Lasers represent a major advance in the control of unwanted hair growth. However, the constraints around pigmentation and acceptable energy levels for “in-home” use may constrain the potential of lasers for widespread commercial success. Thus, the use of chemical technologies in combination with energy-emitting devices may represent an opportunity for meeting the threshold consumer needs and overcoming pigment and energy limitations. A recent report by Hamzavi et al. [61] evaluated the combination of eflornithine cream and laser on facial hair removal. In this double-blinded study, women received laser hair removal on the upper lip region. The right – or left upper lip received eflornithine cream or placebo control in a randomized fashion. Laser treatments were conducted up to six times every four weeks, using a long pulse alexandrite laser (10-40 msec pulse duration) at fluences of 7-40 J/cm2. Using both subjective assessments by investigators and subjects as well as objective hair counts, laser in combination with eflornithine produced greater efficacy than laser treatment alone. In addition, the perceptible onset of efficacy was earlier in the combination group. This study suggests that the combination of laser hair removal with chemical approaches to hair growth control may provide an optimal approach to the management of facial hair.
Another study combined the use of radiofrequency-derived energy with topical aminolevulinic acid (ALA) [62]. This study compared six months of pulsed light bipolar radiofrequency with or without pretreatment with ALA. Unwanted facial hair was treated twice at four – and six-week intervals with half of the radiofrequency treatment area pretreated with topical ALA. This study reported the removal of terminal white hair from 35% with the radiofrequency device alone to 48% when ALA was used in combination. These data suggest that topically applied chemical technologies can augment the hair removal efficacy of energy-emitting devices.
Similarly, Sand et al. [42] reported the results of a study that investigated the use of melanin-encapsulated liposomes with laser therapy for the removal of blond, white, and gray hair. In this study, liposomal melanin was applied prior to laser treatment. Although the combination of the melanin and laser were more effective than treatment with the laser alone, the overall clinically observed reduction in hair growth was too weak to warrant further development of the liposomal melanin formulation.
Together these studies suggest that the combination of laser hair removal and topical hair growth reduction may provide a most favorable regimen for managing facial hair. Achieving optimal efficacy, onset of activity, and the duration of response will have the best opportunity to not only satisfy the consumer, but to improve their lives.