1
|
Nguyen L, Schneider SW, Herberger K. [Picosecond lasers in dermatology]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05144-3. [PMID: 37099130 DOI: 10.1007/s00105-023-05144-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND The picosecond laser is one of the latest laser systems in dermatology and was originally developed to optimize tattoo removal. Advances in this technology has expanded the use of the picosecond laser to numerous other indications. OBJECTIVES This article provides an overview of the technical background as well as the indications of the picosecond laser in dermatological laser medicine and elucidates the possibilities and limits of this laser system. MATERIALS AND METHODS The article is based on a review of the current literature as well as experience from clinical practice in a university laser department. RESULTS The picosecond laser enables a particularly gentle and effective treatment due to ultra-short pulses and the principle of laser-induced optical breakdown. Compared to Q‑switched lasers, the picosecond laser has fewer side effects and is associated with lower pain intensity and shorter downtime. In addition to the removal of tattoos and pigmentary disorders, it is also used in the treatment of scars and rejuvenation. CONCLUSIONS The picosecond laser has a wide range of indications in dermatological laser medicine. The current data indicate that the laser is an effective method with few side effects. Further prospective studies have to be conducted to assess the efficacy, tolerability and patient satisfaction in an evidence-based manner.
Collapse
Affiliation(s)
- Lynhda Nguyen
- Laserabteilung, Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Stefan W Schneider
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Katharina Herberger
- Laserabteilung, Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Zhao Z, Wang T, Li W, Liang Q, Chen W. To evaluate the efficacy and safety of laser interventions for facial acne scars: a systematic review and Bayesian network meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1396. [PMID: 36660635 PMCID: PMC9843402 DOI: 10.21037/atm-22-5997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/20/2022] [Indexed: 01/01/2023]
Abstract
Background There are numerous laser treatments for acne scars in clinical practice. However, there are no clinical studies comparing all laser methods to provide an evidence-based bias for clinicians to choose the best strategy. Therefore, this systematic review and network meta-analysis was conducted to explore the efficacy of different types of laser treatment on acne scars. This study can provide the most effective treatment for acne scars in clinical practice. Methods The databases of PubMed, Embase, Cochrane Library, and Web of Science were searched from their inception to July 2022. The Cochrane risk of bias assessment tool was used to assess the bias of the included original studies. Bayesian network meta-analysis was used to investigate the efficacy of laser treatment strategies in scar improvement, cure rate, and satisfaction. Results As shown by the results, the top 3 treatment options for scar improvement were fractional carbon dioxide laser (FCL) + platelet-rich-plasma (PRP) [surface under the cumulative ranking curve (SUCRA): 0.699], 1064Nd (1,064-nm neodymium-doped yttrium aluminum garnet picosecond laser) + 15%VC (Vitamin C; SUCRA: 0.675), and 1064Nd (SUCRA: 0.627). The standard mean difference (SMD) of FCL + PRP was -1.76 (95% CI: -3.49, -0.03), compared with that of FCL. The top 3 treatment options for improving cure rate were Er (Er:YAG laser treatment) + PRP (SUCRA: 0.873), FCL (SUCRA: 0.773), and FCL + 30% salicylic acid (30%SC) (SUCRA: 0.772). The RR of Er + PRP cure rate was 13.86 (95% CI: 1.79, 107.22), compared with non-laser radiofrequency therapy. Conclusions The findings suggested that combined therapies should be used to treat acne scars. Er + PRP showed the highest cure rate of acne scar, followed by FCL + 30%SC or FCL monotherapy. FCL combined with PRP could improve acne scarring to the greatest extent, and 1064Nd combined with 15%VC can also exert a good effect. As for satisfaction, FCL monotherapy was the most satisfactory methods for patients, followed by PRP monotherapy. Therefore, Er + PRP and FCL + PRP can be used as the first choice for clinical treatment of acne scars. Additionally, using FCL alone is also an effective and elective treatment method due to its affordable cost and comfort.
Collapse
Affiliation(s)
- Zixiao Zhao
- Plastic Surgery Laser Center, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Tao Wang
- Plastic Surgery Laser Center, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Wei Li
- Plastic Surgery Laser Center, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Qi Liang
- Plastic Surgery Laser Center, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Weihua Chen
- Plastic Surgery Laser Center, The Fourth Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
4
|
Picosecond Pulsed-Periodic High-Peak Power Nd:YAG Laser Operationally Controlled by KTP-Based Pockels Cell. CRYSTALS 2022. [DOI: 10.3390/cryst12030368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Electro-optical modulators are effectively used for ultrafast pulse lasers operation control. The scheme of picosecond pulse-periodic high-peak-power Nd:YAG lasers is composed of an active-passive mode-locked and negative feedback-controlled master oscillator and regenerative amplifier based on common end-diode-pumped Nd:YAG crystal. A double-crystal thermally compensated Pockels cell based on KTP crystals of the Y-cut direction is employed as a key control element. The cell was assembled using a pair of equal-length crystals grown according to high-resistivity technology. The scheme provides output pulses with energy up to 1.6 mJ, a duration of 25 ps at repetition rates tunable from 0 to 200 Hz. The laser operation stages are analyzed in detail. The scheme looks attractive and promising for developing advanced ultrafast laser systems with higher repetition rates, peak and, accordingly, average power levels. The Pockels cell based on KTP crystals expands the line of available fast electro-optical control elements, along with the previously used RTP ones. The factors limiting laser pulse energy and repetition rate are discussed. Parasitic nonlinear conversion in the crystals of the Pockels cell along the axis may play an essential role. The results of comparative measurements of the second and third harmonics made with the Pockels cells based on KTP and RTP crystals of both X-cut and Y-cut directions are presented. The minimum second and third harmonics efficiency levels observed in the Y-cut Pockels cells of the KTP crystal seem to be their important advantage.
Collapse
|
5
|
Zhang Y, Yan M, Mi J, Zeng Y, Lin H, Yao M, Dong J, Wang S. Clinical efficacy and safety of a focused-radiofrequency device on middle and lower face rejuvenation: a retrospective clinical study. J COSMET LASER THER 2022; 23:176-183. [PMID: 35244511 DOI: 10.1080/14764172.2022.2048672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of the present study was to evaluate the efficacy and safety of a unipolar focused-RF device used to rejuvenate the middle and lower face and to create an assessment system. This retrospective study comprised 52 patients with mild-to-moderate skin laxity and wrinkles who received 1-3 treatments 1 month apart and were followed up for 1-7 months. At baseline and post-treatment, three blinded observers measured facial contour and lines, analyzed VISIA scores, and assessed the results using Alexiades Comprehensive Grading Scale (ACGS) and Global Aesthetic Improvement Scale (GAIS). Significant improvements were observed (P < .05) in facial width (left 5.95%, right 5.66%), nasolabial folds (left 18.98%, right 20.56%), marionette lines (left 18.88%, right 25.80%), and cheek lines (left 3.35%, right 3.05%) and in the scores of wrinkles (15.37%), texture (13.67%), pores (6.48%), and red areas (6.57%) using VISIA. There was an obvious reduction in wrinkles, laxity, erythema/telangiectasia based on ACGS, and 75% improved and 5.8% much improved using GAIS. There was no severe side effect. We suggest that the unipolar focused-RF device is an effective and safe technique for middle and lower face rejuvenation and provides a series of comprehensive assessment methods based on standardized photos using VISIA.
Collapse
Affiliation(s)
- Yiqiu Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Min Yan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Jing Mi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Ying Zeng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Huyan Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Min Yao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Jiying Dong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Shen Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Salameh F, Shumaker PR, Goodman GJ, Spring LK, Seago M, Alam M, Al-Niaimi F, Cassuto D, Chan HH, Dierickx C, Donelan M, Gauglitz GG, Haedersdal M, Krakowski AC, Manuskiatti W, Norbury WB, Ogawa R, Ozog DM, Paasch U, Victor Ross E, Clementoni MT, Waibel J, Bayat A, Goo BL, Artzi O. Energy-based devices for the treatment of acne scars: 2021 international consensus recommendations. Lasers Surg Med 2021; 54:10-26. [PMID: 34719045 DOI: 10.1002/lsm.23484] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. STUDY DESIGN/MATERIALS AND METHODS An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. RESULTS The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. CONCLUSION Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.
Collapse
Affiliation(s)
- Fares Salameh
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Peter R Shumaker
- VA San Diego Healthcare System and University of California, San Diego, California, USA
| | - Greg J Goodman
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | - Leah K Spring
- Micrographic Surgery and Surgical Oncology, SkinCare Physicians, Chestnut Hill, Massachusetts, USA
| | - Meghan Seago
- VA San Diego Healthcare System and University of California, San Diego, California, USA.,Micrographic Surgery and Surgical Oncology, Scripps Clinic, La Jolla, California, USA
| | - Murad Alam
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | - Henry Hl Chan
- Private Practice and Department of Medicine (Dermatology), University of Hong Kong, People's Republic of China
| | | | - Matthias Donelan
- Department of Surgery, Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Gerd G Gauglitz
- Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andrew C Krakowski
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania, USA
| | | | - William B Norbury
- Department of Surgery, University of Texas Medical Branch, Shriners Hospital for Children-Galveston, Galveston, Texas, USA
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Uwe Paasch
- Department of Dermatology, Venereology, and Allergy, University of Leipzig, Leipzig, Germany
| | | | | | - Jill Waibel
- Miami Dermatology and Laser Institute, Miami, Florida, USA
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, University of Manchester, England, UK.,MRC-SA Wound Healing Unit, Hair & Skin Research Laboratory, Division of Dermatology, University of Cape Town, Cape Town, South Africa
| | - Boncheol Leo Goo
- Naeum Dermatology and Aesthetic Clinic/Skin Rehabilitation Center, Seoul, Korea
| | - Ofir Artzi
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| |
Collapse
|
8
|
Qu Y, Feng X, Liang J, Liu J, Gao D. The Picosecond Laser Effects on Tattoo Removal and Metabolic Pathways. Clin Cosmet Investig Dermatol 2021; 14:1343-1350. [PMID: 34594124 PMCID: PMC8478112 DOI: 10.2147/ccid.s332265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022]
Abstract
Objective We aimed to investigate picosecond laser effects regarding rat tattoo removals. We systematically detected the metabolic pathways considering tattoo pigment particles in rat models. Materials and Methods We employed fluorescein to mark the tattoo dye and utilized a pattern needle to prepare tattoo on rat so as to establish the tattoo removal effects of picosecond laser methods employing animal models. We applied a picosecond laser to process the tattoo and observed the effects along with metabolic pathways for tattoo removal via pathology and imaging approaches. Results Based on the results of characterization, pathology and fluorescence, we discovered that the picosecond laser could effectively remove the pigment particles on rat skin, part of which would be metabolized out of the body through the circulatory system. After picosecond laser treatment, the fluorescence intensity of the rat skin engraved part was gradually weakened. At 8 h after the treatment, the metabolic organs had weak fluorescence, and there was no fluorescence in the metabolic organs at 12 h and 24 h after the treatment. Conclusion The picosecond laser had perfect tattoo removal effects, which could be utilized as a reference for clinical tattoo removal.
Collapse
Affiliation(s)
- Yan Qu
- Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong, 261031, People's Republic of China
| | - Xien Feng
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People's Republic of China
| | - Jin'ning Liang
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People's Republic of China
| | - Junru Liu
- Department of Dermatology, Yantai Yuhuangding Hospital Laishan Branch, Yantai, 264003, Shandong, People's Republic of China
| | - Dong Gao
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People's Republic of China
| |
Collapse
|
9
|
Feng H, Wu Y, Jiang M, Luo X, Yan S, Lu Z. The Efficacy and Safety of Fractional 1064 nm Nd:YAG Picosecond Laser Combined With Intense Pulsed Light in the Treatment of Atrophic Acne Scar: A Split-Face Study. Lasers Surg Med 2021; 53:1356-1363. [PMID: 34082477 DOI: 10.1002/lsm.23428] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/18/2021] [Accepted: 05/17/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES To evaluate the efficacy and safety of fractional 1064 nm Nd:YAG picosecond laser combined with intense pulsed light (IPL) in the treatment of atrophic acne scar with post-inflammatory erythema (PIE). © 2021 Wiley Periodicals LLC. STUDY DESIGN/MATERIALS AND METHODS Seventeen patients received five sessions of treatment at weeks 0, 4, 8, 12, 16 and were followed up at week 28. One half of the face was randomly treated by fractional 1064 nm Nd:YAG picosecond laser combined with IPL (FxPico + IPL), and the other by IPL alone as a control. RESULTS For the 15 patients who completed the study, the FxPico + IPL side demonstrated significant median Échelle D'évaluation clinique des cicatrices D'acné (ECCA) score improvement (P < 0.01), while IPL alone side did not (P = 0.1250). The pore counts for both sides decreased but more pore count reduction was seen on the FxPico + IPL side (P < 0.05). Better scar improvement was observed on the FxPico + IPL-treated side (P < 0.05) while no difference in erythema improvement was seen between the two sides. There was no difference between the two treatments in terms of overall satisfaction. Pain, erythema, edema, petechiae, crusting, reactive acneiform eruptions, and pruritus were common adverse effects and were mild to moderate. CONCLUSION FxPico + IPL is an effective, efficient, and safe treatment regimen for atrophic acne scars complicated by PIE.
Collapse
Affiliation(s)
- Hao Feng
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Road, Shanghai, 200040, China
| | - Yuemeng Wu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Road, Shanghai, 200040, China
| | - Min Jiang
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Road, Shanghai, 200040, China
| | - Xiaoqun Luo
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Road, Shanghai, 200040, China
| | - Shuxian Yan
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Road, Shanghai, 200040, China
| | - Zhong Lu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Road, Shanghai, 200040, China
| |
Collapse
|
10
|
Shi Y, Jiang W, Li W, Zhang W, Zou Y. Comparison of fractionated frequency-doubled 1,064/532 nm picosecond Nd:YAG lasers and non-ablative fractional 1,540 nm Er: glass in the treatment of facial atrophic scars: a randomized, split-face, double-blind trial. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:862. [PMID: 34164496 PMCID: PMC8184496 DOI: 10.21037/atm-21-1715] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Laser treatment of acne scars is common, but quality evidence on its efficacy is still needed. Our study aimed to compare picosecond laser and non-ablative fractional laser’s efficacy and safety in treating acne atrophic scars. Methods This was a randomized, split-face double-blind trial recruiting patients with acne atrophic scars. Facial halves were randomly divided and treated with fractionated frequency-doubled 1,064/532 nm picosecond Nd:YAG laser or non-ablative fractional 1,540 nm Er: glass laser. ECCA score (echelle d'evaluation clinique des cicatrices d’acne) and skin flatness measured with a non-invasive phaseshift rapid in vivo measurement of skin (PRIMOS) system were evaluated one month after the last treatment. Results Twenty-two Fitzpatrick skin type IV patients were included in this study, with an average age of 29.68 years, an average duration of acne scars of 8.8 years. Picosecond laser impacted all acne scar types (before and after treatment; P=0.000 for all types, P<0.001 for V-type, P=0.002 for U-type, and P=0.021 for M-type) and more pronounced effect on ECCA score than non-ablative laser for V-type and U-type acne scars. After treatment, each treatment site’s height was significantly lower than that before treatment (P=0.041) in the picosecond group but not in the non-ablative group (P=0.785). The reported erythema rate was higher in patients treated with a picosecond laser, while edema, exudation, purpura, pain, and long-term AEs were similar between the groups. Conclusions Fractionated frequency-doubled 1,064/532 nm Picosecond Nd: YAG laser showed better efficacy in treating acne atrophic scars than the alternative and provided satisfactory safety with added improvement in pores and the glossiness of the skin. Registration number ChiCTR2100045982 (comparison of fractionated frequency-doubled 1,064/532 nm picosecond Nd: YAG lasers and nonablative fractional 1,540 nm Er: glass in the treatment of facial atrophic scar: a randomized, split-face, double-blind controlled trial).
Collapse
Affiliation(s)
- Yu Shi
- Department of Medical Cosmetology, Tongji University Affiliated Shanghai Skin Disease Hospital, Shanghai, China
| | - Wencai Jiang
- Department of Skin, and Cosmetic Research Department, Tongji University Affiliated Shanghai Skin Disease Hospital, Shanghai, China
| | - Wei Li
- Department of Medical Cosmetology, Tongji University Affiliated Shanghai Skin Disease Hospital, Shanghai, China
| | - Wei Zhang
- Department of Medical Cosmetology, Tongji University Affiliated Shanghai Skin Disease Hospital, Shanghai, China
| | - Ying Zou
- Department of Medical Cosmetology, Tongji University Affiliated Shanghai Skin Disease Hospital, Shanghai, China
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Manuskiatti W, Punyaratabandhu P, Tantrapornpong P, Yan C, Cembrano KAG. Objective and Long-Term Evaluation of the Efficacy and Safety of a 1064-nm Picosecond Laser With Fractionated Microlens Array for the Treatment of Atrophic Acne Scar in Asians. Lasers Surg Med 2020; 53:899-905. [PMID: 33326626 DOI: 10.1002/lsm.23368] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE Fractional 1064-nm picosecond-domain laser has recently been utilized for the treatment of atrophic acne scars and showed promising results. However, data on the safety and efficacy of this procedure in dark-skinned patients are limited. This prospective, self-controlled study was conducted to objectively evaluate the safety and efficacy of a 1064-nm picosecond laser coupled with a microlens array (MLA) for the treatment of atrophic acne scars on Asian skin. STUDY DESIGN/MATERIALS AND METHODS Twenty-six subjects of Fitzpatrick skin types (FSTs) III and IV with atrophic acne scars were enrolled. All subjects were treated with a 1064-nm picosecond laser (spot size of 8 mm, fluence of 1.0 J/cm2 , a repetition rate of 10 Hz) in combination with the MLA handpiece for an average of three passes, for 6 monthly sessions. Objective (measurement of scar volume using three-dimensional (3D) photography and skin roughness analysis using ultraviolet A-light video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline and at 1, 3, and 6 months after the final treatment. RESULTS Statistically significant reduction of the scar volume from baseline at 1, 3, and 6 months after the final treatment were observed by 3D photography and ultraviolet A-light video camera. At the 6-month follow-up, 50% (13 of 26) of the subjects were rated as having at least 50% improvement of the scars. The rate of improvement significantly increased from the 1-month follow-up to the 6-month follow-up (P = 0.013). Similarly, at the 6-month follow-up, the scar volume (P = 0.024) and skin roughness (P = 0.001) also significantly improved, in comparison with the baseline. Mild postinflammatory hyperpigmentation (PIH) was observed to develop in approximately 18% of all the treatment sessions. All cases of PIH were temporary and resolved within 4 weeks on average. CONCLUSIONS The 1064-nm picosecond laser with MLA is a safe therapeutic alternative for the treatment of atrophic acne scars in dark-skinned individuals. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Preawphan Punyaratabandhu
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Ploypailin Tantrapornpong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Kathryn Anne G Cembrano
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| |
Collapse
|
13
|
van Zuuren EJ, Arents BWM, Miklas M, Schoones JW, Tan J. Identifying and appraising patient-reported outcome measures on treatment satisfaction in acne: a systematic review. Br J Dermatol 2020; 185:36-51. [PMID: 33176002 PMCID: PMC8359297 DOI: 10.1111/bjd.19675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND After dermatitis, acne is the next skin disease to contribute most to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified, which together form an Acne Core Outcome Set (ACORN). One of these was satisfaction with acne treatment. OBJECTIVES To identify studies that described the development of patient-reported outcome measures (PROMS), evaluated one or more measurement properties of a PROM, or evaluated the interpretability of a PROM in patients with acne regarding treatment satisfaction. METHODS The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) search strategy for identifying PROMS on acne treatment satisfaction was used. We searched PubMed, MEDLINE, Embase, LILACS, Web of Science, Cochrane Library, Emcare, PsycINFO and Academic Search premier (June 2020). Study selection, data extraction and assessment of methodological quality according to COSMIN guidance were carried out independently by two authors. RESULTS Only one study could be included, describing the development of a treatment satisfaction measure in patients with acne. The development was assessed as inadequate and data on measurement properties were lacking. Additionally, we found 188 studies reporting treatment satisfaction solely as an outcome, using a wide variety of methods, none of them standardized or validated. CONCLUSIONS We could not find a PROM on treatment satisfaction to recommend for a core outcome set in acne. There is an unmet need for a PROM on treatment satisfaction in acne that is robustly developed, designed and validated.
Collapse
Affiliation(s)
- E J van Zuuren
- Dermatology Department, Leiden University Medical Centre, Leiden, the Netherlands
| | - B W M Arents
- Skin Patients Netherlands (Huidpatiënten Nederland), Nieuwegein, the Netherlands
| | - M Miklas
- Windsor Clinical Research Inc., Windsor, ON, Canada
| | - J W Schoones
- Walaeus Library, Leiden University Medical Centre, Leiden, the Netherlands
| | - J Tan
- Windsor Clinical Research Inc., Windsor, ON, Canada.,Western University, London, ON, Canada
| |
Collapse
|
14
|
Qu Y, Wang L, Zhou P, Zhang W. Efficient Picosecond Laser for Tattoo Removal in Rat Models. Med Sci Monit 2020; 26:e924583. [PMID: 32709839 PMCID: PMC7401794 DOI: 10.12659/msm.924583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Tattoos are popular in modern times. Due to the occurance of adverse effects such as poor aesthetic value, scar hyperplasia, and abnormal pigments, there is a high demand for uniform operation standards as well as standards for tattoo technologies. In the present study we used Sprague-Dawley rats to assess the tattoo removal efficacy of use of a picosecond laser at various energy values. Material/Methods Tattoos were made on the backs of rats, then we used a picosecond laser set at various energy parameters to remove the tattoos. After performing the removal procedure in multiple groups, we selected the most suitable energy levels with corresponding parameters for the tattoo removal. We recruited human volunteers who wanted their tattoos removed and used the energy level found to perform best during tattoo removal experiments. The tattoo removal effects were evaluated and verified. Four tattoo volunteers were treated by using the optimal energy parameters for picosecond laser technology. Results Through characterization observation and pathological staining results, it was demonstrated that the 1.9 mJ/μbeam energy laser had the best hollowing effect and the most complete pigment particle crushing effect in the rat skin, and had the best tattoo removal effect. Conclusions We leveraged the evaluation standard to choose the most suitable energy value of the picosecond laser, which had a good tattoo removal effect and could be employed as a reference for clinical removal of tattoos. This process provides criteria for tattoo removal evaluations as well as alternatives for tattoo removal in clinical practice.
Collapse
Affiliation(s)
- Yan Qu
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Lei Wang
- Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai, Shandong, China (mainland)
| | - Pingyu Zhou
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Wei Zhang
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China (mainland)
| |
Collapse
|
15
|
Abstract
Picosecond laser technology was cleared by Food and Drug Administration in 2012 and enhanced our ability to clear both benign pigmentation and dermal ink through a photomechanical impact created in the tissue. This impact created is greater than comparative nanotechnology and can be accomplished with lower fluences and smaller pulse durations. The addition of a diffractive lens array (FOCUS lens) has created a new category in skin rejuvenation by stimulating elastin and collagen through photomechanical and photoacoustic effects and not only through traditional photothermal tissue effects.
Collapse
Affiliation(s)
- Raminder Saluja
- Saluja Cosmetic and Laser Center, Private Practice, 9615 Northcross Center Court, Suite B, Huntersville, NC 28078, USA
| | - Richard D Gentile
- Facial Plastic Surgery, Gentile Facial Plastic Surgery and Aesthetic Laser Center, 821 Kentwood Suite C, Youngstown, OH 44512, USA; Cleveland Clinic Akron General Hospital, Akron, OH, USA.
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Yang CS, Huang YL, Cheng CY, Hu S, Chang SL, Lee MC. A Prospective Study of Fractionated Dual-Wavelength Picosecond Laser in Treating Acne Scar. Lasers Surg Med 2020; 52:735-742. [PMID: 31960996 DOI: 10.1002/lsm.23218] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES The picosecond (PICO) laser has been a new and promising device. But, so far, there have not been many prospective studies investigating the efficacy in acne scar treatment. This study evaluated the efficacy and safety of the dual-wavelength picosecond laser in the treatment of acne scar. STUDY DESIGN/MATERIALS AND METHODS A total of 20 patients with skin type III-IV were enrolled in this study. Eighteen patients completed the study. All patients completed six treatment sessions within a 1-month interval. All patients were treated using both 532 and 1,064 nm fractionated dual-wavelength picosecond handpieces. In evaluation, Goodman and Baron's quantitative global acne scarring grading system (GSS) was scored by two physicians. Patients also judged the results themselves by Visual Analog Scale (VAS) and pain score. RESULTS The average baseline score of GSS quantity and quality were 15.22 and 3.00, respectively. The final scores were 10.61 and 2.33. The average baseline of patient VAS score was 4.28. The final score was 2.00. All scores achieved statistical significance (P < 0.05). No serious long-term side effects were recorded. CONCLUSION Acne scar treatment with the fractionated dual-wavelength picosecond laser has shown both efficacy and safety in this study. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Ching-Sheng Yang
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Aesthetic Medicine, Chang Gung Clinic, 4F., No. 9, Ln. 130, Sec. 3, Minsheng E. Rd., Songshan Dist., Taipei City 105, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Yau-Li Huang
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Aesthetic Medicine, Chang Gung Clinic, 4F., No. 9, Ln. 130, Sec. 3, Minsheng E. Rd., Songshan Dist., Taipei City 105, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Chun-Yu Cheng
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Aesthetic Medicine, Chang Gung Clinic, 4F., No. 9, Ln. 130, Sec. 3, Minsheng E. Rd., Songshan Dist., Taipei City 105, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Sindy Hu
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Aesthetic Medicine, Chang Gung Clinic, 4F., No. 9, Ln. 130, Sec. 3, Minsheng E. Rd., Songshan Dist., Taipei City 105, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Dermatology, Xiamen Chang Gung Memorial Hospital, No. 123, Xiafei Rd., Haicang Dist., Xiamen, China
| | - Shyue-Luen Chang
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Aesthetic Medicine, Chang Gung Clinic, 4F., No. 9, Ln. 130, Sec. 3, Minsheng E. Rd., Songshan Dist., Taipei City 105, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Mei-Ching Lee
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Aesthetic Medicine, Chang Gung Clinic, 4F., No. 9, Ln. 130, Sec. 3, Minsheng E. Rd., Songshan Dist., Taipei City 105, Taiwan.,Department of Cosmetic Science, Chang Gung University of Science and Technology, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan.,Department of Dermatology, Xiamen Chang Gung Memorial Hospital, No. 123, Xiafei Rd., Haicang Dist., Xiamen, China
| |
Collapse
|
18
|
Gold M, Andriessen A, Cohen JL, Goldberg DJ, Grover K, Hu S, Mandy SH, Vega JMK. Pre‐/postprocedure measures for laser/energy treatments: A survey. J Cosmet Dermatol 2019; 19:289-295. [DOI: 10.1111/jocd.13259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 11/25/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Michael Gold
- Gold Skin Care Center Nashville TN USA
- Vanderbilt University School of Medicine and Nursing Nashville TN USA
| | | | - Joel L. Cohen
- AboutSkin Dermatology and DermSurgery Greenwood Village and Lone Tree Englewood CO USA
- Department of Dermatology University of California Irvine Irvine California
| | - David J. Goldberg
- Skin Laser & Surgery Specialists of NY and NJ Hackensack NJ USA
- Icahn School of Medicine at Mt. Sinai New York NY USA
| | - Komel Grover
- Strategic initiatives Swiss American CDMO Dallas Texas
| | - Shasa Hu
- Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Stephen H. Mandy
- Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | | |
Collapse
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Dai Y, Chuang Y, Chen P, Chen C. Efficacy and Safety of Ablative Resurfacing With A High‐Energy 1,064 Nd‐YAG Picosecond‐domain Laser for the Treatment of Facial Acne Scars in Asians. Lasers Surg Med 2019; 52:389-395. [DOI: 10.1002/lsm.23151] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Ying‐Xiu Dai
- Department of DermatologyTaipei Veterans General HospitalTaipei 11221 Taiwan
- Department of Dermatology, School of MedicineNational Yang‐Ming UniversityTaipei 11221 Taiwan
| | | | - Po‐Yu Chen
- Department of DermatologyTaipei Veterans General HospitalTaipei 11221 Taiwan
| | - Chih‐Chiang Chen
- Department of DermatologyTaipei Veterans General HospitalTaipei 11221 Taiwan
- Department of Dermatology, School of MedicineNational Yang‐Ming UniversityTaipei 11221 Taiwan
- Institute of Clinical MedicineNational Yang‐Ming UniversityTaipei 11221 Taiwan
| |
Collapse
|
21
|
Huang C, Hsieh F, Chang H, Peng J, Peng HP. 755 nm picosecond laser for facial atrophic scar—Case reports of long‐term clinical efficacy following up. J Cosmet Dermatol 2019; 18:778-782. [DOI: 10.1111/jocd.12925] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 02/27/2019] [Accepted: 02/19/2019] [Indexed: 11/27/2022]
|
22
|
Gold MH. Dual wavelength treatment protocol with a picosecond laser for the reduction of facial wrinkles. J COSMET LASER THER 2018; 21:147-151. [PMID: 29883215 DOI: 10.1080/14764172.2018.1481514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The potential of a dual wavelength picosecond laser, as a new modality for treating photoaged skin, was investigated in this clinical study. MATERIAL AND METHODS Subjects with bilateral mild-to-moderate facial wrinkling received four picosecond laser treatments, at 3-8 weeks apart, with a double-pass of both 532-nm and 1064-nm split-beam handpieces. Blinded evaluation of clinical photography, by two independent physicians, using the Fitzpatrick Elastosis Scale, was performed at 12 weeks after the fourth treatment. RESULTS Twenty subjects (19 females; mean age 55 ± 7 years, Fitzpatrick Skin Types II-IV) were treated. Blinded evaluation demonstrated 75% (15/20) of the treated faces had improvement of at least one point. Investigator assessments showed a 100% improvement rate in the appearance of wrinkles and a mean elastosis score (ES) improvement of 2.1 ± 0.8 points. Subject satisfaction rate was 74%. Treatments were associated with no to mild discomfort with a mean score of 3.7 ± 1.9 on a scale of 0 (no pain) to 10. Common treatment responses included erythema (98%) and edema (7.5%) that generally resolved within several hours of treatment. CONCLUSION In this study, picosecond laser treatments resulted in significant improvement in facial wrinkles. There were no complications with treatment and minimal downtime.
Collapse
Affiliation(s)
- Michael H Gold
- a Tennessee Clinical Research Center, Gold Skin Care Center , Nashville , TN, USA
| |
Collapse
|
23
|
Lan T, Xiao Y, Tang L, Hamblin MR, Yin R. Treatment of atrophic acne scarring with fractional micro-plasma radio-frequency in Chinese patients: A prospective study. Lasers Surg Med 2018; 50:844-850. [PMID: 29663460 DOI: 10.1002/lsm.22825] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Acne scarring is a common disfiguring sequela of acne vulgaris which can lead to serious psychosocial problems and have a negative effect on patients' quality of life. Although a variety of approaches can be used to treat atrophic acne scars, disadvantages such as long-healing time, dyspigmentation, infections, and prolonged erythema make these treatments unsatisfactory especially for Asians. Fractional micro-plasma radio-frequency is a novel technology that produces minor ablation to the epidermis to promote rapid re-epithelialization, while the radio-frequency evoked thermal effect can stimulate regeneration and remodeling of dermal fibroblasts. OBJECTIVE To evaluate the clinical effectiveness and safety of micro-plasma radio-frequency for the treatment of facial acne scars in Chinese patients. MATERIALS AND METHODS A total of 95 patients with facial atrophic acne scars were treated by micro-plasma radio-frequency using three sessions at 2-month intervals. Patients were seen 1 week after each treatment and 1, 3, 6 months after the final treatment. Improvement was assessed by three independent dermatologists who compared photographs taken before the first treatment and 6 months after the last treatment. Adverse effects were evaluated by a dermatologist who did not participated in the study. Patients also provided self-evaluation of satisfaction levels at the last follow-up visit. RESULTS A total of 86 patients with atrophic acne scars completed the entire study. There was a significant improvement in acne scars after three treatments. The mean score of ECCA grading scale (Echelle d'Evaluation Clinique des Cicatrices d'Acné) was reduced from 107.21 to 42.27 (P < 0.05). A total of 15 of 86 patients showed more than 75% improvement, 57 patients showed 50-75% improvement, and 14 patients showed 25-50%. After three treatments, all subjects showed improvements in spots, large pores, texture, UV damage, red areas, and porphyrin fluorescence. Pain, erythema, edema, effusion, and scab formation were observed in all patients. The average pain score on a visual analog scale was 6.14 ± 1.12 and all patients tolerated the treatments. The average duration of erythema was 6.26 ± 0.92 days. Hyperpigmentation, hypopigmentation, infections, and worsening of scarring were not seen. All patients were either "very satisfied" or "satisfied" with the treatment outcomes. CONCLUSIONS Fractional micro-plasma radio-frequency is an effective and safe treatment for acne scars, and might be a good choice for patients with darker skin. Lasers Surg. Med. 50:844-850, 2018. © 2018 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Ting Lan
- Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Yan Xiao
- Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Li Tang
- Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02115.,Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, 02139
| | - Rui Yin
- Department of Dermatology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| |
Collapse
|
24
|
Negishi K, Akita H, Matsunaga Y. Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser. Lasers Surg Med 2018; 50:851-858. [DOI: 10.1002/lsm.22820] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Kei Negishi
- Institute of Geriatrics; Tokyo Women's Medical University; Tokyo Japan
| | - Hirotaka Akita
- Department of Dermatology; Fujita Health University Banbuntane Hotokukai Hospital; Aichi Japan
| | - Yukiko Matsunaga
- Department of Dermatology; Toho University School of Medicine; Tokyo Japan
- Shiseido Co., Ltd.; Tokyo Japan
| |
Collapse
|