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Rojas-Orrego M, Carreño N, Feuerhake T, Navarrete-Dechent C. In Vivo Evaluation of Laser-Induced Optical Breakdown (LIOBS) by 1064-nm Nd:YAG Fractional Picosecond Laser With Reflectance Confocal Microscopy and Precise Histopathologic Correlation. Lasers Surg Med 2024; 56:650-656. [PMID: 39072796 DOI: 10.1002/lsm.23829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Picosecond lasers with a microlens array can cause laser-induced optical breakdown (LIOBS) and LIC (Intradermal laser-induced cavitation) within high-fluence areas. This study aimed to describe the clinical, reflectance confocal microscopy (RCM), histopathological findings, and the characteristics of vacuoles caused by LIOBS and LIC in individuals with skin types III and IV. MATERIALS AND METHODS This study was performed on six Chilean healthy volunteers, males and females, aged 35-65 years old with Fitzpatrick skin phototypes III-IV. The laser was applied in the inner proximal area of the nondominant arm. RCM evaluation was performed 24 h later; 48 h later, skin biopsies were performed on the laser-treated areas. Clinical, histological, and RCM findings were recorded. RESULTS Every individual developed a 10 mm2 area of clinical erythema in the treated area. Under RCM, all six volunteers had hyporeflective spherical structures at the level of the epidermis, consistent with intraepidermal vacuoles. Histopathological evaluation revealed different sizes of vacuoles in both the epidermis and dermis. CONCLUSION The LIOBS and LIC processes and the secondary production of vacuoles could be highly valuable for effective dermal remodeling treatment and aid in promoting the production of new collagen, elastic fibers, and growth factors that could improve skin texture. These structures were visible under RCM and histopathological evaluation.
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Affiliation(s)
- Maritza Rojas-Orrego
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nestor Carreño
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teo Feuerhake
- Department of Pathology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Ninghua L, Cao L, Song N, Zhang J. Evaluation of 755-nm Picosecond Alexandrite Laser With a Focus Lens Array for the Treatment of Enlarged Facial Pores. J Craniofac Surg 2024; 35:1552-1554. [PMID: 38819149 DOI: 10.1097/scs.0000000000010379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES This study aims to evaluate the use of 755-nm picosecond alexandrite laser with a focus lens array to treat facial pores. METHODS Laser treatment was performed on 129 patients between January 2021 and October 2022. VISIA imaging system was used for photographic assessments, the total average number and pore index was calculated, the physicians' assessment score and patient satisfaction score were collected, and the incidence of disadvantage effects was also documented. RESULTS The mean patient age was 35.2±6.4 years (21-45 y). The total average number of facial pores was 1614.1±412.8, and the total average number decreased to 1262.6±356.2 three months after the last treatment. The pretreatment baseline of pore index was 26.1±4.5, while the pore index was 21.3±3.7 three months after the last treatment. The physicians' assessment score was 2.7 on the 0-to-4 scale, and patient satisfaction score was 3.5 on the 1-to-5 scale. There were no adverse events, such as hyperkeratosis, scarring, and hypo-or hyperpigmentation. CONCLUSIONS 755-nm picosecond alexandrite laser with a focus lens array was safe and effective in the treatment of facial pores with relatively few unanticipated adverse events. LEVEL OF EVIDENCE Level IV-observational study without controls.
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Affiliation(s)
- Liu Ninghua
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital of Fudan University, Shanghai
| | - Luhong Cao
- Department of Otolaryngology Head and Neck Surgery, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, Chengdu, China
| | - Nan Song
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital of Fudan University, Shanghai
| | - Jing Zhang
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital of Fudan University, Shanghai
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Tao J, Hashemi DA, Bajaj S, Wang JV, Geronemus RG. Paired Treatment Using Radiofrequency Microneedling and 755-nm Picosecond Laser With Fractionated Lens Array for Facial Rejuvenation. Dermatol Surg 2024:00042728-990000000-00858. [PMID: 38924506 DOI: 10.1097/dss.0000000000004302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
BACKGROUND Patients frequently complain about fine lines, wrinkles, dyschromia, and photoaging, for which lasers and energy-based devices can treat each of these. Pairing various devices in a single treatment session can be safe and effective, but different technologies, mechanisms, histologies, parameters, and techniques must be considered. OBJECTIVE To examine the utility of a paired treatment regimen using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array to improve the clinical appearance of facial wrinkles and photoaging. MATERIALS AND METHODS A prospective clinical study investigated this paired treatment regimen using 4 monthly sessions. RESULTS Twenty-five subjects were enrolled, while 18 subjects completed 3-month follow-up. The mean age was 54 years, and 92% were women. Fitzpatrick Skin Types I to IV were represented. Assessments compared baseline with the 3-month follow-up. Two of 3 blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 94.4% of cases. For physician Global Aesthetic Improvement Scale, 100% of subjects had clinical improvement. Overall, 88.9% of subjects were considered to be satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION Paired treatment using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array can safely and effectively improve facial wrinkles and photoaging.
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Affiliation(s)
- Joy Tao
- All authors are affiliated with the Laser & Skin Surgery Center of New York, New York, New York
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Yuan Y, He Y, Fang J, Zhang M, Wu Q. Comparison of the fractionated Nd: YAG 1064-nm picosecond laser with holographic optics and the fractional CO 2 laser in atrophic acne scar treatment: a prospective, randomized, split-face study. Int J Dermatol 2024. [PMID: 38924534 DOI: 10.1111/ijd.17296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
KEY POINT The 1064-nm picosecond laser with holographic optics demonstrated significant efficacy in treating atrophic acne scars. BACKGROUND Picosecond lasers with fractionated optics have enabled the development of a breakthrough skin rejuvenation method. The authors compared the fractionated, non-ablative neodymium-doped yttrium aluminum garnet 1064-nm picosecond laser with holographic optics and the fractional CO2 laser in treating atrophic acne scars. METHODS One side of each patient's face was randomly allocated and treated with three sessions of the 1064-nm picosecond laser with holographic optics at 2-month intervals. In contrast, the other side was treated with the fractional CO2 laser. Participants were followed up 3 months after the final session. The primary outcome included the physicians' evaluation using the ECCA grading scale and a four-point scale to assess improvement. The patients' assessment of progress, their overall satisfaction and preferences, and the side effects were also evaluated. RESULTS No significant difference was observed between the two lasers in terms of the mean ECCA scores after treatments (P = 0.209). The physicians' improvement assessment was more significant for the fractional CO2 laser (P = 0.001). The patients' evaluation of improvement and subjective satisfaction were consistent with physicians' four-point scale results. The picosecond laser side had fewer adverse effects (P < 0.001). CONCLUSION The fractionated, non-ablative Nd: YAG 1064-nm picosecond laser with holographic optics and the fractional CO2 laser were effective and safe in treating atrophic acne scars. Significantly better clinical outcomes were observed with the fractional CO2 laser, whereas fewer adverse effects were noted with the 1064-nm picosecond laser with holographic optics.
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Affiliation(s)
- Yucheng Yuan
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Yizhen He
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Jing Fang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Mengli Zhang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Qiuju Wu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
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Chan MWM, Chan AWS, Wong CSM, Shek SYN, Yeung CK, Kono T, Chan HHL. The use of fractional radiofrequency in Asian patients to improve skin texture. Lasers Surg Med 2024; 56:142-149. [PMID: 38247054 DOI: 10.1002/lsm.23752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND AND OBJECTIVES Fractional radiofrequency devices have been demonstrated to improve skin texture, such as smoothness, rhytides, brightness, and atrophic acne scars, by increasing dermal thickness, dermal collagen content, and dermal fibrillin content. The objective of the study is to assess the efficacy and adverse effects of this device on Asian patients of skin type III and IV with skin textural changes. MATERIALS AND METHODS The study was designed as a prospective, open-labeled single-arm study, which was conducted with 20 Chinese patients aged 21-60 years and having irregularities in their skin texture, rhytides, and acne scars. The patients received six treatments at intervals of 4 weeks. Treatment was initiated with the maximum energy tolerated, which was then adjusted during the course of treatment if the patients felt excessive discomfort. A total of two passes were delivered in each session. Physician assessment results and standardized photographs were collected at the baseline, after all treatment visits, and at 1, 2, and 6 months after the final treatment visit. RESULTS A total of 17 patients completed the study according to the established protocol. At the 6-month follow-up, 71% of patients were satisfied and 24% of patients were very satisfied with the received treatments, and the treatment physician reported varying degrees of improvement based on the global assessment scale in 60% of the subjects. While the anticipated side effects, such as erythema, edema, pinpoint bleeding, scab formation, and flare of acne, were noted in the patients, no serious adverse effects occurred. CONCLUSION The use of fractional radiofrequency improves skin texture and is safe for use in Asian patients of skin type III and IV. No long-term serious adverse effects were noted.
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Affiliation(s)
- Mandy W M Chan
- Department of Medicine, Division of Dermatology, The University of Hong Kong, Hong Kong SAR, China
| | - Agnes W S Chan
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Christina S M Wong
- Department of Medicine, Division of Dermatology, The University of Hong Kong, Hong Kong SAR, China
| | - Samantha Y N Shek
- Department of Medicine, Division of Dermatology, The University of Hong Kong, Hong Kong SAR, China
| | - Chi Keung Yeung
- Department of Medicine, Division of Dermatology, The University of Hong Kong, Hong Kong SAR, China
| | - Taro Kono
- Department of Plastic Surgery, Tokai University, Isehara, Kanagawa, Japan
| | - Henry H L Chan
- Department of Medicine, Division of Dermatology, The University of Hong Kong, Hong Kong SAR, China
- Wellman Centre for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Wardhani PH, Prakoeswa CRS, Listiawan MY. Evaluation of Wrinkle and Dermal Thickness in the Forearm before and after Picosecond Laser Therapy. J Cutan Aesthet Surg 2024; 17:7-10. [PMID: 38736857 PMCID: PMC11086935 DOI: 10.4103/jcas.jcas_80_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Skin wrinkles are generated as a result of the aging process. Dermal thickness underneath a wrinkle decreases absolutely. Approximately 20% of dermal thickness disappears as people become elderly. In recent times, people have attempted to reduce wrinkles using various procedures. Currently, available picosecond lasers in dermatology can create mechanical stress and the energy can be fractionated via diffractive lens arrays (DLA). An emerging indication for the picosecond laser includes photorejuvenation. Non-ablative laser skin rejuvenation therapy demonstrates the dermis can be safely reconstructed by only irradiating the skin surface with a laser. The clinical effects of picosecond pulse laser have been frequently reported, but few studies have included histological investigation. Aims and Objectives This study aimed to evaluate wrinkle and dermal thickness in the forearm before and after picosecond laser therapy. Materials and Methods Twenty healthy male and female subjects between 36 and 55 years old with wrinkles in the forearm who met the sample requirements and were willing to participate were recruited in this study. Clinical examination and biopsy for histopathological examination were carried out before and 4 weeks after therapy, then treatment was carried out using a picosecond laser. Results At 1-month follow-up, a significant improvement was noted in wrinkle and dermal thickness (P < 0.05). Conclusions This picosecond 755 nm alexandrite laser with DLA was found to be very effective in treating wrinkles, which was confirmed by a dermatologic assessment from forearm photographic assessment scaled and dermal thickness improvement.
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Affiliation(s)
- Putri Hendria Wardhani
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Cita Rosita Sigit Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Muhammad Yulianto Listiawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Han HS, Hong JK, Park SJ, Park BC, Park KY. A Randomized, Prospective, Split-Face Pilot Study to Evaluate the Safety and Efficacy of 532-nm and 1,064-nm Picosecond-Domain Neodymium:Yttrium-Aluminum-Garnet Lasers Using a Diffractive Optical Element for Non-Ablative Skin Rejuvenation: Clinical and Histological Evaluation. Ann Dermatol 2023; 35:23-31. [PMID: 36750455 PMCID: PMC9905855 DOI: 10.5021/ad.22.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/07/2022] [Accepted: 10/12/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The advent of fractionated picosecond (ps) lasers has provided an opportunity to explore new ways of creating microinjuries in the skin to induce skin rejuvenation. OBJECTIVE To compare the efficacy and safety of diffractive optical element (DOE)-assisted ps neodymium: yttrium-aluminum-garnet (Nd:YAG) lasers with 532-nm and 1,064-nm wavelengths (532-nm and 1,064-nm Nd:YAG P-DOE) using a novel fractional handpiece for the treatment of photoaged skin. METHODS An ex vivo guinea pig skin experiment was performed by evaluating the histology of the skin after 532-nm Nd:YAG P-DOE irradiation. A randomized, prospective, split-face study was performed on eight subjects with 532-nm and 1,064-nm Nd:YAG P-DOE. RESULTS Based on the histological evaluation using ex vivo guinea pig skin, a reasonable safety profile and the potential to generate effective skin rejuvenation was observed using the 532-nm Nd:YAG P-DOE. Results demonstrated that both 532- and 1,064-nm Nd:YAG P-DOE were similarly effective in improving skin texture and skin pores; however, 532-nm Nd:YAG P-DOE was more effective in treating dyspigmentation. CONCLUSION At a preliminary level, this study revealed that 532-nm and 1,064-nm ps Nd:YAG lasers using DOE fractional technology may improve photoaged skin. In conclusion, 532-nm Nd:YAG P-DOE may be especially beneficial for skin with epidermal pigmentary lesions.
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Affiliation(s)
- Hye Sung Han
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jun Ki Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Su Jung Park
- Department of Dermatology, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Byung Cheol Park
- Department of Dermatology, College of Medicine, Dankook University, Cheonan, Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
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Qian C, Jiang Y, Wu Y, Yue B, Yan S, Lu Z. The comparison of the efficacy and safety of fractional 1064 nm Nd:YAG picosecond laser and nonablative fractional 1565 nm laser in the treatment of enlarged pores: A prospective split-face study. Lasers Surg Med 2023; 55:169-177. [PMID: 36718089 DOI: 10.1002/lsm.23635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/29/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVES To compare the efficacy and safety of fractional 1064 nm Nd:YAG picosecond laser and nonablative fractional 1565 nm laser in the treatment of enlarged pores. STUDY DESIGN/MATERIALS AND METHODS Twenty patients received five monthly treatments at months 0, 1, 2, 3, and 4 and were followed up at months 5, 6, and 7. All patients were treated by fractional 1064 nm Nd:YAG picosecond laser (FxPico) on the left face, and nonablative fractional 1565 nm laser (ResurFx) on the right face as a control. RESULTS For the 19 patients who completed the study, both sides demonstrated significant improvement on pore counts (p < 0.01), while there was no significant difference between the two sides 3 months after the final treatment (p = 0.092). Excellence rate on the FxPico side (57.9%) was significantly better than the ResurFx side (36.8%) (p < 0.05). Sebum secretion and porphyrin value significantly decreased on both sides after five treatments and there was a higher reduction of sebum level on the ResurFx side. There was no difference between the two therapies in terms of overall satisfaction. Pain of treatment for the ResurFx side (average VAS 4.45 ± 1.60) is significantly higher than that for the FxPico side (average visual analog scale [VAS] 1.48 ± 1.36) (p < 0.001). Erythema, edema, and petechiae were common adverse effects and were mild to moderate. There was significantly higher incidence of hyperpigmentation for the ResurFx side (52.6%) compared with that for the FxPico side (5.3%) (p < 0.001). CONCLUSION Fractional 1064 nm Nd:YAG picosecond laser and nonablative fractional 1565 nm laser both are effective, efficient, and safe treatment regimens for enlarged pores, while fractional 1064 nm Nd:YAG picosecond laser has better clinical response with less treatment pain, shorter recovery period and much lower induction of hyperpigmentation.
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Affiliation(s)
- Chunyan Qian
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Shanghai Institute of Dermatology, Fudan University, Shanghai, China
| | - Yueqi Jiang
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Shanghai Institute of Dermatology, Fudan University, Shanghai, China
| | - Yuemeng Wu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Shanghai Institute of Dermatology, Fudan University, Shanghai, China
| | - Baishuang Yue
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Shanghai Institute of Dermatology, Fudan University, Shanghai, China
| | - Shuxian Yan
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Shanghai Institute of Dermatology, Fudan University, Shanghai, China
| | - Zhong Lu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Shanghai Institute of Dermatology, Fudan University, Shanghai, China
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Lim SH, Seo HS, Lee YB, Kang H, Hong SP. Morphologic and molecular biologic analyses of the skin rejuvenation effect of the fractional 1064-nm picosecond laser: An animal study. Lasers Surg Med 2023; 55:190-199. [PMID: 36573446 DOI: 10.1002/lsm.23623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Application of the picosecond laser in the field of dermatology has expanded from tattoo removal to skin rejuvenation on a clinical basis. Although various mechanisms of pigment removal have been elucidated, the molecular changes associated with skin rejuvenation have yet to be identified. The aim of this study was to explore the theoretical basis and to evaluate the efficacy of skin rejuvenation using a 1064-nm fractional picosecond laser in a mouse model. METHODS We conducted an in vivo study using a fractional picosecond laser on the skin of old and young female hairless mice and performed topographical, histological, micro-, and electron microscopic assessments. RESULTS The topography of the skin surface was enhanced and showed increased dermal thickness on histological examination. Electron microscopy revealed disarranged collagen bundles with microspaces and vascular leakage in the upper dermis. Levels of collagen synthesis markers and various inflammatory cytokines, such as procollagens, interleukin-1β, tumor necrosis factor-α, and heat shock proteins, were elevated in the laser-treated skin. CONCLUSIONS This study provides a possible mechanism for the skin rejuvenation effect of fractional picosecond laser that has been reported previously in clinical observations. Based on our findings, the fractional picosecond laser could be widely applied in clinical settings where dermal regeneration and promotion of skin rejuvenation is required.
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Affiliation(s)
- Sung Ha Lim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hee Seok Seo
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Young Bin Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kang
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seung Phil Hong
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Zhou Y, Hamblin MR, Wen X. An update on fractional picosecond laser treatment: histology and clinical applications. Lasers Med Sci 2023; 38:45. [PMID: 36658259 PMCID: PMC9852188 DOI: 10.1007/s10103-022-03704-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/29/2022] [Indexed: 01/21/2023]
Abstract
Picosecond lasers have a very short pulse duration and a high peak power density. When fractional optical delivery systems are attached to picosecond lasers, they generate an array of concentrated microspots with a high fluence surrounded by areas with a low fluence. This article discusses the histologic characteristics and clinical applications of fractional picosecond laser treatment. Fractional picosecond laser produces laser-induced optical breakdown (LIOB) and laser-induced cavitation (LIC) in the epidermis and dermis respectively, and can encourage skin regeneration and dermal remodeling. It has been shown that fractional picosecond laser has a positive effect on facial photoaging, enlarged facial pores, dyspigmentation, wrinkles, and atrophic scars. Further research is still needed to confirm the benefits of fractional picosecond lasers.
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Affiliation(s)
- Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, 610041, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, 2028, South Africa
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, 610041, China.
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
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11
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Wardhani PH, Sigit Prakoeswa CR, Listiawan MY. Facial Rejuvenation in Indonesian Skin With a Picosecond 755-nm Laser. J Lasers Med Sci 2022; 13:e45. [PMID: 36743150 PMCID: PMC9841370 DOI: 10.34172/jlms.2022.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/17/2022] [Indexed: 01/27/2023]
Abstract
Introduction: The aging process in the skin naturally happens over time, affected by several factors, of which ultraviolet irradiation is a major factor, and this leads to the appearance of wrinkles, pigmentations, and textural irregularities. Lasers for facial rejuvenation are very popular in Asian patients, but melanin rick skin types like Asians are more susceptible to pigmentary alterations. Most Indonesians have brown skin, and just a few have light skin. The purpose of this study was to know the efficacy and safety of the picosecond 755 nm laser in facial rejuvenation in Indonesian skin. Methods: This is an analysis of 20 healthy patients with Fitzpatrick skin type III-V with facial photoaging from 36 to 55 years. Examinations were evaluated before therapy and 4 weeks after the second therapy. The front and side of both cheeks were photographed and analyzed by using VISIA. Clinical improvement was categorized as excellent-mild. The patients were also asked and examined about the presence of adverse events. Results: The patients were predominantly female with an average age of 44 years. Sixty percent of the patients had a good improvement and 40% of the patients had a moderate improvement. The VISIA analysis showed a significant improvement in wrinkles, pigments, and textures (P < 0.001). Only mild anticipated adverse events were observed, and there was no post-inflammatory hyperpigmentation or hypopigmentation. Conclusion: the picosecond 755 nm laser is effective and safe for facial rejuvenation in the skin of Indonesian patients without significant adverse events.
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Affiliation(s)
- Putri Hendria Wardhani
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Indonesia,Departement of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Cita Rosita Sigit Prakoeswa
- Departement of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia,Correspondence to Cita Rosita Sigit Prakoeswa,
| | - Muhammad Yulianto Listiawan
- Departement of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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12
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Wardhani PH, Prakoeswa CRS, Listiawan MY. Efficacy and safety of picosecond laser for wrinkle in Indonesian skin. J COSMET LASER THER 2022; 24:33-35. [DOI: 10.1080/14764172.2022.2074038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Putri Hendria Wardhani
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Cita Rosita Sigit Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - M. Yulianto Listiawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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13
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Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid versus laser monotherapy for melasma and facial rejuvenation: a multicenter, randomized, double-blinded, split-face study in Chinese patients. Lasers Med Sci 2022; 37:2879-2887. [PMID: 35501519 DOI: 10.1007/s10103-022-03566-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/22/2022] [Indexed: 02/05/2023]
Abstract
To compare the efficacy and safety of 755-nm picosecond alexandrite laser and topical tranexamic acid (TTA) combination therapy with laser monotherapy, for the treatment of melasma and facial rejuvenation. This multicenter, randomized, double-blinded, split-face study enrolled 37 patients who presented with melasma and photoaging. Facial halves were randomized to receive either laser and TTA combination therapy or laser monotherapy. Three treatments were delivered at 4-5 weeks intervals. Patients were followed up for 1, 3, and 6 months post-final treatment and evaluated by blinded investigators for hemi-Melasma Area and Severity Index (hemi-MASI), facial dyschromia, skin texture, laxity, and rhytids. Daily diaries rating healing progress for 7 days posttreatment and satisfaction grading were performed by all patients. Adverse events were recorded. Thirty-six patients completed the follow-up. Compared with the baseline, hemi-MASI, dyschromia, and skin texture on both halves improved significantly through the follow-up (p = 0.000). A significant difference in hemi-MASI and dyschromia between combination therapy halves and monotherapy halves was noticed at 1- and 3-month follow-ups (p < 0.05). The laser monotherapy halves displayed significantly less redness and sensitivity during the 7-day posttreatment recovery period (p < 0.05). Patients' satisfaction ratings for the combination therapy halves were higher than the monotherapy halves at 1-month follow-up (p < 0.05). No severe adverse events were observed. The picosecond alexandrite laser and TTA combination therapy demonstrated synergistic efficacy for hemi-MASI and dyschromia improvements over laser monotherapy. The optimization of the picosecond laser and TTA combination regimen needs further investigation.
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14
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Hu S, Atmakuri M, Rosenberg J. Adverse Events of Nonablative Lasers and Energy-Based Therapies in Subjects with Fitzpatrick Skin Phototypes IV to VI: A Systematic Review and Meta-Analysis. Aesthet Surg J 2022; 42:537-547. [PMID: 35019139 DOI: 10.1093/asj/sjab398] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although there is an abundance of literature on nonablative laser and energy-based therapies for the management of skin conditions, adverse events are inconsistently addressed and range widely across studies. Fitzpatrick skin phototypes (SPTs) IV to VI are believed to be at higher risk. OBJECTIVES The aim of this study was to determine the types and rates of adverse events in nonablative laser and energy-based therapies among patients with SPTs IV to VI. METHODS Articles addressing nonablative laser and energy-based therapies for skin rejuvenation and acne scarring in patients with SPTs IV to VI that provided data on adverse events were included. The pooled prevalence of each adverse event was calculated. To determine whether age, treatment indication, SPT, and device type influenced incidence, subgroup and meta-regression analyses were performed. Heterogeneity was evaluated with the I2 statistic. RESULTS Forty-three studies were included in the meta-analysis. The sample size was 1654, and the median age of subjects was 39.4 years. The most common adverse events were postinflammatory hyperpigmentation (PIH) (rate, 8.1%) and prolonged erythema (rate, 0.6%). The rate of PIH was significantly higher for diode and erbium-doped lasers compared with intense pulsed light and radiofrequency. PIH correlated positively with SPT, laser density, and total energy delivered. CONCLUSIONS Although the overall rate of adverse events in nonablative laser and energy-based therapies for SPTs IV to VI is low, the incidence of PIH is not insignificant. Certain lasers, such as diode, Q-switched Nd:YAG, and erbium-doped lasers, tend to have higher rates of PIH, whereas intense pulsed light and radiofrequency have minimal risk. Higher SPTs and higher energy deliverance correlate positively with the incidence of PIH. LEVEL OF EVIDENCE: 4
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Affiliation(s)
| | - Malika Atmakuri
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic Surgery, Kaiser Permanente-San Rafael Medical Center, San Rafael, CA, USA
| | - Joshua Rosenberg
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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15
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Sun Y, Yang TT, Chih PL, Chen YC, Lan CCE. Favorable Effect after Single Treatment Session of 755-nm Picosecond Laser with A Diffractive Optic Lens on Facial Wrinkles and Pore Size in Asians. J Cosmet Dermatol 2022; 21:2026-2030. [PMID: 35100450 DOI: 10.1111/jocd.14810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Laser therapy has become one of the mainstay treatments for improving signs of aging including wrinkles, large pores, and skin pigmentation. However, in patients with pigmented skin, an increase in complications including post-inflammatory hyperpigmentation (PIH) has been noted. The purpose of this study is to investigate not only the safety profile of 755 nm picosecond laser with diffractive lens array (DLA) at approximately 2250 pulses on the face in people with darker skin, but also to evaluate its efficacy in treating wrinkles and pore sizes after one treatment session among different age groups. METHODS This single-center, retrospective study enrolled patients between age 22 to 65 with both facial wrinkles and enlarged pore sizes. A total of 46 patients (7 male, 39 female, mean age 43) with Fitzpatrick skin types III and IV were enrolled. Two independent data-blinded dermatologists assessed and scored the improvements of patients' wrinkles and pore sizes using photographs. RESULTS After one treatment session, statistically significant improvements were observed in lateral canthal wrinkles (p<0.001) and facial wrinkles (p=0.014). In addition, greater percentage of the patients from the aged group (50-65 years-old) showed clinically significant improvement as compared to the younger group. CONCLUSIONS For patients with type III and IV skin, one session of DLA picosecond laser treatment at around 2250 pulses to the face is safe and effective for clinically meaningful improvement of the wrinkles and pore sizes, especially for the patients from 50- to 65-years of age.
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Affiliation(s)
- Yng Sun
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ting-Ting Yang
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Ling Chih
- Huang PH Dermatology and Aesthetic Clinic, Kaohsiung City, Taiwan
| | - Yin-Chun Chen
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Chen Eric Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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16
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Leight-Dunn H, Hadi A, Patel F, Yao CJ, Tu YM, Chapas A. The effect of a dual-wavelength 532 nm and 1064 nm picosecond-domain laser with a fractionated holographic optic on photoaging and patient age perception: A pilot study. J Cosmet Dermatol 2021; 21:320-326. [PMID: 34908229 DOI: 10.1111/jocd.14654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/25/2021] [Accepted: 11/12/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study evaluated the efficacy of a dual-wavelength 532 nm/1064 nm Nd:YAG picosecond-domain laser with a holographic lens array in treating facial photoaging. METHODS Thirteen subjects were enrolled with 10 completing the study. Receiving three-month treatments, subjects underwent full-face spot treatment of facial lentigines with the 532-nm non-fractionated handpiece, followed by two sequential facial passes of the 1064-nm and the 532-nm fractionated handpieces. Improvement was measured by treating physician evaluation of pigmentation and rhytids as well as blinded reviewer evaluation of pre- and post-treatment image sets taken 12 weeks after the final treatment. Participants completed treatment surveys to assess satisfaction. RESULTS Physician grading on a 5-point scale revealed an average improvement of 1.6 in pigmentation (p = 0.0042) and 0.9 in rhytids (p = 0.0196). Blinded physicians appropriately selected baseline images in 44 of 50 (88%) image sets (10 subjects; five reviewers). On an 11-point scale for overall facial photoaging (0 = no change, 1 = 10% improvement, 2 = 20% improvement, etc.) treating physicians scored mean improvement as 3.3 ± 1.83 (95% CI 1.99 to 4.61; range 1-6), while blinded reviewers scored mean improvement as 2.32 ± 2.62 (range % -4 to 8, 95% CI 1.57 to 3.07). The greatest majority (80%) of participants reported satisfaction with the treatment. Adverse events were mild; however, one patient developed hyperpigmentation, consistent with melasma that was successfully treated with topical agents. CONCLUSION This is the first study to show that picosecond-domain 532 nm/1064 nm laser treatments with combination non-fractionated and fractionated handpieces are well-tolerated, safe, and effective for the treatment of photodamage.
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Affiliation(s)
| | - Ali Hadi
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Christopher J Yao
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
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17
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Vachiramon V, Namasondhi A, Anuntrangsee T, Jurairattanaporn N. A single-blinded, randomized, controlled trial comparing efficacy between low-fluence alexandrite 755-nm picosecond laser and low-fluence neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm picosecond laser for the treatment of ultraviolet B-induced hyperpigmentation. J Cosmet Dermatol 2021; 21:1036-1044. [PMID: 34773725 DOI: 10.1111/jocd.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/08/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hyperpigmentation is a common concern of patients in dermatology clinics. Although there are many treatment options, lasers are considered a promising therapy for various hyperpigmentary conditions. OBJECTIVES This study aims to evaluate the efficacy of alexandrite 755-nm picosecond and neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm picosecond lasers for the treatment of ultraviolet B (UVB)-induced hyperpigmentation in Asians. MATERIALS AND METHODS A randomized, single-blinded study was conducted. UVB-induced hyperpigmentation was performed in three spots by narrowband UVB. After 2 weeks, these three spots were allocated into 755-treated, 1064-treated, and control sites. Patients received weekly laser treatments for five sessions. Follow-ups were scheduled at 1 and 2 months after the last session. RESULTS Twenty patients attended the study. Overall, 755-nm and 1064-nm picosecond lasers showed a significant improvement in the mean lightness index (L*) compared to the control site, which started at Day 49 and Day 77, respectively. The mean L* of the 755-nm-treated site was also higher than that of the 1064-nm-treated site at Day 105 (p ≤ 0.001). Initially, the mean L*, physician's visual analog scale (VAS), and patient satisfaction with the 1064-nm picosecond laser were better than those with the 755-nm picosecond laser. Nevertheless, an inversion of the mean L* and VAS was noted at Day 49, whereas the mean patient satisfaction was noted at Day 77. In the subgroup analysis, a 755-nm picosecond laser effectively treated Fitzpatrick skin types (FPTs) III and IV. However, the mean L* of the 1064-nm picosecond laser was not significantly different from that of the control for FPT4. CONCLUSION The alexandrite 755-nm picosecond and Nd:YAG 1064-nm picosecond lasers appear to be effective and safe modalities for treating UVB-induced hyperpigmentation. With the setting employed in this study, the outcome after the 755-nm picosecond laser treatment seemed superior to that of the 1064-nm picosecond laser treatment, especially for FPT4.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amornrut Namasondhi
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanaporn Anuntrangsee
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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18
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Ren R, Bao S, Qian W, Zhao H. 755-nm Alexandrite Picosecond Laser with a Diffractive Lens Array or Zoom Handpiece for Post-Inflammatory Hyperpigmentation: Two Case Reports with a Three-Year Follow-Up. Clin Cosmet Investig Dermatol 2021; 14:1459-1464. [PMID: 34675582 PMCID: PMC8520414 DOI: 10.2147/ccid.s323872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022]
Abstract
Objective Post-inflammatory hyperpigmentation (PIH) is a reactive hypermelanosis of various skin types, which occurs as a sequela of cutaneous inflammation or injury. Despite generally a self-limited and temporary condition, PIH is still a frustrating problem that can have significant psychosocial effects on patients, especially those with darker skin types. Laser therapy is one of the effective treatments for PIH, and various wavelength lasers and light devices have been utilized in PIH therapy. Nonetheless, data on the long-term efficacy of the 755-nm alexandrite picosecond laser are limited. Methods This study analyzed two cases of PIH treated with a combination of a 755-nm alexandrite picosecond laser and a diffractive lens array or zoom handpiece. Efficacy of the treatment was determined by the images of skin lesions under a fixed light source before and after each treatment, which were independently reviewed by two plastic-surgery specialists blinded to the clinical data. Improvement was classified as complete (>75%), significant (50–75%), mild (25–50%), and inefficient (<25% or no obvious change). Skin imaging analysis was carried out using the VISIA system (Canfield, USA), and dermoscopy was performed at the same time. Results After two to three courses of treatment, all cases showed significant or complete improvement, and no recurrence was observed during the three years of follow-up. Conclusion A 755-nm alexandrite picosecond laser in combination with a diffractive lens array or zoom handpiece had significant and long-term efficacy for the treatment of PIH caused by trauma. However, attention should be paid to the problem of transient deepening of pigmentation during treatment.
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Affiliation(s)
- Rongxin Ren
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Shiwei Bao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wenjiang Qian
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hongyi Zhao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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19
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Kauvar ANB, Sun R, Bhawan J, Singh G, Ugonabo N, Feng H, Schomacker K. Treatment of facial and non-facial lentigines with a 730 nm picosecond titanium: Sapphire laser is safe and effective. Lasers Surg Med 2021; 54:89-97. [PMID: 34402537 PMCID: PMC9291180 DOI: 10.1002/lsm.23450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 11/24/2022]
Abstract
Objective A 730 nm picosecond‐domain laser was developed to improve the clearance of pigmented lesion and reduce adverse events. This study assessed the safety and efficacy of this system for the clearance of lentigines and explores how the short picosecond pulses interact with tissue via histology. Study Design and Methods Twenty subjects with Fitzpatrick skin types II–IV were enrolled in this prospective, IRB‐approved study. Four treatments were administered using a 730 nm picosecond‐domain laser. Pre‐ and posttreatment photos were assessed by blinded reviewers at 4‐ and 12‐week follow‐up visits, using a 5‐point clearance scale. Subject satisfaction was measured using a 5‐point scale. Investigator Global Improvement Score (IGIS) was performed at the 4‐ and 12‐week follow‐up visits, using an 11‐point clearance scale. Subject pain level was measured using an 11‐point scale (no pain [0], extreme pain [10]). Histology of 730 and 532 nm picosecond pulses was compared with 755 and 532 nm nanosecond pulses. Results Sixteen subjects with a total of 118 discontinuous treatment areas, each comprised of 1–20 lesions, completed all study visits. Thirty body regions were studied, including arms (6), hands (16), scalp (1), forehead (2), face (3), and back (2). Spot sizes ranging from 2 to 5 mm diameters were used with fluences ranging from 0.8 to 4.0 J/cm2. Mean pain score was 3.6 of 10 for all four treatments. Ninety‐nine percent of randomly paired 4‐week posttreatment images and 100% of 12‐week posttreatment images were correctly identified from their respective baseline images by three blinded reviewers. Mean IGIS demonstrated scores of 6.7 and 7.0 at 4‐ and 12‐week follow‐up visits, respectively. At the 4‐ and 12‐week follow‐up visits, 76% and 73% of subjects, respectively, were satisfied to highly satisfied. The mean clearance score for all 118 treatment areas was 3 of 4 in follow‐up visits. At 12‐week follow‐up, 36% of 118 treatment areas had a clearance score of 4, and 38% had a clearance score of 3. Post treatment, there was typical erythema, edema, dryness, crusting, and itching but negligible purpura, no pinpoint bleeding, blistering or scarring, and no significant hyperpigmentation or hypopigmentation. Histology showed diffuse, focal epidermal vacuolization ~5–10 µm in diameter and mild extravasation of erythrocytes with 730 nm picosecond pulses, while diffuse epidermal vacuolization was observed with coalescence of vacuoles (~20–100 µm), junctional clefting and mild extravasation of erythrocytes with 755 nm nanosecond pulses. Picosecond pulses of the wavelength of 532 nm produced diffuse, focal epidermal vacuolization and larger dermal vacuoles to depths of 500 µm, while 532 nm nanosecond pulses produced diffuse epidermal vacuolization with coalescence of vacuoles and marked dermal hemorrhage. Conclusion This study demonstrated the potential of a new 730 nm picosecond‐domain laser for the clearance of lentigines. The results showed good clearance with no adverse events and good subject satisfaction in patients with skin type II–III. Additional studies need to be conducted on darker skin types. The histopathologic findings demonstrate that the picosecond 730 nm laser produces excellent selectivity for pigment with minimal disruption of the dermal–epidermal junction and may therefore reduce healing times and the risk of adverse events.
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Affiliation(s)
- Arielle N B Kauvar
- New York Laser & Skin Care, New York, New York, USA.,Department of Dermatology, NYU Langone Medical Center, New York, New York, USA
| | - Rongrong Sun
- Candela Medical, Marlborough, Massachusetts, USA
| | - Jag Bhawan
- Department of Dermatology, School of Medicine, Boston University, Boston, Massachusetts, USA
| | | | - Nkem Ugonabo
- Department of Dermatology, NYU Langone Medical Center, New York, New York, USA
| | - Hao Feng
- University of Connecticut Health Center, Farmington, Connecticut, USA
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20
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Ren R, Zhao H. A case report on the use of 755-nm alexandrite picosecond laser in the treatment of post-inflammatory hyperpigmentation in the nose. J Cosmet Dermatol 2021; 21:2046-2048. [PMID: 34224638 DOI: 10.1111/jocd.14332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
Post-inflammatory hyperpigmentation (PIH), a common sequela of acute or chronic cutaneous inflammation, is an acquired pigmentary disorder. The main treatments for PIH, such as topical agents, photoprotection, and chemical peeling, demonstrated different efficacies with inconsistent outcomes. Here, we reported a case of nasal PIH treated using a 755-nm alexandrite picosecond laser. The patient (female, aged 36 years) presented with a brown macula on the left side of the nasal dorsum 2 years ago, received treatment, and was followed up in the Plastic Surgery Department of Beijing hospital.
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Affiliation(s)
- Rongxin Ren
- The Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongyi Zhao
- The Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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21
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Guida S, Fusano M, Pellacani G, Bencini PL. Fractional 1064 nm picosecond laser and skin photoaging: in vivo evaluation of treatment effects with reflectance confocal microscopy. J COSMET LASER THER 2021; 23:92-96. [PMID: 34672855 DOI: 10.1080/14764172.2021.1994612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Few studies showed the role of picosecond laser (PLS) in the treatment of skin photoaging signs. However, no studies have explored the microscopic effects of PSL in photoaging. The aim of this study is to preliminarily identify clinical variations induced by a 1,064 nm Nd:YAG PSL on the décolleté area, then to apply the treatment protocol to treat facial photoaging and estimate the clinical and microscopic outcomes. A total of 10 consecutive patients with cutaneous photoaging were enrolled. Patients were treated 3 times at monthly intervals with the fractionated 1,064 nm Nd:YAG PSL. In a preliminary phase, PSL treatment was performed on the décolleté to establish its efficacy and safety. Then, the same treatment protocol was applied to all the face and clinical and reflectance confocal microscopy (RCM) were analyzed, comparing baseline (T0) pictures and 4 months after the treatment (T1) ones. On the face, a reduction of dyschromia and wrinkles was observed at T1. Furthermore, the underlying RCM variations were revealed at different skin levels. Our results show the clinical and microscopic effectiveness and safety of the 1,064-nm Nd:YAG PSL in the treatment of skin photoaging signs.
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Affiliation(s)
- S Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Science with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Department of Dermatology, ICLID, Istituto di Chirurgia e Laserchirurgia in Dermatologia, Milano, Italy
| | - M Fusano
- Department of Dermatology, ICLID, Istituto di Chirurgia e Laserchirurgia in Dermatologia, Milano, Italy
| | - G Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Science with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - P L Bencini
- Department of Dermatology, ICLID, Istituto di Chirurgia e Laserchirurgia in Dermatologia, Milano, Italy
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22
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Yu W, Zhu J, Yu W, Shang Y, Lyu D, Lin X, Xu H, Zhang Z. Three-Year Results of Facial Photoaging in Asian Patients After Alexandrite 755 nm Picosecond Laser With Diffractive Lens Array: A Split-Face, Single-Blinded, Randomized Controlled Comparison. Lasers Surg Med 2021; 53:1065-1072. [PMID: 33604905 DOI: 10.1002/lsm.23393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE The long-term efficacy of a picosecond alexandrite laser (PSAL) with a diffractive lens array (DLA) for the treatment of photoaging is absent. To observe the long-term efficacy of PSAL for the treatment of photoaging. STUDY DESIGN/MATERIALS AND METHODS Each patient (n = 10) received 10 treatments at 2-week intervals. One side of the face was randomly selected for treatment. At 1, 3, 6, and 36 months after the final treatment, two blinded physicians evaluated photographs with four clinical indicators of photoaging (dyschromia, skin texture, skin laxity, and rhytids). A quartile scale was used. RESULTS At baseline, there were no significant differences in dyschromia, skin texture, facial laxity, or rhytids between the treated and control sides (P > 0.05). Picosecond laser-treated side showed 0.85 and 1.05 (both P < 0.05) better for dyschromia at 3- and 6-month follow-up, and 0.6 (P < 0.05) better for skin texture at 6-month follow-up. At 36-month follow-up, the degree of photoaging is intensified on the control side while the rejuvenation efficacy maintained on the treated side, with 1.4, 0.75, and 0.8 (all P < 0.05) better for dyschromia, skin texture, and rhytids relative to the control side measures. CONCLUSION Our results demonstrate the long-term efficacy and safety of PSAL with DLA for the treatment of facial photoaging. LIMITATION Small sample size and the lack of objective evaluation. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Wenyou Yu
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jiafang Zhu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Dongze Lyu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Hui Xu
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhen Zhang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
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23
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Wong CSM, Chan MWM, Shek SYN, Yeung CK, Chan HHL. Fractional 1064 nm Picosecond Laser in Treatment of Melasma and Skin Rejuvenation in Asians, A Prospective Study. Lasers Surg Med 2021; 53:1032-1042. [PMID: 33544930 DOI: 10.1002/lsm.23382] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Facial melasma is a disfiguring pigmentation and occurs frequently with aging skin. Topical treatment alone was often suboptimal. A recent study showed that fractional picosecond laser has promising result in benign pigmentary lesions. This study aims to investigate the efficacy and safety of 1064 nm picosecond laser in treatment of facial melasma and skin rejuvenation in Asian skin. STUDY DESIGN/MATERIALS AND METHODS Patients of Asian descent seeking treatment for facial melasma and skin rejuvenation were screened and recruited. Each patient received up to nine laser treatments at 4-6 weeks intervals with a fractionated nonablative 1064 nm picosecond laser. Baseline and posttreatment modified Melasma Area Severity Index (mMASI) and Global Aesthetic Improvement Scale (IGAS) were assessed by blinded investigators based on the clinical photographs. Subject overall satisfaction was assessed by the questionnaires after treatment. All adverse events were documented. RESULTS Twenty patients were recruited with a median age of 52.7 ± 8.2 years. Three subjects had Fitzpatrick skin type III and 17 had skin type IV. All subjects received nine laser sessions. Over 70% of patients were satisfied with the treatment outcomes. There was a statistically significant improvement in mMASI which reduced from 10.8 at baseline to 2.7 and 3.6 at 6 and 12 weeks post-treatment, respectively (both P < 0.01). For skin rejuvenation, 70% reported at least a moderate improvement at 6 weeks of post-treatment. No major side-effect was reported. Erythema was the most frequent transient response, while some reported edema (1.1%). Both resolved spontaneously. None reported hypo- or hyperpigmentation after treatment. The overall mean pain scare (VAS) was 1.92. CONCLUSION Fractionated non-ablative 1064 nm picosecond laser was effective in treatment of melasma and skin rejuvenation. It was also safe and well tolerated. Importantly, there was no hypo or hyperpigmentation reported. Lasers Surg. Med. 00:00-00, 2021. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Christina S M Wong
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mandy W M Chan
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Samantha Y N Shek
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Chi Keung Yeung
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Henry H L Chan
- Division of Dermatology, Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Harvard Medical School, Wellman Centre for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
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Bhargava S, Goldust M, Singer H, Negbenebor N, Kroumpouzos G. Evaluating resurfacing modalities in aesthetics. Clin Dermatol 2021; 40:274-282. [DOI: 10.1016/j.clindermatol.2021.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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25
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Phothong W, Manuskiatti W, Cembrano KAG, Wanitphakdeedecha R, Bowornsathitchai N. The Efficacy and Safety of a Variable Square Pulse (VSP) Erbium:YAG Laser for Treatment of Enlarged Pores in Asians. Lasers Surg Med 2020; 53:616-621. [PMID: 33161583 DOI: 10.1002/lsm.23342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/28/2020] [Accepted: 10/15/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Enlarged pores are one of the most common causes of skin surface irregularities. Existing studies supporting the benefit of lasers and energy-based devices (EBD) for this condition are limited, with a short duration of follow-up period. We aimed to evaluate the efficacy and adverse effects of Er:YAG laser for treatment of enlarged pores in dark-skinned patients. STUDY DESIGN/MATERIALS AND METHODS Nineteen subjects (aged 26-47 years) with skin phototypes III (21.1%) and IV (78.9%) and enlarged pores were treated with 4 monthly sessions of Erbium:YAG laser. Objective (ultraviolet light A video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline, 1-month after each treatment and at 1, 3, and 6 months after the final treatment. RESULTS The weighted mean score of quartile grading scales showed significant improvement in pore size from baseline starting at 1-month after the third treatment and continued until 3 months after the fourth (final) treatment (P < 0.001). However, the improvement dropped significantly at 6 months after the final treatment. Objective measurements of the improvements in skin surface smoothness and wrinkles corresponded with the physician raters' clinical evaluation. CONCLUSIONS Erbium:YAG laser is a safe and effective treatment for enlarged pores in dark-skinned individuals. Maintenance treatments are recommended to achieve a longer-lasting outcome. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Weeranut Phothong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
| | - Kathryn Anne G Cembrano
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
| | - Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
| | - Nutthamon Bowornsathitchai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
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26
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Kwon HH, Yang SH, Cho YJ, Shin E, Choi M, Bae Y, Jung JY, Park GH. Comparison of a 1064-nm neodymium-doped yttrium aluminum garnet picosecond laser using a diffractive optical element vs. a nonablative 1550-nm erbium-glass laser for the treatment of facial acne scarring in Asian patients: a 17-week prospective, randomized, split-face, controlled trial. J Eur Acad Dermatol Venereol 2020; 34:2907-2913. [PMID: 32603006 DOI: 10.1111/jdv.16643] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Novel picosecond lasers using a diffractive optical element (P-DOE) have been available for skin resurfacing with distinct mechanisms. However, there are limited data directly comparing P-DOE and conventional fractional lasers for the treatment of atrophic acne scarring. OBJECTIVES We sought to compare the efficacy and safety of a 1064-nm neodymium-doped yttrium aluminium garnet P-DOE and a non-ablative fractional laser (NAFL) in the treatment of acne scarring. METHODS A prospective, randomized, split-face, controlled trial was performed. One randomly assigned half-side of each patient's face (n = 25) was treated with four consecutive sessions of P-DOE at 3-week intervals and the other side with NAFL, with subsequent follow-up for 8 weeks after the final sessions. The efficacy and safety of the two lasers were determined by the Echelle d'Evaluation Clinique des Cicatrices d'acné (Scale of Clinical Evaluation of Acne Scars; ECCA) grading scale, Investigator's Global Assessment (IGA) score and patients' reports at the final visit. Histologic analysis was also performed. RESULTS The P-DOE-treated side achieved a significantly better improvement in acne appearance (ECCA per cent reduction: 55% vs. 42%) with less severe pain (4.3 vs. 5.6) (P < 0.05). The IGA score and subjective satisfaction were consistent with ECCA score results. Occurrences of treatment-related side-effects were also lower in the group treated with P-DOE (P < 0.05). Histologic analysis revealed elongation and increased density of neocollagen fibres, elastic fibres and mucin throughout the dermis from both sides. CONCLUSIONS Compared with NAFL, P-DOE afforded better clinical outcomes and fewer side-effects in the treatment of acne scarring in Asian patients.
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Affiliation(s)
- H H Kwon
- Oaro Dermatology Clinic, Seoul, Korea
| | - S H Yang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y J Cho
- Oaro Dermatology Clinic, Seoul, Korea
| | - E Shin
- Department of Pathology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - M Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Y Bae
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - J Y Jung
- Oaro Dermatology Clinic, Seoul, Korea
| | - G-H Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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Fan Y, Ma Q, Xin S, Peng R, Kang H. Quantitative and Qualitative Evaluation of Supercontinuum Laser‐Induced Cutaneous Thermal Injuries and Their Repair With OCT Images. Lasers Surg Med 2020. [DOI: 10.1002/lsm.23287] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yingwei Fan
- Beijing Institute of Radiation Medicine Beijing 100850 China
| | - Qiong Ma
- Beijing Institute of Radiation Medicine Beijing 100850 China
| | - Shenghai Xin
- Department of Biomedical Engineering School of Medicine, Tsinghua University Beijing 100084 China
| | - Ruiyun Peng
- Beijing Institute of Radiation Medicine Beijing 100850 China
| | - Hongxiang Kang
- Beijing Institute of Radiation Medicine Beijing 100850 China
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28
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Wu DC, Jones IT, Boen M, Al-Haddad M, Goldman MP. A Randomized, Split-Face, Double-Blind Comparison Trial Between Fractionated Frequency-Doubled 1064/532 nm Picosecond Nd:YAG Laser and Fractionated 1927 nm Thulium Fiber Laser for Facial Photorejuvenation. Lasers Surg Med 2020; 53:204-211. [PMID: 32285983 DOI: 10.1002/lsm.23248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE Fractionated lasers are a popular therapeutic option for facial photorejuvenation. In this study, we compare the safety, tolerability, and efficacy of a fractionated frequency-doubled 1064/532 nm picosecond Nd:YAG fractionated picosecond laser (FPL) versus a fractionated 1927 nm thulium fiber laser (TFL) for facial rejuvenation. STUDY DESIGN/MATERIALS AND METHODS This was a double-blind, randomized, split-face comparison study involving 20 subjects. Facial halves were randomized to receive either FPL or TFL treatment. Three treatments were delivered at 1-month intervals. Subjects were followed up for 1, 3, and 6 months post-final treatment session and evaluated by blinded, non-treating investigators for dyspigmentation, erythema, keratosis, texture, and rhytids on a standardized scale. Subjects also recorded a quantitative daily diary rating healing progress for 14 days after every treatment session. RESULTS Statistically significant improvements in elastosis, erythema, keratosis, dyschromia, and skin texture were noted in both treatment groups. There were no significant differences detected in clinical efficacy between the two groups. Subject daily dairies revealed statistically significant differences in tolerability during the immediate 14-day post-operative recovery period. The facial half treated with FPL displayed significantly less redness on days 3 and 4; significantly less swelling on day 5; significantly less crusting on days 1 through 9; significantly less peeling on days 3 through 9; and significantly less itch on days 4 and 7. There were no unexpected adverse effects observed. CONCLUSION Both FPL and TFL are safe and effective treatment options for facial rejuvenation. FPL may be associated with significantly less downtime. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas C Wu
- Cosmetic Laser Dermatology, San Diego, California, 92121
| | | | - Monica Boen
- Cosmetic Laser Dermatology, San Diego, California, 92121
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29
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Wu DC, Goldman MP, Wat H, Chan HHL. A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med 2020; 53:9-49. [PMID: 32282094 DOI: 10.1002/lsm.23244] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence-based recommendations are developed for the use of picosecond laser in dermatology. STUDY DESIGN/MATERIALS AND METHODS A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors' combined clinical experience, clinical recommendations were developed. RESULTS After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I-IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II-III evidence; tattoo removal was associated with level I evidence. CONCLUSION Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas C Wu
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Heidi Wat
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
| | - Henry H L Chan
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
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30
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Mehrabi JN, Friedman O, Al-Niaimi F, Artzi O. Retrospective photographic review of nontattoo indications treated by picosecond laser. J Cosmet Dermatol 2020; 19:612-621. [PMID: 32045107 DOI: 10.1111/jocd.13285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/12/2019] [Accepted: 12/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Picosecond (PS) lasers were approved by the US FDA in 2012 after being shown to remove tattoos with more success and fewer treatments compared with traditional methods. PS lasers were shown to be versatile, indicated for the treatment of lentigines, café-au-lait macules (CALMs), and acne scars and skin rejuvenation. OBJECTIVE We report our experience treating our patients for different indications using a PS laser. METHODS We performed a retrospective chart and photographic review of all patients seen between 2016 and 2018 that were treated in our centers with a PS laser for nontattoo indications. Clinical outcomes were evaluated using side-by-side comparisons of the clinical photographs by two blinded, independent physicians using a visual analog scale consisting of six levels of treatment response. RESULTS A total of 233 patients were studied. Most sought treatment for solar lentigo (27%) and skin rejuvenation (14%). Epidermal nevi exhibited the greatest improvement with treatment, while acne scarring demonstrated the least. Only 24% of patients experienced noteworthy, transient adverse effects. CONCLUSION Picosecond lasers were efficacious and safe for a variety of indications. They were effective in treating epidermal nevi and pigmented lesions, such as Lentigines and CALMs.
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Affiliation(s)
- Joseph N Mehrabi
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Or Friedman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Dr.Artzi and Associates - Treatment and Research Center
| | - Firas Al-Niaimi
- Department of Dermatology, Tel-Aviv University, Tel-Aviv, Israel
| | - Ofir Artzi
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Dr.Artzi and Associates - Treatment and Research Center.,Department of Dermatology and Venereology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
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Zhang M, Fang J, Wu Q, Lin T. Evaluation of the Safety and Efficacy of a Picosecond Alexandrite Laser With DLA for Acne Scars in Chinese Patients. Lasers Surg Med 2019; 52:176-181. [PMID: 31709575 DOI: 10.1002/lsm.23177] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Recently, picosecond laser treatment has been used as an effective treatment for acne scars. To evaluate the efficacy and safety of a picosecond alexandrite laser with a diffractive lens array in the treatment of acne scars in Chinese patients. STUDY DESIGN/MATERIALS AND METHODS Patients with facial acne scars were treated with a picosecond alexandrite laser in three sessions at 4- to 6-week intervals and followed up for 2 months. Primary outcomes were measured by physicians' blinded evaluation of the acne scar using the ECCA (échelle d'éva physicians'luation clinique des cicatrices d'acné) grading scale. The secondary outcomes included the investigator global assessment (IGA) on the improvement of post-inflammatory erythema (PIE), patients' assessment of improvement on a 4-point scale and of satisfaction on a 5-point scale. Pain scores and adverse effects were also evaluated. RESULT Twenty patients with Fitzpatrick skin types III and IV were enrolled in the study and completed all treatment and follow-up visits. The mean ECCA scores fell from 197.75 ± 35.26 to 142.00 ± 35.92 (a 28% improvement), and the change was significant (P = 0.000). The mean IGA score of PIE improvement was 3.03 ± 0.75 (0 = no improvement and 4 = 76-100% improvement). On the basis of the patients' self-assessment, the average improvement scores were 2.30 ± 0.98 (0 indicating 0-25% improvement and 3 indicating >75% improvement). In total, 50% and 30% of the patients were "satisfied" and "very satisfied," respectively, with the treatment. The mean pain score was 3.20 ± 0.50 (0 = no pain, 10 = maximum pain) with topical anesthesia. The adverse effects included transient and mild erythema, edema, and scabbing. CONCLUSIONS Treatment with a picosecond alexandrite laser with a diffractive lens array is effective and safe for acne scars in Chinese patients. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Mengli Zhang
- Department of Cosmetic Laser Surgery, Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 210042, P.R. China
| | - Jing Fang
- Department of Cosmetic Laser Surgery, Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 210042, P.R. China
| | - Qiuju Wu
- Department of Cosmetic Laser Surgery, Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 210042, P.R. China
| | - Tong Lin
- Department of Cosmetic Laser Surgery, Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 210042, P.R. China
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Wang Y, Lin E, Chen Y, Chiu P, Lin B, Chiang H, Huang Y, Wang K, Lin H, Chang T, Chang C. Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma. J Eur Acad Dermatol Venereol 2019; 34:624-632. [PMID: 31494973 DOI: 10.1111/jdv.15934] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/12/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Y.‐J. Wang
- Department of Dermatology MacKay Memorial Hospital Taipei Taiwan
| | - E.‐T. Lin
- School of Medicine College of Medicine China Medical University Taichung Taiwan
| | - Y.‐T. Chen
- Department of Dermatology Shuang Ho Hospital Taipei Medical University Taipei Taiwan
- School of Public Health College of Public Health and Nutrition Taipei Medical University Taipei Taiwan
| | - P.‐C. Chiu
- Aletheia Holistic Dermatology Center Taichung Taiwan
| | - B.‐S. Lin
- Institute of Imaging and Biomedical Photonics National Chiao Tung University Tainan Taiwan
| | - H.‐M. Chiang
- Department of Cosmeceutics and Graduate Institute of Cosmeceutics China Medical University Hospital Taichung Taiwan
| | - Y.‐H. Huang
- Yung‐Hsueh Huang Dermatology Clinic Changhua Taiwan
| | - K.‐Y. Wang
- Department of Cosmeceutics and Graduate Institute of Cosmeceutics China Medical University Hospital Taichung Taiwan
| | - H.‐Y. Lin
- Department of Applied Cosmetology & Master's Program of Cosmetic Science Hung Kuang University Taichung Taiwan
| | - T.‐M. Chang
- Department of Applied Cosmetology & Master's Program of Cosmetic Science Hung Kuang University Taichung Taiwan
| | - C.‐C. Chang
- School of Medicine College of Medicine China Medical University Taichung Taiwan
- Institute of Imaging and Biomedical Photonics National Chiao Tung University Tainan Taiwan
- Department of Cosmeceutics and Graduate Institute of Cosmeceutics China Medical University Hospital Taichung Taiwan
- Aesthetic Medical Center China Medical University Hospital Taichung Taiwan
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33
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Kelly KM. Science and peace. Lasers Surg Med 2018; 51:5-7. [PMID: 30561812 DOI: 10.1002/lsm.23043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Kristen M Kelly
- Beckman Laser Institute, University of California, Irvine, California 92697
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