Journal of Cosmetic and Laser Therapy, 2010; 12: 7–9

ORIGINAL ARTICLE

Unwanted facial hair removal with laser treatment improves

quality of life of patients

ALI MAZIAR1, NADER FARSI1, MANIJEH MANDEGARFARD2, SHAHAB BABAKOOHI2,

FARZAM GOROUHI2, YAHYA DOWLATI2 & ALIREZA FIROOZ2
1Army University of Medical Sciences, Tehran, Iran and 2Center for Research and Training in Skin Diseases and
Leprosy, Tehran University of Medical Sciences, Tehran, Iran

Abstract
Background: Unwanted facial hair can have adverse psychological effects on women and reduce their quality of life.
Objective: To assess the effects of unwanted facial hair removal with laser on improving quality of life. Methods: In this study,
70 patients treated for unwanted facial hair by laser were assessed by Dermatology Life Quality Index (DLQI) question-
naire on admission and 3 months later after three sessions of laser treatment. Results: The DLQI score before treatment
was 9.42 ⫾ 5.99, which was reduced to 3.12 ⫾ 3.40 after laser treatment (p ⬍ 0.05). Conclusion: Unwanted facial hair
removal with laser can improve the quality of life of patients.

Key Words: Hirsutism, laser, quality of life

Introduction quality of life of patients. In one previous study, 38

Hirsutism affects between 5% and 15% of women,
depending on its definition (1). This can cause a lot
of psychological problems. The affected women may
suffer from anxiety and depression (2–4). In one
study on hirsute women suffering from polycystic
ovarian syndrome, the average time spent per week
dealing with facial hair was 104 minutes and the
majority of women reported checking facial hair fre-
quently in mirrors and by touch, and 75% showed
clinically significant anxiety (5).
There are different ways to solve this problem
such as shaving, waxing, electrolysis and laser treat-
ment, each with some advantages and drawbacks
(6,7). Laser treatment can induce long-lasting hair
reduction with a low risk of side effects (7). Laser
energy causes follicular unit damage by three mech-
anisms: photodermal damage by regional heating,
photomechanical damage by shock wave and photo-
chemical damage by producing toxic mediators for
the hair follicle (8).
Considering the high prevalence of hirsutism and
hypertrichosis among women, along with its adverse
emotional effects, we decided to study the effects of
laser therapy for unwanted hair removal on the
patients suffering from severe facial hirsutism who
had gone to a laser clinic were evaluated by filling
out a Dermatology Life Quality Index (DLQI) ques-
tionnaire before and after treatment. Average DLQI
scores showed a statistically significant change after
treatment. It was concluded that laser treatment of
unwanted facial hair brings about a good impact on
the quality of life of patients. In addition, it was
shown that the DLQI questionnaire is a reliable
instrument for the assessment of the efficacy of
unwanted laser hair removal (9).
Patients and methods
This before-and-after study was done in two private
laser clinics. Seventy women who were seeking laser
treatment for unwanted facial hair were included
after giving informed consent. The mean age of par-
ticipants was 27.9 ⫾ 7.9 years. The youngest patient
was 17 years old, the oldest was 52. The average
duration of unwanted hair was 5.7 ⫾ 0.4 years (1–14
years). Thirty-six patients were single and 34 were
married. The patients were assessed at the first ses-
sion by a validated Persian translation of the DLQI

Correspondence: Alireza Firooz, Center for Research and Training in Skin Diseases and Leprosy, 79 Taleghani Avenue, Tehran 14166, Iran. Fax: 98 21
88978190. E-mail: fi rozali@sina.tums.ac.ir

(Received 8 September 2009; accepted 25 October 2009)

ISSN 1476-4172 print/ISSN 1476-4180 online © 2010 Informa UK Ltd.
DOI: 10.3109/14764170903449802
8 A. Maziar et al.
questionnaire (10). They were asked to complete the
same questionnaire 3 months later after three ses-
sions of laser treatment with a long pulse alexandrite
laser on a monthly basis. Each patient scored 0–3 for
10 items in the questionnaire based on the impact of
unwanted hair: very much ⫽ 3; a lot ⫽ 2; a little ⫽1;
and not at all ⫽ 0. The collected data were analyzed
by SPSS 16 software using a paired sample t-test for
comparison of DLQI scores before and after treat-
ment. A p-value less than 0.05 was considered statis-
tically significant.
Results
The mean DLQI score before treatment was 9.42 ⫾
5.99; 3 months later after three sessions of laser treat-
ment this was reduced to 3.12 ⫾ 3.40 ( p ⬍ 0.05).
Discussion
In this study, we showed that the quality of life of
women suffering from facial hirsutism significantly
improved after treatment with a long pulse alexan-
drite laser using a validated Persian translation of the
DLQI instrument. Although several studies have
evaluated the quality of life of women with polycystic
ovary syndrome (11–13), there have been few studies
assessing quality of life in patients with hirsutism
using the standard DLQI. One of these studies, how-
ever, observed 45 hirsute women (all with brown,
dark or black hair) who had gone to a laser clinic and
were treated with long pulsed ruby, diode and alex-
andrite lasers. These patients reported a high level of
patient satisfaction (71.1%) and willingness to
undergo further treatment (77.85%) despite the fact
that 97.1% had unwanted hair reappearance, as
much after 6 months as it had been pretreatment.
From this group, 15 patients answered a modified
DLQI questionnaire immediately before and at vary-
ing intervals (up to 6 months) after laser treatment.
They also filled out a complementary questionnaire
including details such as treatment efficacy, side
effects, hair re-growth and also the time passing
between laser treatment and unwanted hair reap-
pearance. The patients were subdivided to three
groups according to the second time of completing
the questionnaire: 2 months, 2–4 months, and 4–6
months after first interview. There was a significant
improvement in DLQI scores at 1–2 months but
longer-term benefit was not observed (5).
In another study, 38 patients with severe facial
hirsutism completed a modified DLQI questionnaire
as well as a visual analogue scoring system and an
‘out-of-10’ scoring system before and after three
laser treatments with a long pulse alexandrite laser
at 4–6-week intervals. Also, the patients were scored
independently by a doctor and a nurse. Following
laser epilation, the mean DLQI scores of patients
improved by 5 points, which is close to the findings
of this study (a reduction of 6 points in DLQI score
after laser treatment).
The efficiency of various laser systems in the reduc-
tion of unwanted hair is well documented (7). It has
also been shown that hair reduction induced by laser
will last several months and can be considered perma-
nent (14). This study showed a significant improve-
ment in the quality of life of patients with unwanted
facial hair. The limitation of this study is the lack of
long-term follow-up. The second DLQI was com-
pleted after three sessions of laser, although the major-
ity of patients undergo more frequent treatment
sessions. On the other hand, it is recommended to
evaluate the patients several (at least 6) months after
the last session of laser treatment to assess the long-
term effects on quality of life. Also, social and eco-
nomic aspects of laser therapy should be studied in the
future as this treatment is expensive and requires sev-
eral treatment sessions. Similar studies on patients
undergoing laser treatment for sites other than the face
and also on male subjects will provide more informa-
tion on the effect of laser treatment on quality of life.
Acknowledgement
Hereby, sincere cooperation of the medical and nurs-
ing staff of the Dowlati Skin Clinic and Novin Dide-
gan Clinic in performing this study is appreciated.
Declaration of interest: The authors report no
conflicts of interest. The authors alone are respon-
sible for the content and writing of the paper.
References
1. Azziz R. The evaluation and management of hirsutism. Obstet
Gynecol. 2003;101(5 Pt 1):995–1007.
2. Cronin L, Guyatt G, Griffith L, Wong E, Azziz R, Futterweit
W, et al. Development of a health-related quality-of-life ques-
tionnaire (PCOSQ) for women with polycystic ovary syn-
drome (PCOS). J Clin Endocrinol Metabol. 1998;83(6):
1976–87.
3. Guyatt G, Weaver B, Cronin L, Dooley JA, Azziz R. Health
Related Quality of Life Questionnaire (PCOSQ) for women
with polycystic ovary syndrome (PCOS). J Clin Epidemiol.
2004;57(12):1279–87.
4. Loo WJ, Langin SW. Laser treatment improves quality of life
of hirsute females. Clin Exp Dermatol. 2002;27(6):439–41.
5. Lipton MG, Sherr L, Elford J, Rustin MH, Clayton WJ.
Women living with facial hair: The psychological and behav-
ioral burden. J Psychosom Res. 2006;61(2):161–8.
6. Dawber RP. Guidance for the management of hirsutism. Curr
Med Res Opin. 2005;21(8):1227–34.
7. Haedersdal M, Wulf HC. Evidence-based review of hair
removal using laser and light sources. J Eur Acad Dermatol
Venereol. 2006;20(1):9–20.
8. Wanner M. Laser hair removal. Dermatol Ther. 2005;18(3):
209–16.
9. Conroy FJ, Venus M, Monk B. A qualitative study to assess
the effectiveness of laser epilation using a quality-of-life scor-
ing system. Clin Exp Dermatol. 2006;31(6):753–6.

10. Aghaei S, Sodaifi M, Jafari P, Mazharinia N, Finlay AY. DLQI
scores in vitiligo: Reliability and validity of the Persian ver-
sion. BMC Dermatol. 2004;4:8.
11. Hahn S, Janssen OE, Tan S, Pleger K, Mann K, Schedlowski
M, et al. Clinical and psychological correlates of quality-of-
life in polycystic ovary syndrome. Eur J Endocrinol. 2005;
153(6):53–60.
12. McCook JG, Reame NE, Thatcher SS. Health-related quality
of life issues in women with polycystic ovary syndrome. J
Obstet Gynecol Neonatal Nurs. 2005;34(1):12–20.
Laser hair removal effect on life quality 9
13. Trent ME, Rich M, Austin SB, Gordon CM. Fertility con-
cerns and sexual behavior in adolescent girls with polycystic
ovary syndrome: Implications for quality of life. J Pediatr Ado-
lesc Gynecol. 2003;16(1):33–7.
14. Davoudi SM, Behnia F, Gorouhi F, Keshavarz S, Nassiri
Kashani M, Rashighi Firoozabadi M, et al. Comparison of
long-pulsed alexandrite and Nd:YAG lasers, individually and
in combination, for leg hair reduction: An assessor-blinded,
randomized trial with 18 months of follow-up. Arch Derma-
tol. 2008;144(10):1323–7.
Copyright of Journal of Cosmetic & Laser Therapy is the property of Taylor & Francis Ltd and its content may
not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written
permission. However, users may print, download, or email articles for individual use.
Copyright of Journal of Cosmetic & Laser Therapy is the property of Taylor & Francis Ltd and its content may
not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written
permission. However, users may print, download, or email articles for individual use.