Study of a 532/1064 Fractional Picosecond Laser for Facial Rejuvenation

BACKGROUND AND OBJECTIVES

Picosecond (ps) fractional lasers create small wounds, presumably by laser-induced optical breakdown. We studied a ps fractional laser in the treatment of wrinkles and mottled pigment.

MATERIALS AND METHODS

This was a single center, prospective, open-label clinical trial. Patients with at least 2 facial areas, with visible wrinkles and dyschromia, were enrolled in the study and received 3 treatments at monthly intervals and appeared at 3 follow-up visits at 1, 3, and 6 months after treatment. The laser is an 800 ps fractional system with nominal 10 mm macrospot diameter. Both 532 nm and 1,064 nm wavelengths were applied in each subject. Wrinkle and pigmentation clearance were assessed by 2 blinded investigators using a 5-point clearance scale. Skin improvement was assessed by investigators using the 5-point Global Aesthetic Improvement (GAI) Scale based on before/after photographs for the following categories: (1) fine lines/wrinkles and (2) pigmentation.

RESULTS

A total of 18 healthy subjects at a single site were enrolled. At least moderate pigmentation and fine line/wrinkles improvement were observed in 93% and 79% of patients at 1 month after the last treatment according to GAI, respectively. Pigment clearance approached a mean of approximately 40%.

CONCLUSION

A ps 1,064/532 fractional laser achieves reduction in fine lines and pigment.

Combination therapy in skin of color including injectables, laser, and light devices

With the rapid increase in patients seeking cosmetic treatments, the variation in responses of lightly pigmented skin versus darkly pigmented skin has become increasingly apparent. Despite extensive treatment options in patients with skin of color, there is a paucity of well-designed studies performed on this patient population. The lack of research is concerning, as it is well documented that patients with darker skin types are at an increased risk of adverse events when treated with many of the available modalities used in cosmetic procedures. Fortunately, by combining a variety of treatments, these risks may be abrogated, and combination treatments may be a promising regimen for a wide variety of cosmetic complaints. An overview and evaluation of the research of combination therapy in skin of color is presented.

Randomized, split-body, single-blinded clinical trial of topical broccoli sprout extract: Assessing the feasibility of its use in keratin-based disorders

BACKGROUND

Epidermolysis bullosa simplex is a skin-blistering disorder caused by mutations in keratin (K)14 or K5. Treatment with nuclear factor (erythroid-derived 2)-like 2 inducer sulforaphane ameliorated skin blistering in Krt14-null mice, correlating with induction of K17. To be therapeutically useful for epidermolysis bullosa simplex, topical broccoli sprout extract (BSE), enriched for sulforaphane, would ideally induce the expression of homologous keratins (eg, K6, K17, K16) in the basal layer of human epidermis without impacting expression of defective keratins (K5/K14).

OBJECTIVE

The purpose of this 1-week, randomized, split-body, single-blinded, placebo-controlled trial was to assess the impact of BSE on keratin expression.

METHODS

Five subjects (34-71 years old) applied BSE (500 nmol of sulforaphane/mL) or vehicle alone to the inner aspect of the arm daily. Expression of keratin, nuclear factor (erythroid-derived 2)-like 2, and other markers was assessed using reverse transcription-polymerase chain reaction and indirect immunofluorescence.

RESULTS

One subject (age 71 years) was excluded a posteriori because of poor tissue quality. Topical BSE activated nuclear factor (erythroid-derived 2)-like 2 and up-regulated K17 in the epidermis of all subjects, had variable effects on K16 and K6 expression, and did not alter expression of K14 or K5.

LIMITATIONS

Small sample size is a limitation.

CONCLUSION

BSE represents an attractive therapeutic candidate for K14-associated epidermolysis bullosa simplex.