A pilot study to optimize laser-assisted hair removal using real-time high-speed infrared imaging.
OBJECTIVE: The aim of this study was to investigate thermal effects on the skin surface during laser-assisted hair removal using real-time high-speed infrared imaging. BACKGROUND DATA: Although hair laser removal (HLR) can be considered an inherently safe treatment, there may be approaches to optimise the benefit/risk ratio of this common therapeutic and cosmetic procedure. METHODS: In this pilot study on three subjects, a ruby laser equipped with a cryogen spray cooling (CSC) system was used to investigate the effect of different CSC durations and delay times between CSC and the laser impulse. Skin surface temperature (SST) was assessed in real-time using a high-speed infrared camera (ThermaCam Phoenix) and a special image analysis software (analySIS Doku). RESULTS: There was no substantial difference of SST between the use of CSC spurts of 10 and 20 msec (6.1 degrees C versus 5.7 degrees C). The use of single laser and cooling parameters revealed baseline SST of 31.7 degrees C, immediately after CSC (10 ms) SST of 6.5 degrees C, and after laser pulse SST of 47 degrees C. Using fluences of 10-20 J/cm(2), a marked difference in temperature was observed between the skin surface and hair (e.g., 26.7 degrees C versus 57.5 degrees C). SST of 62-64 degrees C was observed using fluences of 18-20 J/cm(2), resulting in adverse effects. A maximum SST of 59 degrees C was observed using a CSC spurt of 40 msec, whereas a maximum SST of 60 degrees C was recorded for 30, 20, and 10 msec. The use of CSC delay time of 600 msec revealed baseline SST of 34.6 degrees C, immediately after CSC (10 msec) SST of 5.2 degrees C, after 600 msec delay SST of 21.5 degrees C, and SST of 60 degrees C following the laser pulse. By contrast, 100 msec delay time revealed baseline SST of 34.8 degrees C, immediately after CSC (10 ms) SST of 7 degrees C, after 100 msec delay SST of 7.5 degrees C, and SST of 55.2 degrees C following the laser pulse. CONCLUSION: Our preliminary data indicate that side effects of HLR can be avoided using CSC duration of 10 msec with a delay of about 200 msec. Short delay times between the CSC and laser pulse seem to result in lower post-irradiation SST and may therefore lead to less adverse effects. With regard to the fluence used in HLR, it is of importance that the maximum SST remains below 60 degrees C. Based on these preliminary results, real-time high-speed infrared imaging seems to be an interesting method to study the thermodynamics on skin surface during laser treatment.