LAS VEGAS – A large array of home laser and light devices can be purchased on the Internet, with sellers touting their cosmetic benefits in treating acne, age spots, large pores, wrinkles, sagging skin, puffy eyes, rosacea, cold sores, and many other skin conditions.
However, few of the devices have been studied or approved by the Food and Drug Administration, and "some of them sound sort of scary," said Dr. Anne M. Chapas. "There are a lot of junk devices that, at the very least, are a waste of money and, at worst, could be harmful to consumers."
Dr. Anne M. Chapas
Sales of home cosmetic devices totaled $500 million last year, and are expected to nearly double to $950 million in 2015, according to Dr. Chapas.
"At this time, it’s a buyer-beware market," she said at the annual meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery. "As dermatologists, we really need to jump on this" and educate patients and consumers about what the best devices really are.
Extensive Internet listings include devices using blue, yellow, and red light laser ultrasonic therapy. "I know that if I’m confused about it, my patients are certainly going to have a lot of questions," said Dr. Chapas of the department of dermatology at New York University.
Some home devices may serve a purpose for maintenance therapy between office treatments, a strategy that Dr. Chapas employs for some patients with acne. A helpful home device also can generate a patient’s interest in getting office-based laser treatments.
These new home devices tend to fall into four categories, she said: Diode or intense pulsed light devices that target hair removal, light-emitting diode (LED) or heat devices that claim benefits for acne treatment, devices to treat wrinkles using infrared light, and a home phototherapy device that provides UVB.
Hair Removal
Professionals use a variety of laser devices for hair removal – Dr. Chapas said she prefers the long-pulsed alexandrite or long-pulsed Nd:YAG lasers – while home devices tend to use diode, intense pulsed light, or heat technology.
Home devices use lower fluences and longer pulse widths, compared with office-based treatments. To be effective, energy must be absorbed by the hair shaft, penetrate deep enough to affect the follicle, and be administered in a pulse duration that is less than the thermal relaxation time of the hair follicle.
One of the first home laser devices to be studied, the Tria diode laser, showed mean hair reductions of 60% at 1 month, 41% at 6 months, and 33% at 12 months after three home treatments in 77 appropriate users (Lasers Surg. Med. 2007;39:476-93). A skin color sensor blocks the device on darker skin colors that could easily blister. The FDA approved the device for off-face use; it costs approximately $395.
The Silk’n SensEpil by Sephora uses intense pulsed light at low energy and short pulse durations. Approved for use on skin on or below the cheeks, it costs approximately $499 plus the price of disposable parts. Three studies in 34, 20, and 10 females, respectively, found it works best for thin hair on the legs and arms, and is less effective for hair on the axilla or inguinal areas, Dr. Chapas said (J. Cosmet. Laser Ther. 2009;11:106-9; Dermatol. Surg. 2009;35:483-9; and Lasers Surg. Med. 2010;42:287-91).
The No! No! device uses patented Thermicon technology employing a thermal filament to deliver heat to the hair shaft. In a study of 12 patients, twice-weekly treatment for 6 weeks with the low-energy device removed 44% of hair on the legs and 15% of hair in the bikini area at the 12-week follow-up (J. Drugs Dermatol. 2007;6:788-92).
"I think you would have to spend a lot of your time" to get results even on the legs, Dr. Chapas said. The No! No! costs approximately $270.
Acne
Home devices tend to use LED, intense pulsed light, and heat technology. Eight studies since 1999 have shown that office treatments with blue light are effective in eliminating Propionibacterium acnes bacteria, and four home devices now offer self-application of blue light, she noted.
In her office treatments, Dr. Chapas said she usually treats patients for 11-20 minutes twice a week for 4-8 weeks. "For a lot of patients, it’s just a pain to come into the office twice a week for 8 weeks, so there really is a need for a home device," she said. "I think these devices can help, and I now use them in between my PDT [photodynamic therapy] treatments."
The power density of the various devices makes a difference. Lower power density requires twice-weekly, 20-minute applications on each side of the face, which can be difficult for patients to do. Higher-density blue light devices, such as the Tria skin clarifying system, require less than 3 minutes twice a day, she said.