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Choi SY, Koh YG, Roh YJ, Park KY. The efficacy of enoxolone in reducing erythema and pain after laser treatment: A randomized split-face pilot study. J Cosmet Dermatol 2024; 23:2657-2662. [PMID: 38622995 DOI: 10.1111/jocd.16329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/24/2024] [Accepted: 04/08/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Enoxolone, derived from licorice, possesses potent anti-inflammatory, and antioxidant properties. However, its effectiveness in alleviating post-laser reactions has not been extensively studied. AIMS This randomized split-face pilot study aimed to evaluate the effects of enoxolone on skin following laser treatment. PATIENTS/METHODS Ten healthy subjects underwent non-ablative 1550 nm Er:Glass fractional laser treatment and then randomly applied a moisturizer without enoxolone on one side of the face and a dermo-cosmetic formular containing 2% enoxolone mixed with the same moisturizer on the other side. The erythema index (EI), clinician's erythema assessment (CEA), and pain scores were recorded at 30 min, 60 min, and 24 h posttreatment. RESULTS The group treated with enoxolone showed significantly lower EI and CEA compared to the control group at 24 h posttreatment. Additionally, pain scores were notably reduced in the enoxolone-treated group 30 min after treatment. CONCLUSIONS This study suggests that dermo-cosmetic formular containing 2% enoxolone is effective in reducing erythema and pain following laser treatment.
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Affiliation(s)
- Sun Young Choi
- Department of Dermatology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, South Korea
| | - Young Gue Koh
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Yoon Jin Roh
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
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Bin Dakhil A, Shadid A, Altalhab S. Post-inflammatory hyperpigmentation after carbon dioxide laser: review of prevention and risk factors. Dermatol Reports 2023; 15:9703. [PMID: 38205425 PMCID: PMC10777097 DOI: 10.4081/dr.2023.9703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/26/2023] [Indexed: 01/12/2024] Open
Abstract
The CO2 laser has been widely utilized in dermatology; its expanding clinical applications include the management of neoplastic lesions, benign growths, cosmetic conditions, and reactive disorders. The laser's popularity is mainly due to the high precision and short recovery time this technology provides. However, postinflammatory hyperpigmentation (PIH) has been one of the challenging adverse effects of the CO2 laser. Therefore, several modalities have been studied for the prevention of PIH following CO2 laser treatment. This review aims to analyze the incidence of PIH after CO2 laser therapy, identify its risk factors, and assess the efficacy of the examined treatment modalities in preventing PIH. Pubmed and Embase databases were searched for this study, and relative clinical trials were included in the review. Descriptive findings - including age, gender, skin type, types of intervention, and incidence of PIH - were reported. When appropriate, the incidence of PIH was compared across each possible individual factor, such as skin type, gender, and type of intervention. A total of 211 articles were identified, and 14 relevant articles were included in this review. Seventy percent of the subjects were females (n=219), and 30% were males (n=94), with a mean age of 30 years (SD=7.8). The most common skin types were type IV (59%) followed by type III (25%). In total, eight studies investigated the prevention of PIH. The incidence of PIH after CO2 laser significantly varies between studies and differs based on the type of intervention. The studies indicate that the use of Clobetasol propionate 0.05% and fusidic acid cream appeared to effectively reduce PIH, recording an incidence rate of 39% and 53.3%, respectively. The Fitzpatrick-skinphenotype did not appear to influence the risk of PIH. There is a lack of high-powered clinical studies analyzing the incidence of PIH after CO2 laser treatment and the associated risk factors. PIH occurrence may be related to inflammation resulting from thermal damage by the CO2 laser. Consequently, the use of postoperative topical medications with anti-inflammatory properties might reduce its incidence. The use of ultra-potent topical corticosteroids and topical fusidic acid appeared to reduce PIH, possibly reducing postoperative inflammation effectively. Similarly, platelet-containing plasma may be beneficial in reducing CO2 side effects, including PIH. However, more studies are needed to further establish the influence of skin type on PIH and investigate modalities to reduce PIH occurrence after CO2 laser use.
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Affiliation(s)
- Alhanouf Bin Dakhil
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh
| | - Asem Shadid
- Department of Dermatology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Saad Altalhab
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh
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Research Hotspots and Emerging Trends of Facial Rejuvenation: A Bibliometric Analysis. Aesthetic Plast Surg 2022; 47:1039-1058. [DOI: 10.1007/s00266-022-03099-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022]
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The difference in the curative effects of 5-aminolevulinic acid nano-gold photodynamic therapy and 1550 nm erbium glass fractional laser therapy in severe rosacea. APPLIED NANOSCIENCE 2022. [DOI: 10.1007/s13204-022-02642-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Seirafianpour F, Pour Mohammad A, Moradi Y, Dehghanbanadaki H, Panahi P, Goodarzi A, Mozafarpoor S. Systematic review and meta-analysis of randomized clinical trials comparing efficacy, safety, and satisfaction between ablative and non-ablative lasers in facial and hand rejuvenation/resurfacing. Lasers Med Sci 2022; 37:2111-2122. [PMID: 35107665 DOI: 10.1007/s10103-022-03516-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/27/2022] [Indexed: 01/23/2023]
Abstract
Skin aging inevitably begins from the very early days of life. The lasers used in skin rejuvenation are mainly of two types: ablative and non-ablative. This meta-analysis aimed at comparing ablative with non-ablative lasers in terms of their efficacy and safety in skin rejuvenation. Articles published by March 15, 2020 in Embase, Medline (PubMed), Scopus, Cochrane, and clinicalTrials.gov were searched. The inclusion criteria included randomized controlled clinical trials (RCTs) in English using ablative and non-ablative lasers and comparing their safety and efficiency in wrinkle improvement and photoaging therapy. Out of 1353 extracted articles, 11 were selected for qualitative synthesis and of these, 4 were quantitatively analyzed. Different modes of various lasers were implemented; the ablative lasers included Erbium: yttrium-aluminium-garnet (Er:YAG) and CO2, besides the non-ablative lasers, comprised Ytterbium/Erbium, Erbium: Glass, neodymium: yttrium-aluminum-garnet (Nd:YAG), and alexandrite. Pooled analyses on 124 participants showed insignificant differences between ablative and non-ablative lasers in the likelihood of excellent improvement with an odds ratio of 0.83 (95% CI: 0.24, 2.83). The analyses also showed good improvement with an odds ratio of 0.88 (95% CI: 0.44, 1.78), fair improvement with an odds ratio of 1.13 (95% CI: 0.56, 2.26) and side effects with an odds ratio of 0.82 (95% CI: 0.43, 1.56). The efficacy and safety of ablative laser were not higher than those of non-ablative laser in skin rejuvenation. Given the small samples of the included articles, it is recommended that further high-quality RCTs be conducted using larger samples to confirm this conclusion.
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Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Pour Mohammad
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hojat Dehghanbanadaki
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parsa Panahi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Mirza HN, Mirza FN, Khatri KA. Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients. Dermatol Ther 2020; 34:e14432. [PMID: 33084193 DOI: 10.1111/dth.14432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/20/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA-compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms "ablative laser" and "skin resurfacing" from March 2002 until July 2020. Studies included meta-analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self-resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.
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Affiliation(s)
- Humza N Mirza
- University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatima N Mirza
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Khalil A Khatri
- Skin & Laser Surgery Center of New England, Nashua, New Hampshire, USA
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Araco A. Prospective Study on Clinical Efficacy and Safety of a Single Session of Microfocused Ultrasound With Visualization for Collagen Regeneration. Aesthet Surg J 2020; 40:1124-1132. [PMID: 32324851 DOI: 10.1093/asj/sjz363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recent studies have shown that transcutaneous microfocused ultrasound with visualization is beneficial for noninvasive skin tightening, collagen regeneration, and lower face contour improvement. OBJECTIVES The primary study endpoint was the improvement of the laxity and ptosis face skin; the secondary endpoint was the improvement of wrinkles, texture, and hemoglobin content; and the third endpoint was the patient's responses to a patient satisfaction questionnaire. METHODS Patients with soft to moderate skin laxity and ptosis of the face and neck were enrolled and their sex, ethnicity, age, Fitzpatrick skin type, and smoking habit recorded. Patient assessment was made by digital macro-photographs, Vectra H2, and Antera 3D, and strict exclusion criteria were set up. RESULTS From November 2017 to November 2018, 47 women and 3 men with a mean age of 52.8 ± 7.43 years and Araco's Ptosis Scale System 2.7 ± 0.46, which fit the inclusion criteria, were enrolled in the study. All patients signed a consent form and received 1200 spot-lines (400 lines from each transducer) of microfocused ultrasound with visualization. No major side effects were reported during the study and all patients completed the follow-up after 6 months. Wrinkles, texture, Surgeon Assessment Scoring System scores, and patient satisfaction questionnaire scores improved significantly. Patients found the treatment tolerable according to the patient pain scale rate. No statistically significative differences were found among homogenous groups of smokers and nonsmokers. CONCLUSIONS The study proves that microfocused ultrasound with visualization in a single session of treatment in monotherapy is safe and effective for the treatment of face laxity and ptosis when a proper number of energy spot-lines is delivered in the correct tissue layer. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Antonino Araco
- Department of Aesthetic Medicine, University Tor Vergata of Roma, Rome, Italy
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Efficacy, safety, and guidelines of application of the fractional ablative laser erbium YAG 2940 nm and non-ablative laser erbium glass in rejuvenation, skin spots, and acne in different skin phototypes: a systematic review. Lasers Med Sci 2020; 35:1877-1888. [PMID: 32472427 DOI: 10.1007/s10103-020-03046-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Abstract
Non-ablative and ablative fractional erbium lasers are among the most frequently used resources in dermatology for facial rejuvenation and for treating dermatological disorders. This type of erbium laser can be found at wavelengths of 1540 or 1550 nm, which are classified as non-ablative erbium glass, and at 2940 nm, classified as ablative erbium YAG. Despite the reports of their clinical benefits, few scientific studies have demonstrated the efficacy and safety of these lasers in the short or long term. In order to substantiate the effects, benefits, and safety of applying the erbium glass and erbium YAG lasers, a systematic review was carried out from August to December 2019 about studies published in the last 20 years. Randomized clinical trials in humans were considered that evaluated the efficacy, safety, and benefits of applying the fractional lasers erbium glass and erbium YAG to facial rejuvenation, skin spots, and atrophic acne scars. A total of 338 articles were identified; 76 articles remained after their titles and abstracts were read, and 42 articles were selected after removing the duplicates. After the articles were read in full, 17 of these articles were included in the systematic review (453 patients). The erbium glass and erbium YAG lasers seem promising in the short term, with minimal adverse effects; however, the long-term efficacy and safety still present limitations. Consequently, future research is needed, with better methodological standardization and a follow-up with a longer evaluation period for possible permanent adverse effects to determine the standardization and safety of therapy with erbium glass and erbium YAG lasers.
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Wang H, Guo B, Hui Q, Lin F, Tao K. CO 2 lattice laser reverses skin aging caused by UVB. Aging (Albany NY) 2020; 12:7056-7065. [PMID: 32312940 PMCID: PMC7202480 DOI: 10.18632/aging.103063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/24/2020] [Indexed: 01/01/2023]
Abstract
The carbon dioxide (CO2) lattice laser has been successfully used to treat facial skin photoaging induced by UV light. In this study, we analyzed the effect of CO2 lattice laser irradiation on skin photoaging, and investigated the underlying mechanisms. Our results demonstrate that the laser promoted collagen synthesis and proliferation of primary human skin fibroblasts, inhibited cell senescence, and induced expression of superoxide dismutase (SOD) and the signaling protein SMAD3. In addition, this laser reversed cell cycle arrest and fibroblast apoptosis induced by UVB irradiation, and restored fibroblast proliferation inhibited by SMAD3 silencing. Using a rat model of photoaging, our results show that the laser increased collagen expression and dermal thickness, demonstrating that the CO2 lattice laser has a profound therapeutic effect on photoaged skin. Together, our in vitro and in vivo data show that the CO2 lattice laser can reverse the skin aging caused by UVB, and indicate that this effect is mediated through SMAD3.
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Affiliation(s)
- Hongyi Wang
- Reconstructive and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, P.R.China
| | - Bingyu Guo
- Reconstructive and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, P.R.China
| | - Qiang Hui
- Reconstructive and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, P.R.China
| | - Feng Lin
- Reconstructive and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, P.R.China
| | - Kai Tao
- Reconstructive and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, P.R.China
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Wat H, Wu DC, Chan HHL. Fractional resurfacing in the Asian patient: Current state of the art. Lasers Surg Med 2016; 49:45-59. [PMID: 27605303 DOI: 10.1002/lsm.22579] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Fractionated photothermolysis (FP) has revolutionized modern laser technology. By creating selective columns of microthermal damage, fractionated devices allows for greater treatment depths to be achieved without the prolonged downtime and risk of complications seen in traditional fully ablative laser resurfacing. Fractional resurfacing is a proven method to treat a variety of cutaneous conditions. In the Caucasian patient, a wide range of devices and treatment settings can be utilized safely and effectively. However, ethnic skin requires special consideration due to its unique pigmentary characteristics and clinical presentations. In this review article, we detail the current indications and strategies to optimize results and mitigate complications when utilizing fractional resurfacing for the Asian patient. METHODS A review of the MEDLINE English literature was conducted on fractionated laser devices studied in the Asian population. Articles included describe non-ablative devices including fractionated erbium glass, thulium fiber, diode, and radiofrequency devices; and ablative devices including fractionated carbon dioxide (CO2 ) laser, erbium yttrium aluminum garnet and yttrium scandium gallium garnet (YSGG) laser. These data were integrated with the expert opinion of the authors. CONCLUSION Taking into account the unique characteristics and cosmetic concerns of the Asian population, fractional resurfacing can be considered a safe and effective option for the treatment of atrophic and hypertrophic scarring, and photorejuvenation in ethnic skin types. Select cases of melasma may be treated with fractionated non-ablative devices, but utilized with caution. The predominant complication associated with fractional resurfacing for these conditions is post-inflammatory hyperpigmentation (PIH) and rebound worsening of melasma. A greater number of treatments at lower density settings and wider treatment intervals typically produce the lowest risks of PIH without compromising treatment efficacy. Lasers Surg. Med. 49:45-59, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Heidi Wat
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada, T6G 2G3
| | - Douglas C Wu
- Goldman, Butterwick, Groff, Fabi, and Wu Cosmetic Laser Dermatology, San Diego, California, 92121
| | - Henry Hin Lee Chan
- Division of Dermatology, Department of Medicine, University of Hong Kong, Hong Kong, SAR, China.,Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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