Lasers, IPL Safe for Hair Removal in Pigmented Skin Types

Treatments using in‐office laser devices and intense pulsed light (IPL) for hair removal in patients with pigmented skin have comparable hair reduction rates and number of adverse events, according to results published in the Journal of the European Academy of Dermatology and Venereology.

Researchers conducted a systematic review of literature focusing on the use of IPL and three types of lasers believed to be safer options for hair removal in patients with Fitzpatrick skin types III‐VI: long‐pulsed neodymium: yttrium-aluminum-garnet (Nd: YAG), pulsed diode, and alexandrite. They performed the meta‐analysis using Review Manager and included 12 eligible comparative trials.

When comparing the lasers and IPL, the alexandrite laser showed the most efficacy in terms of hair count reduction (standard mean deviation −1.7; 95% CI, −2.6 to −0.78; P <.001) whereas the long‐pulsed Nd:YAG laser was statistically heterogeneous (P <.001; I2 =91%), and the diode laser was not favored (standard mean deviation −0.11; 95% CI, −0.62 to 0.39; P =.66). Regarding the visual analog scale, both the long‐pulsed Nd:YAG and diode lasers led to statistically significantly higher scores than IPL (P <.001 for both), and there was no significant difference between IPL and alexandrite laser (P =.55). In terms of safety, the long‐pulsed Nd:YAG laser had more favorable effect in the incidence of postinflammatory hyperpigmentation (odds ratio [OR], 0.26; 95% CI, 0.1-0.78; P =.03), whereas IPL was more favorable than both the long‐pulsed Nd:YAG and diode lasers when discussing incidence of erythema (OR, 1.61; 95% CI, 0.31-8.42; P =.57 and OR, 0.28; 95% CI, 0.04-2.11; P =.22, respectively). Finally, there were no significant differences in satisfaction scores between IPL and the long‐pulsed Nd:YAG and diode lasers. There were no significant differences between the efficacy and safety of the long‐pulsed Nd:YAG laser when compared with the diode and alexandrite lasers.

The literature review was limited by small sample sizes, the quality of published studies, and the small number of trials that compare laser use for individuals with pigmented skin.

“Additional well-designed trials are still needed to support present findings and help identify optimal treatment modalities for hair reduction in skin of color,” researchers concluded.

Reference

Dorgham NA, Dorgham DA. Lasers for reduction of unwanted hair in skin of color: a systematic review and meta-analysis [published online October 6, 2019]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.15995