Laser and Light-Based Therapies for Managing Hirsutism Concurring with PCOS

Hirsutism – a major concern for women with polycystic ovary syndrome (PCOS), is associated with psychological distress. Hence, effective management of this condition is crucial. A review was the first to specifically evaluate the effectiveness of laser and light-based therapies for hirsutism in women with PCOS. A new study aimed to synthesize existing research on the efficacy of laser and light hair reduction treatments, both as stand-alone therapies and in combination with systemic agents, for treating hirsutism in women with PCOS.

This was a systematic review conducted using MEDLINE, Embase, EMCARE, and CINAHL databases – following PRISMA guidelines. Data on both objective and subjective outcomes of laser or light-based hair reduction therapies were extracted. Due to the heterogeneity of included studies, a meta-analysis was not possible, necessitating a narrative synthesis.

Overall, six studies involving 423 patients with PCOS were reviewed – including four randomized clinical trials and two cohort studies. The Alexandrite laser showed significant improvements in hirsutism severity and psychological outcomes, especially at high fluence. It was also more effective than intense pulsed light (IPL). Combining diode laser with metformin or oral contraceptives was more effective than diode laser alone, and metformin addition to IPL improved outcomes compared to IPL alone. Of note, most treatments were well tolerated. However, the overall certainty of evidence was limited due to the observational nature of some studies.

The findings indicated that laser and light hair reduction therapies––alone and combined with pharmacological agents––are effective for hirsutism in PCOS. These modalities aid in improving psychological well-being and patient quality of life. Future research is needed to provide robust evidence across diverse populations. These results have informed the 2023 International Evidence-based PCOS Guideline, which now includes new recommendations for using laser and light-based hair reduction therapies for women with PCOS and hirsutism.

Source: Tan K, Coster T, Mousa A, et al. JAMA dermatology. 2024 Jun 19.