Laser Hair Reduction to the Residuum Improves Quality of Life in People with Amputations

People with amputations using limb prosthetics commonly develop dermatologic complications, such as impaired skin integrity and folliculitis, at the residuum-prosthesis interface (RPI). Dermatologic complications are the primary cause of dissatisfaction with prosthetics, hindering rehabilitation and leading to prosthesis abandonment. This has a deleterious impact on health-related quality of life (HRQOL). Positive outcomes have been associated with laser hair reduction (LHR) for those with traumatic lower limb amputations; however, this has not been studied in those with upper limb amputations or amputations due to other conditions. We performed a prospective study to assess the effects of skin conditions at the RPI on HRQOL and determine the potential benefit from LHR. Four patients were identified: 75% (n=3) with lower-limb amputations and 25% (n=1) with upper limb amputations. Amputation indications included infection (25%, n=1), congenital malformations (25%, n=1) and trauma (50%, n=2). Participants received 6 sessions of LHR, either alexandrite 755nm alone or in combination with Nd:YAG 1064nm laser. The Skindex-16 survey was performed along with 7 amputee-specific questions. Improvements in HRQOL were seen in all patients and subscales, with an overall average improvement of 50%. Functioning subscale improvement was greatest, at 60%. All patients (100%) were satisfied with LHR treatment. To our knowledge, this is the first study to examine the impact of LHR on the HRQOL of people with upper and lower limb prostheses. LHR is a minimally invasive technique to treat and prevent common dermatologic complications of the RPI, promoting improved self-confidence and prosthesis fit. This study identified an important role for dermatologists to engage with this community to improve their functional capacity and quality of life.