Burning, paradoxical hypertrichosis, leukotrichia and folliculitis are four major complications of intense pulsed light hair removal therapy.

BACKGROUND: Lasers and intense pulsed light (IPL) are now used worldwide for prolonged photo-epilation.

OBJECTIVE: To study the side effects of IPL hair removal therapy among 2541 female hirsute patients as the largest series reported so far in the literature.

METHODS: The first series of 1000 patients were treated by the Lumina IPL system. (Lynton Lasers, UK). The second series of 1541 patients were treated by Vasculight-SR, a multi-functional laser and IPL system (Lumenis, Inc., USA). The fluences used for Lumina varied between 16 and 30 J/cm2. The parameters used for Vasculight-SR were as follows: fluences ranged from 33 to 42 J/cm2; pulse duration was 3-5 ms, and pulse delay was 20-80 ms. The pulse mode was either double or triple. The parameters were chosen according to the patients' Fitzpatrick skin types and tolerance. The cut-off filters frequently used were 695, 755, 645 and 615 nm in descending order of their frequencies. Patients were treated every 4-6 weeks and for eight sessions or more. All patients were followed for up to 20 months.

RESULTS: Series 1 - burning and its sequelae presented as post-inflammatory hyperpigmentation (PIH), post-inflammatory hypopigmentation (PIHPO), bulla and erosion, and finally scar formation in 75, 10, 64 and one case, respectively. Leukotrichia, folliculitis, and paradoxical hypertrichosis were recorded in 40, 35, and 12 more cases, respectively. Series 2 - PIH and PIHPO were recorded in 28 and four patients. Erosion and crust formation were recorded in 28 patients. Paradoxical effect, leukotrichia and acne formation were seen in 79, 27 and 19 cases, respectively.

CONCLUSION: Burning and its sequellae, leukotrichia, paradoxical hypertrichosis and folliculitis are four major side effects of IPL hair removal therapy in our study.