Dark skin tissue reaction in laser assisted hair removal with a long-pulse ruby laser

BACKGROUND: Photo-epilation has become an accepted modality for the removal of unwanted hair. However, adverse effects may occur in darker skin patients. Treatment with the ruby laser is generally advised for skin types I-III. Treatment of over 3000 patients (skin types I-III) in our clinic has resulted in a minimal percentage (approximately 3%) of adverse effects. Increasing pulse duration should allow the epidermis to cool and thus minimize thermal damage so that treatment can be extended to dark skin patients. OBJECTIVES: The purpose of our study was to compare tissue reaction in dark skin patients (skin type IV) after treatment with a long-pulse (20 msec) ruby laser and compare the reaction with a 1 msec ruby laser treatment. RESULTS: Hair removal efficacy was determined to be similar with both pulse durations, but tissue reaction was more severe, including eschar and hypo-pigmentation, following treatment of dark skin patients with the 1 msec protocol. Increasing the pulse duration to 20 msec appears to result in safe and efficacious ruby laser treatment even for darker skinned patients.