Randomized side-by-side comparison of 755-nm diode laser alone and combined with topical photoenhancer gel for hair removal in patients with Fitzpatrick skin type I-V: Efficacy and safety study

Background: Improving laser hair removal (LHR) procedure with novel protocols techniques and photoenhancer ingredients are constantly evolving primarily in an attempt to enhance hair follicle photothermolytic damage and at the same time improve treatment safety and efficacy. Since laser technology advancement feeds market demand-cost relations improving laser hair removal paradigm that will boost clinical outcome and reduce operation costs is deemed necessary in today’s LHR competitive market. Objectives: We tested the safety and efficacy of 755-nm diode LHR system in a randomized, side-by-side comparison study design that compared a combined laser protocol with topical photoenhancer gel (“combined”) vs. laser alone (“solo”). Methods: Twenty women (age range 23-33 years) with Fitzpatrick skin type I-V (skin type II-III: n = 11; skin type IV-V: n = 9) were randomized to side-by-side comparison protocol. One side was treated with laser 755-nm diode + photoenhancer gel (“combined”) whereas the unilateral part was treated with laser 755-nm diode alone (“solo”) protocol. The combined protocol used half the accumulative laser energy compared with the solo side. The laser technique used in both cases was in-motion super hair removal (SHR) at preset kilojoule (kJ). Enrolled subjects received up to 4 treatments. The treatments were spaced every 4-6 weeks. Subjects were assessed at baseline and 2 follow-up visits: 1 and 6 months after the last treatment for reduction in hair count, pain and overall satisfaction. Results: At 1 and 6 month follow-up there were no statistical differences in % hair reduction between the combined (81 ± 16%) vs. the solo (77 ± 15%) protocols (P >.05) and the combined (71 ± 24%) vs. the solo (70 ± 23%) treatment protocols (P >.05), respectively. The average kJ in the combined side was about half that of the solo side (4.2 ± 1.6 kJ vs. 7.6 ± 2.7 kJ, respectively). Subjects reported pain score during the procedure which was found to be significantly higher in the solo (5.5 ± 1.8) vs. the combined (3.8 ± 1.7) protocol (P <.001). There were no differences in subjects’ satisfaction rate in both treatment outcomes at 1- and 6-month follow-ups. Conclusion: Laser hair removal paradigm that combines diode laser 755-nm with photoenhancer gel (reduced kJ) is clinically as effective as solo treatment protocol (standard kJ). The former may significantly reduce standard SHR protocol treatment time and increase patients’ throughput and overall LHR operation costs.