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Two Lasers May Be Better Than One for Hair Removal
Recent advances in laser hair removal include using combination wavelengths, longer pulses, and larger spot sizes for all skin types, and using longer wavelengths for darker skin, according to Dr. E. Victor Ross.
Better pain control and cooling techniques also can make device-based hair removal a more comfortable option for patients, Dr. Ross said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation in Santa Monica, Calif.
When using lasers for hair removal, cooling the skin before and after treatment can reduce pain and swelling, and cooling the skin during laser exposure "tends to minimize the dermal epidermal temperature," said Dr. Ross, director of the Scripps Clinic Laser and Cosmetic Dermatology Center in Carmel Valley, Calif.
Historically, fair-skinned patients have been treated with a 755-nm alexandrite laser for hair removal. For dark or tanned skin, or coarser hair, a 1064-nm Nd:YAG might be more effective, but it can be more painful for patients, Dr. Ross noted.
In his experience, a blended treatment including both the 755-nm and 1064-nm lasers can be more effective for removing fine hair on the legs than either laser alone, he said, adding that some patients still prefer the 755-nm alexandrite laser because the combination therapy is more painful than the 755 nm, although it is less painful than the 1064 nm alone.
New hair removal technologies include ultrasound and microwave radiation, as well as lower-fluence intense pulsed light and diode options with suction.
Approaches using high repetition with low fluence have been applied in some settings. The advantage is less pain, but more research is needed to determine whether lower fluences at high rates of repetition are effective, and what types of treatments are effective for white hair, said Dr. Ross.
Suction devices are an option to assist with permanent hair reduction over larger areas. A larger spot size allows more photons to remain in the target area, while vacuum-assisted suction concentrates more cumulative energy at any given depth and allows for effective treatment at a lower fluence.
Dr. Ross also addressed laser-diode hair removal devices being marketed for home use. The key issues to consider when evaluating at-home devices are safety for all skin types; safety with open or closed eyes; effectiveness in removing fine, gray, or white hair; and, of course, cost.
The TRIA hair removal device from TRIA Beauty Inc. is approved by the Food and Drug Administration for home use. The device packs an 800-nm wavelength and fluences of 7, 12, or 20 J/cm2, and efficacy data on this product are promising, Dr. Ross said.
Dr. Ross disclosed that he is a researcher for and receives funding from multiple laser companies, including Candela, Cutera, Lumenis, Sciton, and Syneron. SDEF and this news organization are both owned by Elsevier.
Recent advances in laser hair removal include using combination wavelengths, longer pulses, and larger spot sizes for all skin types, and using longer wavelengths for darker skin, according to Dr. E. Victor Ross.
Better pain control and cooling techniques also can make device-based hair removal a more comfortable option for patients, Dr. Ross said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation in Santa Monica, Calif.
When using lasers for hair removal, cooling the skin before and after treatment can reduce pain and swelling, and cooling the skin during laser exposure "tends to minimize the dermal epidermal temperature," said Dr. Ross, director of the Scripps Clinic Laser and Cosmetic Dermatology Center in Carmel Valley, Calif.
Historically, fair-skinned patients have been treated with a 755-nm alexandrite laser for hair removal. For dark or tanned skin, or coarser hair, a 1064-nm Nd:YAG might be more effective, but it can be more painful for patients, Dr. Ross noted.
In his experience, a blended treatment including both the 755-nm and 1064-nm lasers can be more effective for removing fine hair on the legs than either laser alone, he said, adding that some patients still prefer the 755-nm alexandrite laser because the combination therapy is more painful than the 755 nm, although it is less painful than the 1064 nm alone.
New hair removal technologies include ultrasound and microwave radiation, as well as lower-fluence intense pulsed light and diode options with suction.
Approaches using high repetition with low fluence have been applied in some settings. The advantage is less pain, but more research is needed to determine whether lower fluences at high rates of repetition are effective, and what types of treatments are effective for white hair, said Dr. Ross.
Suction devices are an option to assist with permanent hair reduction over larger areas. A larger spot size allows more photons to remain in the target area, while vacuum-assisted suction concentrates more cumulative energy at any given depth and allows for effective treatment at a lower fluence.
Dr. Ross also addressed laser-diode hair removal devices being marketed for home use. The key issues to consider when evaluating at-home devices are safety for all skin types; safety with open or closed eyes; effectiveness in removing fine, gray, or white hair; and, of course, cost.
The TRIA hair removal device from TRIA Beauty Inc. is approved by the Food and Drug Administration for home use. The device packs an 800-nm wavelength and fluences of 7, 12, or 20 J/cm2, and efficacy data on this product are promising, Dr. Ross said.
Dr. Ross disclosed that he is a researcher for and receives funding from multiple laser companies, including Candela, Cutera, Lumenis, Sciton, and Syneron. SDEF and this news organization are both owned by Elsevier.
Recent advances in laser hair removal include using combination wavelengths, longer pulses, and larger spot sizes for all skin types, and using longer wavelengths for darker skin, according to Dr. E. Victor Ross.
Better pain control and cooling techniques also can make device-based hair removal a more comfortable option for patients, Dr. Ross said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation in Santa Monica, Calif.
When using lasers for hair removal, cooling the skin before and after treatment can reduce pain and swelling, and cooling the skin during laser exposure "tends to minimize the dermal epidermal temperature," said Dr. Ross, director of the Scripps Clinic Laser and Cosmetic Dermatology Center in Carmel Valley, Calif.
Historically, fair-skinned patients have been treated with a 755-nm alexandrite laser for hair removal. For dark or tanned skin, or coarser hair, a 1064-nm Nd:YAG might be more effective, but it can be more painful for patients, Dr. Ross noted.
In his experience, a blended treatment including both the 755-nm and 1064-nm lasers can be more effective for removing fine hair on the legs than either laser alone, he said, adding that some patients still prefer the 755-nm alexandrite laser because the combination therapy is more painful than the 755 nm, although it is less painful than the 1064 nm alone.
New hair removal technologies include ultrasound and microwave radiation, as well as lower-fluence intense pulsed light and diode options with suction.
Approaches using high repetition with low fluence have been applied in some settings. The advantage is less pain, but more research is needed to determine whether lower fluences at high rates of repetition are effective, and what types of treatments are effective for white hair, said Dr. Ross.
Suction devices are an option to assist with permanent hair reduction over larger areas. A larger spot size allows more photons to remain in the target area, while vacuum-assisted suction concentrates more cumulative energy at any given depth and allows for effective treatment at a lower fluence.
Dr. Ross also addressed laser-diode hair removal devices being marketed for home use. The key issues to consider when evaluating at-home devices are safety for all skin types; safety with open or closed eyes; effectiveness in removing fine, gray, or white hair; and, of course, cost.
The TRIA hair removal device from TRIA Beauty Inc. is approved by the Food and Drug Administration for home use. The device packs an 800-nm wavelength and fluences of 7, 12, or 20 J/cm2, and efficacy data on this product are promising, Dr. Ross said.
Dr. Ross disclosed that he is a researcher for and receives funding from multiple laser companies, including Candela, Cutera, Lumenis, Sciton, and Syneron. SDEF and this news organization are both owned by Elsevier.
Hairpin-Induced Alopecia: Case Reports and a Review of the Literature
Transverse Melanonychia After Radiation Therapy [letter]
Cicatricial Alopecia
A great victory for our patients suffering from cicatricial alopecia—Dr. Pratima Karnik, assistant professor of dermatology at Cleveland’s Case Western Reserve University, received a $1.77 National Institutes of Health grant to fund a 5 year study on hair follicle, stem cell specific, PPAR-gamma deficiency in scarring alopecia.
Her research, published in the Journal of Investigative Dermatology, linked a defect in lipid processing and peroxisome biogenesis to cicatricial alopecia. As a result, it paved the way for a breakthrough finding in understanding the pathophysiology of the permanent hair loss disorder (J Invest Dermatol. 2009 May;129(5):1066-70).
Dr. Karnik and her colleagues found that unprocessed lipids are responsible for developing scarring hair loss. Their research suggests that processed lipids are necessary for hair growth and unprocessed lipids are toxic to hair. The bench-side research has led to clinical findings that treating patients with drugs that enhance lipid processing may relieve the clinical symptoms of the disorder.
Central centrifugal cicatricial alopecia, a scarring hair loss prevalent in African Americans, has no well-defined cause and has been difficult to and frustrating for patients.
Dr. Karnik’s research, and the work of the Cicatricial Alopecia Research Foundation (www.carfintl.org), is helping patients and physicians understand the biology, natural history, and treatment options for patients.
I personally attended a session with NIH Director Dr. Francis S. Collins, on behalf of CARF, where underrepresented and underfunded organizations had a chance to voice their opinions to the NIH and gain the well deserved attention they need.
Dr. Collins suggested that a new structure of communication was being established at the NIH, noting that any organization can send a brief summary of issues it would like to bring to the attention of the NIH. The e-mail address is [email protected]. He ensured us he would look at every e-mail and respond to each one.
Often, rare diseases are difficult to study given the lack of attention and funding. The work of Dr. Karnik and her collaborative team, and organizations like CARF, give hope to the thousands of people suffering from cicatricial alopecia.
A great victory for our patients suffering from cicatricial alopecia—Dr. Pratima Karnik, assistant professor of dermatology at Cleveland’s Case Western Reserve University, received a $1.77 National Institutes of Health grant to fund a 5 year study on hair follicle, stem cell specific, PPAR-gamma deficiency in scarring alopecia.
Her research, published in the Journal of Investigative Dermatology, linked a defect in lipid processing and peroxisome biogenesis to cicatricial alopecia. As a result, it paved the way for a breakthrough finding in understanding the pathophysiology of the permanent hair loss disorder (J Invest Dermatol. 2009 May;129(5):1066-70).
Dr. Karnik and her colleagues found that unprocessed lipids are responsible for developing scarring hair loss. Their research suggests that processed lipids are necessary for hair growth and unprocessed lipids are toxic to hair. The bench-side research has led to clinical findings that treating patients with drugs that enhance lipid processing may relieve the clinical symptoms of the disorder.
Central centrifugal cicatricial alopecia, a scarring hair loss prevalent in African Americans, has no well-defined cause and has been difficult to and frustrating for patients.
Dr. Karnik’s research, and the work of the Cicatricial Alopecia Research Foundation (www.carfintl.org), is helping patients and physicians understand the biology, natural history, and treatment options for patients.
I personally attended a session with NIH Director Dr. Francis S. Collins, on behalf of CARF, where underrepresented and underfunded organizations had a chance to voice their opinions to the NIH and gain the well deserved attention they need.
Dr. Collins suggested that a new structure of communication was being established at the NIH, noting that any organization can send a brief summary of issues it would like to bring to the attention of the NIH. The e-mail address is [email protected]. He ensured us he would look at every e-mail and respond to each one.
Often, rare diseases are difficult to study given the lack of attention and funding. The work of Dr. Karnik and her collaborative team, and organizations like CARF, give hope to the thousands of people suffering from cicatricial alopecia.
A great victory for our patients suffering from cicatricial alopecia—Dr. Pratima Karnik, assistant professor of dermatology at Cleveland’s Case Western Reserve University, received a $1.77 National Institutes of Health grant to fund a 5 year study on hair follicle, stem cell specific, PPAR-gamma deficiency in scarring alopecia.
Her research, published in the Journal of Investigative Dermatology, linked a defect in lipid processing and peroxisome biogenesis to cicatricial alopecia. As a result, it paved the way for a breakthrough finding in understanding the pathophysiology of the permanent hair loss disorder (J Invest Dermatol. 2009 May;129(5):1066-70).
Dr. Karnik and her colleagues found that unprocessed lipids are responsible for developing scarring hair loss. Their research suggests that processed lipids are necessary for hair growth and unprocessed lipids are toxic to hair. The bench-side research has led to clinical findings that treating patients with drugs that enhance lipid processing may relieve the clinical symptoms of the disorder.
Central centrifugal cicatricial alopecia, a scarring hair loss prevalent in African Americans, has no well-defined cause and has been difficult to and frustrating for patients.
Dr. Karnik’s research, and the work of the Cicatricial Alopecia Research Foundation (www.carfintl.org), is helping patients and physicians understand the biology, natural history, and treatment options for patients.
I personally attended a session with NIH Director Dr. Francis S. Collins, on behalf of CARF, where underrepresented and underfunded organizations had a chance to voice their opinions to the NIH and gain the well deserved attention they need.
Dr. Collins suggested that a new structure of communication was being established at the NIH, noting that any organization can send a brief summary of issues it would like to bring to the attention of the NIH. The e-mail address is [email protected]. He ensured us he would look at every e-mail and respond to each one.
Often, rare diseases are difficult to study given the lack of attention and funding. The work of Dr. Karnik and her collaborative team, and organizations like CARF, give hope to the thousands of people suffering from cicatricial alopecia.
Eyelash Growth: A Beneficial Side Effect of Prostaglandin Analogues [letter]
What Is Your Diagnosis? Diffuse Nonepidermolytic Palmoplantar Keratoderma With Woolly Hair and Cardiomyopathy (Naxos-Carvajal Syndrome)
Oral Ivermectin Superior to Malathion Lotion for Persistent Head Lice
Oral ivermectin was found superior to malathion lotion in eliminating persistent head lice infestation in a study of children and their household contacts, according to a report in the March 11 issue of the New England Journal of Medicine.
“Ivermectin may be a good alternative to malathion when topical insecticide resistance is suspected,” said Dr. Olivier Chosidow of the Université Pierre et Marie Curie, Paris, and his associates.
Resistance of head lice to both pyrethroids and malathion appears to be increasing. Ivermectin has been used to treat onchocerciasis, lymphatic filariasis, helminthiases, and ectoparasite infections such as scabies.
Dr. Chosidow and his colleagues assessed the efficacy and safety of ivermectin against head lice in a randomized, double-blind controlled trial of patients recruited from the community who had persistent infestation despite using topical pyrethroid-based or malathion insecticide.
The study involved 812 children and their contacts in 376 households in the United Kingdom, Ireland, France, and Israel. The study households were randomly assigned to receive either active oral ivermectin plus a placebo lotion (185 households and 398 patients) or active malathion lotion plus a placebo tablet (191 households and 414 patients) to ensure blinding to treatment assignment. The medications were given by trained staff at clinics to ensure that they were used properly.
After two treatments, given 1 week apart, any patients who still had head lice infestation were switched to the alternative treatment.
The primary end point – clearance of head lice infestation on day 15 after the first two treatments – was achieved in more than 95% of the ivermectin patients, compared with 85% of the malathion patients. A total of 92% of households in the ivermectin group were cleared of head lice, compared with 79% of households in the malathion group.
Seventy patients with persistent infestation switched to the alternative treatment. After another 2 weeks, 100% of the patients using malathion and 97% of those using ivermectin achieved clearance of head lice, the investigators said (N. Engl. J. Med. 2010;362:896-905).
Seven patients in the ivermectin group (1.8%) and five in the malathion group (1.2%) discontinued treatment because of adverse effects, including impetigo, nausea or vomiting, gastroenteritis, and rash or urticaria.
Two serious adverse events occurred: One girl taking ivermectin developed seizures 6 days after the first dose, and one girl taking malathion developed a severe headache requiring hospitalization 6 days after the first application. Both girls recovered. The seizure was found to have a right rolandic focus, and the patient was given a prescription for oxcarbazepine.
The study was funded by Johnson & Johnson–Merck Sharp & Dohme–Chibret. Dr. Chosidow reported receiving consulting fees from Laboratoires Pierre Fabre and Johnson & Johnson, and lecture fees from Pohl Boskamp.
(Image Copyright: CDC/Reed and Carnrick Pharmaceuticals)
Oral ivermectin was found superior to malathion lotion in eliminating persistent head lice infestation in a study of children and their household contacts, according to a report in the March 11 issue of the New England Journal of Medicine.
“Ivermectin may be a good alternative to malathion when topical insecticide resistance is suspected,” said Dr. Olivier Chosidow of the Université Pierre et Marie Curie, Paris, and his associates.
Resistance of head lice to both pyrethroids and malathion appears to be increasing. Ivermectin has been used to treat onchocerciasis, lymphatic filariasis, helminthiases, and ectoparasite infections such as scabies.
Dr. Chosidow and his colleagues assessed the efficacy and safety of ivermectin against head lice in a randomized, double-blind controlled trial of patients recruited from the community who had persistent infestation despite using topical pyrethroid-based or malathion insecticide.
The study involved 812 children and their contacts in 376 households in the United Kingdom, Ireland, France, and Israel. The study households were randomly assigned to receive either active oral ivermectin plus a placebo lotion (185 households and 398 patients) or active malathion lotion plus a placebo tablet (191 households and 414 patients) to ensure blinding to treatment assignment. The medications were given by trained staff at clinics to ensure that they were used properly.
After two treatments, given 1 week apart, any patients who still had head lice infestation were switched to the alternative treatment.
The primary end point – clearance of head lice infestation on day 15 after the first two treatments – was achieved in more than 95% of the ivermectin patients, compared with 85% of the malathion patients. A total of 92% of households in the ivermectin group were cleared of head lice, compared with 79% of households in the malathion group.
Seventy patients with persistent infestation switched to the alternative treatment. After another 2 weeks, 100% of the patients using malathion and 97% of those using ivermectin achieved clearance of head lice, the investigators said (N. Engl. J. Med. 2010;362:896-905).
Seven patients in the ivermectin group (1.8%) and five in the malathion group (1.2%) discontinued treatment because of adverse effects, including impetigo, nausea or vomiting, gastroenteritis, and rash or urticaria.
Two serious adverse events occurred: One girl taking ivermectin developed seizures 6 days after the first dose, and one girl taking malathion developed a severe headache requiring hospitalization 6 days after the first application. Both girls recovered. The seizure was found to have a right rolandic focus, and the patient was given a prescription for oxcarbazepine.
The study was funded by Johnson & Johnson–Merck Sharp & Dohme–Chibret. Dr. Chosidow reported receiving consulting fees from Laboratoires Pierre Fabre and Johnson & Johnson, and lecture fees from Pohl Boskamp.
(Image Copyright: CDC/Reed and Carnrick Pharmaceuticals)
Oral ivermectin was found superior to malathion lotion in eliminating persistent head lice infestation in a study of children and their household contacts, according to a report in the March 11 issue of the New England Journal of Medicine.
“Ivermectin may be a good alternative to malathion when topical insecticide resistance is suspected,” said Dr. Olivier Chosidow of the Université Pierre et Marie Curie, Paris, and his associates.
Resistance of head lice to both pyrethroids and malathion appears to be increasing. Ivermectin has been used to treat onchocerciasis, lymphatic filariasis, helminthiases, and ectoparasite infections such as scabies.
Dr. Chosidow and his colleagues assessed the efficacy and safety of ivermectin against head lice in a randomized, double-blind controlled trial of patients recruited from the community who had persistent infestation despite using topical pyrethroid-based or malathion insecticide.
The study involved 812 children and their contacts in 376 households in the United Kingdom, Ireland, France, and Israel. The study households were randomly assigned to receive either active oral ivermectin plus a placebo lotion (185 households and 398 patients) or active malathion lotion plus a placebo tablet (191 households and 414 patients) to ensure blinding to treatment assignment. The medications were given by trained staff at clinics to ensure that they were used properly.
After two treatments, given 1 week apart, any patients who still had head lice infestation were switched to the alternative treatment.
The primary end point – clearance of head lice infestation on day 15 after the first two treatments – was achieved in more than 95% of the ivermectin patients, compared with 85% of the malathion patients. A total of 92% of households in the ivermectin group were cleared of head lice, compared with 79% of households in the malathion group.
Seventy patients with persistent infestation switched to the alternative treatment. After another 2 weeks, 100% of the patients using malathion and 97% of those using ivermectin achieved clearance of head lice, the investigators said (N. Engl. J. Med. 2010;362:896-905).
Seven patients in the ivermectin group (1.8%) and five in the malathion group (1.2%) discontinued treatment because of adverse effects, including impetigo, nausea or vomiting, gastroenteritis, and rash or urticaria.
Two serious adverse events occurred: One girl taking ivermectin developed seizures 6 days after the first dose, and one girl taking malathion developed a severe headache requiring hospitalization 6 days after the first application. Both girls recovered. The seizure was found to have a right rolandic focus, and the patient was given a prescription for oxcarbazepine.
The study was funded by Johnson & Johnson–Merck Sharp & Dohme–Chibret. Dr. Chosidow reported receiving consulting fees from Laboratoires Pierre Fabre and Johnson & Johnson, and lecture fees from Pohl Boskamp.
(Image Copyright: CDC/Reed and Carnrick Pharmaceuticals)