Home laser use may boost derm visits

Boston - Laser and light-based devices for home use could provide a safe introduction to treatments for acne, hair removal, photorejuvenation and cellulite - and leave patients wanting more, an expert says.

"Over time, technology gets smaller, faster, safer, less expensive and more user-friendly," says Thomas Rohrer, M.D., clinical associate professor of dermatology, Boston University Medical Center and Mohs fellowship director, Skin Care Physicians of Chestnut Hill, Mass.

Dr. Rohrer says these devices are similar but very stripped-down versions of the devices physicians use in the office.

"They're not going to be nearly as powerful" or effective, a trade-off one makes for safety's sake with home-use devices, he observes. "They may be effective enough, however, to improve some conditions. For the hair, we have seen some devices effectively reduce hair counts in short studies," he says.

Hair-removal devices include the Epila SI 808 Laser (NB Medical) and the No-No and Spa Touch (Radiancy), Dr. Rohrer says. The latter device uses photon recycling (capturing the reflected light and sending it back toward the skin) and emits light at 400 to 1,200 nm, he says. It does not have a heat shield and reduces hair through both light and heat damage.

In a study that led to Spa Touch being the first personal-use laser device approved by the Food and Drug Administration (FDA), the device showed moderate efficacy and minimal side or adverse effects [Lasers Surg Med. 2003;33(1):25-29], he says. Six weeks after receiving six treatments, study patients reported an average two-thirds reduction in unwanted hair counts. At nine months follow-up, patients noted about a one-third reduction.

For patients concerned about hair loss, there's the HairMax LaserComb (Lexington International LLC), which Dr. Rohrer says is one of three treatments that are FDA-approved for hair growth. In a 26-week, multi-center, placebo-controlled study with this device, 93 percent of subjects noticed an increase in hair count, Dr. Rohrer says.

With acne, Dr. Rohrer notes, "There may be some devices that are able to reduce acne counts at least temporarily. At present, no home-use device has been shown to reduce acne long term."

Acne devices sold through medical offices include the Zeno (Tyrell) and ClearTouch Lite (Radiancy), both of which thermally heat acne lesions, he says. In a large study, the Zeno achieved 90 percent reduction in lesion counts in one to two days, Dr. Rohrer says. The ClearTouch Lite uses pulsed light and heat energy (LHE) technology operating at 480 to 1,100 nm with a 14 mm by 27 mm spot size and 6.2 J/cm2 fluence, he adds. In a 19-patient study, this device achieved 63 percent clearance after four weeks of twice-weekly treatments, which improved to 85 percent eight weeks after treatment concluded [J Cosmet Laser Ther. 2004 Jun;6(2):91-95].

In photorejuvenation, he says, "We've seen many different devices that are safe and relatively pain-free." With inexpensive devices such as LEDs, Dr. Rohrer adds, "One can actually achieve subtle but real changes in the skin." Photorejuvenation devices for the home include the NuLase (NuLase International LLC) and ClearTouch Lite, he adds.

Similarly, Dr. Rohrer says the Facial Toning Device (Radiancy) uses LHE technology. In an unpublished study with this device, 69 percent of patients noticed smoother skin, fewer spots (51 percent) and wrinkle reduction (27 percent), he says.