Continuing medical education

Analysis of facial redness by comparing VISIA and YLGTD

BACKGROUND

Erythema, characterized by redness of the skin, is a common symptom in various facial skin conditions. Recent advancements in image processing and analysis techniques have led to the development of methods for analyzing and assessing skin texture. This study aimed to investigate the correlation between the parameters of "You Look Good Today" (YLGTD) and VISIA in the detection and assessment of facial redness.

MATERIALS AND METHODS

Thirty female subjects participated in this experiment, undergoing assessments using both YLGTD and VISIA. The subjects were evaluated for facial redness, and the feature count results within the red zone were measured by VISIA. YLGTD analyzed the number and percentage of red zone pixels. The assessments were conducted between [specific dates] in [location].

RESULTS

The results demonstrated a significant positive correlation between the feature count results within the red zone measured by VISIA and the number of red zone pixels. Similarly, YLGTD exhibited a significant positive correlation with the number and percentage of red zone pixels.

CONCLUSION

In conclusion, our findings suggest a correlation between YLGTD and VISIA in the measurement of facial erythema. YLGTD can serve as a portable device for primary screening assessments, offering a convenient and reliable method to evaluate facial redness. This research contributes to the development of non-invasive techniques for assessing and monitoring facial skin conditions, providing valuable insights for dermatological diagnosis and cosmetic testing.

Quantifying skin sensitivity caused by mechanical insults: A review

BACKGROUND

Skin sensitivity (SS) is a commonly occurring response to a range of stimuli, including environmental conditions (e.g., sun exposure), chemical irritants (e.g., soaps and cosmetics), and mechanical forces (e.g., while shaving). From both industry and academia, many efforts have been taken to quantify the characteristics of SS in a standardised manner, but the study is hindered by the lack of an objective definition.

METHODS

A review of the scientific literature regarding different parameters attributed to the loss of skin integrity and linked with exhibition of SS was conducted. Articles included were screened for mechanical stimulation of the skin, with objective quantification of tissue responses using biophysical or imaging techniques. Additionally, studies where cohorts of SS and non-SS individuals were reported have been critiqued.

RESULTS

The findings identified that the structure and function of the stratum corneum and its effective barrier properties are closely associated with SS. Thus, an array of skin tissue responses has been selected for characterization of SS due to mechanical stimuli, including: transepidermal water loss, hydration, redness, temperature, and sebum index. Additionally, certain imaging tools allow quantification of the superficial skin layers, providing structural characteristics underlying SS.

CONCLUSION

This review proposes a multimodal approach for identification of SS, providing a means to characterise skin tissue responses objectively. Optical coherence tomography (OCT) has been suggested as a suitable tool for dermatological research with clinical applications. Such an approach would enhance the knowledge underlying the multifactorial nature of SS and aid the development of personalised solutions in medical and consumer devices.

Air pollution-induced tanning of human skin

BACKGROUND

Melanism is more frequent in animals living in polluted areas on urban-industrial sites. Given that an increasing number of people are exposed to elevated air pollution levels, it is possible that environmental pollutants affect melanogenesis in human skin. Epidemiological studies have shown that exposure to traffic-related air pollutants such as diesel exhaust particles (DEP) is associated with more clinical signs of hyperpigmentation. However, mechanistic evidence linking DEP exposure to pigmentation has been elusive.

OBJECTIVES

To develop an ex vivo skin model to allow for repetitive topical application of relevant ambient DEP, and to provide proof of concept in humans.

METHODS

We measured skin pigmentation, melanin and pigmentation-associated gene expression, and evaluated oxidative stress.

RESULTS

Repetitive exposure of ex vivo skin to DEP at nontoxic concentrations increased skin pigmentation. This increase was visible to the naked eye, time dependent, and associated with an increase in melanin content and the transcription of genes involved in de novo melanin synthesis. Similarly, in healthy participants (n = 76), repetitive topical application of DEP at nontoxic concentrations increased skin pigmentation. DEP-induced pigmentation was mediated by an oxidative stress response. After the application of DEP, epidermal antioxidants were depleted, lipid peroxidation and oxidative DNA damage were enhanced, and in a vehicle-controlled, double-blind clinical study DEP-induced pigmentation was prevented by the topical application of an antioxidant mixture.

CONCLUSIONS

Similar to solar radiation, air pollutants cause skin tanning. As eumelanin is an antioxidant, it is proposed that this response serves to protect human skin against air pollution-induced oxidative stress.

Reliability and agreement of instrumental skin barrier measurements in clinical pressure ulcer prevention research

In skin and wound research the instrumental measurement of skin function is established. Despite the widespread use, empirical evidence about measurement errors is widely lacking. The aim of this study was to measure reliability and agreement of skin temperature, transepidermal water loss, epidermal hydration, and erythema at the heel and sacral skin. Four experienced researchers performed skin measurements in 15 subjects. Lowest reliability was observed for transepidermal water loss at the sacral skin (ICC (1) 0.46 (95% CI 0.00‐0.78)) and highest for skin temperature at the heel skin (ICC (1) 0.99 (95% CI 0.99‐1.00)). Lowest Standard Errors of Measurement were calculated for skin temperature measurements at the heels (0.11°C) and highest for erythema measurements at the sacral skin (26.7 arbitrary units). There was a clear association between variability of estimates and reliability coefficients. Single measurements of skin temperature, stratum corneum, and epidermal hydration at the sacral and heel skin areas can be used in clinical research and practice. Means of at least two measurements should be used for estimating transepidermal water loss and erythema. Evidence is needed to inform researchers about relative and absolute measurement errors of commonly applied instruments and measurements in skin and wound research.

Comparison of mechanical, chemical and physical human models of in vivo skin damage: Randomized controlled trial

INTRODUCTION

Human in vivo models of skin damage were often used in research of cutaneous disorders. The most commonly used models were tape-stripping as mechanical, sodium lauryl sulphate-induced irritation as chemical and ultraviolet radiation as physical damage model. In regard to differences between models, they were expected to have different responses to damage and recovery, with unique skin parameters' changes over time.

OBJECTIVE

The aim was to compare skin parameters in three different skin damage models on the same anatomical location, with and without topical treatment.

METHODS

Four test sites on each forearm were randomly assigned to three skin damage models with the fourth sites on each forearm chosen as a control, undamaged site. Skin parameters were assessed using non-invasive methods.

RESULTS

Sodium lauryl sulphate irritation caused the strongest damage with delayed reaction to the irritant. Tape stripping leads to highest initial skin barrier disruption but afterwards it showed the fastest skin recovery. Ultraviolet radiation did not affect skin barrier function, but it elevated skin erythema and melanin level. Tested preparation did not lead to changes in measured parameters.

CONCLUSION

The skin of the participants had different response to three skin damage models with distinct changes of skin parameters and recovery. The trial was registered at ClinicalTrials.gov under the identifier NCT03783819.

A quantitative cross-sectional analysis of the melanin index in the skin of preterm newborns and its association with gestational age at birth

BACKGROUND

Estimation of gestational age (GA) is important to make timely decisions and provide appropriate neonatal care. Clinical maturity scales to estimate GA have used skin texture and color to assess maturity at birth facing situations of the uncertainty of pregnancy dating. The size and darkness of the areola around the nipple to grade skin characteristics are based on visual appearance. The melanin index (M-Index) is an optical skin parameter related to the melanin content in the tissue. This study is aimed to associate the M-Index of the skin with the GA.

METHODS

A cross-sectional study evaluated 80 newborns at birth. A photometer device quantified the skin pigmentation on the areolae, forearms, and soles. Paired average differences of M-Index were compared among the three body sites. The skin M-Indexes were compared between subgroups of newborns until 34 weeks or with 34 and more.

RESULTS

The skin over the areola had the highest values of M-Index compared with the forearm or sole areas (P < .001 for both). Infants with a GA between 34 and <37 weeks had higher M-Index values over the areola than the group with a GA with 24 to <34 weeks: 41.7 (8.9) and 38.3 (10.5) median (IQR), P = .005.

CONCLUSIONS

The measurable M-Index values have the potential to improve physical evaluation in assessing GA at birth.

Barrier damaging effects of n-propanol in occlusion-modified tandem repeated irritation test: Modulation by exposure factors and atopic skin disease

BACKGROUND

Recent studies provide evidence for significant and previously underestimated barrier damaging effects of repeated exposure to 60% n-propanol in healthy skin in vivo.

OBJECTIVES

To investigate further the cumulative effects of a range of n-propanol concentrations relevant at the workplace in healthy and atopic dermatitis (AD) individuals, and study the modulation of the outcomes by co-exposure and host-related factors.

METHODS

Healthy adult and AD volunteers were exposed to n-propanol concentrations from 30% to 75% in occlusion-modified tandem repeated irritation test with measurements of erythema, transepidermal water loss, capacitance, and the natural moisturizing factor (NMF) levels at baseline and after 96 hours.

RESULTS

n-Propanol exerted significant barrier damaging effects even at the lowest concentration in both groups. Exposure to all n-propanol concentrations significantly reduced the NMF levels. Preceding low-grade trauma by occlusion/water exposure reduced the skin irritation threshold in both groups. The differences in the severity of the barrier function impairment after exposure to the same concentrations under the same conditions between the AD and control groups were significant.

CONCLUSIONS

The negative effects of cumulative exposure to n-propanol in healthy and atopic skin shown in the study suggest the need for critical re-evaluation of its irritant properties in vivo.

Another Reason for Using Caffeine in Dermocosmetics: Sunscreen Adjuvant

The excessive exposure to ultraviolet (UV) radiation is the main cause of skin cancer, the most commonly diagnosed cancer in the world. In this context, the development of innovative and more effective sunscreens, with bioactive compounds like caffeine, displaying antioxidant and anticancer potential, is required. This research work assessed in vitro and in vivo the efficacy and safety of topical sunscreen formulations containing caffeine as an adjuvant of the UV filters. Sunscreens were prepared with 2.5% w/w caffeine or in the absence of this compound. In order to evaluate the safety of these formulations, stratum corneum hydration, skin barrier and colorimetry were assessed in vivo in healthy subjects before and after skin treatment with the samples. The efficacy of the sunscreens was assessed in vitro, using PMMA plates and a spectrophotometer equipped with an integrating sphere; and in vivo by the determination of the sun protection factor (SPF). None of the formulations caused erythema or impaired the skin barrier function. The in vitro functional characterization showed higher SPF values for the caffeine formulation. The in vivo studies also confirmed the higher SPF value of the formulation combining caffeine with the filters, compared to the caffeine-free sample. This improvement contributed to an increase of, approximately, 25% in the in vivo anti-UVB protection. In conclusion, caffeine was well tolerated by the skin and increased the photoprotective activity, being a new alternative adjuvant in sunscreens formulation.

Enhanced vasoconstrictor potency of the fixed combination calcipotriol plus betamethasone dipropionate in an innovative aerosol foam formulation vs. other corticosteroid psoriasis treatments

BACKGROUND

An aerosol foam formulation of fixed combination calcipotriol 50 μg/g (Cal) and betamethasone 0.5 mg/g (as dipropionate; BD) has been developed for psoriasis vulgaris treatment.

OBJECTIVE

To compare Cal/BD aerosol foam pharmacodynamic activity with Cal/BD ointment and with other topical corticosteroids of different potencies by assessing vasoconstrictor potential.

METHODS

A Phase I, single-centre, investigator-blinded, vehicle-controlled, intra-individual comparison vasoconstriction study. Healthy volunteers received a single application on selected sites of: Cal/BD aerosol foam, clobetasol propionate 0.5 mg/g cream (CP; very potent), Cal/BD ointment (potent), fluocinolone acetonide 0.25 mg/g ointment (FA; moderately potent), BD aerosol foam and aerosol foam vehicle. A seventh untreated site acted as a negative control. Skin blanching was assessed by visual (primary response criterion) and colorimetric a* and L* measurements (secondary criteria), and was analysed over time (6-32 h post-application).

RESULTS

Thirty-five healthy volunteers were included. All active treatments led to significantly greater skin blanching than control. By visual assessment, skin blanching with Cal/BD aerosol foam was significantly less compared with CP cream [mean AUC0-32 2560 vs. 3831; mean difference = -1272; 95% confidence interval (CI): -1598, -945; P < 0.001], similar to BD aerosol foam (mean AUC0-32 2560 vs. 2595; mean difference = -35; 95% CI: -362, 292; P = 0.83) and significantly greater than Cal/BD ointment (mean AUC0-32 2560 vs. 2008; mean difference = 552; 95% CI: 225, 878; P = 0.001) and FA ointment (mean AUC0-32 2560 vs. 1981; mean difference = 578; 95% CI: 251, 905; P < 0.001). Colorimetric assessments a* and L* also indicated significantly reduced skin blanching with Cal/BD aerosol foam compared with CP cream. No adverse events (AEs) were reported.

CONCLUSION

Cal/BD aerosol foam can be considered a more potent formulation than Cal/BD ointment and the moderately potent FA ointment, but less potent than the very potent corticosteroid, CP cream.

Clinical and instrumental assessment of the effects of a new product based on hydroxypropyl chitosan and potassium azeloyl diglycinate in the management of rosacea

BACKGROUND

  Rosacea is a chronic inflammatory skin disease affecting mostly facial skin. Its origin is multifactorial. Important steps in its treatment are avoidance of any triggering factor and control of skin inflammation.

AIM

  To assess the benefit of topical applications of a new product (P-3075).

PATIENTS/METHODS

  A randomized, multicenter, double-blind, placebo-controlled, parallel-group, pilot study was carried out to evaluate the efficacy and tolerability of a cream (P-3075) based on 5% potassium azeloyl diglycinate (PAD, Azeloglicina(®)) and 1% hydroxypropyl chitosan (HPCH). Forty-two patients (rosacea stages I and II) were enrolled and randomized, 28 in the P-3075 group and 14 in the placebo group. They were asked to apply the cream twice daily for 4 weeks. The main assessments were the objective quantification of erythema and skin hydration using the Mexameter(®) and Corneometer(®) devices, respectively. Clinical signs and symptoms were evaluated on a four-point scale.

RESULTS

  The P-3075 cream applied for 28 days was effective in skin protection by reducing erythema, evaluated both instrumentally and clinically. In addition, the clinical assessments of other symptoms such as flushing, stinging, and burning supported the beneficial effect of the P-3075 cream.

CONCLUSIONS

  The anti-inflammatory and moisturizing effects of potassium azeloyl diglycinate combined with the protective properties of HPCH allow the new product to be a good candidate for controlling signs and symptoms of rosacea.

Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation

OBJECTIVE

This study aims to evaluate a topical treatment based on silymarin/methylsulfonilmethane (S-MSM) to improve erythematous-telangiectactic rosacea.

METHODS

Forty-six patients affected by stage I-III rosacea entered this double-blind, placebo-controlled study. Subjects were treated for 1 month. Clinical and instrumental evaluations were done at baseline, after 10 and 20 days, and at the end of the study. Itching, stinging, erythema, and papules were investigated clinically as well as hydration and erythema instrumentally with capacitance and color measurements.

RESULTS

A statistically significant improvement was observed in many clinical and instrumental parameters investigated (P < 0.001). In particular, improvement of skin redness, papules, itching, hydration, and skin color occurred.

CONCLUSIONS

The combination of silymarin and S-MSM can be useful in managing symptoms and condition of rosacea skin, especially in the rosacea subtype 1 erythemato-telangiectatic phase. The action can be considered multicentric and multiphase because of the direct modulating action on cytokines and angiokines normally involved and up-regulated in the case of such skin condition.

Efficacy of oleuropein against UVB irradiation: preliminary evaluation

Oleuropein, a phenolic compound derived from olive leaves and oil, is known to possess several biological properties, many of which may be attributed to its antioxidant and free radical-scavenging activities. Nevertheless, up to now, the cosmetic activity of this molecule has not been extensively investigated. The aim of this work was to evaluate the cosmetic properties of oleuropein against UVB-induced erythema. To this end, an emulsion and an emulgel containing oleuropein were prepared, applied and evaluated on healthy volunteers who had undergone UVB irradiation to investigate its protective and/or lenitive activity. Protective effect was assayed by application of topical preparations before irradiation and lenitive effect was evaluated after erythema induction. Vitamin E was used as the reference compound. Our study was carried out by using noninvasive techniques to assess specific skin parameters: barrier function, skin colour and microcirculation. Results clearly showed that oleuropein formulations highlighted lenitive efficacy by reducing erythema, transepidermal water loss and blood flow of about 22%, 35% and 30% respectively. The study allowed us to point out the lenitive property of oleuropein, opening the way to further trials to deepen our specific knowledge about this natural molecule, which could be used in association with other active ingredients in cosmetics to repair UV damages.

The distribution of melanin in skin determined in vivo

BACKGROUND

There continues to be a need for objective, noninvasive methods to measure melanin concentration in vivo in human skin, independent of the confounding chromophore, haemoglobin. Existing methods are limited by a lack of specificity and inability to resolve the spatial distribution of these chromophores.

OBJECTIVES

To validate and calibrate the measurement of eumelanin in vivo using SIAscopic techniques, relating this with histologically and analytically determined eumelanin concentrations in nonsun-exposed skin from subjects of Fitzpatrick skin types I-VI.

METHODS

Observations were made in five subjects from each of the Fitzpatrick skin types I-VI using chromophore mapping by contact and noncontact SIAscopy and other noninvasive spectrophotometric means. Measurements were performed on the inner aspect of both upper arms. Subsequently two 4 mm punch biopsies were taken from the inner upper arm, one per arm after injection of local anaesthesia. One biopsy was fixed in formalin and processed for histology; specifically, sections were stained for melanin using a silver staining technique and the amount of melanin was graded microscopically. The other biopsy was subjected to an analytical assay to yield precise quantitative measures of melanin. The correlation between the different methods of melanin measurement was determined.

RESULTS

Clear, significant correlations were obtained between contact and noncontact SIAscope-derived eumelanin values and actual eumelanin tissue content (determined both histologically and analytically), across the full range of Fitzpatrick skin types. There was no correlation between SIAscope-derived eumelanin and haemoglobin values, indicating efficient separation of the two chromophores.

CONCLUSIONS

New contact and noncontact chromophore SIAscopic mapping techniques provide robust, rapid noninvasive measures of the concentration and spatial distribution of eumelanin in vivo, independent of haemoglobin, which correspond to true tissue values for this chromophore.

Acute barrier disruption by adhesive tapes is influenced by pressure, time and anatomical location: integrity and cohesion assessed by sequential tape stripping. A randomized, controlled study

BACKGROUND

Tape stripping is an established procedure in stratum corneum (SC) physiology research. Adhesive films are pressed to the surface of the skin and then removed. The superficial layers of the SC adhere to the film and are accessible for further investigations. Although this method is widely used, only scant information about standardization is known. Various protocols are used but are difficult to compare.

OBJECTIVES

The aim of the present study was to investigate the effects of the type of tape, pressure, time, anatomical site and type of applied pressure.

METHODS

Twelve healthy volunteers (age range 20-31 years) were entered in a randomized, controlled study with sequential tape stripping at the volar forearm, upper arm, cheek and back. Different methods (roller, stamp, thumb, stretched skin), total duration of applied pressure (2 s, 10 s), degrees of pressure (2 N stamp, 7 N stamp) and different tapes (D-Squame, Corneofix, Blenderm) were investigated and the impact on barrier function assessed by transepidermal water loss measurements. Furthermore, measurements of SC hydration, skin colour and skin surface pH were performed. Spectroscopic measurements and a Bradford protein assay to determine the mass of removed SC were carried out in parallel.

RESULTS

The degree of barrier disruption, irritation and SC cohesion is influenced by the character of adhesive tapes, total duration of applied pressure (2 s, 10 s; 2 N, 7 N), the kind of method for pressure application (roller, stamp, thumb, stretched skin), anatomical site and condition before stripping (occlusion vs. nonocclusion). The spectroscopic assessment and Bradford protein assay determination showed a significant correlation (P < 0.0001; r = 0.7041).

CONCLUSIONS

The present study showed significant differences between different factors on controlled barrier disruption. The results indicate the importance of defining these factors when a study is initiated and when results of different studies should be compared. Based on our data we propose using a 2 N stamp for a duration of 2 s on 15 sequential D-Squame tape strips on the volar forearm and then discarding the first and second strips. This approach allows the performance of a standardized study with a reasonable amount of resources.

Relationships between visual and tactile features and biophysical parameters in human facial skin

BACKGROUND/PURPOSE

Skin properties, such as colour, hydration and texture, can be studied on a qualitative basis by a clinical assessment or on a quantitative basis using techniques that measure biophysical properties of the skin. The aim of this study was to explore the links between facial skin features and a range of skin biophysical parameters using multivariate methods.

METHODS

A study was conducted on 256 female volunteers from Ile-de-France with apparent healthy skin, aged between 20 and 50, under controlled environmental conditions (mean+/-standard deviation: room temperature 22.9+/-0.3 degrees C; relative humidity 48.5+/-2.3%). The study included a medical questionnaire and a clinical examination of the skin performed by a dermatologist, and a biophysical evaluation of the skin properties. Seventy visual and tactile skin features were assessed on the forehead and the cheek using ordinal variables illustrated by photographic scales. Twenty-eight biophysical measurements were taken in the same areas using the following equipment: Chromameter, Evaporimeter, Corneometer, Skicon, Sebumeter, Sebutape, skin thermometer, skin pH-meter and Silflo. In order to group the variables illustrating a same unimodal phenomenon, a typology of the skin features and a typology of the biophysical parameters were carried out using a clustering method. Then, the relationships between each group of clinical features and each group of biophysical parameters were studied using a series of partial least squares (PLS) regressions.

RESULTS

From eight groups of clinical features and three groups of biophysical parameters that were identified, 12 significant PLS regression models were built. Our findings suggest that differences in chromametric measurements express not only differences in skin colour but also differences in skin surface properties, such as skin vascularity status, thickness, and existence of wrinkles, and also demonstrate that the level of sebum excretion can affect other aspects of the skin surface.

CONCLUSION

Some skin features assessed clinically do not appear to be linked to any biophysical parameter. This finding confirms that certain phenomena evaluated on the basis of visual or tactile skin features are not assessed on the basis of the biophysical properties of the skin measured by our bioengineering techniques. Indeed, visual skin features mainly appreciate the skin surface aspect, contrary to some biophysical surrogate markers known to provide information on underlying epidermal structures. Therefore, both clinical and biophysical assessments must be associated to supply a relevant and accurate approach for skin aspect characterisation.

Skin radiance: how to quantify? Validation of an optical method

BACKGROUND/PURPOSE

The aim of this study was to validate an optic device used to measure the quantity of light reflected by the skin, which depends on the brightness of the skin.

METHODS

This apparatus gives three parameters, called Complexion/diffusion (Cd), Cr (Complexion/reflection) and Complexion/specular position (Csp). Measurements were carried out on the forehead (slightly rounded surface) and the cheekbone (angular surface). To estimate the repeatability and the reproducibility of each parameter, two female subjects (one with a dull complexion and the other with a glowing complexion) and three operators participated in the study. To investigate repeatability, each operator performed 10 consecutive measurements on both zones. To investigate inter-investigator reproducibility, the operators performed the measurements alternately. To investigate day-to-day reproducibility, these measures were achieved during three visits at a 2-day interval, at D1, D3 and D5. To estimate the sensitivity and the specificity, 30 females participated in the study (15 in the dull complexion group and 15 in the glowing complexion group).

RESULTS

Cd was repeatable (variation coefficient <20%), day-to-day reproducible on both sites (generally P>0.05) but not inter-investigators reproducible (generally P<0.05). The sensitivity was 93% on the forehead and 80% on the cheekbone; the specificity was 87% on the forehead and 60% on the cheekbone. Cr was repeatable (variation coefficient <5%), day-to-day reproducible (P>0.05) and not inter-investigators reproducible (generally P<0.05). The sensitivity was 93% on the forehead and 80% on the cheekbone; the specificity was 87% on the forehead and 80% on the cheekbone. Csp was not repeatable (variation coefficient >5%) on both the studied zones and for the three investigators.

CONCLUSION

The repeatability and the day-to-day reproducibility were satisfying for the Cd and Cr parameters on both the studied sites. The sensitivity and the specificity were satisfying for both parameters on both sites, except for the specificity of the Cd parameter on the cheekbone. Therefore, this apparatus is suitable to follow-up an evolution on both the studied sites, but we recommend: (a) that the same trained investigator always performs the measurements, (b) to privilege the forehead in particular for a classification (dull or glowing).

Effect of the 585 nm flashlamp-pumped pulsed dye laser for the treatment of keloids

BACKGROUND

Due to its potential effects on skin microcirculation and collagen metabolism, the 585 nm flashlamp-pumped pulsed dye laser has been proposed for treating abnormal scars. Indeed, one of the main problems with keloidal scars is their disfiguring erythematous color.

OBJECTIVE

To assess the efficacy of the 585 nm pulsed dye laser on the appearance of keloids.

METHODS

Eleven patients with skin phototypes II-IV and keloids were treated with the 585 nm pulsed dye laser. After one to three treatment sessions, clinical assessments of the scars were performed in combination with remittance spectroscopy measurements of the redness and melanin pigmentation. A group of nine keloids covered by silicone gel sheeting served as controls. Data were compared statistically.

RESULTS

During laser treatments, a discrete decrease in redness of the scars was clinically reported. However, this improvement was not confirmed by the objective spectrophotometric data. No side effects, especially hyperpigmentation, were disclosed. The keloids redness was not improved in the control group.

CONCLUSION

The 585 nm pulsed dye laser yields only minimal effects, if any, on the erythema of keloids. Similarly silicone gel sheeting does not modify the keloids redness.