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Yuan Y, He Y, Fang J, Zhang M, Wu Q. Comparison of the fractionated Nd: YAG 1064-nm picosecond laser with holographic optics and the fractional CO 2 laser in atrophic acne scar treatment: a prospective, randomized, split-face study. Int J Dermatol 2024. [PMID: 38924534 DOI: 10.1111/ijd.17296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
KEY POINT The 1064-nm picosecond laser with holographic optics demonstrated significant efficacy in treating atrophic acne scars. BACKGROUND Picosecond lasers with fractionated optics have enabled the development of a breakthrough skin rejuvenation method. The authors compared the fractionated, non-ablative neodymium-doped yttrium aluminum garnet 1064-nm picosecond laser with holographic optics and the fractional CO2 laser in treating atrophic acne scars. METHODS One side of each patient's face was randomly allocated and treated with three sessions of the 1064-nm picosecond laser with holographic optics at 2-month intervals. In contrast, the other side was treated with the fractional CO2 laser. Participants were followed up 3 months after the final session. The primary outcome included the physicians' evaluation using the ECCA grading scale and a four-point scale to assess improvement. The patients' assessment of progress, their overall satisfaction and preferences, and the side effects were also evaluated. RESULTS No significant difference was observed between the two lasers in terms of the mean ECCA scores after treatments (P = 0.209). The physicians' improvement assessment was more significant for the fractional CO2 laser (P = 0.001). The patients' evaluation of improvement and subjective satisfaction were consistent with physicians' four-point scale results. The picosecond laser side had fewer adverse effects (P < 0.001). CONCLUSION The fractionated, non-ablative Nd: YAG 1064-nm picosecond laser with holographic optics and the fractional CO2 laser were effective and safe in treating atrophic acne scars. Significantly better clinical outcomes were observed with the fractional CO2 laser, whereas fewer adverse effects were noted with the 1064-nm picosecond laser with holographic optics.
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Affiliation(s)
- Yucheng Yuan
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Yizhen He
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Jing Fang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Mengli Zhang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
| | - Qiuju Wu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu Province, China
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Tran BQ, Tran TNA, Doan EVL, Nguyen TTP, Nguyen HT. Simultaneous versus sequential fractional CO 2 laser and subcision combination for management of post-acne atrophic scars: A split-face comparative study. J Cosmet Dermatol 2024. [PMID: 38770894 DOI: 10.1111/jocd.16395] [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: 02/20/2024] [Revised: 04/10/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND A combination of fractional CO2 laser and subcision is usually employed for the treatment of post-acne atrophic scars. However, the efficacy and safety of both simultaneous and sequential combination therapies should be explored. AIMS To compare the efficacy and safety of simultaneous and sequential fractional CO2 laser and subcision combination therapies for post-acne atrophic scars. PATIENTS AND METHODS This single-blind, split-face clinical trial included 34 patients with post-acne atrophic scars at our institution. Each patient underwent three sessions of subcision combined with fractional CO2 laser, with a 1-month interval between each session. The left side of the face was treated with simultaneous combination therapy, whereas the right side was treated with sequential combination therapy. Treatment efficacy was assessed at 4, 8, and 12 weeks; and 3 and 6 months after the last session. RESULTS Simultaneous and sequential treatments demonstrated comparable efficacy. Regarding the adverse events, the side of the face undergoing simultaneous treatment experienced longer swelling duration, higher pain levels during laser treatment, and shorter downtime. CONCLUSIONS Despite the longer swelling time and higher pain levels during laser treatment in the simultaneous treatment side, the effectiveness and satisfaction level of the CO2 fractional laser and subcision for treatment of the acne scars were comparable between the two combinations, with a shorter downtime for the simultaneous than for the sequential combination therapy.
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Affiliation(s)
- Bao Quoc Tran
- Department of Dermatology, Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Tu Nguyen Anh Tran
- Department of Dermatology, Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Em Van Loi Doan
- Department of Dermatology, Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Thuy Thi Phan Nguyen
- Department of Dermatology, Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Hao Trong Nguyen
- Department of Dermatology, Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
- Department of Dermatology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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3
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García PN, Andrino RL. Resurfacing of atrophic facial acne scars with a multimodality CO 2 and 1570 nm laser system. J Cosmet Dermatol 2024; 23 Suppl 1:13-18. [PMID: 38587296 DOI: 10.1111/jocd.16283] [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: 02/04/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Scarring is one of the most prevalent long-term complications of acne vulgaris and has cosmetic, psychological, and social burdens. Contemporary management programs integrate multiple modalities to best address the multiple factors underlying their development and persistence. This work assessed the impact of sequential multimodal laser therapy on acne scar geometrics and texture. METHODS Adult patients (n = 16) with Fitzpatrick skin type II-IV and presenting with facial acne scars, underwent three combination ablative (CO2), and nonablative (1570 nm) laser treatment sessions at two-month intervals. Treatment was delivered using a ProScan Hybrid applicator, with each regimen including illumination with both ablative and a nonablative lasers applied in a grid mode sequence. Scar microtopography was assessed at baseline and 6 months after the last treatment session. RESULTS At baseline, all patients had both box and rolling scars, while only three had icepick scars. Six months following treatment, mean scar volume improved from 5.7 ± 5.2 mm3 at baseline to 3.1 ± 3.0 mm3 and mean affected area improved from 165.6 ± 134.0 mm2 94.0 ± 80.1 mm2, translating to 47.0 ± 7.9% and 43.2 ± 8.6% reductions from baseline, respectively. Patients were highly satisfied with treatment outcomes, and no serious adverse reactions were documented during the course of treatment or follow-up. CONCLUSION Multimodal CO2 and 1570-nm laser treatment improved the surface profilometry of patients with atrophic facial acne scars. Customization of both treatment intervals and laser settings to cosmetic regions, scar profiles and skin phototypes may further enhance treatment outcomes and expand its applicability to additional skin deformities.
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4
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Yan H, Sun Y, Hu Y, Wu Y. Ultrapulse carbon dioxide dot matrix laser for facial scar treatment: A meta-analysis. Int Wound J 2023; 21:e14429. [PMID: 37814494 PMCID: PMC10828724 DOI: 10.1111/iwj.14429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
A meta-analysis was performed to investigate the efficacy of ultrapulse carbon dioxide dot matrix laser treatment for patients with facial scars. PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, China Biomedical Literature Database, and Wanfang Database were systematically searched for randomised controlled trials (RCTs) investigating ultrapulse carbon dioxide dot matrix laser treatment for facial scars, and the search was conducted from the time of database inception to July 2023. The retrieved literature was screened independently by two researchers, and data extraction and quality assessments were performed. The meta-analysis was conducted using RevMan 5.4 software. Outcome metrics included overall treatment effectiveness, complication rate, and Echelle d'évaluation clinique des cicatrices d'acné (ECCA) scores. Seventeen RCTs comprising 3703 patients were included, with 1853 patients in the experimental group and 1850 in the control group. The results showed that the experimental group had significantly increased overall treatment efficacy rates (odds ratio [OR]: 3.84, 95% confidence interval [CI]: 3.02-4.90, p < 0.001), reduced complication rates (OR: 0.35, 95% CI: 0.27-0.44, p < 0.001), and improved ECCA scores (standardised mean difference: -1.79, 95% CI: -2.53 to -1.05, p < 0.001) compared with the control group. In conclusion, as the primary treatment modality for facial acne depression scars, ultrapulse carbon dioxide dot matrix laser can significantly increase the overall treatment efficacy rate and ECCA scores and reduce the incidence of complications; however, higher-quality studies are needed for further validation.
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Affiliation(s)
- Hongtao Yan
- Department of DermatologyTaizhou Municipal HospitalTaizhouChina
| | - Yan Sun
- Department of Public Security SupervisionTaizhou Municipal HospitalTaizhouChina
| | - Yayu Hu
- Department of DermatologyTaizhou Municipal HospitalTaizhouChina
| | - Youjun Wu
- Department of DermatologyTaizhou Second People's HospitalTaizhouChina
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5
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Wang Y, Sun Z, Cai L, Zhang F. Comparative efficacy and safety of six photoelectric therapies for the atrophic acne scars: A network meta-analysis. Indian J Dermatol Venereol Leprol 2023; 89:353-362. [PMID: 37067138 DOI: 10.25259/ijdvl_572_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/01/2022] [Indexed: 02/05/2023]
Abstract
Objectives
This network meta-analysis assessed the relative efficacy and safety of six common photoelectric therapies including 1064-nm neodymium-doped yttrium aluminum garnet (Nd: YAG), fractional carbon dioxide laser(FSCO2), fractional micro-plasma radiofrequency(Plasma), micro-needling fractional radiofrequency (MRF), 1550nm or 1540nm erbium-glass non-ablative fractional laser (NAFL) fractional erbium-doped yttrium aluminum garnet (Er: YAG).
Methods
A comprehensive search to identify relevant studies was conducted using four electronic databases. Outcome measures were extracted based on subjective and objective indexes, including the dermatologists’ evaluation(DE), the patients’ overall satisfaction(PS), VAS score, and Postinflammatory hyperpigmentation (PIH).
Results
Eleven published clinical research studies, involving 405 patients were included in this study. Ranking of DE from large to small is as follows: Nd: YAG, FSCO2, Er: YAG, Plasma, NAFL, MRF. In terms of PS, the rand from high to low can be described as follows: Er: YAG, Nd: YAG, FSCO2, Plasma, NAFL, MRF. In connection with the sequencing of adverse events, pain severity from slight to severe as follows: Er:YAG, Nd:YAG, FSCO2, NAFL, MRF, Plasma. The probability of having PIH are presented in order from lowest to highest as follows: MRF, Plasma, Nd: YAG, NAFL, Er: YAG, FSCO2.
Conclusion
FSCO2 remains the mainstream of potentially curative treatment, then again Nd: YAG and Er: YAG require greater efforts to prove their superior effectiveness. NAFL might be appropriate for mild and moderate improvement with its strengths of good tolerance while Plasma fits into patients with higher pain thresholds but an expectation of higher results. MRF has not given expression on absolute predominance for the present.
Registration
PROSPERO CRD42021242160
(available from https://www.crd.york.ac.uk/prospero).
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Affiliation(s)
| | | | - Lingling Cai
- Department of Dermatology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Fengchuan Zhang
- Department of Dermatology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
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Huang CC, Thong HY. Rapid Wound Healing and Acne Scar Improvement After Ablative Fractional Carbon Dioxide Laser Treatment Combined with the Application of Platelet-Lyophilized Treatment (PLT). Clin Cosmet Investig Dermatol 2021; 14:715-721. [PMID: 34211289 PMCID: PMC8241013 DOI: 10.2147/ccid.s316505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/15/2021] [Indexed: 01/12/2023]
Abstract
Objective There are several clinical cases on the application of PRP (platelet-rich plasma) therapies. To improve disadvantages such as the inability to be standardized and stored long term, we proposed a novel platelet-lyophilized treatment (PLT) to enhance the wound healing rate and improve acne scarring. Study Design A single-blinded study at a single health care center was performed. All subjects were treated with a fractional carbon dioxide laser. On the right side of the face, 2 mL PLT solution (dissolved in normal saline) was applied, while on the left side of the face (control group), 2 mL normal saline was applied. The treatment described above was repeated every 3 to 4 weeks, and 4 treatments were performed in total. Assessments were performed prior to each treatment and at the one-month follow-up after the fourth treatment. Subjective assessments included questionnaires administered by the principal investigator and a self-assessment questionnaire completed by the subjects. Moreover, VISIA complexion analysis was used for objective data collection, and spots, wrinkles, texture, pores, UV spots, brown spots, red areas, and porphyrins were objectively analyzed. Results Our data indicated that the PLT side showed a more rapid recovery than the saline side; on average, the sloughing off of the crusts was noted on day 5 and day 6. The improvement rate for skin spots, texture, and pores was significantly increased on the PLT side, with the pigment and pore size both having a statistically significant improvement of p<0.001, while the texture had a significant improvement of p<0.01. Conclusion The results suggested that the application of PLT could be a novel method to enhance wound healing and improve acne scarring after laser skin rejuvenation.
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Affiliation(s)
- Chieh-Chen Huang
- Department of Dermatology, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
| | - Haw-Yueh Thong
- Department of Dermatology, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
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Lan T, Tang L, Xia A, Hamblin MR, Jian D, Yin R. Comparison of Fractional Micro-Plasma Radiofrequency and Fractional Microneedle Radiofrequency for the Treatment of Atrophic Acne Scars: A Pilot Randomized Split-Face Clinical Study in China. Lasers Surg Med 2020; 53:906-913. [PMID: 33326634 DOI: 10.1002/lsm.23369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/21/2020] [Accepted: 11/29/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Both fractional micro-plasma radiofrequency (RF) and fractional microneedle RF are novel devices that can be applied for the treatment of atrophic acne scars, and they have both been proved to be effective. To compare the clinical effectiveness and adverse reactions of fractional micro-plasma RF and fractional microneedle RF for the therapy of facial atrophic acne scars in a randomized split-face study. STUDY DESIGN/MATERIALS AND METHODS Sixty patients with facial atrophic acne scars received three applications at 2-month intervals in a randomized split-face study using fractional micro-plasma RF and fractional microneedle RF on different sides of the face. Three independent dermatologists evaluated the improvement in acne scars using the ECCA grading scale (Echelle d'Evaluation Clinique des Cicatrices d'Acné) by comparing the digital images and graded the improvement in the acne scars. Patients were asked to provide a self-evaluation of satisfaction for efficacy and safety. Adverse effects were also recorded after each treatment. RESULTS In total sixty patients completed the entire study. A significant improvement was observed in the appearance of acne scars, and the mean ECCA scores improved significantly after both modalities. The mean decrease in ECCA scores from the baseline was significantly more pronounced in fractional micro-plasma RF as compared with fractional microneedle RF (41.33 ± 20.19 vs 32.17 ± 17.35; P < 0.05). The degree of clinical improvement was also significantly better for fractional micro-plasma RF. Pain, erythema, and swelling were observed in all patients after both treatments. The pain was more intense during micro-plasma RF treatment (P = 0.000), and the duration of pain and erythema were longer than with fractional microneedle RF (P = 0.000). Postinflammatory hyperpigmentation (PIH) was observed in one patient on the fractional micro-plasma RF side while no PIH was observed on the fractional microneedle RF side. No infections or worsening of scarring was observed with either treatment. No subject was dissatisfied with the efficacy of either device. Rolling scars tended to respond better to fractional micro-plasma RF treatment compared with fractional microneedle RF (P = 0.000). CONCLUSIONS Both fractional micro-plasma RF and fractional microneedle RF are effective and safe methods for improving atrophic acne scars. Fractional micro-plasma RF is significantly more effective for atrophic acne scars, especially for rolling scars. However, fractional microneedle RF has fewer side effects plus shorter downtime, and patients are more comfortable after the treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Ting Lan
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China.,Department of Cosmetic Dermatology, Luxury Skincenter, Xi'an, 710048, China
| | - Li Tang
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Aiai Xia
- Department of Dermatology, Southwest Hospital, Army 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.,Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, 2028, South Africa
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Rui Yin
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
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8
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Kaçar N, Dursun R, Akbay M, Gökşin Ş. The early and late efficacy of single-pass fractional carbondioxide laser, fractional radiofrequency, and their combination in acne scars: A prospective, split-face, single-blinded, controlled clinical study. Dermatol Ther 2020; 33:e14444. [PMID: 33099836 DOI: 10.1111/dth.14444] [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: 09/24/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 01/21/2023]
Abstract
We investigated the effectiveness of fractional carbon dioxide laser (FCO2 ) vs fractional radiofrequency (FRF) and FCO2 vs FRF plus FCO2 combination in the treatment of acne scars. Twenty-seven patients were included. Scar severity was scored with "Echelle d'évaluation clinique des cicatrices d'acné" (ECCA) by a dermatologist blinded to treatment. FCO2 and FRF were administered to the right and left halves of the patients' faces, respectively, at the first three visits, once a month. At the fourth visit, FCO2 was administered to both sides. Last evaluation was performed 6 months after the last treatment. Mean ECCA scores for both face halves decreased gradually at each visit compared with Visit-1; however, the effect size of decrease was higher in the right half of the face and in terms of gender differences was higher in women for both sides that the difference was more pronounced for the FRF side. There was no statistically significant change in the mean VAS patient satisfaction scores in the following visits compared with Visit-2 on both halves (P > .05). Side effects were similar; but lasted longer in the FCO2 side. Both FCO2 and FRF are effective treatment methods in the treatment of atrophic acne scars. Combining FCO2 to FRF improves patient satisfaction. FRF may achieve better results in women compared with men. To our knowledge the study is unique prospective, controlled clinical study comparing the efficacy of FCO2 and FRF plus FCO2 combination treatments.
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Affiliation(s)
- Nida Kaçar
- Faculty of Medicine, Department of Dermatology, Pamukkale University, Denizli, Turkey
| | - Recep Dursun
- Faculty of Medicine, Department of Dermatology, Necmettin Erbakan University, Konya, Turkey
| | - Merve Akbay
- Faculty of Medicine, Department of Dermatology, Pamukkale University, Denizli, Turkey
| | - Şule Gökşin
- Faculty of Medicine, Department of Dermatology, Pamukkale University, Denizli, Turkey
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9
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Helou J, Korkomaz J, Stephan F, Soutou B. Searching predictive factors of efficacy and safety in a fractional CO 2 laser. Dermatol Ther 2020; 33:e13985. [PMID: 32639071 DOI: 10.1111/dth.13985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 06/26/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Abstract
A few studies discussed short outcomes in fractional CO2 laser. This study aimed to seek factors of medium-term efficacy and safety in patients treated for facial rejuvenation or acne scars. This single-center, prospective, single-arm, evaluator-blinded cohort study included patients of 18 years and older undergoing a fractional CO2 laser for facial skin rejuvenation or atrophic acne scars. One session of ultrapulsed fractional 10 600 nm CO2 laser was performed with the Deep FX TM mode in acne scars and the Active FX TM mode in facial rejuvenation and acne scars. Follow-up was carried out for 6 months. In the end, a patient self-satisfaction assessment was obtained. A blinded physician graded improvement based on pretreatment and 6-month photography. The study included 75 patients, of whom 88% were women. Forty-five had facial rejuvenation, and 30 had atrophic acne scars treatment. Half of the patients were satisfied. The physician-blinded evaluation indicated "good to very good" improvement in 46.7% of facial rejuvenation patients, and 30% of acne scars patients. Hyperpigmentation and folliculitis were recorded in 15 and 3 patients, respectively. This study did not find statistically significant factors to predict outcomes in a fractional CO2 laser. We could however note better results in acne scar patients of thicker skin, and facial rejuvenation patients of younger age and thinner skin. We counted more hyperpigmentation events in phototypes III and IV, and it was reversible in all cases.
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Affiliation(s)
- Josiane Helou
- School of Medicine, Université Saint-Joseph, Beirut, Lebanon.,Department of Dermatology, Hôtel-Dieu de France Hospital, Beirut, Lebanon
| | | | - Farid Stephan
- School of Medicine, Université Saint-Joseph, Beirut, Lebanon.,Department of Dermatology, Hôtel-Dieu de France Hospital, Beirut, Lebanon
| | - Boutros Soutou
- School of Medicine, Université Saint-Joseph, Beirut, Lebanon.,Department of Dermatology, Hôtel-Dieu de France Hospital, Beirut, Lebanon
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10
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del Río-Sancho S, Castro-López V, Alonso MJ. Enhancing cutaneous delivery with laser technology: Almost there, but not yet. J Control Release 2019; 315:150-165. [DOI: 10.1016/j.jconrel.2019.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 12/30/2022]
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11
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Koren A, Isman G, Cohen S, Bar Ilan E, Salameh F, Sprecher E, Artzi O. Efficacy of a combination of diluted calcium hydroxylapatite‐based filler and an energy‐based device for the treatment of facial atrophic acne scars. Clin Exp Dermatol 2019; 44:e171-e176. [DOI: 10.1111/ced.13952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 12/01/2022]
Affiliation(s)
- A. Koren
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - G. Isman
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - S. Cohen
- Department of Plastic and Reconstructive Surgery Assaf Harofeh Medical Center Zerifin Israel
| | - E. Bar Ilan
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - F. Salameh
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - E. Sprecher
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
- Department of Human Molecular Genetics and Biochemistry Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - O. Artzi
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
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12
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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]
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Abstract
BACKGROUND Modalities for atrophic acne scarring can be classified depending upon the needs they satisfy; that is, resurfacing, lifting/volumization, tightening, or surgical removal/movement of tissue that is required for correction. A plethora of treatment options have resulted from the need to treat various acne scar types, variability of responses noted in various skin types, and increasing popularity of minimally invasive modalities. Still, there is a lack of consensus guidelines on treatment or combination therapies for various clinical scenarios. OBJECTIVE This systematic review includes a critical evaluation of the evidence relevant to these modalities and various multimodality therapies. METHODS We performed a systematic literature search in Medline and EMBASE databases for studies on acne scar management. Also, we checked the reference lists of included studies and review articles for further studies. A total of 89 studies were included in our quality of evidence evaluation. RESULTS The efficacy of lasers and radiofrequency in atrophic acne scarring is confirmed by many comparative and observational studies. Other modalities can be used as an adjunct, the choice of which depends on the type, severity, and number of atrophic scars. Minimally invasive procedures, such as fractional radiofrequency and needling, provide good outcomes with negligible risks in patients with dark or sensitive skin types. CONCLUSIONS There is a lack of high-quality data. Fractional lasers and radiofrequency offer significant improvement in most types of atrophic acne scars with minimal risks and can be combined with all other treatment options. Combination therapies typically provide superior outcomes than solo treatments.
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14
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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.
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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
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