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Tao J, Hashemi DA, Bajaj S, Wang JV, Geronemus RG. 755-nm Picosecond Laser With Diffractive Lens Array for Acne Scars in Fitzpatrick Skin Types V and VI. Dermatol Surg 2024:00042728-990000000-00949. [PMID: 39250814 DOI: 10.1097/dss.0000000000004398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
BACKGROUND Patients commonly complain about the appearance of acne scars. While various lasers and energy-based devices can offer clinical improvement, many of them are limited in treating patients with skin of color. Concerns exist regarding efficacy and safety, including risks of scarring, prolonged dyspigmentation, necrosis, and burns. OBJECTIVE To examine the utility of a 755-nm picosecond laser with fractionated lens array in improving the clinical appearance of acne scars in patients with Fitzpatrick skin types V and VI. MATERIALS AND METHODS A prospective clinical study investigated this laser using up to 5 monthly treatments. RESULTS Twenty-four subjects were enrolled, while 17 subjects completed a 3-month follow-up. The mean age was 33.9 years, and 95.8% of the subjects were women. Fitzpatrick skin types V and VI were represented. Assessments compared baseline to 3-month follow-up. Two of the 3 blinded reviewers agreed on identifying pretreatment and post-treatment photographs for 82.4% of the cases. For physician Global Aesthetic Improvement Scale, 100% of the subjects had clinical improvement. Overall, 94.1% of subjects were satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION A 755-nm picosecond laser with fractionated lens array can safely and effectively improve acne scars in patients with Fitzpatrick skin types V and VI.
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Affiliation(s)
- Joy Tao
- All authors are affiliated with the Laser & Skin Surgery Center of New York, New York, New York
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2
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Tao J, Hashemi DA, Bajaj S, Wang JV, Geronemus RG. Paired Treatment Using Radiofrequency Microneedling and 755-nm Picosecond Laser With Fractionated Lens Array for Facial Rejuvenation. Dermatol Surg 2024:00042728-990000000-00858. [PMID: 38924506 DOI: 10.1097/dss.0000000000004302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
BACKGROUND Patients frequently complain about fine lines, wrinkles, dyschromia, and photoaging, for which lasers and energy-based devices can treat each of these. Pairing various devices in a single treatment session can be safe and effective, but different technologies, mechanisms, histologies, parameters, and techniques must be considered. OBJECTIVE To examine the utility of a paired treatment regimen using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array to improve the clinical appearance of facial wrinkles and photoaging. MATERIALS AND METHODS A prospective clinical study investigated this paired treatment regimen using 4 monthly sessions. RESULTS Twenty-five subjects were enrolled, while 18 subjects completed 3-month follow-up. The mean age was 54 years, and 92% were women. Fitzpatrick Skin Types I to IV were represented. Assessments compared baseline with the 3-month follow-up. Two of 3 blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 94.4% of cases. For physician Global Aesthetic Improvement Scale, 100% of subjects had clinical improvement. Overall, 88.9% of subjects were considered to be satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION Paired treatment using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array can safely and effectively improve facial wrinkles and photoaging.
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Affiliation(s)
- Joy Tao
- All authors are affiliated with the Laser & Skin Surgery Center of New York, New York, New York
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3
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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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Harnchoowong S, Vachiramon V, Jurairattanaporn N. Cosmetic Considerations in Dark-Skinned Patients. Clin Cosmet Investig Dermatol 2024; 17:259-277. [PMID: 38321987 PMCID: PMC10844008 DOI: 10.2147/ccid.s450081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024]
Abstract
For dermatologists, diversities of human races result in an opportunity to encounter patients with various skin types. Cosmetic procedures have gained more popularity and become more accessible over the past decades. Thus, the selection of appropriate treatment protocol for each patient becomes inevitable. This review will focus on basic knowledge and key points in performing safe cosmetic-related procedures in patients with dark-complexioned skin. In terms of structure and function of the skin, people of color have equal epidermal thickness, corneocyte size and melanocyte number. However, they have more stratum corneum compaction, melanosome dispersion and melanocyte activity than fair skin individuals. Data regarding drug penetration and cutaneous irritation showed conflicting results. Superficial chemical peels and microdermabrasion can be done safely in dark-skinned patients. Medium-depth peel should be used with extreme caution. While deep-depth peel should be avoided at all times due to pigmentary and textural complications. Prolonged treatment interval, use of priming agents and sun protection are recommended. Injectable materials including botulinum toxin and soft tissue augmentation by hyaluronic acid filler can be done harmlessly in dark-skinned patients. Lasers and energy-based devices should be done with caution. Higher melanin dispersion and melanocyte activity acts as competitive chromophore. Pigmentary or textural changes can occur after aggressive treatment protocol. High energy setting, pulse stacking, short wavelength lasers and short treatment interval should be avoided in dark-skinned patients.
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Affiliation(s)
- Sarawin Harnchoowong
- Department of Dermatology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Vasanop Vachiramon
- Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Natthachat Jurairattanaporn
- Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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5
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Nunez JH, Strong AL, Comish P, Hespe GE, Harvey J, Sorkin M, Levi B. A Review of Laser Therapies for the Treatment of Scarring and Vascular Anomalies. Adv Wound Care (New Rochelle) 2023; 12:68-84. [PMID: 35951024 DOI: 10.1089/wound.2021.0045] [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] [Indexed: 01/15/2023] Open
Abstract
Significance: Laser use has become part of the gold standard of treatment as an effective adjuvant in multimodal therapy for pathologic scarring caused by burns, trauma, acne, and surgery, as well as vascular anomalies. Understanding indications and applications for laser therapy is essential for physicians to improve patient outcomes. Recent Advances: Since the 1980s, the medical use of lasers has continuously evolved with improvements in technology. Novel lasers and fractionated technologies are currently being studied in the hopes to improve treatment efficacy, while reducing complications. Recent advancements include acne treatment with novel picosecond lasers, new hypertrophic scar therapies with simultaneous laser and intense pulsed light use, and novel systems such as lasers with intralesional optical fiber delivery devices. In addition, optimizing the timing of laser therapy and its use in multimodal treatments continue to advance the field of photothermolysis. Critical Issues: Selecting the correct laser for a given indication is the fundamental decision when choosing a laser balancing effective treatment with minimal complications. This article covers the principles of laser therapy, the preferred lasers used for the treatment of scarring and vascular anomalies, and discusses the current evidence behind these laser choices. Future Directions: To optimize laser therapy, larger randomized control trials and split scar studies are needed. Continued advancement through better randomized controlled studies will help to improve patient outcomes on a broader scale.
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Affiliation(s)
- Johanna H Nunez
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amy L Strong
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Comish
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Geoffrey E Hespe
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jalen Harvey
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Sorkin
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Benjamin Levi
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Lee DW, Ryu H, Choi HJ, Park ES. Improvement in linear depressed atrophic scar using 755-nm picosecond alexandrite laser vs. ablative fractional carbon dioxide laser. J COSMET LASER THER 2022; 24:48-55. [PMID: 35864581 DOI: 10.1080/14764172.2022.2100915] [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: 10/17/2022]
Abstract
ABBREVIATIONS AFL = ablative fractional laser, CO2= carbon dioxide, LiOB = laser-induced optical breakdown, PIH = postinflammatory hyperpigmentation, mVSS = Modified Vancouver scar scale.
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Affiliation(s)
- Da Woon Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hyeongrae Ryu
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hwan Jun Choi
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Eun Soo Park
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Bucheon, Korea
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7
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Chen SX, Cheng J, Watchmaker J, Dover JS, Chung HJ. Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations. Dermatol Surg 2022; 48:441-448. [PMID: 35165220 DOI: 10.1097/dss.0000000000003397] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lasers and energy-based devices (EBD) are popular treatments for skin rejuvenation and resurfacing. Achieving desired outcomes and avoiding complications require understanding the effects of these devices at a histologic level. Currently, no comprehensive review summarizing the histologic effects of laser and energy-based treatments exists. OBJECTIVE To describe how lasers and EBD alter skin histology and improve the overall understanding of these devices. MATERIALS AND METHODS A PubMed search was conducted for studies with histologic analysis of fractional picosecond laser, fractional radiofrequency microneedling, nonablative lasers, and ablative lasers. RESULTS Fractional picosecond lasers induce intraepidermal and/or dermal vacuoles from laser-induced optical breakdown. Fractional radiofrequency microneedling delivers thermal energy to the dermis while sparing the epidermis, making it safer for patients with darker skin phototypes. Fractional nonablative lasers induce conical zones of coagulation of the epidermis and upper dermis. Ablative lasers vaporize the stratum corneum down to the dermis. Traditional ablative lasers cause diffuse vaporization while fractional ablative lasers generate columns of tissue ablation. CONCLUSION Lasers and EBD are effective for skin resurfacing and rejuvenation and have different mechanisms with disparate targets in the skin. Safe and effective use of devices requires understanding the histologic laser-tissue interaction.
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Affiliation(s)
- Stella X Chen
- Harvard Combined Dermatology Residency Program, Boston, Massachusetts
| | - Judy Cheng
- Department of Dermatology, Northwestern Medical Group, Chicago, Illinois
| | | | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Hye Jin Chung
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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8
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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.
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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
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9
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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.
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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
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10
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Ren R, Bao S, Qian W, Zhao H. 755-nm Alexandrite Picosecond Laser with a Diffractive Lens Array or Zoom Handpiece for Post-Inflammatory Hyperpigmentation: Two Case Reports with a Three-Year Follow-Up. Clin Cosmet Investig Dermatol 2021; 14:1459-1464. [PMID: 34675582 PMCID: PMC8520414 DOI: 10.2147/ccid.s323872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022]
Abstract
Objective Post-inflammatory hyperpigmentation (PIH) is a reactive hypermelanosis of various skin types, which occurs as a sequela of cutaneous inflammation or injury. Despite generally a self-limited and temporary condition, PIH is still a frustrating problem that can have significant psychosocial effects on patients, especially those with darker skin types. Laser therapy is one of the effective treatments for PIH, and various wavelength lasers and light devices have been utilized in PIH therapy. Nonetheless, data on the long-term efficacy of the 755-nm alexandrite picosecond laser are limited. Methods This study analyzed two cases of PIH treated with a combination of a 755-nm alexandrite picosecond laser and a diffractive lens array or zoom handpiece. Efficacy of the treatment was determined by the images of skin lesions under a fixed light source before and after each treatment, which were independently reviewed by two plastic-surgery specialists blinded to the clinical data. Improvement was classified as complete (>75%), significant (50–75%), mild (25–50%), and inefficient (<25% or no obvious change). Skin imaging analysis was carried out using the VISIA system (Canfield, USA), and dermoscopy was performed at the same time. Results After two to three courses of treatment, all cases showed significant or complete improvement, and no recurrence was observed during the three years of follow-up. Conclusion A 755-nm alexandrite picosecond laser in combination with a diffractive lens array or zoom handpiece had significant and long-term efficacy for the treatment of PIH caused by trauma. However, attention should be paid to the problem of transient deepening of pigmentation during treatment.
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Affiliation(s)
- Rongxin Ren
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Shiwei Bao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wenjiang Qian
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hongyi Zhao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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11
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Kaewkes A, Manuskiatti W, Cembrano KA, Wanitphakdeedecha R. Treatment of abdominal striae distensae in Fitzpatrick skin types IV to V using a 1064-nm picosecond laser with a fractionated microlens array. Lasers Surg Med 2021; 54:129-137. [PMID: 34420222 DOI: 10.1002/lsm.23471] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/21/2021] [Accepted: 08/08/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Striae distensae are atrophic dermal scars that can cause psychosocial distress among affected patients. Despite numerous available therapeutic modalities, no gold standard treatment has been established. OBJECTIVE To evaluate the long-term efficacy and safety of a fractional 1064-nm picosecond laser for the treatment of striae alba in individuals with dark skin types. MATERIALS AND METHODS Twenty volunteers with Fitzpatrick skin types IV-V who presented with striae alba were enrolled. Subjects were treated with a fractional 1064-nm picosecond laser for four sessions at 4-week intervals. The skin texture, average melanin index (MI), and melanin variation score were assessed using Antera 3D® before treatment, at 1 month after the second treatment, and at 1, 3, and 6 months after the last treatment. Two independent investigators evaluated clinical improvement by comparing pretreatment and posttreatment photographs. The patient satisfaction rates were likewise assessed. Adverse effects were recorded during the entire study period. RESULTS Significant improvement of skin texture was seen at 1 month after the final treatment (p < 0.001) and continuously improved until the 6-month follow-up visit (p = 0.003). The average MI significantly increased at 1 month after the final treatment (p < 0.001), whereas the melanin variation score decreased throughout the follow-up period. Investigator assessment at the 6-month follow-up revealed that 90% of subjects had moderate to marked improvement of striae appearance. Only two of 20 subjects (10%) developed transient postinflammatory hyperpigmentation (PIH) after laser treatment. CONCLUSION Fractional picosecond 1064-nm laser is effective and well-tolerated for the treatment of striae alba in dark-skinned individuals with a low incidence of PIH.
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Affiliation(s)
- Arisa Kaewkes
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kathryn Anne Cembrano
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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12
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Ren R, Zhao H. A case report on the use of 755-nm alexandrite picosecond laser in the treatment of post-inflammatory hyperpigmentation in the nose. J Cosmet Dermatol 2021; 21:2046-2048. [PMID: 34224638 DOI: 10.1111/jocd.14332] [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: 05/09/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
Post-inflammatory hyperpigmentation (PIH), a common sequela of acute or chronic cutaneous inflammation, is an acquired pigmentary disorder. The main treatments for PIH, such as topical agents, photoprotection, and chemical peeling, demonstrated different efficacies with inconsistent outcomes. Here, we reported a case of nasal PIH treated using a 755-nm alexandrite picosecond laser. The patient (female, aged 36 years) presented with a brown macula on the left side of the nasal dorsum 2 years ago, received treatment, and was followed up in the Plastic Surgery Department of Beijing hospital.
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Affiliation(s)
- Rongxin Ren
- The Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongyi Zhao
- The Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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13
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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.
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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
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14
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Hu S, Lin MY, Lin CS, Chung WH. Comparison of 1550-nm nonablative fractional laser versus 755-nm picosecond laser with diffractive lens array for atrophic facial acne scars in asian skin: A prospective randomized split-face clinical study. DERMATOL SIN 2021. [DOI: 10.4103/ds.ds_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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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.
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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
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16
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Manuskiatti W, Yan C, Tantrapornpong P, Cembrano KAG, Techapichetvanich T, Wanitphakdeedecha R. A Prospective, Split-Face, Randomized Study Comparing a 755-nm Picosecond Laser With and Without Diffractive Lens Array in the Treatment of Melasma in Asians. Lasers Surg Med 2020; 53:95-103. [PMID: 32865858 DOI: 10.1002/lsm.23312] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Treatment of melasma with lasers remains a challenge due to its limited clinical efficacy in addition to high rates of recurrence and side effects. Recently, picosecond lasers have shown favorable results in treatment of benign pigmented lesions. To compare the efficacy and safety of using a 755-nm picosecond laser for the treatment of melasma in a split-face manner, having one side treated with a fractionated beam (diffractive lens array [DLA] coupling) and with a full-beam (flat optics) on the other side. STUDY DESIGN/MATERIALS AND METHODS Eighteen subjects presenting with mixed-type melasma were enrolled. Each patient was randomly treated with a 755-nm picosecond laser coupled with DLA on one side of the face and without DLA (flat optics) on the other side. The laser was delivered through an 8-mm spot size with an average fluence of 0.4 J/cm2 at 2.5 Hz for a total of two passes without pulse overlapping. All subjects received five monthly treatments. Subjective (clinical evaluation) and objective (color readings) assessments on the degree of pigment clearance and adverse effects were obtained at 1-, 3-, and 6-month after the final treatment. RESULTS At 6 months after the last treatment, physician-rating scores were 1.50 ± 0.76 and 1.50 ± 0.65 of the DLA and flat-optics sides, respectively. Pigment clearance significantly improved from 1 to 6 months after the treatment on each side (P = 0.019 on DLA and P = 0.023 on flat-optics sides). No statistically significant differences in physician-rating scores between the two treatment techniques were observed at all follow-up visits. Objective assessments of melasma clearance corresponded to the clinical evaluation. However, the full-beam (flat optics) provided lower incidence of pos-tinflammatory hyperpigmentation than the fractioned one. CONCLUSIONS A 755-nm picosecond laser is safe and effective for the treatment of melasma in dark-skinned individuals. The use of DLA does not provide additional benefit over the flat optics in clearing pigmentation. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ploypailin Tantrapornpong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kathryn Anne G Cembrano
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanya Techapichetvanich
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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17
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Kwon HH, Yang SH, Cho YJ, Shin E, Choi M, Bae Y, Jung JY, Park GH. Comparison of a 1064-nm neodymium-doped yttrium aluminum garnet picosecond laser using a diffractive optical element vs. a nonablative 1550-nm erbium-glass laser for the treatment of facial acne scarring in Asian patients: a 17-week prospective, randomized, split-face, controlled trial. J Eur Acad Dermatol Venereol 2020; 34:2907-2913. [PMID: 32603006 DOI: 10.1111/jdv.16643] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Novel picosecond lasers using a diffractive optical element (P-DOE) have been available for skin resurfacing with distinct mechanisms. However, there are limited data directly comparing P-DOE and conventional fractional lasers for the treatment of atrophic acne scarring. OBJECTIVES We sought to compare the efficacy and safety of a 1064-nm neodymium-doped yttrium aluminium garnet P-DOE and a non-ablative fractional laser (NAFL) in the treatment of acne scarring. METHODS A prospective, randomized, split-face, controlled trial was performed. One randomly assigned half-side of each patient's face (n = 25) was treated with four consecutive sessions of P-DOE at 3-week intervals and the other side with NAFL, with subsequent follow-up for 8 weeks after the final sessions. The efficacy and safety of the two lasers were determined by the Echelle d'Evaluation Clinique des Cicatrices d'acné (Scale of Clinical Evaluation of Acne Scars; ECCA) grading scale, Investigator's Global Assessment (IGA) score and patients' reports at the final visit. Histologic analysis was also performed. RESULTS The P-DOE-treated side achieved a significantly better improvement in acne appearance (ECCA per cent reduction: 55% vs. 42%) with less severe pain (4.3 vs. 5.6) (P < 0.05). The IGA score and subjective satisfaction were consistent with ECCA score results. Occurrences of treatment-related side-effects were also lower in the group treated with P-DOE (P < 0.05). Histologic analysis revealed elongation and increased density of neocollagen fibres, elastic fibres and mucin throughout the dermis from both sides. CONCLUSIONS Compared with NAFL, P-DOE afforded better clinical outcomes and fewer side-effects in the treatment of acne scarring in Asian patients.
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Affiliation(s)
- H H Kwon
- Oaro Dermatology Clinic, Seoul, Korea
| | - S H Yang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y J Cho
- Oaro Dermatology Clinic, Seoul, Korea
| | - E Shin
- Department of Pathology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - M Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, 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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18
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Wu DC, Goldman MP, Wat H, Chan HHL. A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med 2020; 53:9-49. [PMID: 32282094 DOI: 10.1002/lsm.23244] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence-based recommendations are developed for the use of picosecond laser in dermatology. STUDY DESIGN/MATERIALS AND METHODS A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors' combined clinical experience, clinical recommendations were developed. RESULTS After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I-IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II-III evidence; tattoo removal was associated with level I evidence. CONCLUSION Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas C Wu
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Heidi Wat
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
| | - Henry H L Chan
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
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19
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Choi ME, Paik SH, Lee WJ, Won CH, Lee MW, Choi JH, Chang SE. Treatment of acne scars with a fractional 1064-nm Nd:YAG picosecond laser and histopathologic findings. Dermatol Ther 2020; 33:e13297. [PMID: 32144858 DOI: 10.1111/dth.13297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/10/2020] [Accepted: 03/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Seung Hwan Paik
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Woo Jin Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Chong Hyun Won
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Mi Woo Lee
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jee Ho Choi
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sung Eun Chang
- Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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20
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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.
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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
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21
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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.
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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
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22
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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.
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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
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23
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Wang Y, Lin E, Chen Y, Chiu P, Lin B, Chiang H, Huang Y, Wang K, Lin H, Chang T, Chang C. Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma. J Eur Acad Dermatol Venereol 2019; 34:624-632. [PMID: 31494973 DOI: 10.1111/jdv.15934] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/12/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Y.‐J. Wang
- Department of Dermatology MacKay Memorial Hospital Taipei Taiwan
| | - E.‐T. Lin
- School of Medicine College of Medicine China Medical University Taichung Taiwan
| | - Y.‐T. Chen
- Department of Dermatology Shuang Ho Hospital Taipei Medical University Taipei Taiwan
- School of Public Health College of Public Health and Nutrition Taipei Medical University Taipei Taiwan
| | - P.‐C. Chiu
- Aletheia Holistic Dermatology Center Taichung Taiwan
| | - B.‐S. Lin
- Institute of Imaging and Biomedical Photonics National Chiao Tung University Tainan Taiwan
| | - H.‐M. Chiang
- Department of Cosmeceutics and Graduate Institute of Cosmeceutics China Medical University Hospital Taichung Taiwan
| | - Y.‐H. Huang
- Yung‐Hsueh Huang Dermatology Clinic Changhua Taiwan
| | - K.‐Y. Wang
- Department of Cosmeceutics and Graduate Institute of Cosmeceutics China Medical University Hospital Taichung Taiwan
| | - H.‐Y. Lin
- Department of Applied Cosmetology & Master's Program of Cosmetic Science Hung Kuang University Taichung Taiwan
| | - T.‐M. Chang
- Department of Applied Cosmetology & Master's Program of Cosmetic Science Hung Kuang University Taichung Taiwan
| | - C.‐C. Chang
- School of Medicine College of Medicine China Medical University Taichung Taiwan
- Institute of Imaging and Biomedical Photonics National Chiao Tung University Tainan Taiwan
- Department of Cosmeceutics and Graduate Institute of Cosmeceutics China Medical University Hospital Taichung Taiwan
- Aesthetic Medical Center China Medical University Hospital Taichung Taiwan
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24
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Abstract
Over the past 30 years, the treatment of acne scars has undergone changes that have been significantly influenced by the concurrent development of new devices. The advent of fractional resurfacing lasers was a watershed moment for acne scarring therapy. The author recounts a career history of considerations of acne scarring treatments as well as the literature supporting the experiences causing changes in practice. Fractional ablative and nonablative lasers, sublative radiofrequency, picosecond lasers, microneedling with and without radiofrequency and fillers are the bulk of the treatments covered, along with a discussion of combination therapy. A practical algorithm for acne scarring for selection of treatment modalities is presented.
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Affiliation(s)
- Amy Forman Taub
- Advanced Dermatology, Lincolnshire and Glencoe, IL, USA.
- Northwestern University Medical School, Chicago, USA.
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25
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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
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26
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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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