Results of a prospective, split-side controlled trial enrolling 22 patients with skin types II-VI indicate hair removal with the long-pulsed 1,064 nm Nd:YAG laser is associated with significant improvement in lesions of hidradenitis suppurativa without causing significant adverse effects.
Detroit - The long-pulsed 1,064 nm Nd:YAG laser provides safe and effective treatment for hidradenitis suppurativa, according to a study conducted by dermatologists Bassel H. Mahmoud, M.D., Ph.D.; Emily Tierney, M.D.; Camile Hexsel, M.D.; David Ozog, M.D.; and Iltefat Hamzavi, M.D., Henry Ford Medical Center, Detroit.
A total of four laser treatments were performed at monthly intervals and patients were followed for an additional two months thereafter.
Responses were assessed using a modification of the Lesion, Area and Severity Index (LASI) scoring system described by Sartorius et al. Improvement was noted at the laser-treated sites within one month after the first session and continued to increase over time, even during the two months after the final laser session.
At the six-month visit, the mean modified LASI score for all laser-treated sites combined was reduced significantly from baseline, and was significantly lower compared with the mean score for the control sites.
The laser treatment was associated with pain in 40 percent of patients, but didn't interfere with their daily activities. There were no significant adverse events related to its use. Patient satisfaction with the treatment was favorable and exceeded levels of satisfaction with previous medical therapy.
"Available medical treatments for hidradenitis suppurativa, including systemic antibiotics, retinoids and biologics, have limited efficacy and significant side effects.
"Furthermore, although surgery can be effective, it is associated with significant morbidity, including risks of infection and permanent scarring.
"The long-pulsed Nd:YAG laser offers a method to deliver effective localized treatment with a better safety profile compared with surgery," says Dr. Mahmoud, postdoctoral research fellow, department of dermatology, Henry Ford Hospital.
"Although previous concepts held that the apocrine gland is the site of onset for hidradenitis suppurativa, several histopathologic studies revealed that it begins with perifollicular inflammation and then spreads into the deep dermis to affect the apocrine gland secondarily.
"This information, combined with the positive outcomes achieved in the treatment of dissecting cellulitis, suggested use of the hair removal laser to treat hidradenitis suppurativa by targeting the follicular units," Dr. Mahmoud tells Dermatology Times.