Retinal Damage in Laser Hair Removal

[NutellaMmm]

I am currently on 3rd year rotations and this morning we had an interesting patient come in worried that he had received retinal damage after laser hair removal around the top of the eyebrows and on the cheek below the eye socket. He said the place he went to was reputable but did not have him use protective eye wear because it would have made it difficult to access the area he was having lasered. He said the whole process lasted under 5 minutes, the applicator was placed close to his skin, and he closed his eyes during the whole process. He said when he got home he started wondering about it, not because he had any symptoms with his vision, but because he had a headache. He then looked online and said he read that laser hair removal without protective eyewear can cause permanant while painless retinal damage and blindness - he then freaked out and came in, he was very worried when we saw him.

Honestly, I didn't even know this procedure could cause retinal damage, but I'm just a med student on rotations... but the physician (family medicine) I was working with also didn't seem to know much about the specifics, but said he expected the patient would be okay since it was a short time and the laser was not directed into his eyes, even though he was not wearing any eye protection.

He seemed unsure as he has not received this question too many times, but he also did not look in the patient's eyes.

How often does retinal damage occur with this procedure that has become so common (and becoming increasingly popular)? If he came in several hours after the laser procedure and did not have any vision impairment, does that mean damage did not occur? How long after exposure in this case would damage occur and how would a physician know?

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[Shnurek]

Sounds to me like hypochondriasis. No visual symptoms and eye was closed during the whole procedure? C'monnn.

Common lasers for hair removal:
Alexandrite - 755 nm (Red) - most effective, but safest on light skin.
Pulsed Diode Array - 810 nm (near-infrared) - for light to medium type skin.
ND: YAG laser - 1064 nm (near-infrared) - for darker skin. Yag is capable of treating all six skin colors. However, there is not sufficient evidence that this laser can produce effective long-term hair removal).

Higher wavelengths penetrate more deeply through the layers of skin/eye cells but they carry much less energy so less likely to knock out the DNA. However, I don't know the amplitude of the laser energy.

I believe the reason that the Doctor and the staff wear protection is against cumulative damage from so many procedures.

However, this is just my amateur SDN opinion.

 

[Visionary]

No way that any laser used for hair removal would damage the retina through closed eyelids. Aim it into the eye, and that's a different story.