Efficacy of laser hair removal in hidradenitis suppurativa: A systematic review and meta-analysis

IF 2.2 3区医学 Q2 DERMATOLOGY Lasers in Surgery and Medicine Pub Date : 2024-05-20 DOI:10.1002/lsm.23796

William D. Shipman III MD, PhD, Monica N. Williams MD, Kathleen C. Suozzi MD, Anna S. Eisenstein MD, PhD, Jeffrey S. Dover MD

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Abstract

Objectives

Hidradenitis suppurativa (HS) is a chronic inflammatory condition characterized by painful nodules, draining tunnels, and fibrotic scarring in intertriginous, hair-bearing areas. The pathogenesis involves follicular occlusion and subsequent rupture, leading to uncontrolled inflammation. Treatment options for HS are limited and lack universal effectiveness. Laser hair removal (LHR) has been explored as a potential treatment; however, the efficacy and appropriate laser modalities remain unclear. This systematic review examined the efficacy and adverse effects of LHR in HS.

Methods

A comprehensive literature search was conducted from inception to September 2023 in Ovid MEDLINE, Ovid Embase, and The Cochrane Library (Wiley) with predefined inclusion and exclusion criteria, and a meta-analysis was conducted.

Results

Ten studies were selected (n = 227 total patients) and included six randomized controlled trials, two nonrandomized experimental studies, and two case series. Various laser modalities, including long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) (n = 115), intense pulsed light (n = 18), Alexandrite (n = 54), intralesional 1064 nm diode (n = 20), and combined fractional CO₂ and long-pulsed Nd:YAG laser (n = 20), consistently demonstrated significant improvement in HS disease severity, irrespective of the disease scoring method used. Minimal adverse effects (primarily mild pain and erythema) were reported. A meta-analysis of three studies utilizing long-pulsed Nd:YAG laser demonstrated a standardized mean difference in disease severity of −1.68 (95% confidence interval: −2.99; −0.37), favoring treatment with LHR for HS.

Conclusions

Hair follicles are key in HS pathogenesis and all included studies showed a significant improvement in HS disease severity after LHR regardless of the laser device used, likely related to hair follicle unit destruction. HS is a complex and heterogenous condition, and multiple disease scoring methods complicate outcome comparisons across studies. However, LHR, utilizing various techniques, is an effective treatment option for HS with minimal adverse effects.

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激光脱毛对化脓性扁桃体炎的疗效：系统回顾与荟萃分析。

目的：化脓性扁平湿疹（HS）是一种慢性炎症，其特征是在生发区的三叉神经间出现疼痛结节、引流隧道和纤维化瘢痕。发病机制包括毛囊闭塞和随后的破裂，导致炎症失控。HS 的治疗方法有限，而且缺乏普遍的有效性。激光脱毛（LHR）已被视为一种潜在的治疗方法，但其疗效和适当的激光模式仍不明确。本系统性综述研究了激光脱毛对 HS 的疗效和不良反应：方法：在 Ovid MEDLINE、Ovid Embase 和 Cochrane Library (Wiley) 中按照预定义的纳入和排除标准进行了从开始到 2023 年 9 月的全面文献检索，并进行了荟萃分析：共筛选出 10 项研究（n = 227 名患者），包括 6 项随机对照试验、2 项非随机实验研究和 2 项病例系列研究。各种激光模式，包括长脉冲掺钕钇铝石榴石（Nd:YAG）（n = 115）、强脉冲光（n = 18）、亚历山大激光（n = 54）、1064 nm 二极管（n = 20）以及点阵 CO2 和长脉冲 Nd:YAG 激光联合疗法（n = 20），无论采用哪种疾病评分方法，都能显著改善 HS 的疾病严重程度。据报道，不良反应极少（主要是轻微疼痛和红斑）。对使用长脉冲 Nd:YAG 激光的三项研究进行的荟萃分析表明，疾病严重程度的标准化平均差异为-1.68（95% 置信区间：-2.99；-0.37），LHR 治疗 HS 更受青睐：结论：毛囊是HS发病的关键，所有纳入的研究都显示，无论使用哪种激光设备，LHR治疗后HS疾病严重程度都有显著改善，这可能与毛囊单位破坏有关。HS 是一种复杂的异质性疾病，多种疾病评分方法使不同研究的结果比较变得复杂。不过，采用不同技术的 LHR 是治疗 HS 的有效方法，且不良反应极小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.