LASER HAIR

REDUCTION
OVERVIEW OF LHR PATIENTS
INTRODUCTION

 Permanent hair reduction is defined as the long-term,

stable reduction in the number of hairs re-growing after a
treatment regime, which may include several sessions.
 The number of hairs regrowing – stabilize over time ,
greater than the duration of the complete growth cycle of
hair follicles( four to twelve months according to body
location)
 Does not necessarily imply the elimination of all hairs in
the treatment area.
 Regrowing hair are thinner and lighter in colour with
miniaturization of hair follicles.
 CONSIDERATIONS FOR LHR
 Chromophore: melanin ( present in the hair bulb, shaft,
bulge area, hair follicular epithelium.)
 Absorption by epidermal melanin – increased chances of
adverse effects in darker skin types.
 Ideal candidate for LHR is light skinned individual with
dark hair.
 Melanization of hair follicles occurs in anagen- hairs in
anagen are susceptible to damage.
 Hair in early anagen phase are closer to the skin surface-
s/c fat is better thermal insulator so that thermal damage
remains confined to the hair follicle.
TARGETING THE BULGE
LONG PULSE ND:YAG LASER
1064
LASER PARAMETERS
Parameter Definition Units
Fluence / Actual amount of energy applied to Joules/sq cm
energy density unit area of target tissue.
Power Time rate at which energy is Joules/sec
emitted by laser
Irradiance / Power applied per unit area Watts /sq cm
power density (concentration of beam of light )
Pulse duration Amount of time laser energy is ns, ms
applied
Pulse width Repetition rate of pulse hertz
LASER PARAMETERS
MECHANISM OF ACTION
 Photo thermal destruction:-
• Selective target – hair melanin or exogenous
substance
• Melanin present in hair bulb ,shaft & ORS of anagen
hair
• In addition , nonpigmented bulge area containing
stem cells is also targeted.
• Outcome depends on fiztpatricks skin type, fluence,
wavelength, spot size & cooling
 Photochemical destruction:-
• Can be used for non pigmented hairs.
• Uses photosensitizer (ALA) to product targeted
reaction & therapeutic effect.
INDICATIONS
 Cosmetic disfigurement:- excess of facial or
body hairs.
 Hirsuitism :- terminal hairs in women in
androgen dependent area
 Hypertrichosis :- -congenital
- drug induced-CA, phenytoin
 Hair removal from grafted donor site.
 Removal of hairs for medical treatment
purpose ;eg-pilonidal sinus, pseudofolliculitis
barbae
CONTRAINDICATIONS
 Superficial cut- injury.
 Active infections like herpes labialis
 Keloidal tendency
 Unrealistic expectations
 Associated photoaggrevated diseases like SLE,
 Unstable psoriasis and vitiligo
REQUIREMENT
 PRE OPERATIVE WORK-UP
 Detailed history – herpes labialis, medications,
hypertrophic scars/ keloids
 Proper patient counseling.
 Investigations - LH, FSH, DHEAS, Free testosterone,
prolactin, abdominal USG, TFTs
 No plucking/ waxing/ electrolysis( shaving and depilatory
creams allowed).
 4-6 wks prior to the treatment session- sunscreen
application ; in pts. with dark skin- hydroquinone.
 Informed consent and photographs.(pre & post)
 Performing a test patch.(not necessary)
 Shaving prior to treatment session.
PROCEDURE
Clean the area (Anesthesia if pt. too apprehensive.)

Protective devices – eye shields, goggles. precooling of area.

Setting laser parameters- individualized.

Hand piece held perpendicular to the skin surface.

Laser pulses placed adjacent to each other with minimal overlap(10%).

Normal immediate response: Vaporization of hair shaft with

perifollicular edema and erythema.

Check for signs of epidermal damage

 POST PROCEDURE
 Ice packs – reduce post operative pain/ swelling.
 Antibiotic – steroid combination ointment only
for 3 to 5 days
 Strict sun protection.

SCHEDULE: Repeat treatment after

approximately 4-6 wks – above neck regions and
10-12 wks- below neck regions. 5-6 sessions
required to achieve satisfactory results.
13 yrs old male patient , with b/l anotia of left ear and micrortia of
right ear , undergoing reconstructive surgery (details not available )
with scalp flap- postauricular .
Posted for LHR of grafted skin.
 4th /10mm/50J/15 msec
2 /10mm/50J/15 msec
nd

7th /10mm/50J/15 msec

18 yrs old female with regular menses , with excessive
hairs on chin and upper lips ,
Hormonal Profile & USG – WNL, thyroid profile not done
Not on any active medication at present

Completed 7 sittings with moderate response (grade 3)

3rd/6mm/60 J/45 msec 7th/ 6mm/ J/60 msec

4th /6mm/60 J/60 msec

k/c/o PCOS with derra nged
hormonal profile but normal
USG, on tab metformin 500
mg bd , no other treatment
taken
Pt posted for LHR,
completed 7 sittings with no
response.
5th
/10mm/50 J/ 15 msec

2nd/10mm/50 J/ 15 msec
17 yrs old unmarried female with
menstrual irregularities came for LHR
with excess of hairs on chin n upper
lips
Hormonal profile (2/9/13) s/o
hyperprolactinemia , rest lab – wnl
Not on any active treatment at
present completed 11 settings of LHR
with little response.
 5th sitting/ 6mm/60 J/45 msec

9th/70/6mm/15
THANK YOU