A Google search on "home laser" yielded 154,000,000 website links overseas and 48,000,000 when searched in the US. Most of the initial listings are for hair removal devices but there are also ones for treating acne and for facial rejuvenation and others treat skin conditions like psoriasis, vitiligo and dermatitis. Many of these home laser and light or ultrasonic devices can be purchased on the Internet. Sellers tout the benefits of these products in treating acne, age spots, large pores, wrinkles, sagging skin, puffy eyes, rosacea, cold sores, and many other skin conditions. However, few of the devices have been studied or approved by the Food and Drug Administration. Some of them sound sort of scary and could be a waste of money or at worst harmful. Sales of home cosmetic devices totaled $500 million last year, and are expected to nearly double to $950 million in 2015. Women have been removing hair from their legs for quite some time. Now it is a multibillion dollar per year industry.
These new home devices tend to fall into four categories:
Diode or intense pulsed light devices that target hair removal,Light-emitting diode (LED) or heat devices that claim benefits for acne treatmentRejuvenation devices to treat wrinkles using laser or infrared light Home phototherapy devices that provide UVB light.Home devices use lower fluences and longer pulse widths (lower power and less penetration), compared with office-based treatments.
Hair Removal Devices
To be effective, energy in the form of heat must be absorbed by the hair shaft, penetrate deep enough to affect the follicle or root of the hair, and be administered quickly enough to stop transference of the heat to skin surrounding the hair follicle and shaft. Since hair grows in cycles and is most sensitive to treatments during the active growth cycle, it takes several laser treatments to remove hair for good. All of the devices work best and are safest on dark hair in the presence of light skin color.
One of the first home laser devices to be studied was the Tria diode laser.
Studies showed average hair reductions of 60% at 1 month, 41% at 6 months, and 33% at 12 months after three home treatments in 77 appropriate users (Lasers Surg. Med. 2007;39:476-93). In another study 86 percent of patients experienced more than 30 percent hair reduction, and 38 percent had more than 80 percent hair reduction at one year after the last of 8 monthly treatments. Hair removal was complete for 31 percent, and of those who experienced regrowth, 69 percent reported that the hair was finer and lighter than before treatment. A skin color sensor blocks the device on darker skin colors otherwise these individuals will form skin blisters. The FDA approved the device for off-face use; it costs approximately $395.
The Silk’n SensEpil by Sephora uses intense pulsed light at low energy and short pulse durations. It also has a built-in Skin Color Sensor that locks the device on darker skin tones.
It is FDA approved for use on skin on or below the cheeks, it costs approximately $499 plus the price of disposable parts. Three studies in 34, 20, and 10 females, respectively, found it works best for thin hair on the legs and arms, and is less effective for hair in the armpit or groin areas (J. Cosmet. Laser Ther. 2009;11:106-9; Dermatol. Surg. 2009;35:483-9; and Lasers Surg. Med. 2010;42:287-91).
The No! No! Hair device uses patented Thermicon technology employing a thermal filament to deliver heat to the hair shaft without a light so they claim it is safe for all skin and hair colors.
It is the most heavily advertised hair removal device at least on late night television. In a study of 12 patients, twice-weekly treatment for 6 weeks with the low-energy device removed 44% of hair on the legs and 15% of hair in the bikini area at the 12-week follow-up (J. Drugs Dermatol. 2007;6:788-92).
In another study of 23 patients (7 men, 16 women) aged 18-55 years two sites on one leg of each patient were shaved 4 days before baseline, and then were treated every 3-4 days with the No! No! device on one site on the leg and by shaving the other site for 8 weeks. There was no significant difference between the 2 areas in terms of number of active hair follicles, hair regrowth, thickness or color after 1 month. That is to say singing the hair away with the device was no different than shaving it off. The No! No! device is basically an expensive razor.
The No! No! costs approximately $270.
Devices to Treat Acne
Eight studies since 1999 have shown that doctors' office treatments with blue light are effective in eliminating Propionibacterium acnes bacteria the causative agent of acne. Just clearing the bacteria isn’t enough a lot of the time because the bacteria produce irritating proteins that can be left behind so additional medical treatment with prescription or over the counter medications is frequently required. The Tria system comes with washes and topical creams, or patients can use the device with whatever prescription regimen they are on.
Four home devices now offer self-application of this blue light. The power density of the various devices makes a difference. Lower power density requires twice-weekly, 20-minute applications on each side of the face, which can be difficult for patients to do. Higher-density blue light devices, such as the Tria skin clarifying system, require less than 3 minutes twice a day.
The TRIA Skin Perfecting Blue Light uses blue light to kill bacteria in the pores thereby unclogging the pores and eliminating break outs.
Studies have showed 70% clearance of treated areas within 2 weeks. A company-sponsored study of the Tria device in 33 adults showed significant reductions in inflammatory acne lesions after 3 weeks of treatments (J. Drugs Dermatol. 2011;6:596-602). The device's blue light cartridge has to be replaced about every 2 months. The FDA approved the device for the treatment of acne, it costs approximately $245.
The No! No! Skin uses heat generated by light to treat acne. A green light releases oxygen from porphyrins produced by the bacteria to kill the bacteria. A red light diminishes pain and swelling.
It also costs about $270.
The Claro home device by Sephora
combines heat and intense pulsed light:
-Blue Light (400-430nm): stimulates the production of oxygen, which attacks the bacteria that causes acne
- Red Light (600nm): combines with heat to soothe the inflammation, redness and soreness of each pimple while accelerating the healing process
- Infra-Red Energy (700nm): creates heat that helps to kill the acne bacteria while increasing the effectiveness of blue light
It costs approximately $195 and comes in 3 colors - red, black and blue.
ThermaClear Acne Clearing Device delivers a 2-second pulse of targeted heat to each pimple to kill acne causing bacteria.
It's FDA cleared and advertised as safe and effective on all skin types and tones.
Zeno uses the combination of a topical medication containing 1% salicylic acid and skin moisturizer followed by the application of a small vibrating heat generating hand held device to treat acne.
At $40 it may be the cheapest device available.
Skin Wrinkle Removal - Rejuvenation
The PaloVia fractionated laser (Palomar Medical Technologies) was the first FDA-cleared at-home laser for treating wrinkles around the eyes.
There are two phases to the wrinkle treatment plan – the Initial Phase of one treatment per day for 30 days and the Maintenance Phase of one treatment 2 times per week. It costs about $500. A blinded study of 34 subjects presented at the 2010 meeting of the American Society for Laser Medicine and Surgery reported a 1-point improvement on the 9-point Fitzpatrick wrinkle scale in 90% of patients after 4 weeks of daily use and in 79% after 4 weeks of twice-weekly maintenance treatments.
Phototherapy
The Levia UVB device (Lerner Medical Devices) is approved for home use to treat psoriasis, vitiligo, and atopic dermatitis.
It directs concentrated ultraviolet B (UVB) light, which has a long history in treating psoriasis, to psoriasis plaques. The treatments require a prescription and programming of the device. Multiple studies have shown that home UVB therapy is as effective as office treatments.
I have not covered the scarier sounding devices in this blog. In conclusion I think we will see doctors doing laser hair removal as a thing of the past. It makes we wonder if the home laser tattoo removal kit is just around the corner.
