As new laser technology continues to be introduced to the market, patients keep searching for the newest, latest and greatest device. The current trend seems to be centered on what patients can do themselves, minimizing the amount of time needed in the office.
At-home laser, light, and even heat-based devices have recently begun to hit the market with force. Do these devices work? Will they take away from the "in- office" professional procedure business? What is currently out there, and what can we expect to see?
Laser hair removal
Safety has always been the main concern with the at-home market, as we have all seen burns, dyspigmentation or even scarring from improper laser use.
While these safety concerns, so far, have been addressed by devices approved by the Food and Drug Administration (FDA), there are still many devices available via the Internet that do not offer the same safety profile. It is important for physicians to be familiar with the devices that are out there so that we may properly advise and educate our patients.
In 2007, the FDA approved the promotion of the at-home laser hair removal device, the Tria, from SpectraGenics, which was officially introduced to the public this past spring.
This system uses a diode laser, known to be successful for hair removal in the professional environment. The Tria is sold via physicians' offices or medically run spas. The cost varies slightly, but it is generally around $1,000.
The device is a diode laser emitting light at a wavelength of 810 nm. Pulse fluences range from 7J/cm2 to 20J/cm2 with pulse widths of 125 ms to 650 ms. Classic in- office pulse widths for light skin types are generally much shorter than these pulse widths.
The longer pulse widths allow for a potential increase in safety and a decrease in peak heat with the at-home device. The safety measures do not, however, protect against skin burns related to misuse, use on improper skin types, or overuse.
The device will emit approximately 300 pulses (1 cm spot size) with each charge. Large-area treatment times may be too long for most patients to perform, and recharging the device may be necessary when using on multiple areas. Treatment protocols indicate one treatment every month for six to eight months.
Despite some of the practical setbacks, the efficacy for this diode hair removal device is well documented (Wheeland et al. Lasers in Surg Med. 2007); sixty percent reduction in hair counts at four weeks after the third treatment in all sites. Though some regrowth was evident at 12-month follow-up visits, hair counts were still reduced by 33 percent.
Another at-home hair removal device currently on the market in the United States is the Silk'n (Home Skinovations). This technology uses intense pulsed light at low fluences (up to 5J/cm2 ), combined with acoustical energy.
The "home pulsed light" (HPL) technology was introduced to the market earlier this year. It is indicated for hair removal on the trunk but not on the face and neck. Like the Tria, it is safe for lighter skin types only.
Clinical trials demonstrated a 54 percent to 65 percent reduction in hair counts at three months after the third visit. Regrowth was evident at the six-month visit, with hair reduction counts of 41 percent to 54 percent, according to the company.
This device is available for purchase through physicians' offices and costs approximately $800, with an additional cost for replacement bulbs based on frequency of use.