title: Hormonal profile and efficacy of long pulse Nd-YAG laser in treatment of hirsutism.
abstract: BACKGROUND
  Hormones, particularly androgens play a vital role in hair growth, differentiation and distribution. Hirsutism is a common entity among Nepalese population with skin types III, IV and V. Long pulsed lasers are commonly used for hair removal.
  
  
  METHODS
  This is a prospective analytical study done in Dhulikhel Hospital Kathmandu University Hospital, Kavre, Nepal from November 2010 to November 2011. Patients were first subjected to hormonal evaluation. Androgens, their tropic hormones, insulin resistance markers and endocrine components were measured and compared. Subjects were then categorized into two groups according to androgen levels: group A (n=30) with significantly high androgen (total testosterone and dehydroepiandrosterone sulfate) or elevated luteinizing hormone: follicle stimulating hormone ratio, consistent with Polycystic Ovarian Syndrome (PCOS) and group B (n=30). Adrenal tumour was ruled out in all patients. All patients received long pulse Nd-YAG laser (50J/cm²; 50 msec pulse duration) therapy at four weeks interval to achieve at least 50% hair reduction.
  
  
  RESULTS
  Among group A patients, average 8.1 treatment sessions were required for substantial hair reduction, whereas, average 5.7 sessions produced similar results in group B patients (p-value <0.05).
  
  
  CONCLUSIONS
  Patients with high androgen level and elevated LH: FSH ratio requires more treatment sessions for hair removal with long pulsed ND-YAG laser than patients with normal or low hormone level.
authors.affiliation: Department of Dermatology, Venereology and Lepreology, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel.
authors.forename: D
authors.initials: D
authors.lastname: Karn
authors.affiliation: Department of Dermatology, Venereology and Lepreology, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel.
authors.forename: S
authors.initials: S
authors.lastname: K C
authors.affiliation: Department of Dermatology, Venereology and Lepreology, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel.
authors.forename: M
authors.initials: M
authors.lastname: Timalsina
authors.affiliation: Department of Clinical Biochemistry, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal.
authors.forename: P
authors.initials: P
authors.lastname: Gyawali
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D005260:Female; D006065:Gonadotropins, Pituitary / Q000097:blood; D006204:Hair Removal / Q000379:methods*; D006628:Hirsutism / Q000097:blood* / Q000532:radiotherapy*; D006801:Humans; D007333:Insulin Resistance; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy; D008875:Middle Aged; D009390:Nepal; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D000728:Androgens; D006065:Gonadotropins, Pituitary; D013739:Testosterone