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Evidence toolbox: summaries of two new Cochrane reviews that could apply to your next consultation

Treatments for

unwanted hair

How effective are laser treatment and photoepilation for unwanted hair growth?

Unwanted hair growth is a therapeutic

challenge. Epilation with laser devices and intense pulsed light are commonly used although the long-term effect is uncertain.

Our objective was to assess the effects of epilation with lasers and light sources.

Method We searched the Cochrane Skin Group's Specialised Register in February 2004; Medline (from 1966) and Embase (from 1980) in April 2005. We searched

reference lists of collected trials and contacted trial authors. The selection criteria were

RCTs.

Primary outcomes were objective reduction in hair counts, adverse effects and

subjective reduction in hairiness. Secondary outcomes were participants' satisfaction and personal observations such as softer,

finer or paler hairs. Two authors independently extracted data and assessed trial

quality.

Main results We included 11 randomised controlled trials involving 444 people, none of which were of high methodological quality. Many trials were excluded, mainly because of their non-randomised design. The randomisation procedures were either unclear or inadequate, using coin tossing, alternation, drawing lots or cards, or open tables of random numbers. The interventions and outcomes were too heterogeneous to be

entered in a meta-analysis. Most trials examined a short-term effect.

There appeared to be a short-term effect of about 50 per cent hair reduction with alexandrite and diode lasers up to six months after treatment, but little evidence was obtained for an effect of intense pulsed light, neodymium:YAG or ruby lasers. Long-term removal was not documented. Pain, redness, swelling, burned hairs and pigment changes were infrequent adverse effects.

Authors' conclusions Some treatments lead to temporary short-term hair removal. High quality research is needed.

Reference Haedersdal M, Gøtzsche PC. Laser and photoepilation for unwanted hair growth. Cochrane Database of Systematic Reviews 2006, issue 4.

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