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Laser and photoepilation for unwanted hair growth

Background

Unwanted hair growth is a therapeutic challenge and considerable resources are spent to achieve a hair‐free appearance. Epilation with laser devices (alexandrite, diode, neodymium:YAG, and ruby lasers) and intense pulsed light are commonly used although the long‐term effect is uncertain.

Objectives

To assess the effects of epilation with lasers and light sources.

Search methods

We searched the Cochrane Skin Group's Specialised Register in February 2004; MEDLINE (from 1966) and EMBASE (from 1980) in April 2005. We searched reference lists of collected trials and contacted trial authors.

Selection criteria

Randomised controlled trials of laser or photoepilation.

Data collection and analysis

Primary outcomes were objective reduction in hair counts, adverse effects and subjective reduction in hairiness. Secondary outcomes were participants´ satisfaction and personal observations such as softer, finer, or paler hairs. Two authors independently extracted data and assessed trial quality.

Main results

We included eleven randomised controlled trials involving 444 people, none of which were of high methodological quality. A large number of trials were excluded, mainly because of their non‐randomised design. The randomisation procedures were either unclear or inadequate, using coin tossing, alternation, drawing lots or cards, or open tables of random numbers. The interventions and outcomes were too heterogeneous to be entered in a meta‐analysis. Most trials examined a short‐term effect up to six months after final treatment. There appeared to be a short‐term effect of approximately 50% hair reduction with alexandrite and diode lasers up to six months after treatment, whereas little evidence was obtained for an effect of intense pulsed light, neodymium:YAG or ruby lasers. Long‐term hair removal was not documented with any treatment. Pain, skin redness, swelling, burned hairs and pigmentary changes were infrequently reported adverse effects.

Authors' conclusions

Some treatments lead to temporary short‐term hair removal. High quality research is needed on the effect of laser and photoepilation.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Unwanted hair removal by laser systems and intense pulsed light sources

Unwanted hair growth is a challenge and considerable resources are spent to achieve a hair‐free appearance. Hair removal with laser devices (alexandrite, diode, neodymium:YAG, and ruby lasers) and intense pulsed light are widespread methods for hair removal although the long‐term effect is uncertain.

Eleven randomised controlled trials were included in the review, none of which were of high quality. A large number of trials were excluded, mainly because of their non‐randomised designs. There appeared to be a short‐term effect of approximately 50% hair reduction with alexandrite and diode lasers up to six months after treatment, whereas there was little evidence for an effect with intense pulsed light, neodymium:YAG or ruby lasers. Long‐term hair removal was not recorded for any treatment. Infrequently reported adverse effects were pain, skin redness, swelling, burned hairs and pigmentary changes.