laser hair removal. is it permanent?

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Prof. Osama B MoawadEnergy Based Hair Removal1Human hair growth patterns convey social information about sex, age, and racial background

Excess Hair

The presence of excessive hair can be a source of distress that can lead to such psychological problems as anxiety, depression, and reduced quality of life.

Excess HairClassification of Excess HairHuman hair growth patterns convey social information about sex, age, and racial background. Patients with abnormalities of hair growth can experience considerable emotional stress and social exclusion. It is classified as either hypertrichosis or hirsutism.

Hirsutism is defined as the abnormal growth of terminal hair in women in male-pattern (androgen-dependent) sites, such as the face and chest. Hypertrichosis refers to excess hair growth at anybody site that is not androgen dependent.Although hypertrichosis is often a primarily cosmetic problem, it may also represent a cutaneous sign of an underlying systemic disease. It can provide an important aid in diagnosis, and familiarity with its various causes is important. One of the two major mechanisms of hypertrichosis is the conversion of vellus to terminal hairs. The surge of androgen production in adolescence causes the follicles in the axillae, groin, and, in males, the beard and chest, to grow larger and deeper into the dermis and undergo conversion to terminal hairs.

Hypertrichosis often involves a similar vellus-to-terminal switch in body regions that donot usually bear terminal hairs. The mechanisms of the vellus-to-terminal switch are poorly understood. Even when it is caused by androgens, it is not understood why, in some areas, such as the axilla and pubis, androgens may spur hair growth, whereas in others, such as the scalp, hair growth may be reduced.

The other chief mechanism of hypertrichosis involves changes in the hair-growth cycle. Longer hair is created by increased time spent in the anagen phase, whereas greater hair density can be caused by a decrease in hair shedding as a result of a decrease in the percentage of follicles in telogen phase. Areas of the body with longer, denser hair, such as the scalp, have an increased percentage of follicles in anagen stage. Like the vellus-to-terminal switch, control and alteration of the hair cycle is just beginning to be understood. Follicles in each body area have their own intrinsic growth pattern, which may be altered by systemic influences, such as androgens, thyroid hormone, and growth hormone. When follicles spend longer in anagen than is normal for their location, hypertrichosis results.

Many reports of hypertrichosis erroneously called hirsutism, a term that should be reserved for the subclass of hypertrichosis caused by excess androgen-sensitive hair growth. The diagnosis of hirsutism should be made only in women or children who have hypertrichosis in an adult, male pattern distribution. Such patients should be evaluated for other signs of hyperandrogenism. Prof Moawad, recommends the following laboratory tests when evaluating patients for hyper-androgenism: total and free testosterone, dehydroepiandrosterone sulfate (DHEAS), and 17-hydroxyprogesterone.

In polycystic ovaries syndrome (PCOS), the free testosterone is most important. Although the LH/follicle-stimulating hormone (FSH) ratio may be elevated, this is not considered a reliable test, because approximately 50% of patients with PCOS will not demonstrate this. If the total testosterone levels are markedly elevated at levels greater than 200 ng/dl, in the context of the abrupt appearance of virilizing signs such as hirsuitism and clitoromegaly, then a virilizing tumor, such as an arrhenoblastoma, must be ruled out.

Because an elevated DHEAS may be observed in approximately half of the patients with PCOS, an elevated 17-hydroxyprogesterone level will help confirm the diagnosis of late-onset congenital adrenal hyperplasia. Prof Moawad may recommend anti-androgen like Yasmin contraceptive or spironolactone or Diane 35 to control your excess androgens and make your hair more responsive to laser treatment. Today, removing unwanted body hair is an increasingly prevalent trend in our society, and photoepilation by laser or other light-based technology is the fastest growing procedure in cosmetic dermatology. Other methods for removing unwanted hair include bleaching, plucking, shaving, waxing, and chemical depilatories.

4HypertrichosisHypertrichosis is defined as hair growth that is abnormal for the age, sex, or race of an individual at any body site that is not androgen dependent

Recognized forms of hypertrichosis are reviewed. Hirsutism, which is male-pattern hairgrowth in a female or child, is not included in this review. Hypertrichosis is categorized as congenital oracquired, and regional or generalized. Methods of managing hypertrichosis are also briefly reviewe5HirsutismHirsutism is defined as the abnormal growth of terminal hair in women in male-pattern (androgen-dependent) sites, such as the face and chest

Classification of Excess HairHuman hair growth patterns convey social information about sex, age, and racial background. Patients with abnormalities of hair growth can experience considerable emotional stress and social exclusion. It is classified as either hypertrichosis or hirsutism.

Hirsutism is defined as the abnormal growth of terminal hair in women in male-pattern (androgen-dependent) sites, such as the face and chest. Hypertrichosis refers to excess hair growth at anybody site that is not androgen dependent.Although hypertrichosis is often a primarily cosmetic problem, it may also represent a cutaneous sign of an underlying systemic disease. It can provide an important aid in diagnosis, and familiarity with its various causes is important. One of the two major mechanisms of hypertrichosis is the conversion of vellus to terminal hairs. The surge of androgen production in adolescence causes the follicles in the axillae, groin, and, in males, the beard and chest, to grow larger and deeper into the dermis and undergo conversion to terminal hairs.

Hypertrichosis often involves a similar vellus-to-terminal switch in body regions that donot usually bear terminal hairs. The mechanisms of the vellus-to-terminal switch are poorly understood. Even when it is caused by androgens, it is not understood why, in some areas, such as the axilla and pubis, androgens may spur hair growth, whereas in others, such as the scalp, hair growth may be reduced.

The other chief mechanism of hypertrichosis involves changes in the hair-growth cycle. Longer hair is created by increased time spent in the anagen phase, whereas greater hair density can be caused by a decrease in hair shedding as a result of a decrease in the percentage of follicles in telogen phase. Areas of the body with longer, denser hair, such as the scalp, have an increased percentage of follicles in anagen stage. Like the vellus-to-terminal switch, control and alteration of the hair cycle is just beginning to be understood. Follicles in each body area have their own intrinsic growth pattern, which may be altered by systemic influences, such as androgens, thyroid hormone, and growth hormone. When follicles spend longer in anagen than is normal for their location, hypertrichosis results.

Many reports of hypertrichosis erroneously called hirsutism, a term that should be reserved for the subclass of hypertrichosis caused by excess androgen-sensitive hair growth. The diagnosis of hirsutism should be made only in women or children who have hypertrichosis in an adult, male pattern distribution. Such patients should be evaluated for other signs of hyperandrogenism. Prof Moawad, recommends the following laboratory tests when evaluating patients for hyper-androgenism: total and free testosterone, dehydroepiandrosterone sulfate (DHEAS), and 17-hydroxyprogesterone.

In polycystic ovaries syndrome (PCOS), the free testosterone is most important. Although the LH/follicle-stimulating hormone (FSH) ratio may be elevated, this is not considered a reliable test, because approximately 50% of patients with PCOS will not demonstrate this. If the total testosterone levels are markedly elevated at levels greater than 200 ng/dl, in the context of the abrupt appearance of virilizing signs such as hirsuitism and clitoromegaly, then a virilizing tumor, such as an arrhenoblastoma, must be ruled out.

Because an elevated DHEAS may be observed in approximately half of the patients with PCOS, an elevated 17-hydroxyprogesterone level will help confirm the diagnosis of late-onset congenital adrenal hyperplasia. Prof Moawad may recommend anti-androgen like Yasmin contraceptive or spironolactone or Diane 35 to control your excess androgens and make your hair more responsive to laser treatment. Today, removing unwanted body hair is an increasingly prevalent trend in our society, and photoepilation by laser or other light-based technology is the fastest growing procedure in cosmetic dermatology. Other methods for removing unwanted hair include bleaching, plucking, shaving, waxing, and chemical depilatories.

6Temporary Methods of Hair Removal

Bleaching does not remove the hair follicle, but it serves to lighten the color of the external hair shaft so that it is less noticeable BleachingSeveral types of commercial hair bleaches are available: neutral oil bleaches, color oil bleaches, cream bleaches, and powder bleaches all of which contain hydrogen peroxide as the active ingredient. While a 6% concentration of peroxide bleaches, softens, and oxidizes the hair, the addition of 28% ammonia accelerates its bleaching action. The addition of persulfate to intensify peroxide hair bleach hasresulted in generalized urticaria, asthma, syncope, and shock

While, bleaching is a quick, easy, and painl