Laser Epilation, Depilation, Photoepilation

Unwanted hair is a serious concern for millions of women. The wish to have smooth and nice looking skin is a never-ending pursuit. Currently the issue can be divided into two options:

Depilation: the hair being removed from its follicle.

Epilation: the act of removing the entire hair, including follicle, from the skin.

As long as none of the ways are pathogenetic and bring no desired effect for a long period of time, it became necessary to look for more advanced and modern methods of hair removal. If neither of these methods achieves the desired effect it will be required to pursue new methods.

Here are the following methods used until recently:

• Physical: hair follicular diathermocoagulation (electrocoagulation), Electrolysis, ultrasound and photo-epilation.
• physicochemical: electrophoresis, like Lydasa (Lydasum) and enzymatic epilation.
  Cosmetologists started using lasers in their practice and have been using special lasers for epilation for about 20 years. It’s widely known that laser hair removal is the best option to get rid of unwanted hair.

Most lasers currently available in the market target specific chromophores – biological structures that have a certain absorption spectrum. For instance they are such structures as hemoglobin and melanosome.
During the treatment process, laser hair removal machines selectively target the melanin in the hair follicle, disabling or destroying it no matter the skin color. Accordingly, the photosensitivity type is considered to be very important for physical epilation. This feature is at the basis of Fitzpatrick skin phototypes classification:
Skin Type Skin Color Tanning History
I very fair, "transparent" Always burns, never tans
II fair Always burns, tans with difficulty
III fair to light olive Burns mildly, tans slowly
IV olive to brown Rarely burns, tans with ease
V dark brown Very rarely burns, tans very easily
VI black Never burns, tans very easily

It should be remembered that while working with the first two skin types that they’re highly sensitive. Unprofessionally performed procedures may lead to skin burns and irritation.

Laser energy affects all hair differently. There are three types of hair:
Long hair - beard and moustache hair, pubic and genital hair.
Bristly hair- eye brows, eyelashes, external acoustic meatus as well as nose hairs
Peach fuzz – hair that grows on different parts of the body.
The hair growth cycle is a normal physiological process. It happens invisibly because hairs have different phases of their growth.

According to Moretti G. there are three main phases of the hair growth cycle:

• Anagen, active growth phase, which is subdivided into proanagen, mesanagen and metanagen. This phase usually lasts several years;
• Catagen – transitive phase, is the phase where the hair is no longer growing but has not yet shed. It usually lasts, on average, two weeks;
• Telogen - when the follicle is in a so-called resting phase. It usually lasts 5-6 weeks.
  Normally 85-90% of hair is in the longest anagen phase of growth, 9-14% - is in telogen and only 1% is in catagen.

The laser works best on actively growing hairs (anagen phase). Since not every hair in any one area is in the active growth (anagen) phase, patients will need multiple treatments with intervals to effectively treat any given area.

Since May 2007 the VIRTUS institute has been performing laser epilation using the new diode laser MeDioStar XT with its wavelength 808 nm (Asclepion Laser Technologies GmbH).

The Diode laser is indicated for effective removal of unwanted body hair. Traditional techniques such as shaving, plucking and waxing- provide only temporary relief and may actually stimulate hair growth. It can also be medically beneficial in cases where traditional methods result in scarring, allergic reactions, and ingrown hairs.

Patients who have the following problems may not be good candidates for laser hair removal:

• Skin lesions
• Epilepsy
• Pregnancy
• Skin cancer
• Active herpes and other skin infections

The part of the skin that is to be treated should be shaved or hair-removal cream/ lotion should be applied at least 12 to 24 hr before the beginning of the treatment to avoid skin irritation. Any lotion or make-up should be removed prior to the laser epilation (in the case of a facial area treatment). Less sensitive areas like the legs, hands and back do not require anaesthesia. In the case of more sensitive body parts being treated, like upper lip, underarm and bikini areas, it is recommended to use anaesthetic cream, although the laser cooling system makes the whole procedure practically painless.
In order to satisfy patients demands and not to frustrate the expectancy it is very important to specify the hair type and colour, hairbreadth as well as hormonal status. It is also recommended to start the patient’s case-record listing the following:
1. Current diseases that can cause hypertrichosis;

• hormonal dysregulations
• familial hypertrichosis
• course of medications
• tumors

2. Inflammatory skin diseases;
3. Herpes simplex (especially perioral area);
4. Herpes genitalis (especially in case of bikini hair removal);
5. Colloid and hypertrophic scarring;
6. Such skin diseases like vitiligo and psoriasis;
7. currently taken photo - sensibilizing drugs and roaccutane.
During its practical use the full course of this treatment method, which includes from 5-7 procedures, was tested on more than 3000 patients from 18 to 65 years of age. Excellent results showed in 85% of patients, good in 10%, (meaning a large amount of removed hair, normal hair replacement with peach fuzz, less intensive hair growth rate) and in 5% some additional examinations and procedures became necessary.
Hair removal is performed for all types of hair, on any part of the body, for example: upper lip, thighs, lower leg, bikini, chest, hands.
Thanks to its wide treatment modes range, MeDioStar XT is very effective for tanned and darker skin. It is alsouseful during the summer season with some doctor’s suggestions that will be provided at the consultation.

37 year old patient with symptoms of polycystic ovary (hormone changes, irregular menstrual cycles, intensive hair growth on the face, fingers and toes, acne and oily skin, obesity). Gynecologist-endocrinologist recommended a course of antiandrogens due to the high level of androgenic hormones. The patient declined the suggested treatment course. Having had 6 laser epilation treatments the patient was 80% satisfied. Because the hormonal problem was not resolved, the patient was recommended to repeat the procedure in one year.

23 year old patient with intensive hair growth on his back

The amount of unwanted hair was considerably reduced after 5 laser treatments by diode laser MeDioStar XT at fluence 40 J/cm². The patient was 85% satisfied. The outcome for the patient remains stable after 7 months since the last treatment. Our practical experience proves the effectiveness of this epilation approach.