Use of 532-nm Q-switched Nd:YAG laser for smoker's gingival hyperpigmentation

Acute exposure of 532 nm laser differentially regulates skin tissue transcription factors

High energy laser, particularly 532 nm, is widely used in defense and medical applications and there is need to address its occupational safety. Thermal and non-thermal effects of 532 nm high energy laser on skin are cause of concern. This study indicates impact of 532 nm laser on rat skin and first of its kind of attempt to understand transcriptional activation of genes as an early response following laser exposure. Skin of experimental rats were exposed to 532 nm radiance at 0.1, 0.25 and 0.50 W/cm2 for 10 sec. Thermographic changes of skin exposed to 532 nm laser exhibited increased Tmax temperature in radiance dependent manner. After thermal imaging, skin of experimental rats was collected 1 h post laser exposure for studying differential gene expression. The skin exposed to lower power density (0.1 W/cm2) did not show significant changes in expression of gene pathways studied. At moderate radiance (0.25 W/cm2), predominantly canonical wnt/B-catenin pathway genes notch1, axin2, ccdn1, wnt5a and redox homeostasis genes; txn1, nqo1 and txnrd1 were expressed. At higher radiance (0.5 W/cm2), significant repression of genes related to wound healing process particularly notch/wnt pathway viz. hes5, wnt1, wn3b with higher expression of dab2 was recorded. The data obtained from these studies would help in drawing safety limits for skin exposure to 532 nm laser. Further, genes expressed at moderate and high level of radiance exposure to skin were distinct and differential and provide new avenue to configure pathway to counteract laser induced delay in tissue injury and hair follicular damage.

Dose-dependent study of effects of 532-nm continuous wave laser on rat skin: A mechanistic insight

Visible lasers emitting in the green spectral region are being routinely employed in various medical and defense fields namely treatment of pigmented lesions, tattoo inks, port wine stains, dazzling the target or mob dispersal. Despite their increasing applications, lasers also tend to pose occupational hazards to operators, ancillary personnel, individuals undergoing laser therapies. This study was aimed at investigating the effects of different doses of 532-nm continuous wave laser on rat skin. The present study demonstrated that higher fluences of 532-nm continuous wave (CW) laser induces significant tissue damage through induction of tumor necrosis factor-α, cyclooxygenase-2, tumor protein (p53), PARP 1, caspase3 which in turn leads to tissue damage and cell death. Furthermore, level of heat shock proteins, pAkt were found up-regulated as a cope up response to laser-induced stress. On the basis of the findings, irradiation with 532-nm CW laser up to 2.5 J/cm² was found within the safe exposure limits. Thus, it is probably the first attempt to demonstrate the tissue damage induced by 532-nm CW laser on skin, which may help in choosing safe laser dose for certain skin-based applications and evolving methods to ameliorate laser-inflicted injuries.

A novel 1565 nm non-ablative fractional device for stretch marks: A preliminary report

BACKGROUND

Striae Distensae (SD) is a very common dermatologic condition. We evaluated the effectiveness and safety of a novel non-ablative fractional 1565 nm laser (ResurFX) on the appearance of SD.

MATERIALS AND METHODS

Twelve Caucasian subjects with various stages of SD received three non-ablative laser treatments. Each treatment consisted of two different laser settings, in order to achieve a demarcated dense impact together with a diffused deep impact. Three months after the last treatment, SD improvement was assessed by blinded and non-blinded reviewers using clinical images and 3D image analyses.

RESULTS

Good clinical improvement (between 51% and 75%) was observed in all patients. Most patients showed improvement of > 50% in the volume of depressions and in lesion color (91.7% and 83.3% of patients, respectively). The average pain during treatment was generally defined as tolerable and the average downtime was 4 days. Transient erythema and severe edema were noted immediately after the procedure, but long-lasting or severe adverse effects were not observed. All patients noted a good improvement and were satisfied with the treatment and the results.

CONCLUSIONS

The treatment with the 1565 nm ResurFX laser resulted in improved pigmentation, volume, and textural appearance of SD.

Systematic review of treatment modalities for gingival depigmentation: a random-effects poisson regression analysis

OBJECTIVE

Repigmentation variably occurs with different treatment methods in patients with gingival pigmentation. A systemic review was conducted of various treatment modalities for eliminating melanin pigmentation of the gingiva, comprising bur abrasion, scalpel surgery, cryosurgery, electrosurgery, gingival grafts, and laser techniques, to compare the recurrence rates (Rrs) of these treatment procedures.

MATERIAL AND METHODS

Electronic databases, including PubMed, Web of Science, Google, and Medline were comprehensively searched, and manual searches were conducted for studies published from January 1951 to June 2013. After applying inclusion and exclusion criteria, the final list of articles was reviewed in depth to achieve the objectives of this review. A Poisson regression was used to analyze the outcome of depigmentation using the various treatment methods.

RESULTS

The systematic review was based on case reports mainly. In total, 61 eligible publications met the defined criteria. The various therapeutic procedures showed variable clinical results with a wide range of Rrs. A random-effects Poisson regression showed that cryosurgery (Rr = 0.32%), electrosurgery (Rr = 0.74%), and laser depigmentation (Rr = 1.16%) yielded superior result, whereas bur abrasion yielded the highest Rr (8.89%).

CONCLUSIONS

Within the limit of the sampling level, the present evidence-based results show that cryosurgery exhibits the optimal predictability for depigmentation of the gingiva among all procedures examined, followed by electrosurgery and laser techniques.

CLINICAL SIGNIFICANCE

It is possible to treat melanin pigmentation of the gingiva with various methods and prevent repigmentation. Among those treatment modalities, cryosurgery, electrosurgery, and laser surgery appear to be the best choices for treating gingival pigmentation.

An assessment of the occupational hazards related to medical lasers

OBJECTIVE

Occupational hazards associated with medical laser applications remain poorly understood and uncharacterized.

METHODS

A literature search was performed using PubMed, and all articles relevant to beam and nonbeam medical laser hazards were reviewed. The Rockwell Laser Industries Laser Accident Database was searched for medical laser injuries and abstracted.

RESULTS

Eye injuries, skin burns, injuries related to the onset of fires, and electric shock have been reported in relation to medical laser use. It is probable that both acute and chronic health effects have been experienced by medical personnel as the result of exposure to laser generated air contaminants.

CONCLUSIONS

Because of the clinical benefits they provide, the growth of laser technologies and applications are anticipated to result in an increase in the number and type of medical personnel with future exposure to laser hazards.