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Mineroff J, Maghfour J, Ozog DM, Lim HW, Kohli I, Jagdeo J. Photobiomodulation CME part II: Clinical applications in dermatology. J Am Acad Dermatol 2024:S0190-9622(24)00187-7. [PMID: 38307144 DOI: 10.1016/j.jaad.2023.10.074] [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: 05/09/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 02/04/2024]
Abstract
Photobiomodulation (PBM) is an emerging treatment modality in dermatology with increasing office and home-based use. PBM is the use of various light sources in the red light (620-700 nm) and near-infrared (700-1440 nm) spectrum as a form of light therapy. PBM is often administered through low-level lasers or light-emitting diodes. Studies show that PBM can be used effectively to treat conditions secondary to cancer therapies, alopecia, ulcers, herpes simplex virus, acne, skin rejuvenation, wounds, and scars. PBM offers patients many benefits compared to other treatments. It is noninvasive, cost-effective, convenient for patients, and offers a favorable safety profile. PBM can be used as an alternative or adjuvant to other treatment modalities including pharmacotherapy. It is important for dermatologists to gain a better clinical understanding of PBM for in-office administration and to counsel patients on proper application for home-use devices to best manage safety and expectations as this technology develops. PBM wavelengths can induce varied biological effects in diverse skin types, races, and ethnicities; therefore, it is also important for dermatologists to properly counsel their skin of color patients who undergo PBM treatments. Future clinical trials are necessary to produce standardized recommendations across conditions and skin types.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York
| | - Jalal Maghfour
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan
| | - David M Ozog
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Henry W Lim
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Indermeet Kohli
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; Department of Physics and Astronomy, Wayne State University, Detroit, Michigan
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York.
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Rathod D, Foroughi A, Mekokishvili L, Wollina U, Lotti T, Rajan A, Goldust M. A cross-sectional, multi-center study on treatment of facial acne scars with low-energy double-pass 1450-nm diode laser. Dermatol Ther 2020; 33:e13326. [PMID: 32208551 DOI: 10.1111/dth.13326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/15/2020] [Accepted: 03/18/2020] [Indexed: 01/30/2023]
Abstract
Acne scars are the ultimate outcome of acne vulgaris, a prevalent skin disorder affecting the pilo-sebaceous unit. Laser resurfacing has been demonstrated to be an efficient therapy option for acne scars. Hence, we adopted this concept and conducted a study to evaluate the safety and efficacy of low-energy double-pass 1450-nm diode laser on acne scars. This study was conducted on 48 patients with acne scars, treated at 4-week interval with low-energy double-pass 1450-nm diode laser. Patients were evaluated clinically and with photographs, at day 0, first month and third month post the final treatment and during follow-up visit. Five treatment sessions were completed by all patients. Approximately, 79.2% of patients showed around 30% improvement. At the end of third month follow-up, 92.9% of the patients demonstrated >30% improvement. Vesicle formation was observed in two cases, with no post-inflammatory hyperpigmentation and transient hyperpigmentation was observed in one case, which vanished within 2 months. Our study showed that 1450-nm diode laser treatment was efficient and well endured in facial acne scars when used with double-pass at low-energy.
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Affiliation(s)
- Dipali Rathod
- Consultant Dermatologist, Mumbai, Maharashtra, India
| | | | - Lali Mekokishvili
- Department of Dermatology, Caucasus International University, Faculty of Medicine, Tbilisi, Georgia
| | - Uwe Wollina
- Department of Dermatology and Allergology, StädtischesKlinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
| | - Torello Lotti
- University of Studies Guglielmo Marconi, Rome, Italy
| | - Aswath Rajan
- Department of Dermatology, Venereology and Leprology, Goa Medical College, Bambolim, Goa, India
| | - Mohamad Goldust
- University of Rome G. Marconi, Rome, Italy.,Department of Dermatology, University Medical Center Mainz, Mainz, Germany.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
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A Review and Update of Treatment Options Using the Acne Scar Classification System. Dermatol Surg 2019; 45:411-422. [DOI: 10.1097/dss.0000000000001765] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Laser treatment for posttraumatic injury offers the clinician the unique opportunity for early intervention in mediating early scar formation, or for reducing the appearance of scars after maturation. In this review, the authors focus on the mechanisms by which lasers exert their therapeutic effects, highlighting several popular lasers and dosimetry used, and underscoring the power of combined surgical scar revision in managing posttraumatic facial scars.
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Kwon HH, Park HY, Choi SC, Bae Y, Jung JY, Park GH. Novel device-based acne treatments: comparison of a 1450-nm diode laser and microneedling radiofrequency on mild-to-moderate acne vulgaris and seborrhoea in Korean patients through a 20-week prospective, randomized, split-face study. J Eur Acad Dermatol Venereol 2017; 32:639-644. [PMID: 29178495 DOI: 10.1111/jdv.14714] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/08/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND While device-based acne treatments are widely applied for patients not tolerating conventional medications, related controlled studies have been still limited. Recently, non-ablative 1450-nm diode laser (DL) and fractional microneedling radiofrequency (FMR) have been effectively used for acne, in addition to well-recognized dermal remodelling effects. OBJECTIVE To compare the clinical course of acne treatment between DL and FMR. METHODS Twenty-five Korean patients with mild-to-moderate facial acne completed treatments with DL and FMR through a 20-week, randomized split-face study. One randomly assigned half side of each patient's face received DL and the other side by FMR. Treatments were scheduled to receive three consecutive sessions at 4-week intervals. Objective assessments including revised Leeds grades, lesion counts, sebum output measurements, and patients' subjective satisfaction were investigated. RESULTS Both DL and FMR demonstrated steady improvement of acne and seborrhoea during treatment sessions. While results between two devices were similar during treatment sessions, FMR was superior to DL in the 12-week follow-up. Patients' subjective assessments for seborrhoea improvement were similar between two devices, while those for acne, skin texture, and acne scars were more satisfactory for FMR. For safety profile, no significant difference was observed between two regimens, while mild postinflammatory hyperpigmentation was observed only in DL side. CONCLUSION Both DL and FMR demonstrated efficacies for acne and seborrhoea, with reasonable safety profile. FMR was more effective than DL for the long-term maintenance, and subjective assessments for texture and scar improvements. Therefore, a few sessions of these devices would be a viable option for acne treatments.
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Affiliation(s)
- H H Kwon
- Oaro Dermatology Clinic, Seoul, Korea
| | - H Y Park
- Oaro Dermatology Clinic, Seoul, Korea
| | - S C Choi
- Oaro Dermatology Clinic, Seoul, Korea
| | - Y Bae
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - J Y Jung
- Oaro Dermatology Clinic, Seoul, Korea
| | - G-H Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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Kurokawa I, Oiso N, Kawada A. Adjuvant alternative treatment with chemical peeling and subsequent iontophoresis for postinflammatory hyperpigmentation, erosion with inflamed red papules and non-inflamed atrophic scars in acne vulgaris. J Dermatol 2016; 44:401-405. [PMID: 27743393 DOI: 10.1111/1346-8138.13634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 08/29/2016] [Indexed: 11/30/2022]
Abstract
The standard management of acne vulgaris in Japan includes a combination of topical treatment with benzoyl peroxide (BPO) and BPO/clindamycin (CLDM), topical adapalene and systemic antimicrobials. However, the treatment of therapy-resistant complications such as postinflammatory hyperpigmentation (PIH), erosions with inflamed red papules and atrophic scars has not been established. We performed chemical peeling with glycolic acid and iontophoresis with ascorbyl 2-phosphate 6-palmitate and DL-α-tocopherol phosphate for the treatment of PIH, erosions with inflamed red papules and non-inflamed atrophic scars in 31 patients with acne vulgaris (mild to severe severity), and evaluated the efficacy and safety of these interventions. In most of cases, there was remarkable improvement in PIH and erosions with inflamed red papules after treatment. There was also some improvement in non-inflamed atrophic scars without erythema. Mild redness and irritation was observed in four cases as adverse reactions. Early initial treatment of PIH and erosions with red papules by chemical peeling and iontophoresis is an effective and safe method to prevent the formation of atrophic scars in patients with acne vulgaris.
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Affiliation(s)
- Ichiro Kurokawa
- Department of Dermatology and Acne Clinical Research Center, Meiwa Hospital, Nishinomiya, Japan
| | - Naoki Oiso
- Department of Dermatology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Akira Kawada
- Department of Dermatology, Faculty of Medicine, Kinki University, Osaka, Japan
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Wanner M, Sakamoto FH, Avram MM, Anderson RR. Immediate skin responses to laser and light treatments. J Am Acad Dermatol 2016; 74:807-19; quiz 819-20. [DOI: 10.1016/j.jaad.2015.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 12/23/2022]
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Immediate skin responses to laser and light treatments. J Am Acad Dermatol 2016; 74:821-33; quiz 834, 833. [DOI: 10.1016/j.jaad.2015.06.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 12/17/2022]
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Cohen BE, Elbuluk N. Microneedling in skin of color: A review of uses and efficacy. J Am Acad Dermatol 2016; 74:348-55. [PMID: 26549251 DOI: 10.1016/j.jaad.2015.09.024] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 09/09/2015] [Accepted: 09/12/2015] [Indexed: 11/18/2022]
Abstract
In ethnic skin, traditional skin resurfacing procedures such as dermabrasion, chemical peels, and laser therapy can be effective but can also be associated with prolonged recovery and risk of complications. These complications can include a higher risk of dyspigmentation and scarring, and unsatisfactory clinical outcomes. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. Microneedling may offer a more advantageous safety profile, particularly in the skin-of-color population (Fitzpatrick skin types IV-VI), compared with more conventional resurfacing modalities. Thus far, it has been shown to be effective for a number of dermatologic conditions in this population, including scarring, melasma, melanosis, skin rejuvenation, acne vulgaris, and primary hyperhidrosis. This article aims to provide a comprehensive review of the literature regarding the efficacy and safety of microneedling in skin of color.
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Affiliation(s)
- Brandon E Cohen
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Nada Elbuluk
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
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Cohen BE, Brauer JA, Geronemus RG. Acne scarring: A review of available therapeutic lasers. Lasers Surg Med 2015; 48:95-115. [PMID: 26414762 DOI: 10.1002/lsm.22410] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE The utilization of lasers in dermatology has greatly expanded in recent decades. Acne scarring is a common indication in which lasers play an important therapeutic role. STUDY DESIGN/MATERIALS AND METHODS Available lasers include traditional ablative lasers, such as carbon dioxide and erbium lasers, traditional non-ablative lasers, such as neodymium, diode, alexandrite, pulsed dye lasers and intense pulse light, as well as both ablative, and non-ablative fractional laser systems. CONCLUSION We sought to provide a framework for understanding the various types of lasers available to treat acne scars and review the primary literature pertaining to the efficacy, safety, and advantages of each laser discussed.
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Affiliation(s)
- Brandon E Cohen
- The Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, 240 East 38th Street, New York, NY 10016
| | - Jeremy A Brauer
- The Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, 240 East 38th Street, New York, NY 10016
- Laser & Skin Surgery Center of New York, 317 E 34th St, New York, NY 10016
| | - Roy G Geronemus
- The Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, 240 East 38th Street, New York, NY 10016
- Laser & Skin Surgery Center of New York, 317 E 34th St, New York, NY 10016
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Preissig J, Hamilton K, Markus R. Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface. Semin Plast Surg 2013; 26:109-16. [PMID: 23904818 DOI: 10.1055/s-0032-1329413] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Numerous laser platforms exist that rejuvenate the skin by resurfacing its upper layers. In varying degrees, these lasers improve the appearance of lentigines and rhytides, eliminate photoaging, soften scarring due to acne and other causes, and treat dyspigmentation. Five major classes of dermatologic lasers are currently in common use: ablative and nonablative lasers in both fractionated and unfractionated forms as well as radiofrequency technologies. The gentler nonablative lasers allow for quicker healing, whereas harsher ablative lasers tend to be more effective. Fractionating either laser distributes the effect, increasing the number of treatments but minimizing downtime and complications. In this review article, the authors seek to inform surgeons about the current laser platforms available, clarify the differences between them, and thereby facilitate the identification of the most appropriate laser for their practice.
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Affiliation(s)
- Jason Preissig
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
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