Ruby laser treatment for hirsutism: clinical response and patient tolerance.

We report the results of a study of the ruby laser in normal mode for treatment of hirsutism in 43 patients with skin types I-IV. A pulse width of 950 microseconds, a 4 mm spot and a fluence sufficient to produce minimal whitening of the epidermis were used (mean 48 J/cm2). In each patient, one site was treated once only, and a second site received four treatments at monthly intervals. After a single treatment, hair counts had reduced to a mean of 46% (median 67, reduced to 26) of the pretreatment values at 1 month, but increased to 80% (median 42) at 3 months and were 66% (median 37) at 6 months. One month after three treatments, hair counts had reduced to a mean of 29% (median 60, reduced to 15) of pretreatment values, and 3 months after four treatments at the same site, counts had increased to 44% (median 21). Patient tolerance of the treatment was good and higher fluences tended to be tolerated at consecutive visits. The first treatment was followed by mild, short-lived erythema and swelling in 60% (25 of 42) patients. Fourteen per cent (six of 42) experienced mild blistering and 33% (14 of 42) crusting. More severe reactions were seen infrequently. These results indicate that normal mode ruby laser treatment is well tolerated. Sustained reduction in hair counts can be achieved for at least 6 months, and multiple treatments produce greater clinical effects.