ORIGINAL ARTICLE A split axilla comparison study of axillary hair removal with low fluence high repetition rate 810 nm diode laser vs. high fluence low repetition rate 1064 nm Nd:YAG laser R. Wanitphakdeedecha,* K. Thanomkitti, P. Sethabutra, S. Eimpunth, W. Manuskiatti Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *Correspondence: R. Wanitphakdeedecha. E-mail: sirwn@mahidol.ac.th Abstract Background A low fluence, high repetition rate 810 nm diode laser using constant motion technique has been recently introduced with advantages of less treatment discomfort and fewer side effects compared with traditional laser hair removal. Objective To compare hair reduction and side effects of low fluence high repetition rate 810 nm diode with high fluence low repetition rate 1064 nm Nd:YAG lasers. Methods Forty-nine subjects were randomly received five monthly treatments with diode laser on one side of their axilla and long-pulsed Nd:YAG laser on the other side. Hair count was recorded at baseline, 1- and 6-month follow- up visits. Results Percentage of axillary hair reduction at 1-month follow-up visit after receiving diode and Nd:YAG laser treatment were 71.0% and 82.3%, respectively, and at 6-month follow-up were 35.7% and 54.2%, respectively. There were significant differences in hair reduction between both laser systems at 1- and 6-month follow-ups (P < 0.001 and P < 0.001, respectively). Patients reported lower pain on the diode laser side (P < 0.001). Side effects of both laser systems were mild and transient erythema and swelling. Conclusions High fluence low repetition rate Nd:YAG laser was superior in hair reduction and provided higher patient satisfaction. However, low fluence high repetition rate diode laser was less painful. Received: 09 April 2011; Accepted: 25 August 2011 Conflict of interest The authors have no relevant financial interest in this article. Funding sources None declared. Introduction Unwanted facial and body hair is a common problem, generating a high level of interest for treatment innovations. Affected patients are amenable to either cosmetic procedures or medical treatment. A wide range of modalities for the management of unwanted hair have been advocated over the years with varying degrees of clinical response. 1 Current methods of hair removal include topical eflor- nithine, shaving, waxing, depilatories and electrolysis. Unfortu- nately, no single treatment method can achieve complete hair eradication in every skin and hair type. 2 Lasers and light sources have been used to address this problem with improved success rates in properly selected patients and emerged as the gold standard to remove unwanted hair. Principle of traditional laser hair removal is based on the use of low repeti- tion rate with the highest fluence as possible to destroy hair folli- cles without damaging the surrounding tissue. Even though, this technology is effective in hair removal, it is associated with side effects, such as pain and postinflammatory hyperpigmentation, especially in patients with darker skin tone. 3 A novel low fluence, high repetition rate 810 nm diode laser using multiple passes in constant motion technique has been recently introduced as another option of laser hair removal with less treatment discomfort and fewer side effects when compared with traditional laser hair removal. 4 This device has been proved to provide clinical advantages in patients with dark skin because of its low fluences but high average power, and high repetition rate. 5 The purpose of this study were to quantitatively assess hair reduction and side effects after using low fluence, high repetition rate 810 nm diode laser vs. high fluence, low repetition rate 1064 nm Nd:YAG laser at 1- and 6-months after a series of five laser treatments. ª 2011 The Authors JEADV 2011 Journal of the European Academy of Dermatology and Venereology ª 2011 European Academy of Dermatology and Venereology DOI: 10.1111/j.1468-3083.2011.04231.x JEADV