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Kim KE, Jeong JY, Jo JY, Ryu HJ, Kim IH. Efficacy of skin rejuvenation with a fractional 1927-nm thulium laser alone or combined with a chemical peel: a controlled histopathological preliminary study in a mouse model. Lasers Med Sci 2023; 38:262. [PMID: 37947906 DOI: 10.1007/s10103-023-03928-6] [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: 05/29/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
Many patients demand minimally invasive treatments for skin rejuvenation, such as nonablative laser and superficial chemical peels. Combination therapy yet has not been studied histopathologically. The purpose of this study is to assess the histopathological efficacy of a 1927-nm thulium laser-assisted salicylic acid (SA) peel in skin rejuvenation. A six-segment table was drawn on the shaved back of C57BL/6 mouse. All segments were irradiated with the thulium laser-different tips and passes were used for specific segments. A 30% SA peel was then applied to the right-hand segments. After treatment, the skin samples were collected from each segment and examined for dermal thickness, collagen density, and melanin content. Greater thickness was seen in the combination therapy group compared with the laser alone group and in those segments receiving more passes with larger beam-sized tip. Collagen density increased in all treated skin segments, irrespective of the group. No adverse events were noted in the treated areas. The sample size was small and mouse skin has histological differences with human skin. The combination of a thulium laser and 30% SA peel has a synergistic effect on dermal thickness, so that can be suggested as a novel skin rejuvenation technique.
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Affiliation(s)
- Ko Eun Kim
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Republic of Korea
- Department of Dermatology, College of Medicine, Korea University, Jeokgeum-Ro 123, Danwon-Gu, Ansan-Si, Gyeonggi-Do, Republic of Korea
| | - Jae Yeong Jeong
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Republic of Korea
- Department of Dermatology, College of Medicine, Korea University, Jeokgeum-Ro 123, Danwon-Gu, Ansan-Si, Gyeonggi-Do, Republic of Korea
| | - Ju Young Jo
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Republic of Korea
- Department of Dermatology, College of Medicine, Korea University, Jeokgeum-Ro 123, Danwon-Gu, Ansan-Si, Gyeonggi-Do, Republic of Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Republic of Korea
- Department of Dermatology, College of Medicine, Korea University, Jeokgeum-Ro 123, Danwon-Gu, Ansan-Si, Gyeonggi-Do, Republic of Korea
| | - Il-Hwan Kim
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Republic of Korea.
- Department of Dermatology, College of Medicine, Korea University, Jeokgeum-Ro 123, Danwon-Gu, Ansan-Si, Gyeonggi-Do, Republic of Korea.
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Kurmuş G, Tatlıparmak A, Aksoy B, Koç E, Aşiran Serdar Z, Ergin C. Efficacy and safety of 1927 nm fractional Thulium fiber laser for the treatment of melasma: a retrospective study of 100 patients. J COSMET LASER THER 2019; 21:408-411. [DOI: 10.1080/14764172.2019.1683581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- G. Kurmuş
- Department of Dermatology, Istinye University, School of Medicine, Istanbul, Turkey
| | - A. Tatlıparmak
- Department of Dermatology, Bahçeşehir University, School of Medicine, Istanbul, Turkey
| | - B. Aksoy
- Department of Dermatology, Bahçeşehir University, School of Medicine, Istanbul, Turkey
| | - E. Koç
- Department of Dermatology, Medicalpark Ankara Hospital, Ankara, Turkey
| | - Z. Aşiran Serdar
- Department of Dermatology, Bahçeşehir University, School of Medicine, Istanbul, Turkey
| | - C. Ergin
- Department of Dermatology, Medicalpark Ankara Hospital, Ankara, Turkey
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Tao J, Champlain A, Weddington C, Moy L, Tung R. Treatment of burn scars in Fitzpatrick phototype III patients with a combination of pulsed dye laser and non-ablative fractional resurfacing 1550 nm erbium:glass/1927 nm thulium laser devices. Scars Burn Heal 2018; 4:2059513118758510. [PMID: 29799583 PMCID: PMC5965338 DOI: 10.1177/2059513118758510] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introduction: Burn scars cause cosmetic disfigurement and psychosocial distress. We present two Fitzpatrick phototype (FP) III patients with burn scars successfully treated with combination pulsed dye laser (PDL) and non-ablative fractional lasers (NAFL). Case 1: A 30-year-old, FP III woman with a history of a second-degree burn injury to the bilateral arms and legs affecting 30% body surface area (BSA) presented for cosmetic treatment. The patient received three treatments with 595 nm PDL (7 mm, 8 J, 6 ms), six with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4–8 passes) and five with the 1927 nm thulium laser (10 mJ, 30% density, 4–8 passes). Treated burn scars improved significantly in thickness, texture and colour. Case 2: A 33-year-old, FP III man with a history of a second-degree burn injury of the left neck and arm affecting 7% BSA presented for cosmetic treatment. The patient received two treatments with 595 nm PDL (5 mm, 7.5 J, 6 ms), four with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4–8 passes) and two with the 1927 nm thulium laser (10 mJ, 30% density, 4–8 passes). The burn scars became thinner, smoother and more normal in pigmentation and appearance. Discussion: Our patients’ burn scars were treated with a combination of PDL and NAFL (two wavelengths). The PDL targets scar hypervascularity, the 1550 nm erbium:glass stimulates collagen remodelling and the 1927 nm thulium targets epidermal processes, particularly hyperpigmentation. This combination addresses scar thickness, texture and colour with a low side effect profile and is particularly advantageous in patients at higher risk of post-procedure hyperpigmentation. Conclusion: Our cases suggest the combination of 595nm PDL plus NAFL 1550 nm erbium:glass/1927 nm thulium device is effective and well-tolerated for burn scar treatment in skin of colour.
While all scars can be bothersome, burn scars can be particularly troubling. They can be large, itchy, painful and limit range of motion. Patients with medium and darker skin tones may be more likely to develop dark and discoloured scars due to burns and other scarring injuries. In our case series, we used two types of lasers to treat thick, darkly pigmented burn scars in two patients with medium and darker skin tones. While the pulsed dye laser targets the redness and thickened aspects of scars to restore a more normal appearance, the non-ablative fractional resurfacing laser creates microscopic zones of controlled injury to resurface scars, stimulate new collagen growth, improve texture and lighten excess pigmentation. Treatments were performed once a month for 6–12 months. Using these lasers in combination, our treatment method made our patients’ scars thinner, smoother and more evenly coloured over time, resulting in a more natural appearance. This multi-modal approach was a safe and effective no-downtime method for the improvement of scars in skin of colour patients.
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Affiliation(s)
- Joy Tao
- Division of Dermatology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Amanda Champlain
- Division of Dermatology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Charles Weddington
- Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Lauren Moy
- Division of Dermatology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Rebecca Tung
- Division of Dermatology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
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Kwon IH, Bae Y, Yeo UC, Lee JY, Kwon HH, Choi YH, Park GH. Histologic analyses on the response of the skin to 1,927-nm fractional thulium fiber laser treatment. J COSMET LASER THER 2017; 20:12-16. [DOI: 10.1080/14764172.2017.1358455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Youin Bae
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | | | - Jin Yong Lee
- Department of Dermatology, Kangwon National University Hospital, Chuncheon, Korea
| | | | - Young Hee Choi
- Department of Pathology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine and Research Insititute for Complementary & Alternative Medicine, Hallym University, Hwaseong, Korea
| | - Gyeong-Hun Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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Sarkar R, Aurangabadkar S, Salim T, Das A, Shah S, Majid I, Singh M, Ravichandran G, Godse K, Arsiwala S, Arya L, Gokhale N, Sarma N, Torsekar RG, Sonthalia S, Somani VK. Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group. Indian J Dermatol 2017; 62:585-590. [PMID: 29263531 PMCID: PMC5724305 DOI: 10.4103/ijd.ijd_488_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly.
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Affiliation(s)
- Rashmi Sarkar
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | | | - T Salim
- Consultant Dermatologist, Cutis Institute of Dermatology and Aesthetic Sciences, Calicut, Kerala, India
| | - Anupam Das
- Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Swapnil Shah
- Consultant Dermatologist, Solapur, Maharashtra, India
| | - Imran Majid
- Dermatology, Govt Medical College, Srinagar, Kashmir, India
| | - Mohan Singh
- Consultant Dermatologist, Mohan Singh Diseases Hospital, Phagwara, Punjab, India
| | - G Ravichandran
- Senior Consultant and Coordinator, Dermatology, Apollo Hospitals, Chennai, India
| | - Kiran Godse
- Dermatology, D Y Patil Hospital, Navi Mumbai, India
| | - Shehnaz Arsiwala
- Consultant Dermatologist, Saifee Hospital, Prince Aly Khan Hospital, Mumbai, India
| | - Latika Arya
- Consultant Dermatologist, L A Skin & Aesthetic Clinic, New Delhi, India
| | - Narendra Gokhale
- Consultant Dermatologist, Sklinic Skin Clinic, Indore, Madhya Pradesh, India
| | - Nilendu Sarma
- Dermatology, Dr. B.C. Roy Postgraduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
| | - R G Torsekar
- Consultant Dermatologist, Fortis Hospital, Mulund, Mumbai, India
| | - Sidharth Sonthalia
- Consultant Dermatologist, Skinnocence: The Skin Clinic, Gurgaon, Haryana, India
| | - V K Somani
- Consultant Dermatologist, Skintrendz, Himayat Nagar, Hyderabad, India
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Wat H, Wu DC, Chan HHL. Fractional resurfacing in the Asian patient: Current state of the art. Lasers Surg Med 2016; 49:45-59. [PMID: 27605303 DOI: 10.1002/lsm.22579] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Fractionated photothermolysis (FP) has revolutionized modern laser technology. By creating selective columns of microthermal damage, fractionated devices allows for greater treatment depths to be achieved without the prolonged downtime and risk of complications seen in traditional fully ablative laser resurfacing. Fractional resurfacing is a proven method to treat a variety of cutaneous conditions. In the Caucasian patient, a wide range of devices and treatment settings can be utilized safely and effectively. However, ethnic skin requires special consideration due to its unique pigmentary characteristics and clinical presentations. In this review article, we detail the current indications and strategies to optimize results and mitigate complications when utilizing fractional resurfacing for the Asian patient. METHODS A review of the MEDLINE English literature was conducted on fractionated laser devices studied in the Asian population. Articles included describe non-ablative devices including fractionated erbium glass, thulium fiber, diode, and radiofrequency devices; and ablative devices including fractionated carbon dioxide (CO2 ) laser, erbium yttrium aluminum garnet and yttrium scandium gallium garnet (YSGG) laser. These data were integrated with the expert opinion of the authors. CONCLUSION Taking into account the unique characteristics and cosmetic concerns of the Asian population, fractional resurfacing can be considered a safe and effective option for the treatment of atrophic and hypertrophic scarring, and photorejuvenation in ethnic skin types. Select cases of melasma may be treated with fractionated non-ablative devices, but utilized with caution. The predominant complication associated with fractional resurfacing for these conditions is post-inflammatory hyperpigmentation (PIH) and rebound worsening of melasma. A greater number of treatments at lower density settings and wider treatment intervals typically produce the lowest risks of PIH without compromising treatment efficacy. Lasers Surg. Med. 49:45-59, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Heidi Wat
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada, T6G 2G3
| | - Douglas C Wu
- Goldman, Butterwick, Groff, Fabi, and Wu Cosmetic Laser Dermatology, San Diego, California, 92121
| | - Henry Hin Lee Chan
- Division of Dermatology, Department of Medicine, University of Hong Kong, Hong Kong, SAR, China.,Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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