were extracted from the literature. This was followed by a clinical question review, a consensus Delphi process, and validation of the results by peer review. The task force concluded that there ...

Dermatologic Surgery, 2006

W e are sharing our experience of using a Long Pulse Flash Lamp device to remove unwanted hair in patients undergoing isotretinoin therapy for severe acne.

Current Pediatric Research, 2021

This study was aimed to evaluate the successful of skin laser therapy on some dermatological cases. A study was carried out on 327 patient suffering from different dermatological cases included the following cases; Port-wine stains 42 case, Hemangiomas 57 case, Wrinkles 61 case, Warts 82 case and Scars 85 case. All those patients were expected to Laser therapy applied on effected skin. The result showed 95.1% as a total healing percent among 327 different skin lesions. There were no significant differences in the healing percentages among the five cases. From this study we can conclude that, Laser therapy can give highly successful therapy against different diseases of skin. The skin is the body's largest organ, acting as a protective shield from the external environment. Many skin infections are not life-threatening, resources and energy go towards diseases that have greater impacts on human health [1]. An additional, albeit understudied concern, however, is the psychosocial and occupational effects of skin disease. The overall lifetime incidence of skin disorder was found to be 15 out of the 50 nations in Europe, with eczema (7.9 percent) and psoriasis (5.2 percent) topping the list of conditions, with vitiligo finishing behind them (1.9 percent).

IP innovative publication pvt. ltd, 2019

Introduction: Isotretinoin is an approved drug from the United States (US) Food and Drug Administration (FDA) for the treatment of severe recalcitrant nodular acne. Based on reports of poor wound healing and scarring, many practitioners believe that the majority of cutaneous laser treatments should be delayed at least six to 12 months after a patient discontinues isotretinoin treatment. The purpose of this study was to investigate the safety and the efficacy of fractional carbon dioxide laser combined with the low (6mg/day), medium (18mg/day) or high dose (30mg/day) of isotretinoin for the treatment of acne and acne scars and, investigation of the factor associated with the synchronous use of isotretinoin and fractional CO2 laser. Settings and Design: The study was retrospective, non- randomized, single-centre, open case series performed in our private clinic. A retrospective chart review was conducted for all patients registered at our private clinic for assessment of acne from April 2016 through March 2018. Materials and Methods: In this study, 80 patients with acne scarring were treated with 10,600nm fractional CO2 laser. Out of eighty, 60 patients in three experimental groups received different dose of isotretinoin (n=20, low dose: 6mg/day; n=20, medium dose: 18mg/day; n=20, high-dose: 30mg/day) prior to the initial fractional CO2 laser treatment. 20 patients with acne scarring who was treated only with the fractional CO2 laser served as control. Acne scars improvement, healing period and presence of keloids formation was taken in account as outcome measured after 6 months follow-up. Statistical analysis: Comparisons of differences in the demographic profile, efficacy and healing period among four groups was done by Kruskal–Wallis test. Multiple comparisons were performed using Kruskal-Wallis test followed by the p-value was adjusted using the Holm-Bonferroni sequential correction “P” to identify independent factors associated with synchronous use. Results: In the fractional CO2 laser with medium-dose isotretinoin group, all patients demonstrated normal wound healing also satisfactory acne scar improvement. Moreover, no hypertrophic scars or keloids were observed in patients from this group. Grade of acne, doses of isotretinoin, No of the treatment session, % of MTZ applied during the session, level of MTZ and passes per session were an independent factor that significantly correlated synchronous use of with isotretinoin and fractional CO2 laser. Conclusion: Based on findings the author concluded that synchronous use of a medium dose of isotretinoin and the fractional CO2 laser was an excellent choice for the future treatment regime.

Albanian Journal of Trauma and Emergency Surgery

Over the past three decades, the indications for the use of lasers have increased dramatically. Combined with the interest paid by the media, the volume of laser procedures has progressively increased, as has the number of complications arising from their use. Knowing the principles behind laser surgery can help minimize the potential for complications; however, as with all surgical procedures, in addition to excellent surgical results, undesirable results are inevitable. Laser technologies have evolved effectively these past decades with a broader spectrum of clinical applications accompanied by improved outcomes. Cutaneous lasers and lights are considered safe interventions with an associated rapid healing time. Post-treatment consequences are usually mild and spontaneously resolving, with erythema and edema lasting hours to days. More troublesome while less common adverse events include urticaria, erosions, blistering, infection, hyperpigmentation, hypopigmentation, burns and del...

Lasers in Surgery and Medicine

Background and Objectives: 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. Study Design/Materials and Methods: 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. Results: 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. Conclusions: 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.

International Archives of BioMedical and Clinical Research

Background: Acne is a common disease. Variety of treatment methods are available. Oral isotretinoin is an effective treatment but has some precautions. Methods: In this study, the attitude of dermatologists in western area of Saudi Arabia toward isotretinoin and their practice are being studied through online questionnaire survey. Results: More than half of responding dermatologists used the dose of 0.5mg per kg per day. Variable dosing, length of therapy, and laboratory investigations were reported. All responding dermatologists did laboratory investigations before commencing therapy and most did it as well after one month. Most of responding dermatologists thought it was safe to perform laser hair removal during or shortly (1-2 months) post isotretinoin therapy, but laser resurfacing was not thought to be safe to do while on therapy. The most common side effects encountered with oral isotretinoin were skin and lip dryness and chelitis. All dermatologists counselled females for teratogenicity and pregnancy prevention. There were variable responses to depression, blood donation abstinence and irritable bowel syndrome. Conclusions: In conclusion, isotretinoin is an effective therapy for acne. There is a controversy among physicians on the dose, length of therapy and laboratory follow up. Controversies for depression, irritable bowel syndrome still exist.

Dermatologic Surgery, 2010

BACKGROUND Laser hair removal is a safe and effective procedure for the treatment of unwanted body hair but is not exempt from side effects. A rare but significant adverse effect with this treatment modality is paradoxical hypertrichosis.

American Journal of Clinical Dermatology

Advances in laser technology have been so marked over the past two decades that successful eradication of many cutaneous pathologies and congenital defects, including vascular and pigmented lesions, tattoos, scars, and unwanted hair, can now be fully realized. Because of the relative ease with which many of these lesions can be removed, coupled with a low incidence of adverse postoperative sequelae, demand for laser surgery has increased substantially. In this review, the currently available laser systems with cutaneous application are outlined, with special reference to recent advancements and modifications in laser technology that have greatly expanded the laser surgeon's armamentarium and improved upon overall treatment efficacy.

Dermatologic Surgery, 2001

Background. Hypertrichosis is a common problem for which laser hair removal is becoming the treatment of choice. Optimal wavelength, pulse duration, spot size, fluence, and skin cooling parameters for various skin types have not yet been firmly established.Objective. To evaluate the long-term efficacy and safety of a 3-msec 755 nm alexandrite laser equipped with a cryogen cooling device for patients with Fitzpatrick skin types I–V.Methods. Eighty-nine untanned patients with skin types I–V underwent a total of 492 treatments of laser hair removal over a 15-month period. Each patient in the study underwent a minimum of three treatment sessions spaced 4–6 weeks apart (mean treatments 5.6). Retrospective chart review and patient interviews were used to establish hair reduction results. Treatment sites included the axillae, bikini, extremities, face, and trunk. A 3-msec pulse width, 755 nm alexandrite laser equipped with a cryogen spray cooling device was used in this study. Spot sizes of 10–15 mm were used. A spot size of 10 mm was used for fluences greater than 40 J/cm2, a spot size of 12 mm was used for fluences of 35–40 J/cm2, and spot sizes of 12 and 15 mm were used for fluences less than 30 J/cm2. Fluences ranging from 20 to 50 J/cm2 (mean fluence 36 J/cm2) were used.Results. The patients had a mean 74% hair reduction. Skin type I patients had an average of 78.5% hair reduction using a mean fluence of 40 J/cm2 (35–50 J/cm2) and a 10–12 mm spot size (12 mm in more than 95% of treatments). Skin type II patients had a mean 74.3% hair reduction using a mean fluence of 38 J/cm2 (30–40 J/cm2) and a 12–15 mm spot size. Skin type III patients had a mean 73.4% hair reduction using a mean fluence of 37 J/cm2 (25–40 J/cm2) and a 12–15 mm spot size. Skin type IV patients had a mean 71.0% hair reduction using a mean fluence of 31 J/cm2 (25–35 J/cm2) and a 12–15 mm spot size. A patient with skin type V had a 60% hair reduction using a mean fluence of 23 J/cm2 (20–25 J/cm2) and a 12–15 mm spot size. The efficiency of hair removal directly correlates significantly with the fluence used. Rare side effects included transient postinflammatory hyperpigmentation (n = 9; 10%), burn with blisters (n = 1; 1%), and postinflammatory hypopigmentation (n = 2; 2%). All complications resolved without permanent scarring.Conclusion. The 3-msec cryogen cooling-equipped alexandrite laser can safely and effectively achieve long-term hair removal in patients with skin types I–V. The best results are achieved in untanned patients with skin types I–IV.