While the amount of hair reduction varies depending on the treatment parameters and body site, most reports have proved that multiple treatments are necessary to achieve the best results [75-80]. As a rule, 6-10 laser treatments are required during the first year to achieve long-term results [59]. With most laser systems, a single treatment can reduce hair counts by 10-40%, three treatments by 30-70% and after repeated treatments, as much as 90%. These results can be maintained via posttreatment follow-up for as long as 12 months [60]. However, most published studies on laser hair removal are uncontrolled, small-based (less than 50 subjects), and have used a variety of treatment protocols, equipment, skin types, and hair colors [62]. None of the presently utilized lasers has been proven to destroy hair permanently, and long-term results are still lacking [62]. It has been reported that the hair that does grow back will be smaller, lighter, and less noticeable [52]. The goal is to use the highest fluence tolerated by the subject without causing unwanted side effects. In areas
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Table 8.1 Comparison of Skin-Cooling Methods [53]
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with a high percent of anagen follicles (i. e., face), treatments should be four weeks apart whereas other areas such as legs and back can be treated at 8-12 week intervals. Subjects with Fitzpatrick skin type I-III and dark hair are the best candidates, and respond equally well to the different lasers [78]. The following choices of lasers are recommended based on hair and skin color:
1. Light, thin hair and Fitzpatrick I-II have the choice of the Ruby or Alexndrite laser,
2. Brown hair, medium thickness, and Fitzpatrick skin phenotype II-IV can use the ruby, alexandrite, or IPL
3. Black, coarse hair, and Fitzpatrick skin IV-VI – diode or Nd:YAG (1).