Journal of the American Academy of Dermatology

Volume 53, Issue 1, July 2005, Pages 85-88

Laser Surgery

Paradoxical hypertrichosis after laser

epilation
Author links open overlay panelAbdulmajeedAlajlanMDJerryShapiroMD, FRCPCJason
KRiversMD, FRCPCNinaMacDonaldBScNJudyWigginRNHarveyLuiMD, FRCPC
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https://doi.org/10.1016/j.jaad.2004.06.054Get rights and content

Objective

Hair removal using lasers or broadband intense pulsed light has

become one of the most ubiquitous medical procedures. At our center
a small proportion of patients have spontaneously reported what they
believed to be increased hair growth at sites of previous laser epilation.
We sought to retrospectively review the prevalence and features of this
paradoxical effect.

Methods
This was a single center, retrospective study that included all patients
who underwent laser hair removal during a 4-year period with a long-
pulsed alexandrite laser. All cases of laser-induced hypertrichosis were
assessed clinically by history, examination, and laboratory tests, and
confirmed by review of serial clinical photographs taken during the
course of the laser treatments. The clinical features of patients with
postlaser hypertrichosis were compared with 50 patients randomly
selected from among all those who had undergone laser hair removal
at our center (n = 489).

Results

Of 489 patients, 3 (0.6%, 95% confidence interval: 0.01-1.9%) treated

with the long-pulsed alexandrite laser (755 nm) reported increased hair
after laser hair epilation. There was a trend for this adverse effect to
occur in darker skin phototypes (IV) and with black hair as compared
with the unaffected comparison group (n = 50). However, the small
number of cases (n = 3) did not provide sufficient power to adequately
test factors such as age, sex, treatment settings, and number of
treatments statistically.

Conclusion

Postlaser hair removal hypertrichosis is a real but rare occurrence in

our experience.

Section snippets
Methods
This retrospective study included all patients who underwent laser hair
removal at a single center between June 1999 and June 2003. A long-
pulsed 755-nm alexandrite laser (Epitouch 5100, Lumenis Ltd [formerly
Sharplan Medical Systems], Santa Clara, CA) was used for all
patients. Most of the laser procedures were done primarily by trained
nurses under the direct supervision of dermatologists; the remainder of
the procedures were performed by board-certified dermatologists.
Patients were included

Case 1
A 39-year-old woman of Mediterranean descent with type IV skin and
black hair underwent laser hair removal to her face in June 1999. At an
initial laser setting of 7-mm spot size, 30-millisecond pulse duration,
and 23 J/cm2 fluence, there was a good immediate release of exposed
hairs, but this immediate hair release became progressively more
resistant with successive sessions. She reported a gradual increase in
facial hair despite ongoing laser sessions. This became evident on
clinical

Results
Of 489 patients, 3 reported postlaser epilation hypertrichosis during a
4-year period (0.6%, 95% confidence interval: 0.01-1.9%). In those
patients, the laser treatments were considered the most likely cause
for hypertrichosis, because hair growth occurred exclusively at treated
sites. All 3 of our patients had black hair and skin phototype IV. The
median age, race, skin type, hair color, and treatment settings for
these individuals and the comparison group are summarized in Table I.
As

Discussion
It was several years after the FDA approved laser hair removal devices
when posttreatment hypertrichosis, a rare paradoxical effect of this
type of treatment, arose. Moreno-Arias et al2 and Hirsch et
al3 independently reported a collection of cases where increased hair
growth developed after hair epilation procedures with intense pulse
light and 755-nm alexandrite laser, respectively. Likewise in our center,
we have noticed this rare event for which we have sought possible
precipitating

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