For Hidradenitis Suppurativa, Hair Removal Aids Tx

GRAPEVINE, TEX — Hair removal by intense pulsed light is a useful adjunctive treatment for refractory hidradenitis suppurativa, based on experience with 10 patients at one center.

Five of the treated patients had clear improvement in their clinical status after 3–4 hair-removal treatments, with reduced or resolved lesions in the treated area. The remaining five patients had improvement after four to eight treatments, Dr. Agneta Troilius said at the annual meeting of the American Society of Lasers in Medicine and Surgery. The treatment also resulted in less scarring than usually occurs when hidradenitis suppurativa (HS) lesions resolve.

"Hair removal is one element of treatment" for a disease that affects as many as 4% of women, said Dr. Troilius, head of the laser and vascular anomaly section of the department of dermatology at Lund University in Malmö, Sweden.

The series included women aged 21–45 years with skin type II or III who had active HS for several years and had lesions that had affected their social lives.

Treatment was with an intense pulsed light (IPL) device, the Ellipse model made by Danish Dermatologic Development, using the hair applicator to deliver 645- to 950-nm light. Treatment was with a fluence of 17–19 J/cm2, delivered as 20- to 40-microsecond pulses with a 1.5-microsecond delay. Treatments were at 1-month intervals. For pain control, treated areas were pretreated with a eutectic mixture of lidocaine and prilocaine (EMLA), and also were treated with contact cooling.

"One drawback to this treatment is that it is painful to treat in the affected areas," Dr. Troilius said. Treatment of HS may be further refined by combining hair removal with photodynamic therapy or anti-inflammatory therapy with newly available biologic drugs.