Question:
Has anyone tried laser hair removal?
I'd like to know if anyone has tried the laser system
too,
Answer:
I have been conducting an extensive investigation into laser hair
removal (LHR), and found that it does not work very well at all,
considering the very high treatment prices.
Treatments typically are sold in packages of 2 to 6, over a period
of one year. The total cost may be as much or more than a full
course of electrolysis treatments; however, laser results are very
temporary, while competently performed electrolysis results are
permanent. Laser results may last a little longer than waxing, but
cost 10 to 20 times more, over a period of say one year.
Also, certain high power ruby lasers have been shown to cause
darkened pigmentation that lasts for three months in one quarter
of patients.
Here are some additional details and supporting evidence:
The U.S. FDA does not permit any of the six lasers, and one pulsed-
light system that it has cleared to market to claim anything more
than temporary results.
The first laser FDA cleared for hair removal was Thermolase's
SoftLight. This is a low-power ND:YAG laser, used in combination with
a black carbon activating lotion.
SoftLight was cleared to market by the FDA in Apr'95, but it is not
allowed to claim "painless" treatments nor "permanent" or even "long
term" results. The following article in the Sep'96 FDA Consumer
magazine clearly states that Softlight may claim only a "hair
reduction for up to three months after treatment":
http://www.fda.gov/fdac/features/796_hair.html
Even Thermolase's SoftLight brochure states that they do not intend
to kill hair follicles! Permanent hair removal can ONLY be achieved
through killing hair follicles.
Since March 1997, the FDA has cleared four Long Pulse Ruby Lasers
(LPRL's): Palomar Medical Technologies' EpiLaser; Laser Industries'
(aka Sharplan) EpiTouch; MEHL/Biophile's Chromos 694; and Polytec
PI's LaseAway. FDA does not allow any of them to make claims greater
than that of the SoftLight, despite the fact that some of them can
emit up to 30 times more energy per square centimeter.
Hard data is difficult to find due to the secrecy of the
manufacturers, but some information has begun to come out in recent
months, and all of it that I have seen indicates very rapid regrowth
in the vast majority of subjects.
The best known of the LPRLs is Palomar Medical Technologies'
Epilaser. A scientific paper on the early clinical experiments that
led to the Epilaser, "Damage to Hair Follicles by Normal-Mode Ruby
Laser Pulses", was published in Dec'96 in the Journal of The American
Academy of Dermatology, Volume 35, No.6, pp.889-94.
The experiment involved 13 subjects, each of whom received laser
pulses on six test sites, each one inch square. A graph in the paper
clearly shows that regrowth averaged 58 percent after 3 months, and
75 percent after 6 months. The authors also state that by 6 months, 5
of the 13 had 100 percent regrowth.
Also, tissue examinations revealed damage to the lining of hair
follicles, but NOT the dermal papilla. The papilla is located at
the base of the follicle and must be destroyed in order to prevent
hair regrowth.
More recently, I have obtained a copy of a March 1997 patient letter
issued by the Massachusetts General Hospital (MGH), under the
signature of 8 doctors, including Dr. R. Rox Anderson. This letter is
significant because Dr. Anderson developed the underlying technology
of the Epilaser, which MGH licensed to Palomar in 1995, in return for
an R&D contract and 5.5 percent of net Epilaser-related revenue.
The letter has this to say about the effectiveness of Epilaser
treatments performed on about 100 test subjects, having multiple
areas treated:
"After 1000 treatment sessions with volunteers our research indicates
that approximately twenty percent (20% of the subjects will have
permanent hair removal after a single treatment. All other volunteers
have shown hair removal that lasts 2-3 months. For most patients,
therefore, multiple treatments may be required at 2-3 months
intervals or as soon as the stubs of hairs reappear. So far, we can
not predict who will respond with permanent or temporary hair loss
after laser therapy. You may want to consider doing a test site to
determine your individual response if you desire to have permanent
hair removal before embarking in full treatments."
So there appears to be an 80 percent probability that the hair will
regrow after 2 to 3 months. I even doubt the claim that 20 percent
received permanent hair removal - I suspect the experimenters have
simply described any missing hair after a brief period of
observation, probably less than one year, as apparently permanent
hair loss.
The MGH patient letter also warns about a temporary side-effect
involving skin darkening:
"Increased pigmentation at the treated site is evanescent [rapidly
fading] but can last for approximately three months in about 25% of
the patients; in all subjects, so far, all pigmentary changes have
been reversible."
Some clinics have either claimed or expressed the hope that several
treatments over the course of about one year, would effect
substantially permanent hair removal, but I have never seen any
scientific supporting evidence. The FDA's prohibition of claims of
permanence covers all treatment regimens.
On 8 July 97, ESC Medical Systems announced that it had received FDA
clearance to market its Epilight pulsed-light system for hair
removal. I have discussed this device with Mr. Richard Felten, of
FDA, and he confirms that like the five previously cleared lasers,
ESC provided no proof of permanent or long-term hair removal, so
cannot make such claims.
On 8 August, Cynosure received FDA clearance for its Alexandrite
laser hair removal system, but its wavelength is not significantly
different than a ruby laser's, so there is little reason to expect
better results.
Finally, consumers should beware of false and misleading claims by
clinics offering laser hair removal. It seems that is the only way
they can sell such poor results at the very high prices they charge.
Posing as a consumer, I have telephoned nearly a dozen clinics,
some more than once, and I believe that all provided misleading
information, in some cases outright lies. Most clinics are owned
and operated by physicians, so consumers may be more likely to
believe them. The fact is that medicine has its share of unethical
practitioners, like all other professions.
I have communicated with a handful of persons who have had laser hair
removal, none of whom had permanent results.
Recently, I spoke with one consumer who spent $2000 on laser hair
removal on her legs. Nearly five months after treatment, her skin was
still discoloured, which was slowly fading, and her hair was
regrowing. She feared exposing her legs to the sun, because that may
tend to slow the fading of the discolouration; also, she indicated
that it is not a visually pleasing effect. She claims that the doctor
told her of a clinical trial in which patients went several years
without experiencing regrowth, but when she asked for a copy of the
scientific paper, she was told that it was too technical for her to
understand. Had she been given the paper, she would have learned that
none of the subjects received permanent hair removal, and that
regrowth was very rapid.
