Proteolytic enzymes chymotrypsin and papain combined with Alexandrite laser hair removal versus laser hair removal alone for the treatment of facial hirsutism: a randomized comparative study

Laser hair removal is the treatment of choice for reducing unwanted hair in hirsute patients. However, preventing hair regrowth remains a challenge. This study aimed to evaluate the combined effect of laser and enzymatic hair removal. Fifty-nine Greek women with facial hirsutism were divided into 2 groups. Group I was treated with combination of Alexandrite laser and iontophoresis of chymotrypsin and papain solutions. Group II was treated with laser alone. Outcomes included trichoscopic hair counts and patient-reported hair-free intervals (HFIs). Hair reduction from baseline was significantly higher in group I than in group II both after the 10th session (83.88 ± 10.63% vs 44.56 ± 23.52%) and at follow-up (80.28 ± 11.56% vs 25.68 ± 29.97%). The increase in HFI from the 1st to the 10th session was significantly higher in group I (38.05 ± 24.47% vs 19.82 ± 12.42%). Combination of Alexandrite laser and iontophoresis of proteolytic enzymes led to greater hair reduction, better early maintenance of the achieved result and longer HFIs than laser alone.