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

Deciphering the role of skin aging in pigmentary disorders

Skin aging is a complex biological process involving intrinsic and extrinsic factors. Skin aging contains alterations at the tissue, cellular, and molecular levels. Currently, there is increasing evidence that skin aging occurs not only in time-dependent chronological aging but also plays a role in skin pigmentary disorders. This review provides an in-depth analysis of the impact of skin aging on different types of pigmentary disorders, including both hyperpigmentation disorders such as melasma and senile lentigo and hypopigmentation disorders such as vitiligo, idiopathic guttate hypomelanosis and graying of hair. In addition, we explore the mechanisms of skin aging on pigmentation regulation and suggest several potential therapeutic approaches for skin aging and aging-related pigmentary disorders.

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.

Efficacy of 532-nm Nd: YAG Fractional Picosecond Laser with 9 mm High Coverage Handpiece Micro Lens Array in the Treatment of Facial Partial Unilateral Lentiginosis: A Case Report

Introduction: Facial partial unilateral lentiginosis (PUL) is an infrequent skin pigmentation disorder characterized by multiple lentigines. Despite the availability of various treatment modalities, there is no standard treatment for PUL. This study reports a successful treatment of facial PUL in a female patient using a novel 532-nm Nd:YAG fractional picosecond laser (FPL). Case Report: The patient underwent four treatment sessions at four-week intervals. The treatments were administered using a 9 mm high coverage handpiece micro lens array (MLA), with a fluence of 0.2-0.4 J/cm2, a frequency of 2 Hz for 2-3 passes, and approximately 10% overlap. The treatment was well-tolerated by the patient, with significant improvement in pigmentation and no significant side effects observed. The outcomes confirmed the efficacy of the 532-nm Nd:YAG FPL in treating facial PUL. Conclusion: The 532-nm Nd:YAG FPL appears to be an effective and well-tolerated treatment for facial PUL, offering significant improvement in pigmentation without notable side effects.

Review of Fractional Nonablative Lasers for the Treatment of Dermatologic Conditions in Darker Skin Phototypes

BACKGROUND

Fractional nonablative lasers (NAFLs) have demonstrated efficacy and safety for treating dermatologic conditions in patients with darker skin phototypes. Nonablative lasers are preferred in darker skin tones due to lower risk of postinflammatory hyperpigmentation.

OBJECTIVE

This review aims to identify the ideal laser options and parameters for treating common dermatologic conditions in patients with skin types IV-VI.

MATERIALS AND METHODS

A comprehensive literature search was conducted on PubMed in May 2023. Of 1,065 articles were identified, and 40 articles met the inclusion criteria. The studies were classified based on design, dermatologic condition, and skin phototype of patients, and assigned levels of evidence according to the Modified Criteria of the Oxford Center of Evidence Based Medicine.

RESULTS

Strong level 1 evidence supports the treatment of melasma and atrophic scars using NAFL. Moderate level 2 evidence was found for using NAFL in acne vulgaris, striae, and skin rejuvenation; 45% of the studies examined skin types III-IV, 20% III-V, 7.5% II-IV, 5% II-V, 5% IV alone, and 2.5% I-IV.

CONCLUSION

Further research is needed to determine the optimal treatment modalities and parameters for skin types V and VI. Appropriate device selection and conservative treatment settings are crucial for optimizing outcomes and minimizing adverse events.

Skin aging from mechanisms to interventions: focusing on dermal aging

Skin aging is a multifaceted process that involves intrinsic and extrinsic mechanisms that lead to various structural and physiological changes in the skin. Intrinsic aging is associated with programmed aging and cellular senescence, which are caused by endogenous oxidative stress and cellular damage. Extrinsic aging is the result of environmental factors, such as ultraviolet (UV) radiation and pollution, and leads to the production of reactive oxygen species, ultimately causing DNA damage and cellular dysfunction. In aged skin, senescent cells accumulate and contribute to the degradation of the extracellular matrix, which further contributes to the aging process. To combat the symptoms of aging, various topical agents and clinical procedures such as chemical peels, injectables, and energy-based devices have been developed. These procedures address different symptoms of aging, but to devise an effective anti-aging treatment protocol, it is essential to thoroughly understand the mechanisms of skin aging. This review provides an overview of the mechanisms of skin aging and their significance in the development of anti-aging treatments.