The following is a summary of “Comparative effectiveness of ice packs versus topical lidocaine-prilocaine mixture for pain control in laser hair removal of the axilla: A rater-blinded randomized controlled trial,” published in the MARCH 2023 issue of Dermatology by Roongpisuthipong, et al.


Moderate to severe pain is linked to laser hair removal. For a study, researchers sought to evaluate the effectiveness of an ice pack and a topical lidocaine-prilocaine combination for axillary laser hair removal pain relief.

Before each of the three monthly 810 nm diode laser sessions, participants were randomly assigned to apply a topical anesthetic to one axilla and cold packs to the other. Participants reported discomfort on the visual analog scale (VAS) immediately after, and five minutes after a laser session served as the primary outcome. Following therapy, two blinded photoraters evaluated the erythema, general edema, and perifollicular edema. A record was kept of skin temperatures, patient preferences, and negative incidents.

About 88 of the 90 (98%) planned laser sessions were administered. After receiving lidocaine-prilocaine laser therapy as opposed to ice, participants’ VAS scores were greater right away (P =.03). The VAS scores with ice were higher five minutes later, according to the subjects (P =.03). The majority of participants (53 out of 88; 60.2%) said they preferred ice (P =.055). There were no documented severe negative events.

The pain reduction related to axillary laser hair removal was the same with topical anesthetic and pain control with ice, regardless of how long it has been since treatment.

Reference: jaad.org/article/S0190-9622(22)03065-1/fulltext