Permanent laser hair removal with low fluence high repetition rate versus high fluence low repetition rate 810 nm diode laser--a split leg comparison study.

High fluence diode lasers with contact cooling have emerged as the gold standard to remove unwanted hair. However, laser hair removal is associated with pain and side effects, especially when treating dark or tanned skin. A novel diode laser with low level fluence (5-10 J/cm2) with a high repetition rate at 10 Hz (Soprano XL in SHR mode, Alma Lasers, Chicago, IL) using multiple passes in constant motion technique was compared to traditional one pass high fluence (25-40 J/cm2) diode laser (LightSheer ET, Lumenis, Santa Clara, CA) in a prospective, randomized split-leg study on 25 patients with Fitzpatrick skin types I-V. Hair counts were done six months following the fifth treatment and were found to be comparable with a 86-91% hair reduction. There was one superficial burn with the high energy diode treatment. The rapid, multiple pass in-motion technique was faster and associated with significantly less pain. Multiple passes of diode laser at low fluences but with high average power results in permanent hair removal with less discomfort and fewer adverse effects, especially on darker skin.