Paradoxical Hypertrichosis After Laser Therapy: A Review

BACKGROUND Laser hair removal is a safe and effective procedure for the treatment of unwanted body hair but is not exempt from side effects. A rare but significant adverse effect with this treatment modality is paradoxical hypertrichosis. OBJECTIVE To evaluate the potential etiologies, risk factors, related laser types, and treatment options for the development of excess hair after laser therapy. MATERIALS AND METHODS An analysis of previously published case studies and review articles along with our own experience was used to gather information regarding this phenomenon. RESULTS Paradoxical hypertrichosis has a low incidence, ranging from 0.6% to 10%, and most commonly occurs on the face and neck. All laser and light sources have the potential to cause hair induction, especially in individuals with darker skin types (III–VI); with dark, thick hair; and with underlying hormonal conditions. Possible causes include the effect of inflammatory mediators and subtherapeutic thermal injury causing induction of the hair cycle. Treatment for paradoxical hypertrichosis is laser therapy of the affected area. CONCLUSIONS Paradoxical hypertrichosis is a rare side effect of laser hair removal; the pathogenesis of this event remains widely unknown. We recommend further large‐scale studies to investigate this effect. The authors have indicated no significant interest with commercial supporters.

[1]  J. Shapiro,et al.  Paradoxical hypertrichosis after laser epilation. , 2005, Journal of the American Academy of Dermatology.

[2]  C. Raulin,et al.  IPL technology: A review , 2003, Lasers in surgery and medicine.

[3]  B. Jackson.  Lasers in ethnic skin: a review. , 2003, Journal of the American Academy of Dermatology.

[4]  T. Reineke,et al.  Hair Reduction Using Intense Pulsed Light Source , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[5]  S. Vlachos,et al.  Efficacy of long‐ and short pulse alexandrite lasers compared with an intense pulsed light source for epilation: a study on 532 sites in 389 patients , 2003, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[6]  S. Liew.  Laser hair removal: guidelines for management. , 2002, American journal of clinical dermatology.

[7]  C. Castelo-Branco,et al.  Paradoxical Effect After IPL Photoepilation , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[8]  C. Castelo-Branco,et al.  Side‐Effects After IPL Photodepilation , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[9]  R. Anderson,et al.  Damage to hair follicles by normal-mode ruby laser pulses. , 1996, Journal of the American Academy of Dermatology.

[10]  S. Lanigan,et al.  Incidence of side effects after laser hair removal. , 2003, Journal of the American Academy of Dermatology.

[11]  D. Goldberg,et al.  Laser hair removal pearls , 2008, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[12]  M. Radmanesh,et al.  Burning, paradoxical hypertrichosis, leukotrichia and folliculitis are four major complications of intense pulsed light hair removal therapy , 2008, The Journal of dermatological treatment.

[13]  A. Sharifian,et al.  A comparison study of the efficacy and side effects of different light sources in hair removal , 2006, Lasers in Medical Science.

[14]  M. Namazi.  UV light may induce hypertrichosis through production of PGE2. , 2007, Medical hypotheses.

[15]  S H Liew,et al.  Unwanted body hair and its removal: a review. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[16]  Andrea Willey,et al.  Hair stimulation following laser and intense pulsed light photo‐epilation: Review of 543 cases and ways to manage it , 2007, Lasers in surgery and medicine.

[17]  Julian M Handley,et al.  Adverse events associated with nonablative cutaneous visible and infrared laser treatment. , 2006, Journal of the American Academy of Dermatology.

[18]  Jane G. Khoury,et al.  Comparative Evaluation of Long‐Pulse Alexandrite and Long‐Pulse Nd: YAG Laser Systems Used Individually and in Combination for Axillary Hair Removal , 2008, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[19]  S. Lanigan,et al.  A review of the adverse effects of laser hair removal , 2006, Lasers in Medical Science.

[20]  C. James,et al.  Histological study of hair follicles treated with a 3‐msec pulsed ruby laser , 1999, Lasers in surgery and medicine.

[21]  A. El Bedewi.  Hair removal with intense pulsed light. , 2004, Lasers in medical science.

[22]  T. Michaud,et al.  [Laser hair removal]. , 2009, Annales de dermatologie et de venereologie.

[23]  M. Gold.  Lasers and light sources for the removal of unwanted hair. , 2007, Clinics in dermatology.

[24]  A. E. Bedewi.  Hair removal with intense pulsed light , 2004, Lasers in Medical Science.

[25]  Jeung-Hoon Lee,et al.  Induction of synapse associated protein 102 expression in cyclosporin A‐stimulated hair growth , 2008, Experimental dermatology.

[26]  K. Egawa,et al.  Local hypertrichosis associated with a human papillomavirus type 1‐induced wart , 2005, The British journal of dermatology.

[27]  S. Vlachos,et al.  Development of Terminal Hair Following Skin Lesion Treatments with an Intense Pulsed Light Source , 2002, Aesthetic Plastic Surgery.

[28]  R. Anderson,et al.  Permanent hair removal by normal-mode ruby laser. , 1998, Archives of dermatology.

[29]  J. Syme‐Grant,et al.  Post-surgical hypertrichosis. , 2006, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[30]  S. Liew.  Laser Hair Removal , 2002 .

[31]  J. Dover,et al.  Pigmented guinea pig skin irradiated with Q-switched ruby laser pulses. Morphologic and histologic findings. , 1989, Archives of dermatology.

[32]  E. Battle,et al.  Laser‐assisted hair removal for darker skin types , 2004, Dermatologic therapy.

[33]  M. Schönermark,et al.  Effective treatment of hypertrichosis with pulsed light: a report of two cases. , 1997, Annals of plastic surgery.

[34]  C. Dierickx,et al.  Hair removal by lasers and intense pulsed light sources. , 2000, Seminars in cutaneous medicine and surgery.

[35]  A. Firooz,et al.  Lasers may induce terminal hair growth. , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[36]  C. Barcaui.  Localized hypertrichosis after intense pulsed light treatment for tattoo removal. , 2007, Dermatologic Surgery.

[37]  C. Barnes,et al.  Comparison of adverse events of laser and light-assisted hair removal systems in skin types IV-VI. , 2007, Journal of drugs in dermatology : JDD.

[38]  D. Goldberg,et al.  Guidelines for laser hair removal , 2008, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[39]  E. Bernstein.  Hair Growth Induced by Diode Laser Treatment , 2005, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[40]  S. Vlachos,et al.  Hair induction after laser-assisted hair removal and its treatment. , 2006, Journal of the American Academy of Dermatology.

[41]  Ellen S. Marmur,et al.  Paradoxical effects of hair removal systems: a review , 2006, Journal of Cosmetic Dermatology.

[42]  David J Goldberg,et al.  Laser- and light-based hair removal: an update , 2007, Expert review of medical devices.

[43]  A. Firooz,et al.  Letter: Lasers May Induce Terminal Hair Growth: COMMUNICATION AND BRIEF REPORT , 2006 .

[44]  Z. Naito,et al.  Histological hair removal study by ruby or alexandrite laser with comparative study on the effects of wavelength and fluence , 2004, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[45]  R. Trüeb.  Causes and Management of Hypertrichosis , 2002, American journal of clinical dermatology.