Efficacy of 800 nm diode laser to treat trichostasis spinulosa in Asian patients

Abstract

Context:Trichostasis spinulosa (TS) is a common but underdiagnosed follicular disorder involving retention of successive telogen hair in the hair follicle. Laser hair removal is a newer treatment modality for TS with promising results.Aims:This study aims to evaluate the efficacy of 800 nm diode laser to treat TS in Asian patients.Subjects and Methods:We treated 50 Indian subjects (Fitzpatrick skin phototype IV–V) with untreated trichostasis spinulosa on the nose with 800 nm diode laser at fluence ranging from 22 to 30 J/cm2 and pulse width of 30 ms. The patients were given two sittings at 8 week intervals. The evaluation was done by blinded assessment of photographs by independent dermatologists.Results:Totally 45 (90%) patients had complete clearance of the lesions at the end of treatment. Five (10%) subjects needed one-third sitting for complete clearance. 45 patients had complete resolution and no recurrence even at 2 years follow-up visit. 5 patients had partial recurrence after 8–9 months and needed an extra laser session.Conclusions:Laser hair reduction in patients with TS targets and removes the hair follicles which are responsible for the plugged appearance. Due to permanent ablation of the hair bulb and bulge, the recurrence which is often seen with other modalities of treatment for TS is not observed here.

Trichostasis Spinulosa: A Case Report with an Unusual Presentation

“…Several treatment modalities have been reported in the literature, including topical keratolytic agents, emollients, hydroactive adhesive pads, and tretinoin solution; however, their effects are usually temporary [17, 18]. Other reported treatments include 800-nm diode laser, which shows 90% complete clearance of the lesions, short-pulsed 755-nm Alexandrite laser, which can cure all patients in the study without recurrence in 3 months, and long-pulsed 755-nm Alexandrite laser, which diminishes more than 50% of lesions in 51% of patients [19-21]. Nevertheless, none of these were noted as a curative treatment.…”

Trichostasis spinulosa: An entity with cosmetic concern

“…Treatment Keratolytics, tretinoin not effective Treatment-resistant Long remission possible with lasers [28][29] Topical retinoids, Azelaic acid Benzoyl peroxide Salicylic acid and glycolic acid peels [17] Keratolytics, topical retinoids effective Oral retinoids and lasers like PDL, KTPL, alexandrite laser, longpulsed diode laser, Q-switched Nd:YAG laser, and fractional carbon dioxide laser are effective [28,29] Spontaneous resolution via transepidermal elimination may occur Needle evacuation, topical and oral retinoids, dermabrasion and lasers [28,29] Spontaneous resolution may be seen Keratolytics Topical and oral retinoids Vitamin D analogous Sometimes persistent with relapsing course [32] diode lasers, long pulse1064-nm ND: YAG laser) is found to be safe and successful in slowing hair regrowth in TS, offering a definitive curative option. [3,2,[40][41][42][43] Improvement in the skin texture, appreciated as reduction in roughness is an added cosmetic advantage besides complete clearance of the comedo-like plugs. Areas with thinner skin such as the face and axilla allow better penetration and delivery of laser energy and respond better than back and extremities.…”

“…Suboptimal therapeutic regimens have been guided largely by case reports, with the mainstay of treatment being keratolytics and topical retinoids. [2] Recently, lasers have emerged as a promising treatment modality. [2,3] We present a review of the pathogenesis, clinicopathologic features, associated conditions, dermoscopic features, and treatment of TS.…”

“…[2] Recently, lasers have emerged as a promising treatment modality. [2,3] We present a review of the pathogenesis, clinicopathologic features, associated conditions, dermoscopic features, and treatment of TS.…”

Unconventional uses of laser hair removal: A review

“…[ 50 ] Its effectiveness has been reported,[ 51 52 ] with minimal discomfort and side effects, and no recurrence in 90% of the cases, even after 2 years. [ 53 ]…”