Hair Removal With Blended 755/1064 nm Laser Energy

Background and objectives The 1064 nm wavelength is optimized for dark skin, but within the range of available fluences for commercially available 1064 nm devices, may not provide effective treatment for lighter hair. The 755 nm alexandrite wavelength can treat a full range of hair colors but is not ideal for darker skin. The hypothesis is that a new laser system capable of emitting 755/1064 nm wavelengths simultaneously allows for safer, effective, and less painful hair reduction over a range of skin and hair types. Study design/materials and methods We completed treatment in 36 patients in this institutional review board approved prospective randomized study. Ages ranged from 20 to 55 and the distribution of skin types was: I (14% of patients), II (50% of patients), III (18% of patients), IV (18% of patients). Areas included the axilla and lower extremity. A prototype laser system emitted 755/1064 nm simultaneously. The spot size was 12 mm and the pulse duration was 3 milliseconds. The percentage of each wavelength in the mixture varied from 0% to 100%. Total radiant exposure ranged from 20 to 50 J/cm2 . Test spots were performed with escalating doses of light for each category (alexandrite alone, Nd YAG alone, and blended). Patients returned within 1 week for evaluation of side effects. The highest fluence without side effects for each category was then applied in two sessions 1 month apart. Final hair counts were performed 2 months after the final treatment. Results Optimal light doses (in J/cm2 ) for the range of skin types were as follows: for alexandrite alone, YAG alone, and blended. (Skin type I) 40, 70, 40-10; (II) 40, 70, 40-10; (III) 34, 60, 30-20; (IV) 26, 60, 20-30; (V) 18, 50, 14-36. After 2 months, there was greater than 50% hair reduction in 40%, 24%, and 60% of subjects on the lower extremity for the alexandrite, Nd YAG, and blended groups, respectively, and 20%, 25%, and 24% for the axilla. Our data show that for "challenging" cases, that is, darker skin types or tanned skin with lighter hairs, a 70/30 mixture of Nd:YAG and alexandrite wavelengths tended to produce the greatest hair reduction and least epidermal compromise while maintaining a lower pain level than Nd YAG alone. Conclusions Modeling and data suggest that 755/1064 nm mixture is useful in lighter hair removal treatment for darker skin types. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.