Treatment of trichostasis spinulosa in skin phototypes III, IV, and V with an 800-nm pulsed diode laser

BACKGROUND. Trichostasis spinulosa (TS) is a common follicular disorder that results from the retention of multiple vellus hairs within pilosebaceous follicles. A variety of treatment modalities have been used with variable but largely transient success. OBJECTIVES. To determine whether a pulsed diode laser irradiation would provide a therapeutic response to TS for a prolonged period. METHODS. Thirteen subjects with untreated TS and skin phototypes III, IV, and V were treated with a 800-nm pulsed diode laser at fluences ranging from 24 to 40J/cm² (mean, 36J/cm²) and a 12- to 20-ms (mean 18 ms) pulse width. Two treatments were delivered at 4-week intervals. Evaluation of improvement was performed at 4 and 20 weeks after the last treatment by a blinded assessment of clinical photographs. RESULTS. Complete clearing of the lesions was achieved for a period of 8 to 12 weeks. A decrease in dark-plug appearance of greater than 50% was noted in half of the subjects 20 weeks after the second treatment. No pigmentary changes and scarring occurred in any subjects. CONCLUSION. Pulsed diode laser proved to be a safe and long-term effective treatment for TS in dark-skinned individuals.