A New 675 nm Laser Device in the Treatment of Melasma: Results of a Prospective Observational Study

A 675 nm Laser in the Treatment of Facial Melasma in Dark Skin Types

Background: Melasma therapy can be difficult and requires employing different treatment approaches. Laser therapy is a good alternative for treating melasma, especially for patients with refractory cases. Objective: To evaluate the efficacy and safety of newcomer wavelength 675 nm diode laser in treating melasma in darker skin types. Methods: Nineteen female patients with facial melasma were recruited. They received four sessions of 675 nm laser at one-month intervals using the following parameters: power 5-6 W, pulse duration 100-150 ms, spacing 2000 mm, and stack one up to 4 passes. One month after the last treatment session, the evaluation was done subjectively through the modified melasma area and severity index (mMASI) score and objectively using the Antera 3D camera. Results: After treatment, there was a highly statistically significant reduction in mMASI scores. In addition, the scores on the Antera camera recorded highly statistically significant differences in the treated areas' melanin and hemoglobin average levels. Conclusion: The novel 675 nm laser represents a safe and efficient approach in treating melasma in darker phototype patients.

Exploring the potential of the emerging 675 nm laser across diverse skin pathologies: a comprehensive review

BACKGROUND

Low-level laser therapy (LLLT) at 675 nm, within the red light spectrum, has emerged as a noninvasive therapeutic option for various dermatological conditions, including aging-related skin changes, melasma, acne vulgaris, and striae distensae.

AIMS

This review aims to elucidate the therapeutic potential of the 675 nm laser in dermatology by synthesizing existing research evidence and clinical outcomes.

METHODS

A literature search was conducted on PubMed to include studies investigating the efficacy of the 675 nm laser in diverse dermatological conditions. Parameters such as treatment protocols, patient demographics, and outcome measures were analyzed to assess the laser's therapeutic associations. The literature search composed of clinical trials or review articles. Studies were additionally identified by searching reference lists of included articles. Only articles in English were utilized for this review.

RESULTS

The 675 nm laser demonstrates efficacy in addressing aging-related skin changes, including facial rejuvenation and wrinkle reduction, with significant improvement observed in skin texture and collagen remodeling. Additionally, the laser exhibits promising outcomes in treating melasma and hyperpigmentation disorders, acne vulgaris, and striae distensae, offering selective damage to target tissues with minimal adverse effects.

CONCLUSIONS

The 675 nm laser presents a versatile and innovative therapeutic option in dermatology, offering noninvasive treatment modalities for various health and cosmetic concerns. Further research and clinical trials are warranted to optimize treatment protocols and fully elucidate its therapeutic potential in diverse patient populations.

Laser Emission at 675 nm: Molecular Counteraction of the Aging Process

BACKGROUND/OBJECTIVES

Many lasers applied in skin rejuvenation protocols show emissions with wavelengths falling in the red or near-infrared (NIR) bands. To obtain further in vitro data on the potential therapeutic benefits regarding rejuvenation, we employed a 675 nm laser wavelength on cultured human dermal fibroblasts to understand the mechanisms involved in the skin rejuvenation process's signaling pathways by analyzing cytoskeletal proteins, extracellular matrix (ECM) components, and membrane integrins.

METHODS

Normal human dermal fibroblasts (NHDFs) were irradiated with a 675 nm laser 24 h after seeding, and immunofluorescence microscopy and Western blotting were applied.

RESULTS

The results demonstrate that the laser treatment induces significant changes in human dermal fibroblasts, affecting cytoskeleton organization and the production and reorganization of ECM molecules. The cell response to the treatment appears to predominantly involve paxillin-mediated signaling pathways.

CONCLUSIONS

These changes suggest that laser treatment can potentially improve the structure and function of skin tissue, with interesting implications for treating skin aging.

High-powered 675-nm laser: Safety and efficacy in clinical evaluation and in vitro evidence for different skin disorders

BACKGROUND

Laser technology is a viable therapeutic option for treating a number of skin pathologic conditions, including pigmented lesions, vascular lesions and acne scars.

AIM

In this work, through in vitro and clinical investigations we test the efficacy, the safety and the speed of treatment of high-powered laser system emitting a 675-nm in the management of various skin condition.

MATERIALS AND METHODS

In vitro experiments were performed irradiating adult human dermal fibroblasts cells (HDFa) with 675-nm laser for 24, 48 and 72 h with different fluences and Ki-67+ cells were counted. The confocal microscopy images of control and treated samples were acquired. Clinical skin rejuvenation/diseases treatments with 675 nm laser device were performed with different laser parameters in 11 patients with pigmented lesions, 5 patients with acne scars and 23 patients for skin rejuvenation. Data were evaluated with the validated global score using 5-point scales (GAIS) and patient's satisfaction scale.

RESULTS

The application of the high-power 675 nm laser has proven effective in stimulating cell proliferation in in vitro experiments and it led to good results for all skin pathologies. GAIS showed values between 3 and 4 points for all treated pathologies, all scores between '75%-good improvements' and '100%-excellent improvements'. The treatment time was reduced by 50% compared to the old parameters setting, resulting in a faster and good patient's satisfying technique. No serious adverse effects were recorded.

CONCLUSION

the preclinical and clinical data confirm the efficacy and safety of this high-powered 675 nm laser for several skin condition.

Clinical application of 675 nm laser therapy for dorsal hand skin hyperpigmentation

BACKGROUND

Noninvasive skin rejuvenation treatment is growing in recognition to aesthetic medicine.

AIM

The objective of the study was to assess the efficacy and the safety of the 675-nm laser source treatment of photodamaged hands.

MATERIALS AND METHODS

The study included 21 patients (6 males and 15 females) with a mean age of 63 (± 9) years. Patients were treated with -two to three sessions of the 675-nm laser with a 1-month interval between sessions. Photos of each patient were collected at baseline, and 3 months after the last laser session. The 5-point Global Aesthetic Improvement Scale (GAIS) was recorded with their final assessment session (3 months).

RESULTS

The total GAIS scores showed satisfactory results: 15 patients (71%) experienced 4 score (excellent improvement) changes and 6 patients (29%) experienced 3 score (good improvement) changes. Clinical images showed good efficacy and visible aesthetic results for the management of photodamaged skin. No serious adverse effects were recorded.

CONCLUSION

This study demonstrates the safety and efficacy of for the aesthetic improvement of skin pigmentation and texture for photodamaged hands.

The 675-nm wavelength for treating facial melasma

BACKGROUND

Melasma is an acquired skin problem. It characterises sun-exposed areas, particularly on the face, with irregular borders and bilateral distribution. With this study, we want to strengthen the scientific literature regarding the use of a 675-nm laser device for the treatment of women and men with facial melasma pigmentary and vascular symptoms.

MATERIALS AND METHODS

Eighteen patients were treated for facial melasma. A total of three sessions at 30-day intervals were performed with a 675-nm laser device. A five-point Global Aesthetic Improvement Scale was used to separately assess the improvement of the patient's skin 3 months after the last treatment (T1) compared to baseline (T0). The pain during treatment was measured using a Visual Analog Scale of 10 points. The non-ablative laser system used emits red light with a wavelength of 675 nm through a 13 × 13 mm scanning system.

RESULTS

At T1 , a consistent improvement in the pigmentary and vascular components was visible. This is always combined with a considerable reduction in vascular expression.

CONCLUSION

Our research shows that individuals with Fitzpatrick phototypes II to III can treat facial melasma with the 675-nm laser source system without risk. Due to its interaction with melanin, collagen and haemoglobin chromophores, as well as its excellent capacity to penetrate tissues with less heating, this system is promising in the treatment of pigmentary and vascular illnesses such as melasma. The great success of the technology we used came from the reduced levels of inflammation produced after the treatments and the low energy level implied.

New 675 nm Laser Device: The Innovative and Effective Non-Ablative Resurfacing Technique

Background and Objectives: Photo/chrono-aging is usually expressed as facial discolouration, wrinkles, redness, elastosis, laxity, and dehydration, thus representing major signs of ageing that often lead to a negative phycological impact on a patient's quality of life. Several types of treatment have been tested during the last decade, especially laser treatments. This article aims to share our experience in the treatment of photoaging with a new 675 nm laser source system on facial chrono-ageing. Materials and Methods: Thirty-five (35) patients were treated with the 675 nm laser device: 32 females (mean age 49 years) and 3 men (mean age 57 years), with Fitzpatrick skin types I-III (9% type I, 43% type II, 48% type III), facial wrinkles and hyperpigmented spots. The efficacy of this treatment was assessed using the Modified Fitzpatrick Wrinkles Scale (FWS), which was calculated before starting the treatment and after 6 months. The pain was evaluated using the VAS Pain Scale. Results: All 35 patients showed a significant improvement in facial wrinkles according to the FWS (from 1.96 to 1.73 at the 3-month follow-up, up to a value of 1.43 at 6 months). In a small group of patients, it was observed that 44% of them showed vascular moderate improvement and that 13% showed a vascular marked improvement after treatment. No side effects were detected except a mild erythematous rash in two patients, and the VAS Pain scale was assessed at 1.17. Conclusions: Red Touch allows a uniform and stable result to be achieved over time with minimum discomfort.

Thermal effect analysis on cuboid Pr:YLF crystals pumped by blue laser diodes

Using blue laser diodes (LDs) to pump Pr:YLF crystals can directly realize visible-band laser output. Compared with the traditional frequency doubling and LD direct output method, it has the advantages of simple design, compact structure, and high beam quality. For solid-state lasers, pump-induced thermal effects of gain media are the principal limiting factors for the desired high-power output. In this paper, internal temperature space model distribution of a rectangular cross-section Pr:YLF crystal is established. On this basis, the temperature distribution, thermal stress distribution, and thermal focal length variation of single-end pumped and double-end pumped laser crystals are analyzed. The results are verified by COMSOL simulations and experimental measurements. To our knowledge, this analysis is the first to examine the thermal effect of a rectangular cross-section Pr:YLF crystal, analyzing the limit power that the crystal can withstand, which paves the way for better performances of visible lasers with stable and high-power output.

Striae Distensae: Clinical Results and Evidence-Based Evaluation of a Novel 675 nm Laser Wavelength

Background: A current popular aesthetic problem, especially among younger women, is striae distensae (SD), also referred to as "stretch marks.". Aim: The potential use of the 675 nm laser has been investigated in the treatment of SD. Methods: Patients underwent three sessions of the 675 nm laser with a 1-month interval between sessions. A total of three sessions were performed. The Manchester Scar Scale was used to assess stretch mark changes, and the mean scores related to each parameter at baseline and 6M FU after the last treatment session were measured. A clinical photographic evaluation was performed to show the aesthetic improvement of SD. Results: The patients' treated areas were the abdomen, thighs, buttocks, and breasts. Mean scores related to each Manchester Scar Scale parameter, with their relative percentage change, at baseline and 6M FU after the last treatment session were significantly improved. The total mean Manchester Scar Scale score significantly diminished from 14.16 (±1.30) to 10.06 (±1.32) at 6M FU (p < 0.01). The clinical photographs showed promising aesthetic SD improvement. Conclusions: 675 nm laser therapy demonstrated a good tolerance for the treatment of stretch marks applied to various body areas preventing any discomfort for the patient and with a significant improvement in skin texture.

Comparing Traditional and “In-Motion” Intense Pulsed Light Techniques for Hair Removal: A Split Study

Background and Objectives: Hair removal is a common aesthetic concern for patients referred to dermatologists and aesthetic physicians. Lasers and lights are one of the mainstays in the management of this condition. Among these devices, intense pulsed lights (IPLs) are broadly used in order to reduce the number and width of the hair present. Currently used techniques are associated with a high risk of side effects, such as hyper or hypopigmentation. Materials and Methods: Thirty patients seeking hair removal in one or more body areas with skin phototypes 1 to 4 were recruited to perform this study. All areas to be treated were divided into two equal regions; one side was treated with the standard IPL hair removal procedure, while the other was treated with a new “in-motion” IPL technology. Results and hair removal rates were evaluated six months after the last treatment. Results: Out of the 30 patients treated, all patients experienced hair reduction. No statistically significant difference in hair removal was noted among the two sides. A statistically significant reduction in pain during the procedure was observed in the side treated with the “in-motion” technique. Conclusions: Traditional and “in-motion” IPL techniques have similar results in hair removal; the “in-motion” technology seems to guarantee a better safety profile than the traditional technique, as well as maintains the same results over time and a faster treatment time. A more extensive clinical study will be necessary to confirm our study’s results.

Q-Switched Nd:YAG Laser to Manage Hyperpigmentation in Asians: A Multicenter Study

(1) Introduction: In cosmetic dermatology, benign hyperpigmentation is a prevalent issue. Solar lentigo and other melanoses are bringing patients to the attention of physicians more and more often. The Q-switched 1064/532-nanometer (nm) laser is the gold standard device to treat these conditions. A new generation of these machines, able to shorten pulse duration to hundreds of picoseconds, has emerged showing better preliminary results. In order to treat hypermelanoses in Asians, we used a Q-switched laser with a picosecond pulse. (2) Methods: A retrospective recruitment of 31 Asian individuals requesting treatment for melanosis was conducted at Catanzaro’s Magna Graecia University, University of Rome Tor Vergata and Villa Bella Antiaging. Although they might have varied, the treatment settings were typically as follows: for dermic lesions, a pulse wavelength of 1064 nm with a duration of 450 picoseconds (ps) was used, and for epidermal lesions, a pulse wavelength of 532 nm with a duration of 370 ps was used. Up to four laser treatments were carried out, each at least 30 days apart. During a three-month follow-up after the final session, patient satisfaction was evaluated using a visual analogue scale (VAS). Images taken prior to laser treatments and thereafter were compared, and the aesthetic effect was scored on a five-point scale by two blinded specialists. (3) Results: Of the 31 patients recruited, 25 (80.6%) were female and 6 were male (19.4%). The average stated age was 48.96 ± 13.68. During the dermatological examination, all patients were found to have nearly completely removed melanosis, with a mean VAS score of 7.03 ± 1.35 and a five-point evaluation scale of 2.71 ± 0.78. Conclusions: The Q-switched 1064/532 nm laser can be seen as a safe and effective option to treat benign hypermelanosis in Asian patients. Compared to other technologies, the use of a picosecond pulse appears to promise superior outcomes. To validate the results of this investigation, however, a clinical trial comparing the many commercially accessible therapy options is required.

Laser emission at 675 nm: In vitro study evidence of a promising role in skin rejuvenation

Light-based therapies have been proven to influence and perhaps reverse skin ageing at clinical, molecular and histologic levels. Laser technology decreases photodamage by promoting collagen type I and III synthesis and enhancing the expression of heat shock protein. Aims: This study aims to assess different doses of 675 nm irradiation on human dermal fibroblast cells to evaluate the potential therapeutic effects on the rejuvenation process. Methods: This study employed a laser system that emits 675 nm wavelength: 260, 390, 520 and 650 J/cm² doses were tested on adult human dermal fibroblast cells. Cellular viability, proliferation, and synthesis of type I and III collagen were studied. Results: No dose tested showed effects on cell viability and proliferation at 24 and 48 h from the irradiation. Doses of 260 and 520 J/cm² causes a significant decrease in type I collagen fluorescence intensity, while 390 J/cm² elicits a significant increase in type III collagen expression. Conclusions: Our results showed that 675 nm laser irradiation does not affect cell viability while modulating cell proliferation and collagen synthesis in human adult cultured fibroblasts in vitro. These findings suggest that 675 nm laser irradiation potentially plays a role in skin rejuvenation.

Fractional Q-Switched 1064 nm Laser for Treatment of Atrophic Scars in Asian Skin

Background and Objectives: Asian patients with Fitzpatrick skin type III-IV are a less studied subtype of patients in the medical literature. Q-Switched, 1064 nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser with a fractionated beam profile (QSF) is a new modality that was reported to be effective in the treatment of scars. This study aims to evaluate the efficacy and safety of QSF Nd: YAG laser in treating scars in Asian patients. Materials and Methods: A total of 29 Subjects were treated with 1064 nm QSF laser. Each patients had three treatments with a fractionated microlens array handpiece every 8 weeks). Efficacy of treatment was evaluated using the Goodman and Baron's quantitative grading scale before and 3 months after the last treatment. Results: All 29 patients treated had significant improvement of acne scars according to Goodman and Baron's Quantitative Global Acne Scarring Grading System. No side effect has been observed except some minor erythematous reactions in three patients. Conclusions: Our results confirm that the 1064 nm QSF Nd: YAG laser is a safe and effective technique for treating scars in Asians.

Wavelength extension and power improvement of red Pr3+:YLF lasers

High-power red lasers (mainly at 639 and 670 nm) based on Pr³⁺:YLF crystals have been presented in many works. However, the spectral resources of Pr³⁺:YLF in the red region have not been fully developed to obtain lasers due to their relatively low emission cross sections and the irrepressible strong emission at ∼639 nm. In this work, we propose a scheme to further develop the spectral resources of Pr³⁺:YLF in the red region and improve the red laser powers based on this crystal. The laser wavelengths are obtained from 634.5 to 674.7 nm (continuous tunings are achieved at some wavebands). To the best of our knowledge, the output powers obtained at 638.7, 644.6, 670.1, and 674.7 nm (2.88 W, 1.87 W, 3.55 W, and 1.73 W, respectively) are the highest to date. Furthermore, lasing originating from the ³P₂ energy level of Pr³⁺:YLF (∼653 nm) is realized for the first time.

Combination of Specific Vascular Lasers and Vascular Intense Pulsed Light Improves Facial Telangiectasias and Redness

Background and objectives: Facial telangiectasias are dilated blood vessels that can represent a cosmetic issue for patients. They may be associated with other conditions, such as rosacea. Laser and light treatments are nowadays becoming a cornerstone in the management of these lesions. Materials and Methods: In total, 68 patients seeking medical treatment for facial telangiectasias were enrolled from 1 March 2019 to 1 March 2020 at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). A protocol consisting of a 1064 Nd:YAG laser for darker blue telangiectasias and 532 nm Nd:YAG for red lesions followed by intense pulsed light with an optimized spectrum for vascular lesion 3 weeks after the first procedure was proposed. A three-month follow-up visit assessed patient’s satisfaction using a visual analog scale (VAS). Two dermatologists measured clinical results using a 4-point scale, comparing pictures before treatment and at follow-up. Results: A total of 68 patients (32 males and 36 females) completed the study, performing all requested treatments. No severe side effects were reported. Patient satisfaction was very high (8.15 ± 1.05 out of a 10-point VAS scale), as well as dermatologists’ clinical evaluations (2.19 ± 0.74 out of 3). Conclusions: The combination of vascular lasers and Vascular Intense Pulsed Light acting specifically on small blood vessels may help to improve the aesthetic outcome, reducing side effects. A prospective study with a larger number of participants will be necessary to confirm this study’s findings.

Recycled Sericin Hydrolysates Modified by Alcalase® Suppress Melanogenesis in Human Melanin-Producing Cells via Modulating MITF

Because available depigmenting agents exhibit short efficacy and serious side effects, sericin, a waste protein from the silk industry, was hydrolyzed using Alcalase® to evaluate its anti-melanogenic activity in human melanin-producing cells. Sericin hydrolysates consisted of sericin-related peptides in differing amounts and smaller sizes compared with unhydrolyzed sericin, as respectively demonstrated by peptidomic and SDS-PAGE analysis. The lower half-maximum inhibitory concentration (9.05 ± 0.66 mg/mL) compared with unhydrolyzed sericin indicated a potent effect of sericin hydrolysates on the diminution of melanin content in human melanoma MNT1 cells. Not only inhibiting enzymatic activity but also a downregulated expression level of tyrosinase was evident in MNT1 cells incubated with 20 mg/mL sericin hydrolysates. Quantitative RT-PCR revealed the decreased mRNA level of microphthalmia-associated transcription factor (MITF), a tyrosinase transcription factor, which correlated with the reduction of pCREB/CREB, an upstream cascade, as assessed by Western blot analysis in MNT1 cells cultured with 20 mg/mL sericin hydrolysates for 12 h. Interestingly, treatment with sericin hydrolysates for 6-24 h also upregulated pERK, a molecule that triggers MITF degradation, in human melanin-producing cells. These results warrant the recycling of wastewater from the silk industry for further development as a safe and effective treatment of hyperpigmentation disorders.

Di (Isoquinolin-1-Yl) Sulfane (DIQS) Inhibits Melaninogenesis by Modulating PKA/CREB and MAPK Signaling Pathways

The novel synthetic compound Di (isoquinolin-1-yl) sulfane (DIQS) was identified by zebrafish larva screening during the development of an agent to inhibit abnormal hyperpigmentation. In this study, we investigated the inhibitory effect of DIQS on melanogenesis and its underlying mechanism. DIQS inhibited melanin production and tyrosinase activity in B16F10 cells stimulated with α-melanocyte-stimulating hormone (α-MSH), as well as zebrafish embryos and reconstituted human skin tissue containing melanocytes. DIQS decreased the mRNA and protein expression of microphthalmia-associated transcription factor (MITF) and tyrosinase at a concentration of 10 μM. DIQS also inhibited the phosphorylation of cAMP response element-binding protein (CREB) and p-p38 and p-JNK stimulated by α-MSH. These results suggest that DIQS attenuates hyperpigmentation via inhibition of the cAMP/PKA/CREB/MITF/tyrosinase axis and MAPK pathways. Liquid chromatography–tandem mass spectrometry analysis revealed that DIQS blocked the conversion of tyrosine to L-3,4-dihydroxyphenylalanine (L-DOPA) in zebrafish embryos. Finally, we confirmed that DIQS was non-toxic in reconstituted human tissues such as the epidermis, used to test skin sensitization, and the cornea, used to test eye irritation. In summary, the results of this study suggest the potential of DIQS as a small-molecule agent for skin-whitening cosmetics and the treatment of hyperpigmentation disorders without biological toxicity.

Blue Laser (450 nm) Treatment of Solar Lentigines

This study tested a blue light source for the treatment of solar lentigines. A total of 14 patients with solar lentigines were treated with radiation from a novel, high-power 450 nm blue laser that was created for this project. The group contained eight patients with solar lentigines on the face, two patients with the lesions on the dorsal of the hands, and four patients with the lesions on the trunk and forearms. The best results (complete recovery) have been achieved for the lesions on the face and dorsal of the hands. The treatment of lesions on the trunk and forearms was not fully satisfying due to the occurrence of slight scarring. This study shows that, in some cases, the use of a blue laser may be an alternative to the use of longer wavelength sources.

Skin Manifestations after Ionizing Radiation Exposure: A Systematic Review

Morphological and functional skin alterations secondary to the action of ionizing radiation are well documented. In addition to its application in the medical field, ionizing radiation represents a public health problem for diagnostic and therapeutic purposes due to the potential risk of exposure to unexpected events, such as nuclear accidents or malicious acts. With regard to the use of ionizing radiations in the medical field, today, they constitute a fundamental therapeutic method for various neoplastic pathologies. Therefore, the onset of adverse skin events induced by radiation represents a widespread and not negligible problem, affecting 95% of patients undergoing radiotherapy. A systematic literature search was performed from July 2021 up to August 2021 using PubMed, Embase, and Cochrane databases. Articles were screened by title, abstract and full text as needed. A manual search among the references of the included papers was also performed. This systematic review describes the various skin reactions that can arise following exposure to ionizing radiation and which significantly impact the quality of life, especially in cancer patients.

Addressing Human Skin Ethnicity: Contribution of Tissue Engineering to the Development of Cosmetic Ingredients

Recent publications describe various skin disorders in relation to phototypes and aging. The highest phototypes (III to VI) are more sensitive to acne, with the appearance of dark spots due to the inflammation induced by Cutibacterium acnes (previously Propionibacterium acnes). Dryness with aging is due to a lower activity of specific enzymes involved in the maturation of lipids in the stratum corneum. To observe and understand these cutaneous issues, tissue engineering is a perfect tool. Since several years, pigmented epidermis with melanocytes derived from specific phototypes allow to develop in vitro models for biological investigations. In the present study, several models were developed to study various skin disorders associated with phototypes and aging. These models were also used to evaluate selected ingredients’ ability to decrease the negative effects of acne, inflammation, and cutaneous dryness. Hyperpigmentation was observed on our reconstructed pigmented epidermis after the application of C. acnes, and pollutant (PM10) application induced increased inflammatory cytokine release. Tissue engineering and molecular biology offer the capability to modify genetically cells to decrease the expression of targeted proteins. In our case, GCase was silenced to decrease the maturation of lipids and in turn modify the epidermal barrier function. These in vitro models assisted in the development of ethnic skin-focused cosmetic ingredients.

Could 675-nm Laser Treatment Be Effective for Facial Melasma Even in Darker Phototype?

Objective: The study assesses the safety and efficacy of a 675-nm laser source on melasma. Background: Melasma is a frequent acquired skin disease defined by the presence of hyperpigmented macules on the face. Methods: Study protocol included up to three sessions of the 675-nm laser. Objective evaluation was assessed by using a 5-point visual analogue pain scale (VAS) (range, 0-4). Treatment tolerance was assessed using the 5-point VAS. Results: A mean 3.1 ± 0.7 improvement was reached according to photographic evaluation by VAS. Patients treated one time showed mean clearance of 3.3 ± 0.76, patients treated two times showed mean clearance of 3.0 ± 0.71, and patients treated three times showed mean clearance of 3.0 ± 1. Pain score mean was 1.2 ± 0.4. Conclusions: The 675-nm laser system seems to be safe and effective even in the treatment of facial melasma in patients with Fitzpatrick phototypes IV to V.

Nanosecond Q-Switched 1064/532 nm Laser to Treat Hyperpigmentations: A Double Center Retrospective Study

(1) Benign hyperpigmentations are a common problem in cosmetic dermatology. Melasma, solar lentigo, and other acquired hyperpigmentations represent an aesthetic issue for an increasing number of patients. The gold standard in managing this condition is currently 1064/532 nanometers (nm) Q-Switched lasers. This study reports our experience on the use of a Q-switched laser with a nanosecond pulse to treat these conditions. (2) Methods: A total of 96 patients asking for benign hyperpigmentation removal were consecutively enrolled at the Magna Graecia University of Catanzaro and Tor Vergata University of Rome. Treating parameters were the following: 1064 nm with a pulse duration of 6 nanoseconds (ns) for dermic lesions and 532 nm with 6 ns for epidermal ones. Up to five treatments with a minimum interval between laser treatments of thirty days were performed. A follow-up visit three months after the last session assessed patient satisfaction with a Visual Analogue Scale (VAS). Two blinded dermatologists assessed the cosmetic result using a five-point scale comparing pictures before treatment and at follow-up. (3) Results: 96 patients were included; 47 participants were women (49.0%) and 49 men (51.0%). The mean reported age was 50.0 ± 17.3 years. All patients reached a good to complete hyperpigmentation removal at the dermatological evaluation with a mean VAS score of 8.91 ± 1.07. (4) Conclusions: Q Switched 1064/532 nm laser may be considered the gold standard treatment for benign hyperpigmentations. Our results confirm the literature findings on the effectiveness of these devices.

Q-Switched 1064/532 nm Laser with Picosecond Pulse to Treat Benign Hyperpigmentations: A Single-Center Retrospective Study

(1) Benign melanoses are a frequent issue in aesthetic dermatology. Solar lentigo, ephelides, café au lait spots, and other melanoses represent a cosmetic issue for a growing number of subjects. The Q-switched 1064/532-nanometer (nm) laser may be considered the gold standard for management of these aesthetic issues. A new generation of Q-switched lasers, capable of concentrating the energy pulse in the spectrum of hundreds of picoseconds, is emerging, promising better results than previous ones. In this paper, we report the use of a Q-switched laser with a picosecond pulse to manage hypermelanoses. (2) Methods: 36 patients seeking melanosis removal were retrospectively enrolled at Magna Graecia University of Catanzaro. Treatment parameters, although variable, were the following: 1064 nm with a pulse duration of 450 picoseconds (ps) for dermic lesions and 532 nm with 370 ps for epidermal lesions. Up to four treatments, with a minimum interval between laser treatments of 30 days, were performed. After the last session, patients’ satisfaction was assessed at a three-month follow up with a Visual Analogue Scale (VAS). Two blinded dermatologists measured the aesthetic outcome using a five-point scale comparing pictures before laser sessions and during follow-up. (3) Results: 36 patients were enrolled; 23 were females (63.9%) and 13 males (36.1%). The mean reported age was 49.2 ± 18.9 years. All participants were assessed with a complete/almost complete melanosis removal at the dermatological evaluation, with a mean VAS score of 9.39 ± 0.90. (4) Conclusions: The Q-switched 1064/532 nm laser may be considered the main weapon in treating benign hypermelanosis. The picosecond pulse seems to guarantee better results than other devices. However, a clinical trial comparing Q-switched nanosecond pulse with picosecond pulse is necessary to confirm this study’s findings.

Laser Therapy for the Treatment of Morphea: A Systematic Review of Literature

Morphea, also known as localized scleroderma (LoS), comprises a set of autoimmune sclerotic skin diseases. It is characterized by inflammation and limited thickening and induration of the skin; however, in some cases, deeper tissues might also be involved. Although morphea is not considered a life-threatening disease, the apparent cosmetic disfigurement, functional or psychosocial impairment affects multiple fields of patients’ quality of life. Therapy for LoS is often unsatisfactory with numerous treatments that have only limited effectiveness or considerable side effects. Due to the advances in the application of lasers and their possible beneficial effects, the aim of this study is to review the reported usage of laser in morphea. We present a systematic review of available literature, performed with MEDLINE, Cinahl, Central, Scopus, Web of Science, and Google Scholar databases. We identified a total of twenty relevant studies (MEDLINE n = 10, Cinahl n = 1, Central n = 0, Scopus n = 2, Web of Science n = 5, Google Scholar n = 2) using laser therapy for LoS. Eight studies were focused on the use of PDL, six on fractional lasers (CO₂ and Er:YAG), four on excimer, and two on either alexandrite or Nd:YAG.

Novel Chemically Modified Curcumin (CMC) Analogs Exhibit Anti-Melanogenic Activity in Primary Human Melanocytes

Hyperpigmentation is a dermatological condition characterized by the overaccumulation and/or oversecretion of melanin pigment. The efficacy of curcumin as an anti-melanogenic therapeutic has been recognized, but the poor stability and solubility that have limited its use have inspired the synthesis of novel curcumin analogs. We have previously reported on comparisons of the anti-melanogenic activity of four novel chemically modified curcumin (CMC) analogs, CMC2.14, CMC2.5, CMC2.23 and CMC2.24, with that of parent curcumin (PC), using a B16F10 mouse melanoma cell model, and we have investigated mechanisms of inhibition. In the current study, we have extended our findings using normal human melanocytes from a darkly pigmented donor (HEMn-DP) and we have begun to study aspects of melanosome export to human keratinocytes. Our results showed that all the CMCs downregulated the protein levels of melanogenic paracrine mediators, endothelin-1 (ET-1) and adrenomedullin (ADM) in HaCaT cells and suppressed the phagocytosis of FluoSphere beads that are considered to be melanosome mimics. All the three CMCs were similarly potent (except CMC2.14, which was highly cytotoxic) in inhibiting melanin production; furthermore, they suppressed dendricity in HEMn-DP cells. CMC2.24 and CMC2.23 robustly suppressed cellular tyrosinase activity but did not alter tyrosinase protein levels, while CMC2.5 did not suppress tyrosinase activity but significantly downregulated tyrosinase protein levels, indicative of a distinctive mode of action for the two structurally related CMCs. Moreover, HEMn-DP cells treated with CMC2.24 or CMC2.23 partially recovered their suppressed tyrosinase activity after cessation of the treatment. All the three CMCs were nontoxic to human dermal fibroblasts while PC was highly cytotoxic. Our results provide a proof-of-principle for the novel use of the CMCs for skin depigmentation, since at low concentrations, ranging from 5 to 25 µM, the CMCs (CMC2.24, CMC2.23 and CMC2.5) were more potent anti-melanogenic agents than PC and tetrahydrocurcumin (THC), both of which were ineffective at melanogenesis at similar doses, as tested in HEMn-DP cells (with PC being highly toxic in dermal fibroblasts and keratinocytes). Further studies to evaluate the efficacy of CMCs in human skin tissue and in vivo studies are warranted.

Histological Skin Changes After Treatment with 675 nm Laser

Objective: To evaluate the histological effects of a new 675-nm laser device on the skin. Background: Innovative technologies based on physical principles have been proposed in recent years to improve the treatment of aging skin. Laser technology is currently being studied for its potential in skin care treatments. A new 675-nm laser device is being used for the treatment of hyperpigmentation, scars, and various types of wrinkles. Methods: A 42-year-old man underwent a 675-nm RedTouch^® laser session for the treatment of aging signs on the neck. Two 2.5-mm biopsies were taken from the treated area and the adjacent area untreated with the laser, 45 days after the procedure. Comparison of the immunohistochemistry findings and assessment of the collagen and elastin fibers were performed by a board-certified dermatopathologist. Results: Skin biopsies revealed histological changes that comprised proliferation of new collagen fibers in the treated area, when compared to that in the untreated areas. Conclusions: Histological analysis suggests that the 675-nm laser has a potential role in stimulating collagen remodeling, with a significant increase in thin and new collagen fibers.

The Anti-Ageing and Whitening Potential of a Cosmetic Serum Containing 3-O-ethyl-l-ascorbic Acid

Skin ageing has many manifestations such as wrinkles, dryness, hyperpigmentation, and uneven skin tone. Extrinsic and intrinsic factors, especially solar ultraviolet light (UVB), contribute to skin ageing; its main features are brown spots, alterations in melanin pigmentation, and a decrease in collagen and hyaluronic acid linked to oxidative stress. Several studies showed that topical products containing ingredients with antioxidant activity can reduce oxidative damage; to provide a maximum anti-ageing effect to the skin, topical products can combine various ingredients. C-SHOT SERUM contains a combination of two molecules with a proven anti-ageing activity: a high percentage (30%) of a more stable vitamin C derivative, 3-O-ethyl-l-ascorbic acid, and lactic acid (1%). The product showed a high biocompatibility, assessed through an MTT assay on keratinocytes and on Reconstructed Human Epidermis (RHE, SkinEthic); the anti-ageing activity was demonstrated on human dermal fibroblasts and keratinocytes by a statistically significant increase in collagen production and a reduction of a UVB-induced DNA damage marker (γ-H2AX histone), indicating DNA protection. Moreover, a depigmenting activity, shown by a highly significant decrease in melanin content on treated Reconstructed Human Pigmented Epidermis (RHPE), was assessed. According to the data of our study, the tested product contrasts the effect of skin ageing and irregular pigmentation due to the physiological decline of the skin.

Development of Pigmentation-Regulating Agents by Drug Repositioning

Skin color is determined by the processes of melanin synthesis and distribution. Problems in various molecules or signaling pathways involved in melanin synthesis contribute to skin pigmentation defects. Several trials have been conducted on the production of pigmentation-regulating agents, and drug repositioning has emerged as a modern technique to identify new uses for existing drugs. Our research team has researched substances or drugs associated with pigmentation control and, as a result, nilotinib, sorafenib, and ICG-001 have been found to promote pigmentation, while 5-iodotubercidin inhibits pigmentation. Therefore, these substances or medications were suggested as potential therapeutics for pigmentation disorders by drug repositioning.

'Dr. Google, What Is That on My Skin?'-Internet Searches Related to Skin Problems: Google Trends Data from 2004 to 2019

The Internet is a common source of health information as search engines propose websites that should answer users' queries. The study aimed to investigate the search behavior of Google users related to skin clinical signs as well as to analyze their geographical, secular, and seasonal patterns. The data of Google Trends was used to analyze the number of Google searches related to skin problems from January 2004 to December 2019. Thirty-four topics representing dermatologic complaints were identified. The interests of all topics were calculated in proportion to the Relative Search Volume (RSV) of 'Scar'. Geographical patterns as well as secular and seasonal trends were analyzed. Countries with few users who searched for skin problems were excluded from the analysis. Globally, gaining the most attention were 'Itch' proportion to RSV of 'Itch' (2.21), 'Hair loss' (1.56), 'Skin rash' (1.38), 'Perspiration' (1.32), and 'Scar' (1.00). In 42 of the 65 analyzed countries, 'Itch' was the most popular topic, followed by 'Hair loss' (n = 7), and 'Pustule' (n = 6). The RSV of all topics increases over time, with 'Comedo' (5.15 RSV/year), 'Itch' (4.83 RSV/year), and 'Dandruff' (4.66 RSV/year) being the most dynamic ones. For 23 topics, the highest interest was noted during warm months. Considering skin manifestations, Google users are mainly interested in itch, hair loss, and skin rash. An increasing number of individuals worldwide seem to use Google as a source of health information for dermatological clinical signs during the study period.

Inhibitory Effect and Mechanism of Scutellarein on Melanogenesis

Fairer skin is preferred in many Asian countries and there is a high demand for skin whitening and lightening products. However, in recent years, problems related to the safety of using whitening agents have emerged. This study demonstrates that plant-derived scutellarein effectively inhibits melanogenesis in B16 melanoma cells. However, baicalein, which is similar to scutellarein in its chemical structure, does not show any inhibitory effect on melanogenesis. Cellular tyrosinase activity is decreased by scutellarein in a dose-dependent manner. No cytotoxicity is observed at the effective concentration range. Additionally, both the protein and mRNA levels of tyrosinase are significantly decreased by scutellarein. Further, the risk of leukoderma development also is determined by evaluating the production of free hydroxyl radicals (˙OH); scutellarein treatment does not induce ˙OH production. Scutellarein shows no risk of causing leukoderma. Our results suggest that scutellarein or plant extracts containing high concentrations of scutellarein have the potential to inhibit melanin production and serve as cosmetic skin-lightening agents.