Comparative study between Ruby, Alexandrite and Diode lasers in hirsutism

Background: Hirsutism is a common problem for which laser is being the treatment of choice. Several lasers with varying wavelengths, pulse durations, energy fluences and skin cooling systems, are currently used for hair removal. However, the ideal laser parameters and group of patients who respond better after treatment remain largely unknown. Objectives: A prospective study to evaluate the long term efficiency and safety of three different (Ruby, Alexandrite, Diode) laser hair reduction systems and to determine which candidates respond better for hair reduction. Methods: 171 female patients with Fitzpatrick skin types IIIV with the problem of hirsutism, in the beard area were divided into three groups. Group one included 60 patients, who were treated by ruby laser; group two included 51 patients who were treated by Alexandrite laser whereas the third group included 60 patients who were treated by diode laser. Detailed history, Hormonal assay and abdomino-pelvic ultrasonography were performed to differentiate between idiopathic and pathological hirsutism. Treatment was Egyptian Dermatology Online Journal Vol. 1 No 2:5, December 2005 2 performed in multiple sessions with an interval of 4 weeks using either: ruby laser, long pulsed Alexandrite laser or diode laser. Hair thickness and rate of hair reduction and re-growth were recorded by using Hair counts and photographs before treatment and after 1,3,6,9 &12 months from the initial treatment. Results: All patients had reduction in hair count and delayed hair re-growth. Patients less than 30 years of age responded better than those more than 30 years regardless of the other clinical factors or the type of laser used. There was a significant statistical difference between them at 6 and 12 months follow up (P< 0.05).Patients with hirsutism due to any underlying cause responded as the idiopathic ones. Medical treatment (antiandrogen drugs) during the course of laser sessions had no role in improving the results. Concerning laser parameters, the three lasers used were found to have positive results in hair reduction. Conclusion: The three types of lasers showed variable degrees of improvement concerning the percentage of hair reduction and the rate of hair re-growth. The best results were obtained with diode followed by the Alexandrite. Ruby laser produced the poorest results. The least complications were observed with the diode laser, followed by the Alexandrite. Age plays an important role in the efficacy of laser hair removal diode laser proved to be the most effective and safest laser in this study.