A Cochrane review [Abstract] 1 included 11 trials involving a total of 444 people. There appeared to be a short-term effect of approximately 50% hair reduction with alexandrite and diode lasers up to six months after treatment, whereas little evidence was obtained for an effect of intense pulsed light, neodymium:YAG or ruby lasers. Long-term hair removal was not documented with any treatment. Pain, skin redness, swelling, burned hairs and pigmentary changes were infrequently reported adverse effects.
A hospital-based comparative, observational prospective study 2 was carried out on female patients with hirsutism over a period of 18 months with 2 groups of participants: with idiopathic hirsutism (n=50) and with PCOS (n=50). Laser hair reduction was done with long pulsed (1064 nm) Nd:YAG laser in both groups up to 6 sessions, 4 weeks apart and followed for 3 months post last laser session. Excellent response (> 75% reduction, both clinically and trichoscopically with decrease in hair shaft thickness, hair shaft colour, terminal vs. vellus hair ratio and hair density per cm2) from baseline was seen in 70% of patients in idiopathic hirsutism and in 54% of patients in PCOS group. After 3 months of follow-up of the last laser session, the results persisted better in patients with idiopathic cause than in those due to PCOS.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes), by indirectness (differences in studied patients), and by imprecise results (limited study size for each comparison).
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