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An Assessor-Blinded, Randomized Trial With 18 Months of Follow-up

Seyyed Masoud Davoudi, MD; Fereydoun Behnia, MD; Farzam Gorouhi, MD; Saeed Keshavarz, MD; Mansour Nassiri Kashani, MD; Mehdi Rashighi Firoozabadi, MD; Alireza Firooz, MD

Arch Dermatol. 2008;144(10):1323-1327.

Objective  To compare the long-term effectiveness and safety of long-pulsed Nd:YAG and alexandrite lasers, individually and in combination, in long-term leg hair reduction.

Design  Randomized, single-center, within-participant, investigator-blinded, active-controlled clinical trial.

Setting  Private skin laser center.

Participants  Twenty individuals aged 16 to 50 years with skin phototypes III and IV.

Interventions  The medial and lateral sides of each participant's legs were randomly assigned to receive 1 of the following laser treatments: (1) long-pulsed 1064-nm Nd:YAG laser (12-mm spot size); (2) long-pulsed 755-nm alexandrite laser (12-mm spot size); (3) long-pulsed 755-nm alexandrite laser (18-mm spot size); and (4) a combination of long-pulsed 1064-nm Nd:YAG laser and long-pulsed 755-nm alexandrite laser (treatments 1 and 2). Identified areas were treated for a total of 4 sessions at 8-week intervals.

Main Outcome Measures  Hair reduction from baseline based on hair counting with digital photography by 2 blinded assessors, 8 and 18 months after the last treatment session.

Results  Fifteen participants completed the trial. The mean (SD) hair reduction 18 months after the last treatment, as measured by the assessors from digital photographs, were 75.9% (19.0%) for the 12-mm spot size alexandrite laser, 84.3% (12.4%) for the 18-mm spot size alexandrite laser, 73.6% (11.4%) for the Nd:YAG laser, and 77.8% (15.9%) for the combination therapy (analysis of variance, P > .05). The incidence of adverse effects (hyperpigmentation) and pain severity were significantly greater in areas that received combination therapy (P = .001).

Conclusions  After 18 months of follow-up, alexandrite and Nd:YAG lasers were efficacious for leg hair removal. Combination therapy did not have any additional benefit and caused more adverse effects.

Author Affiliations: Department of Dermatology, Baqiyatallah University of Medical Sciences (Drs Davoudi, Keshavarz, and Firooz), and Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences (Drs Behnia, Gorouhi, Nassiri Kashani, Rashighi Firoozabadi, and Firooz), Tehran, Iran.

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