Page 215 - Chapter 3 - Laser/IPL Hair Removal

Chapter 3 – Fundamentals of Laser/IPL Hair Removal 2nd Edition
How do the hair removal lasers compare – a short review?
There are three main types of laser on the hair removal market these days – the diode, Alexandrite and Nd:YAG lasers. They are all ‘long-pulsed’ and all have been shown to be effective, to a point. But, how do they compare?
We carried out a short review of the scientific literature (see ‘References’) to see what clinical researchers across the planet thought.
Interestingly, it appears that the wavelength is not very important! As long as it is in the red/infrared part of the spectrum (between 600 and 1200nm) it doesn’t really matter which wavelength you choose.
Raff et.al. found that larger spot diameters and longer pulsewidths appeared to give better results with the Nd:YAG. Goh used this laser on darker volunteers (Fitz 4 to 6) and found that ‘slowed’ growth in 73% of cases compared with 64% with an IPL unit. He also found that post- inflammatory hyperpigmentation occurred following IPL treatments, but not with the YAG laser.
An excellent study by Tina Alster et.al. found that the Nd:YAG laser generated a 70-90% level of hair reduction with an Nd:YAG at 40 to 50J/cm2 over 3 treatment sessions, on twenty Fitz 4 to 6 females. These results were observed 12 months after the third session. They also found transient pigmentary changes on the skin which mostly resolved themselves.
Bouzari et.al. carried out a comparative study with Alexandrite, diode and Nd:YAG lasers, on 75 patients. They found that the Alexandrite and diode lasers appeared to perform better than the Nd:YAG, but we think that they didn’t use the most appropriate parameters for that laser.
Khoury et.al. also compared these lasers, individually and in combination mode. They found the best results with the Alexandrite on its own, followed by the combined Alexandrite/ YAG, the doped laser and then the Nd:YAG on its own. They state that there was no observable benefit of combining the Alexandrite with the Nd:YAG over the Alexandrite on its own. But, as with Bouzari above, this depends heavily on the chosen fluence and pulsewidths.
Seyyed et.al. also found that combining the Alexandrite with an Nd:YAG laser and firing them simultaneously was not beneficial, and, in fact, resulted in more adverse effects in the skin.
Lasers and IPLs are basically the same - they can all generate the same results, but only if used correctly.
There are two main differences:
The first is that each system will interact with the epidermal melanin to a different extent. Alexandrite lasers will likely induce more epidermal damage compared with the other systems, purely because of its higher absorption. So, these systems tend to be used only on the lighter skin tones, while Nd:YAG laser are 'best' for darker skins (but can be used on all skin tones).
________________________________________________________________________ 215 Chapter 3, Ed. 2.0 Laser/IPL Hair Removal
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