Permanent Laser Hair Removal for Women with Polycystic Ovary Syndrome
Excessive facial hair in women causes emotional distress and impairs their quality of life. A study at the Glasgow Royal Infirmary’s Plastic Surgery Unit compared the effectiveness and side effects of the Alexandrite Laser and Intense Pulsed Light System (IPL) on the removal of facial hair in women with Polycystic ovary syndrome (PCOS). Between 4 and 6% of women have this condition, with up to 80% of these going on to develop hirsutism. It is therefore one of the most common reasons for women to want to remove facial hair.
In the above mentioned study, 31 women completed all treatments and follow ups. Inclusion criteria were: a diagnosis of PCOS; facial hirsutism comprising brown or black hair; Fitzpatrick skin types I–V; and patients over the age of 16. In the study the patients had one side of their faces treated with the Alexandrite and the other with IPL. Patients underwent 6 full treatments with 6 week intervals between treatments.
Patient Satisfaction for the Alexandrite Laser versus IPL
- Happiness with pre-treatment hair removal methods (e.g., depilation, waxing, shaving) scored a median of 1.2 (0 very unhappy and 10 very happy).
- At all stages of follow-up, patient satisfaction with the Alexandrite-laser treated side was significantly higher than that on the IPL side. After 1 month for example, median satisfaction had increased to 8.7 on the Alexandrite laser side and 5.7 on the IPL side.
- Twenty-eight out of 31 patients (93%) said they were satisfied with Alexandrite laser treatment compared to 60% on the IPL side.
Hair Count Reduction for the Alexandrite Laser versus IPL
At all follow-up points the decrease in hair counts on the Alexandrite side was greater than that on the IPL side, despite using higher fluences with the latter. At 1 month follow-up for example, hair counts had decreased 21% on the IPL side and 52% on the Alexandrite side. These findings were beneath those previously published for the Alexandrite laser, where reductions in hair growth of up to 86% have been reported 6 months later. This probably reflected the androgenic drive for facial hair growth in women with PCOS.
The study postulated that a possible reason for the Alexandrite laser’s greater effectiveness was that it delivers all of its fluence in 5, 10 0r 20 milliseconds pulse and at a potentially optimum wavelength for the destruction of hair follicles. In contrast, the IPL delivers broadband light, some of which is likely to be less effectively absorbed by the melanin in the follicle. Additionally, the IPL delivers its fluence split into 2–4 pulses with a 20–40 milliseconds delay between pulses, which results in a slower energy build-up in the follicle and may cause less thermal transfer to the germinative elements of the follicle such as the bulge and hair bulb. Therefore, less follicular destruction and more hair re-growth would be the end result.
Side-Effects of the Alexandrite Laser versus IPL
Both systems were well tolerated by most patients. Three patients (10%) sustained small areas of blistering on the IPL-treated side. In two cases this settled within 14 days without scarring. The third patient also healed without scarring but a small area did become temporarily hyperpigmented. Blistering is very rare with the Alexandrite on white skin types. On dark skin types the nd: YAG laser should be used.
Hair Removal Study Findings
The Alexandrite laser outperformed the IPL system in terms of:
- Larger hair count reductions
- Longer Hair Free Intervals
- Higher levels of patient satisfaction
The Alexandrite laser was more effective at reducing facial hirsutism in women with PCOS than the IPL. It is probable that this is due to the specific wavelength, short pulse duration and single pulse delivery of the Alexandrite laser, resulting in more follicular destruction than the IPL where the energy delivered is split into between 2 and 4 pulses with a 20–40 milliseconds delay in between.