Carbon Assisted Q-Switched Nd:YAG Laser Treatment with Two Different Sets of Pulse Width Parameters Offers a Useful Treatment Modality for Severe Inflammatory Acne: A Case Report

Treatment Indications of Carbon Solution-Assisted Nd: YAG Laser According to Patient Satisfaction: A Retrospective Study

INTRODUCTION

Carbon solution-assisted Nd:YAG lasers were previously used in enlarged pores; hair removal; acne and acne scars; and facial rejuvenation.

OBJECTIVES

The aim of this study is to determine the patient satisfaction for different treatment indications of carbon solution-assisted 1064 nm Nd:YAG lasers.

METHODS

This is a retrospective study that included the patients who were treated with carbon solution-assisted 1064 nm Nd:YAG laser with any indication in a private dermatology practice. A pre-prepared carbon solution was applied 30 minutes before the laser treatment with the following parameters: a spot size of 8mm, fluence of 1.3 J/cm2 and a frequency of 8Hz. Patient satisfaction was assessed with GAIS.

RESULTS

A total of 272 patients were included; of these 70 patients had acne lesions, 135 patients had melasma, 27 patients had post-inflammatory hyperpigmentation, 17 patients had ephelides and 23 patients had solar lentigines. The mean patient satisfaction for solar lentigo patients (4.35/5) was greater than for that of acne patients (4.26/5) which was greater than that of ephelide patients (3.94/5) which was greater than that of melasma patients (3.67/5) which was greater than that of post inflammatory hyperpigmentation patients (2.30/5) CONCLUSIONS: This study revealed that carbon solution-assisted 1064 nm Nd:YAG laser therapy is effective in the treatment of solar lentigo, acne vulgaris, ephelides and melasma. However, it fails to provide therapeutic efficacy in post inflammatory hyperpigmentation.

The Effect of Cosmetic Treatment and Gel Laser Therapy on the Improvement of Comedogenic Skin Type

Comedogenic skin care receives little attention compared to the care or treatment of more serious acne manifestations. Traditional therapies may have limited success with potential side effects. Cosmetic care supported by the effect of a biostimulating laser may offer a desirable alternative. The aim of the study was to evaluate the biological effectiveness of combined cosmetic treatment with lasotherapy on comedogenic skin type using noninvasive bioengineering methods. Twelve volunteers with comedogenic skin type underwent a 28-week application of Lasocare Basic 645^® cosmetic gel containing Lactoperoxidase and Lactoferrin in combination with laser therapy (Lasocare^® method). The effect of treatment on skin condition was monitored using noninvasive diagnostic methods. The parameters were the amount of sebum, the pore count, the ultraviolet-induced red fluorescence assessment of comedonic lesions (percentage of the area and quantification of orange-red spots), hydration, transepidermal water loss, and pH. A statistically significant decrease in sebum production was observed on the skin of the treated volunteers, as well as a decrease in porphyrins, indicating the presence of Cutibacterium acnes populating comedones and causing enlarged pores. The balance of epidermal water in the skin was regulated adjusting the acidity of the skin coat in individual zones, which decreased the presence of Cutibacterium acnes. Cosmetic treatment in combination with the Lasocare^® method successfully improved the condition of comedogenic skin. In addition to transient erythema, there were no other adverse effects. The chosen procedure appears to be a suitable and safe alternative to traditional treatment procedures known from dermatological practice.

Short-pulsed and Q-switched ND-YAG laser with topical carbon versus fractional CO2 laser in the treatment of enlarged facial pores: A split-face comparative study

OBJECTIVES

To assess and compare the efficacy and safety of topical carbon plus short-pulsed and Q-switched Nd-YAG laser to fractional carbon dioxide (CO₂ ) laser in improving the appearance of wide facial pores.

MATERIALS AND METHODS

Thirty Egyptian patients with wide facial pores were treated in a split-face manner with two sessions of fractional CO₂ laser on one side of the face and topical carbon followed by short-pulsed and Q-switched Nd-YAG laser on the other side at 4-week intervals. Clinical evaluation by Investigator Global Assessment (IGA), patient satisfaction level, and photography before treatment and 1 month after the second laser session was performed and adverse effects were monitored. Dermoscopic evaluation by dermoscopy pore score and optical coherence tomography (OCT) evaluation by surface irregularities score were performed at baseline and 1-month posttreatment.

RESULTS

One month after treatment, both modalities produced significant reduction in IGA score, dermoscopy pore score, and surface irregularities by OCT (p < 0.001, p < 0.001). Both procedures were well-tolerated. There was no significant difference in IGA, dermoscopy pore score, surface irregularities score by OCT, adverse effects or patient satisfaction level between both treated sides.

CONCLUSION

Fractional CO₂ laser and topical carbon application followed by short-pulsed and Q-switched Nd-YAG laser can be safely and effectively used to improve the appearance of wide facial pores.

Fractional carbon dioxide laser versus carbon-assisted Q-switched Nd: YAG laser in the treatment of dilated facial pores

BACKGROUND

The treatment of dilated facial pores is difficult, and the ideal modality is not established yet. Different ablative and nonablative lasers have been used in the treatment of dilated pores with variable outcomes.

AIM

To evaluate and compare the efficacy of fractional CO2 laser versus carbon-assisted Q-switched Nd: YAG laser in dilated facial pores.

METHODS

The study included 80 patients with dilated pores divided into two groups each containing 40 patients. Group (A) had fractional CO2 laser treatment, and group (B) received Q-switched Nd: YAG laser treatment after the application of a carbon solution on the face. The treatment was repeated monthly for a total of 3 sessions. Objective and subjective assessments of the clinical outcome were performed.

RESULTS

Both modalities significantly improved the dilated pores; however, the clinical response was statistically higher and the improvement was maintained for a longer duration of time in the factional laser group compared with the carbon-assisted Q-switched Nd: YAG laser group (p = 0.01). The downtime was significantly lower in the Q-switched Nd: YAG laser group, and the patients' satisfaction rates were comparable in both groups.

CONCLUSION

The two laser systems appear to be effective, safe, and well-tolerated in the treatment of dilated pores. The fractional CO2 laser was associated with a significantly higher and more prolonged clinical response.

Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser

The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.

Intense Pulsed light Versus 1,064 Long-Pulsed Neodymium: Yttrium-Aluminum- Garnet Laser in the Treatment of Facial Acne Vulgaris

INTRODUCTION

Laser and light-based procedures provide a good and safe modality for treatment of active acne lesions when used properly.

AIM

To compare the clinical efficacy of intense pulsed light (IPL) versus 1,064 long-pulsed Neodymium:Yttrium-Aluminum- Garnet (Nd: YAG) in treatment of facial acne vulgaris.

MATERIALS AND METHODS

Seventy four patients recruited between June 2013 and August 2014 was enrolled in this controlled, single-blind, split-face clinical trial. All participants received 3 sessions of IPL on the right side of the face and 1,064-nm Nd:YAG on the left side of the face at 4-weeks intervals. Final assessment was made by comparison of the changes in the count of inflammatory acne lesions (inflammatory papules, pustules, nodules and cyst) and non-inflammatory acne lesions (Comedones) and the acne severity score between both therapies, based on standardized photography.

RESULTS

At the final visit, the inflammatory acne lesions were reduced on the IPL and 1,064-nm Nd:YAG treated sides by 67.1% and 70.2% respectively (p<0.05 for each), while non inflammatory acne lesions were reduced by 18.3% and 19.3% respectively (p>0.05 for each). For both therapies, there was significant difference in the improvement on inflammatory acne lesions in comparison to non-inflammatory lesions (p<0.05 for each). There was no significant difference in the efficacy of the two therapies in reducing the percentage of both types of acne lesions count from baseline to the end of the study (p>0.05 for each).

CONCLUSION

Both IPL and 1,064-nm Nd:YAG laser are effective in treatment of inflammatory facial acne vulgaris. There is no significant difference between the effects of both therapies on facial acne lesions.

Enlarged pores treated with a combination of Q-switched and micropulsed 1064 nm Nd:YAG laser with and without topical carbon suspension: A simultaneous split-face trial

BACKGROUND AND AIMS

Enlarged facial pores remain one of the major cosmetic concerns among Asian females. This study attempted to assess and compare the efficacy of a combination of the Q-switched and quasi long-pulsed (micropulsed) Nd:YAG laser to reduce the size of the enlarged pores with and without an exogenous photoenhancer.

METHODS

In twenty five female subjects mean age 34.04 yr and skin type II-IV, a carbon lotion as a photoenhancer was applied on one side of the face (Method 1) and the other side was used as the control (Method 2). The entire face was then treated with a single pass of the 1064 nm Nd:YAG laser in the micropulsed mode, pulse fluence and width of 2.3 J/cm(2) and 300 µsec, respectively. Multiple passes were then delivered in the Q-switched mode (2.5 J/cm(2) and 5 nsec).

RESULTS

Three weeks after the final treatment, 75% of the subjects showed improvement with method 1 whereas 67% showed improvement with method 2. No adverse side effects were reported with either method.

CONCLUSIONS

Although histological confirmation was not performed, we were able to prove both subjectively and objectively that the use of the combination of the micropulsed and Q-switched modes of the Nd:YAG laser was useful in reducing pore size, and that the photoenhancer improved the efficacy.