Light-Based Home-Use Hair Removal Devices: A Cross-Sectional Survey (2024)

Abstract

Key words: Hair removal, home-based lasers, survey

INTRODUCTION

Light-based home-use hair removal devices have become increasingly popular over the last decade.[1,2,3,4,5,6] A variety of options are available in the market these days, and most of these products are easy to use and have a good safety profile. With the COVID-19 pandemic, the relevance of these devices has increased as patients are understandably more hesitant to visit clinics for nonemergency reasons. Most of these devices produce intense pulse light (IPL), while some are true lasers (mainly diode). The common IPL-based devices emit a wavelength ranging from 500 to 1200 nm. Previous studies have shown that these devices are effective in hair reduction. Side effects were also minimal, and erythema was the most common side effect noted.[1,2] However, most studies have been conducted on lighter skin types (Fitzpatrick skin type 1 to type 4) and for relatively short follow-up durations (3–6 months). There have been isolated studies that have evaluated the use of IPL-based home-use devices in combination with radiofrequency for darker skin types.[7] The main objective of our study was to evaluate the frequency of use of light-based home-use hair removal devices in our population and to assess patient satisfaction with the same.

MATERIALS AND METHODS

A cross-sectional survey method was used. Ethical clearance was obtained from the institutional ethics committee. Respondents were conveyed that participation in the study was voluntary. The questionnaire was finalized by two dermatologists with experience in laser hair removal and piloted. The final version was sent as an electronic link on social media shared through female employees and students in our university. Among those who responded, only the responses of those who were using the devices were analyzed. Besides the demographic variables, the questionnaire covered questions related to the frequency of use of the home-use device, the brand used, side effects, and satisfaction.

Results of the responses were expressed in frequencies and percentages. For those who had used both clinical-based and home-based devices for laser hair removal, satisfaction scores were statistically compared using Mann–Whitney U-test.

RESULTS

A total of 111 responses were obtained; of those, the number of responders who were using home-based devices for hair removal was 39 (35%). All of them were using the same for facial hair. On self-evaluation of skin type, 28 of the 39 (71.7%) who were using home-based devices classified their skin as “never burns, always tans.” The most common frequency of maintenance usage was once in a month (24, 61%). IPL-based devices were the most common ones used in our sample, with Philips Lumea^® being the most popular brand (25, 64%). Other brands being used included – Beurer^®, Tria^®, Remington^®, Illuminage^®, Silk'n^®, and Mlay^®. Most of the respondents (25, 64%) were aware of the type of light/laser output in their device (IPL/diode). Only 4 of the respondents mentioned side effects, and the common side effects mentioned included redness, superficial burns, and discoloration. Almost half the samples were sharing the same device with other family members (19, 48.7%). Regarding self-perceived effectiveness on a scale of 1–10 (10 being very effective) for hair reduction, the average score was 6.07. Of patients who were using home-based devices, 34 (87%) also had experience with clinic-based lasers and the corresponding mean score for clinic-based lasers was 7.15. The difference between the scores was statistically significant at P < 0.05 (Mann–Whitney U - Z-score - 2.4134, P = 0.01596). Of the total, eight patients had a known history of polycystic ovarian disease (PCOD), while 20 were not sure if they had the same. The other patients did not have any known history of PCOD.

Regarding other questions related to practices in the context light/laser-based hair removal:

• Is it OK to bleach hair before the sessions – 8 (20.5%) disagreed, while 31 (79.5%) were unsure

• Hair removal lasers can be used during pregnancy – 8 (20.5%) agreed, 12 (30.7%) disagreed, and 19 (48.7%) were not sure

• Hair removal lasers only have local side effects – 28 (71.7%) agreed, 9 (23%) disagreed, and 2 (0.5%) were not sure.

DISCUSSION

Light-based home-use hair removal devices are becoming increasingly popular. High safety profile and good outcomes, combined with privacy and the convenience of using the same in the comfort of one's home, make these devices an attractive choice.[2,8] The relevance would be more in the context of the COVID-19 pandemic, when social distancing puts nonessential medical services on the backburner. The number of products available in the market has increased significantly. It is therefore also important for dermatologists to be aware of different brands and their properties, to help make shared decisions with patients on choosing a specific product.[8] Patients need to be familiar with the instructions for the machine that they are using, especially safety issues. Patients also need to be aware of general practical aspects related to laser/lights in the context of hair removal.

Light-based home-use hair removal also work on the principle of selective photothermolysis, as in the case of clinic-based laser devices. However, in general, the fluence is lower compared to professional lasers.[9] Although this reduces efficacy, the positive aspect is that this ensures a better safety profile. This is reflected in our study too, where the safety profile seemed to be very good, but the self-perceived efficacy, as compared to professional lasers, was less. Studies have shown that the home-use hair removal devices can produce significant hair reduction, especially if used for long-term maintenance. It is also suggested that it might be a good “companion” or adjunct treatment to maintain the results from professional hair removal lasers.[9]

Most home-based devices are IPL-based/single wavelength output in the region of about 810 nm, which is associated with low phototoxic potential. In our study too, the IPL-based devices were the most popular, and most responders did not notice any adverse effects. However, many of these devices have different energy settings, and the patient must be aware of the potential of side effects when using higher energy settings. Most manufacturers do not recommend the need to use protective goggles during the procedure, and they also warn against using the device too close to the eyes. However, patients should understand that if the contact area is not tightly pressed over the skin, the flash can be transmitted to the eyes. Most devices also carry detailed instructions and videos on their websites, including important points such as recommendations to avoid using the device in pregnant or lactating women. One of the possible side effects theoretically attributed to home use lasers is paradoxical hair growth because of the low-level radiant exposure; however, some studies have suggested that this is very unlikely.[10]

The respondents in our study seemed to be aware of the type of the device in terms of output (IPL vs. diode), but many were not sure of important aspects such as safety in pregnancy and the possibility of nonlocal adverse effects such as the effect on eyes.

The chance of cross-infection due to shared devices would seem to be less, but there are no studies to conclusively comment on this. In our study, almost half the respondents were sharing the device with other members in the family. It would be important to properly sterilize the device properly in this context.

To the best of our knowledge, this is the first such survey related to the use of light-based home-use hair removal devices in our region. Larger surveys are indicated to assess the knowledge, attitudes, and practices related to home-based laser/light devices in general populations. There is also a need for more larger randomized controlled trials to conclusively develop recommendations for these devices.[1]

Besides the small sample size, the respondents were generally from a higher socioeconomic group with higher educational levels, so it would be difficult to extrapolate and generalized results. We did not include an interview or focus group discussion, thereby limiting the value of the data. We did not statistically correlate the responses with underlying conditions such as PCOD because of the relatively low number of patients who gave a history of the same.

CONCLUSIONS

There seems to be a significant use of light-based home-use hair removal devices in our region, based on our limited sample. The most popular type in our study was IPL-based devices. Patient acceptability, safety profile, and satisfaction for the same are high. However, patient awareness needs to be improved further in some aspects, especially related to safety. The dermatologist should be aware of the common devices available in the market and their properties to ensure that the patients are aware and make better-informed decisions while choosing and continuing to use these devices.

REFERENCES