| Background. Laser hair removal targets the endogenous chromophore melanin, which is mainly found in the hair shaft. The abundance of melanin in the epidermis of patients with dark skin color has always been regarded as hazardous, due to the increased incidence of side effects in this patient population.;Objective. The study Objective is to establish the efficacy and safety of using the 3 msec Alexandrite laser in patients with skin types IV–VI, and the role of a topical corticosteroid in preventing side effects.;Methods. Thirty seven patients with skin types IV–VI (IV = 12, V = 15 and VI = 10) and brown or black hair were recruited and divided into two groups. The first group of twenty six patients was treated with 18mm spot size and the second group of eleven patients was treated with the 15mm spot size. After obtaining informed consent, non-facial test and treatment areas of similar skin and hair characteristics were selected. Optimal fluence was selected to result in perifollicular erythema and edema. Hair shafts in the treatment and control areas were counted and clipped for measurement of the thickness at the base. The 3 msec Alexandrite laser was used with fluences between 8 and 32 J/cm2. Two 16 cm 2 areas were treated; one was pre-treated with a class I topical corticosteroid (TCS) cream (betamethasone dipropionate) 10 minutes pre-laser and twice a day for 5 days post-laser. The dynamic cooling device (DCD) spray duration was set at 90 msec, and the delay was set at 20 msec. Pain was graded on a scale from one to ten. Patients were followed up on day 1 and 7 and at l. 3 and 6 months. Histological samples from the two treatment areas and control were obtained from 5 patients.;Results. 31 patients completed the study (with skin types IV = 10. V = 13 and VI = 8). The average hair count reduction at six months was 35.4%. The average hair thickness reduction was 31.2%. At one week hyperpigmentation was seen in 48.4% of the laser only treated area and in 45.2% of laser/TCS treated area. The effect of TCS was minimal, and more prominent at 1 and 3 months. The incidence of hyperpigmentation was higher in the 15 mm group then the 18 mm group as a result of using higher fluence. (Abstract shortened by UMI.). |
