A more different problem is the laser and light-based removal of nonpigmented hair. Since laser hair removal of unwanted hair is based on melanin absorption, blonde, and white hair have proved to be very difficult to treat. A variety of methods have been utilized with less impressive results than are seen with the removal of pigmented hair.
Recently, a group in Germany investigated the use of a topically applied liposomal melanin spray in 42 patients prior to diode laser treatment with the hope to provide a chro- mophore in patients with blonde, white or gray hair [39]. Overall, results were disappointing, and patients in the treatment group showed only a 14% reduction in hair six months after three treatment cycles. The authors concluded that this was not an efficacious or cost-effective treatment.
A different approach to target nonpigmented hair has been utilizing a combined light/ bipolar radiofrequency device. Sadick and Laughlin treated 36 adults with white and blonde hair using a combined light/bipolar radiofrequency device [40]. They obtained an average hair reduction of 48%, six months after four treatments. In a similar study, Goldberg et al. evaluated a combined pulsed light bipolar radiofrequency device with and without pretreatment with a topical photosensitizer (5-ALA) [41]. Six months after two treatments, increased efficacy was found in the group who received pretreatment with topical 5-ALA (48% vs. 35% reduction in hair).