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Shimojo Y, Nishimura T, Tsuruta D, Ozawa T, Kono T. In Silico Evaluation of Nanosecond Laser Treatment of Pigmented Lesions Based on Skin Optical Properties Using a Model of Melanosome Disruption Threshold Fluence. Lasers Surg Med 2024. [PMID: 39344140 DOI: 10.1002/lsm.23848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/19/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVES This study aimed to evaluate the efficacy and safety of nanosecond laser treatment of pigmented lesions in silico using a model of melanosome disruption threshold fluence (MDTF) based on skin optical properties. METHODS Particle size analysis and scanning electron microscopy were performed to determine the threshold fluence for melanosome disruption using a nanosecond laser. By inputting the obtained threshold fluence into the MDTF model and considering the variability in skin optical properties, irradiation parameters were calculated and compared with the results from clinical studies. RESULTS The threshold fluences for 532 and 755 nm nanosecond laser irradiation were determined to be 3.0 and 15.0 J/cm2, respectively. In silico analysis showed that the incident fluence for moderately pigmented skin should be 1.2 times that for lightly pigmented skin, whereas it should be 50% lower than that for lightly pigmented skin to achieve the same level of energy deposition. Clinically applied fluences for moderately pigmented skin are at the low end of the calculated range of values, suggesting that the clinical fluence is chosen to minimize energy deposition in normal tissues. CONCLUSIONS Our results showed that the MDTF model can be used to evaluate nanosecond laser treatments and provide clinical guidance on fluence settings based on laser-tissue interactions in moderately pigmented skin. The in silico method can, therefore, provide a robust and quantitative retrospective evaluation of the treatment effects that accounts for variation in irradiation parameters among patients by combining the MDTF model with the in vivo optical properties of individual skin types.
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Affiliation(s)
- Yu Shimojo
- Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Graduate School of Engineering, Osaka University, Osaka, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | | | - Daisuke Tsuruta
- Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Toshiyuki Ozawa
- Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Taro Kono
- Department of Plastic Surgery, School of Medicine, Tokai University, Kanagawa, Japan
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Lee SY, Kim KR, Kim S, Han HS, Hong JY, Seok J, Park KY. Refractory solar lentigines successfully treated with 532-nm nanosecond Nd:YAG Vasculature Salvage Laser Surgery (VSLS) system: Case series. Skin Res Technol 2024; 30:e70055. [PMID: 39300791 PMCID: PMC11413330 DOI: 10.1111/srt.70055] [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: 07/21/2024] [Revised: 08/26/2024] [Accepted: 08/28/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Solar lentigo, a common epidermal hyperpigmented lesion found in sun-exposed areas, results from the proliferation of melanocytes and the accumulation of melanin. Although various treatments for solar lentigo have been explored, they often lead to complications, including prolonged erythema and post-inflammatory hyperpigmentation (PIH), posing significant concerns. OBJECTIVES AND METHODS This study evaluated the safety and efficacy of the Vasculature Salvage Laser Surgery (VSLS) system. We treated six Korean patients, each with solar lentigo, in a single session using the 532-nm nanosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) VSLS system, with follow-up periods ranging from 3 to 10 weeks. RESULTS The treatment led to the complete removal of pigmented lesions in all patients without resulting in PIH, even in cases where previous laser treatments had failed. The only side effect observed was mild erythema, which resolved over the long term in most instances. CONCLUSIONS The VSLS system emerges as a safe and effective treatment for pigmented lesions, including refractory solar lentigines. Nonetheless, additional studies are required to verify its long-term efficacy.
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Affiliation(s)
- So Young Lee
- Department of DermatologyCollege of MedicineChung‐Ang UniversitySeoulRepublic of Korea
| | - Ka Ram Kim
- Department of DermatologyCollege of MedicineChung‐Ang UniversitySeoulRepublic of Korea
| | - Seunghyeon Kim
- Department of DermatologyCollege of MedicineChung‐Ang UniversitySeoulRepublic of Korea
| | - Hye Sung Han
- Department of DermatologyChung‐Ang University Gwangmyeong HospitalChung‐Ang University College of MedicineGwangmyeong‐siRepublic of Korea
| | - Ji Yeon Hong
- Department of DermatologyCollege of MedicineChung‐Ang UniversitySeoulRepublic of Korea
| | - Joon Seok
- Department of DermatologyCollege of MedicineChung‐Ang UniversitySeoulRepublic of Korea
| | - Kui Young Park
- Department of DermatologyCollege of MedicineChung‐Ang UniversitySeoulRepublic of Korea
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Mohamed EM, Abd Elaleem HL, Ahmed MAH, Rageh MA. Efficacy and Safety of 577-nm Yellow Laser in the Treatment of Pigmented Epidermal Lesions. Lasers Surg Med 2024; 56:551-556. [PMID: 38890816 DOI: 10.1002/lsm.23814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/29/2024] [Accepted: 05/19/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES Freckles and lentigines are common pigmented problems which not only cause substantial cosmetic morbidity but also create psychosocial concern. The available modalities for the treatment of pigmented lesions are often unsatisfactory for patients, require a long treatment period, and often cause skin irritation. With the advent of lasers, safe and effective treatment options for epidermal pigmentation have become more varied for different Fitzpatrick skin types. We aimed to evaluate the efficacy and safety of 577-nm yellow laser in the treatment of pigmented epidermal lesions. METHODS This study was carried out on 50 patients presented with pigmented epidermal lesions (25 presented with freckles and 25 presented with lentigines). Each patient received four treatment sessions with a 577-nm diode laser at 2-week intervals. RESULTS There was significant improvement in freckles and lentigines, as 23 out of 50 patients showed marked improvement, 11 patients showed moderate improvement, 10 patients showed mild improvement, and only six patients had no changes. Moreover, 23 patients were very satisfied, 18 patients were satisfied, and nine patients were not satisfied. As regards the safety of the 577-nm yellow laser, there was no significant adverse effect among patients except pain, erythema, and hyperpigmentation, which resolved within one month after treatment. CONCLUSIONS This study showed that the 577-nm yellow laser is an effective, safe, and well-tolerated device in the treatment of freckles and lentigines.
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Affiliation(s)
- Essamelden M Mohamed
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Hazem L Abd Elaleem
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Mona A H Ahmed
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Mahmoud A Rageh
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Chen C, Ke Y. Applications of Long-Pulse Alexandrite Laser in Cosmetic Dermatology: A Review. Clin Cosmet Investig Dermatol 2023; 16:3349-3357. [PMID: 38021435 PMCID: PMC10661922 DOI: 10.2147/ccid.s441169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
The long-pulse alexandrite laser uses Cr3+:BeAl2O4 crystals as the activation medium and has a 755nm wavelength and millisecond pulse duration. The long-pulse alexandrite laser has been utilized for hair removal, vascular lesions, pigmented lesions, and other conditions because melanin and hemoglobin in the skin, subcutaneous tissues, and skin appendages can specifically absorb this type of laser. To serve as a guide and source of inspiration for the clinical use of this type of laser, we review the present research status and advancement of the long-pulse alexandrite laser in the treatment of the aforementioned categories of disorders.
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Affiliation(s)
- Changhan Chen
- Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
- Wenzhou Key Laboratory of Laser Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
| | - Youhui Ke
- Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
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Laser treatment of benign melanocytic lesion: a review. Lasers Med Sci 2022; 37:3353-3362. [PMID: 36097230 DOI: 10.1007/s10103-022-03642-9] [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: 10/20/2021] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Treatment of pigmented lesions is one of the major challenges of laser and cosmetic practitioners. The most common pigmented lesions that are treated by lasers are melanocytic nevi, ephelides, solar lentigines, and café au lait macules. Melanin absorbs different wavelengths (500-1100 nm); thereby, treatment of various pigmented lesions requires the application of lasers with different wavelengths. Choosing the most appropriate type of laser depends on various factors such as the chromophore and the location of a specific lesion in the skin. In this paper, we aim to review the most efficient laser treatment protocols for each pigmented skin lesion and compare their efficacy in each part based on the previous studies.
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Ma SY, Gong YQ, Zhang WJ, Liang BH, Li YM, Xie ZM, Zhu HL. Split-face comparison of the efficacy of picosecond 532 nm Nd:YAG laser and Q-switched 755 nm Alexandrite laser for treatment of freckles. J COSMET LASER THER 2022; 24:22-27. [DOI: 10.1080/14764172.2022.2049311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Shao-Yin Ma
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
| | - Ye-Qing Gong
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
| | - Wen- Jun Zhang
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
| | - Bi-Hua Liang
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
| | - Yue-Ming Li
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
| | - Zhi-Min Xie
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
| | - Hui-Lan Zhu
- Guangzhou Institute of Dermatology, Guangzhou, GD, China
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Vachiramon V, Namasondhi A, Anuntrangsee T, Jurairattanaporn N. A Randomized, Evaluator-blinded Comparative Study of a Potassium Titanyl Phosphate (KTP) 532-nm Picosecond Laser and an Alexandrite 755-nm Picosecond Laser for the Treatment of Solar Lentigines in Asians. J Cosmet Dermatol 2022; 21:4370-4377. [PMID: 35129875 DOI: 10.1111/jocd.14831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Various pigment-specific lasers can be used to treat solar lentigines. However, the most effective treatment options remain to be explored to reduce complications, such as post-inflammatory hyperpigmentation, especially in dark-skinned patients. OBJECTIVES This study aims to compare the efficacy and safety between the KTP 532-nm picosecond laser and the alexandrite 755-nm picosecond laser for the treatment of solar lentigines in Asians. MATERIALS AND METHODS Thirty patients who had at least two solar lentigines on their arms were enrolled. A total of 30 paired lentiginous lesions were randomly selected for a single treatment with either a KTP 532-nm picosecond laser or an alexandrite 755-nm picosecond laser. Mean luminance score (L*) was evaluated at baseline and at six, and 12 weeks to determine treatment efficacy. Improvement was assessed by a blinded physician using a 5-point score. Satisfaction was rated by patients using a visual analogue scale. All adverse events were documented. RESULTS All 30 patients completed the study. Both lasers showed significant improvement in mean L* from baseline (p<0.001). With the parameter settings employed, lesions treated with the alexandrite 755-nm picosecond laser showed greater improvement in mean L* when compared with treatment with the KTP 532-nm picosecond laser at 12 weeks follow-up (p=0.002). According to physician scoring, more than 50% improvement was observed in 25 and 19 lesions of the alexandrite 755-nm picosecond laser group and the KTP 532-nm picosecond laser group, respectively. Adverse events did not differ between groups. A significantly higher satisfaction score was observed with the alexandrite 755-nm picosecond laser at the last visit (p=0.038). CONCLUSION Both types of picosecond laser may be used to treat solar lentigines. Proper treatment settings and endpoint observation are the most important factor to achieve a successful outcome.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amornrut Namasondhi
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanaporn Anuntrangsee
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Singh A, Goyal T, Singh P. A split-face study to evaluate the efficacy of Nd:YAG laser versus radiofrequency cauterization for the treatment of ephelides on face. PIGMENT INTERNATIONAL 2022. [DOI: 10.4103/pigmentinternational.pigmentinternational_54_20] [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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Kauvar ANB, Sun R, Bhawan J, Singh G, Ugonabo N, Feng H, Schomacker K. Treatment of facial and non-facial lentigines with a 730 nm picosecond titanium: Sapphire laser is safe and effective. Lasers Surg Med 2021; 54:89-97. [PMID: 34402537 PMCID: PMC9291180 DOI: 10.1002/lsm.23450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 11/24/2022]
Abstract
Objective A 730 nm picosecond‐domain laser was developed to improve the clearance of pigmented lesion and reduce adverse events. This study assessed the safety and efficacy of this system for the clearance of lentigines and explores how the short picosecond pulses interact with tissue via histology. Study Design and Methods Twenty subjects with Fitzpatrick skin types II–IV were enrolled in this prospective, IRB‐approved study. Four treatments were administered using a 730 nm picosecond‐domain laser. Pre‐ and posttreatment photos were assessed by blinded reviewers at 4‐ and 12‐week follow‐up visits, using a 5‐point clearance scale. Subject satisfaction was measured using a 5‐point scale. Investigator Global Improvement Score (IGIS) was performed at the 4‐ and 12‐week follow‐up visits, using an 11‐point clearance scale. Subject pain level was measured using an 11‐point scale (no pain [0], extreme pain [10]). Histology of 730 and 532 nm picosecond pulses was compared with 755 and 532 nm nanosecond pulses. Results Sixteen subjects with a total of 118 discontinuous treatment areas, each comprised of 1–20 lesions, completed all study visits. Thirty body regions were studied, including arms (6), hands (16), scalp (1), forehead (2), face (3), and back (2). Spot sizes ranging from 2 to 5 mm diameters were used with fluences ranging from 0.8 to 4.0 J/cm2. Mean pain score was 3.6 of 10 for all four treatments. Ninety‐nine percent of randomly paired 4‐week posttreatment images and 100% of 12‐week posttreatment images were correctly identified from their respective baseline images by three blinded reviewers. Mean IGIS demonstrated scores of 6.7 and 7.0 at 4‐ and 12‐week follow‐up visits, respectively. At the 4‐ and 12‐week follow‐up visits, 76% and 73% of subjects, respectively, were satisfied to highly satisfied. The mean clearance score for all 118 treatment areas was 3 of 4 in follow‐up visits. At 12‐week follow‐up, 36% of 118 treatment areas had a clearance score of 4, and 38% had a clearance score of 3. Post treatment, there was typical erythema, edema, dryness, crusting, and itching but negligible purpura, no pinpoint bleeding, blistering or scarring, and no significant hyperpigmentation or hypopigmentation. Histology showed diffuse, focal epidermal vacuolization ~5–10 µm in diameter and mild extravasation of erythrocytes with 730 nm picosecond pulses, while diffuse epidermal vacuolization was observed with coalescence of vacuoles (~20–100 µm), junctional clefting and mild extravasation of erythrocytes with 755 nm nanosecond pulses. Picosecond pulses of the wavelength of 532 nm produced diffuse, focal epidermal vacuolization and larger dermal vacuoles to depths of 500 µm, while 532 nm nanosecond pulses produced diffuse epidermal vacuolization with coalescence of vacuoles and marked dermal hemorrhage. Conclusion This study demonstrated the potential of a new 730 nm picosecond‐domain laser for the clearance of lentigines. The results showed good clearance with no adverse events and good subject satisfaction in patients with skin type II–III. Additional studies need to be conducted on darker skin types. The histopathologic findings demonstrate that the picosecond 730 nm laser produces excellent selectivity for pigment with minimal disruption of the dermal–epidermal junction and may therefore reduce healing times and the risk of adverse events.
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Affiliation(s)
- Arielle N B Kauvar
- New York Laser & Skin Care, New York, New York, USA.,Department of Dermatology, NYU Langone Medical Center, New York, New York, USA
| | - Rongrong Sun
- Candela Medical, Marlborough, Massachusetts, USA
| | - Jag Bhawan
- Department of Dermatology, School of Medicine, Boston University, Boston, Massachusetts, USA
| | | | - Nkem Ugonabo
- Department of Dermatology, NYU Langone Medical Center, New York, New York, USA
| | - Hao Feng
- University of Connecticut Health Center, Farmington, Connecticut, USA
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Synergistic Effect of 300 μm Needle-Depth Fractional Microneedling Radiofrequency on the Treatment of Senescence-Induced Aging Hyperpigmentation of the Skin. Int J Mol Sci 2021; 22:ijms22147480. [PMID: 34299100 PMCID: PMC8305123 DOI: 10.3390/ijms22147480] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 01/08/2023] Open
Abstract
Aging-associated dermatological pigmentary diseases are associated with accumulation of senescence cells and the disruption of basement membrane due to chronic ultraviolet radiation (UVR) exposure. Our study is on the synergistic effect of the novel 300 μm needle-depth fractional microneedling radiofrequency (FMR) treatment and conventional Q-switched ND:YAG laser on aging-associated hyperpigmentation of the skin. The prospective controlled clinical trial of 25 Asian women revealed significantly higher improvements not only on wrinkles, but also on hyperpigmentation. Additional ex vivo study revealed significant reduction of pro-melanogenic markers as well as senescent keratinocytes, while increased expression of collagen type IV on the epidermal basement membrane, after additional FMR treatment on UV-irradiated human tissues. These results demonstrate that 300 μm needle-depth FMR might effectively remove senescent keratinocytes that secrete pro-melanogenic markers, and repair disrupted basement membrane, therefore preventing constant hyperpigmentation of the aged skin.
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Kim HO, Kim HR, Kim JC, Kang SY, Jung MJ, Chang SE, Park CW, Chung BY. A Randomized Controlled Trial on the Effectiveness of Epidermal Growth Factor-Containing Ointment on the Treatment of Solar Lentigines as Adjuvant Therapy. ACTA ACUST UNITED AC 2021; 57:medicina57020166. [PMID: 33668564 PMCID: PMC7918714 DOI: 10.3390/medicina57020166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 01/28/2023]
Abstract
Background and Objective: Little is known about the anti-pigmentation effects of whitening agents on solar lentigines. Epidermal growth factor (EGF) has been used as a booster for wound healing in the skin, and it has been suggested to have anti-pigmentation effects. This study aimed to evaluate the effect and safety of EGF-containing ointment for treating solar lentigines with a Q-switched (QS) 532 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (Bluecore company, Seoul, Republic of Korea). Materials and Methods: Subjects who underwent QS 532 nm Nd:YAG laser treatment of solar lentigines were randomly assigned to treatment with an EGF ointment or petrolatum. After the laser procedure, the subjects were administered the test ointment twice a day for 4 weeks. The physician's assessment of the degree of pigment clearance and patient's satisfaction were assessed after 4 and 8 weeks. Additionally, the melanin index (MI), erythema index (EI), transepidermal water loss (TEWL), and post-inflammatory hyperpigmentation (PIH) were evaluated. This trial was registered with ClinicalTrials.gov (NCT04704245). Results: The blinded physician's assessment using 5-grade percentage improvement scale and patient's satisfaction were significantly higher in the study group than in the control group at the 4th and 8th weeks. The MI was significantly higher in the control group than in the study group at the 4th and 8th weeks. The EI and TEWL did not differ significantly between the two groups at either time point. The incidence of PIH was higher in the control group (37.5%) than in the EGF group (7.14%) at the 8th week. Conclusions: The application of EGF-containing ointment on facial solar lentigines with a QS 532 nm Nd:YAG laser showed efficient and safe therapeutic effects, with less PIH. Thus, EGF-containing ointment could be suggested as the promising adjuvant treatment strategy with a QS laser for solar lentigines.
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Affiliation(s)
- Hye One Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
| | - Hye Ran Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
| | - Jin Cheol Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
| | - Seok Young Kang
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
| | - Min Je Jung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
| | - Sung Eun Chang
- Asan Medical Center, Department of Dermatology, Ulsan University College of Medicine, Seoul 05505, Korea;
| | - Chun Wook Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
- Correspondence: (C.W.P.); (B.Y.C.); Tel.: +82-2-829-5221 (C.W.P.); +82-2-849-9092 (B.Y.C.)
| | - Bo Young Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea; (H.O.K.); (H.R.K.); (J.C.K.); (S.Y.K.); (M.J.J.)
- Correspondence: (C.W.P.); (B.Y.C.); Tel.: +82-2-829-5221 (C.W.P.); +82-2-849-9092 (B.Y.C.)
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Badawi A, Osman MA, Kassab AN. [Treatment of nevus of Ota and Ito and epidermal nevus syndrome]. Hautarzt 2020; 71:926-931. [PMID: 33145623 DOI: 10.1007/s00105-020-04710-3] [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: 11/29/2022]
Abstract
Nevus of Ota, nevus of Ito and nevus of Hori are special melanocytic nevi that have a slate-brown or blue/grey coloring. They are pigmented disorders characterized by its heterotopic melanocytic dermal location and by blue/brown unilateral and sometimes bilateral facial patch in case of nevus of Ota, and in the supraclavicular, scapular, and deltoid region in case of nevus of Ito. It is more common in patients with Asian and dark-skinned ethnic backgrounds. Histologically, elongated, dendritic melanocytes are seen scattered mainly throughout the upper third of reticular dermis. An acquired variant is called Hori's nevus with more bilateral facial distribution, similar to melasma. Dermal melanocytosis can also occur elsewhere on the body, including inside the mouth. Despite its benign nature, patients frequently seek therapy because of its facial involvement. QS lasers are used effectively to treat these lesions. The number of treatment sessions correlates with clinical improvement. Post laser hypo- and hyperpigmentation are common side effects mainly affecting patients with darker skin.
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Affiliation(s)
- A Badawi
- National Institute of Laser Enhanced Sciences (NILES), Cairo University, Giza, Ägypten. .,Dermatology and Allergeology department, Faculty of Medicine, University of Szeged, Szeged, Ungarn.
| | - M A Osman
- National Institute of Laser Enhanced Sciences (NILES), Cairo University, Giza, Ägypten
| | - A N Kassab
- National Institute of Laser Enhanced Sciences (NILES), Cairo University, Giza, Ägypten
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Sayed KS, Tuqan S, Hilal RF. Q-Switched Nd:YAG (532 nm) Laser Versus Intra-Dermal Tranexamic Acid for Treatment of Facial Ephelides: A Split Face, Randomized, Comparative Trial. Lasers Surg Med 2020; 53:324-332. [PMID: 32592273 DOI: 10.1002/lsm.23291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/14/2020] [Accepted: 06/14/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES To compare the efficacy and safety of intradermal injection of tranexamic acid (TXA) versus Q switched (QS) KTP (532 nm) in the treatment of facial ephelides. STUDY DESIGN/MATERIALS AND METHODS A randomized comparative split-face study included a total of 30 female patients with bilateral facial ephelides. One cheek was treated by intra-dermal TXA injections and the other was treated by QS-KTP (532 nm). Patient assessment was performed by photography, pigmentation area, severity index and spectrophotometry at baseline, 1 week after treatment, and 2 months after treatment. RESULTS A significant difference was found between both sides regarding the percentage change of pigmentation area, severity score (PSI) and melanin index (MI) after treatment and during follow up, favoring laser (P = 0.001). PSI decreased after treatment by 66.5% and 15.4% (laser and TXA sides respectively), further decrease after follow-up was 69.4% with laser and 26.1% with TXA. MI improved by 3.7% after KTP laser to 7.7% after follow-up and by 2.4% after TXA injections to 6.5% after follow-up. Four patients developed post-inflammatory hyperpigmentation following QS-KTP. CONCLUSION QS-KTP laser is superior to intradermal TXA injection in the treatment of facial ephelides. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Khadiga S Sayed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samar Tuqan
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rana F Hilal
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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14
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Chan MWM, Shek SYN, Yeung CK, Chan HHL. A Prospective Study in the Treatment of Lentigines in Asian Skin Using 532 nm Picosecond Nd:YAG Laser. Lasers Surg Med 2019; 51:767-773. [PMID: 31115070 DOI: 10.1002/lsm.23103] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate safety and efficacy of treatment with the picosecond Nd:YAG 532 nm for lentigines in Asian skin. STUDY DESIGN/MATERIALS AND METHODS This was a prospective, open-label cohort study, using a novel picosecond 532-nm laser for the treatment of facial lentigines. Subjects received up to three laser treatments every 4-6 weeks and were assessed at 4 and 12 weeks after final treatment. Primary endpoint was degree of improvement in lentigines at 12 weeks after the final treatment, assessed by treating investigator based on Physicians Global Assessment. Secondary end-points included degree of improvement in lentigines at 12 weeks after final treatment, assessed by subject (Subject's Global Assessment), and change in mean relative Melanin index (MI) value at 3 months after final treatment as compared to baseline as assessed by mexameter measurement. RESULTS A total of 20 patients (3 male, and 17 female) of Asian-descent with Fitzpatrick skin type III and IV, with lentigines on the face were included in this study. A total of 89 lesions were treated with the laser setting of 532-nm, 750 picoseconds, fluence of 0.2-0.5 J/cm 2 , and spot size of 4 mm. One hundred and thirty-seven treatment sessions were given in total. Eighteen patients (90%) achieved a moderate to significant improvement at 12-week follow-up based on a 5-grade physician global assessment scale. The improvement rate of relative MI (MI in the lesion minus normal skin) was 33.30 ± 18.71 and 37.63 ± 19.25% at 4- and 12-week follow-up. Post-inflammatory hyperpigmentation (PIH) occurred in 14 of 137 sessions (10.2%), and hypopigmentation occurred in one patient with five lesions (3.6%). CONCLUSION This study demonstrates that using picosecond Nd:YAG laser 532 nm for removal of solar lentigines in darker skin type appears to be safe and effective. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. LIMITATIONS Small study group.
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Affiliation(s)
- Mandy W M Chan
- Department of Medicine, Division of Dermatology, The University of Hong Kong, 4/F, Professorial Block, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong SAR, China
| | - Samantha Yee-Nam Shek
- Department of Medicine, Division of Dermatology, The University of Hong Kong, 4/F, Professorial Block, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong SAR, China
| | - Chi Keung Yeung
- Department of Medicine, Division of Dermatology, The University of Hong Kong, 4/F, Professorial Block, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong SAR, China
| | - Henry Hin-Lee Chan
- Department of Medicine, Division of Dermatology, The University of Hong Kong, 4/F, Professorial Block, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong SAR, China.,Wellman Center for Photomedicine, Dermatology Service at Massachusetts General Hospital, 55 Fruit Street Boston, Boston, MA, 02114, USA
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15
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Passeron T, Genedy R, Salah L, Fusade T, Kositratna G, Laubach H, Marini L, Badawi A. Laser treatment of hyperpigmented lesions: position statement of the European Society of Laser in Dermatology. J Eur Acad Dermatol Venereol 2019; 33:987-1005. [DOI: 10.1111/jdv.15497] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/14/2019] [Indexed: 12/16/2022]
Affiliation(s)
- T. Passeron
- Department of Dermatology Centre Hospitalier Universitaire Nice Université Côté d'Azur Nice France
- INSERM U1065, Team 12, C3M Université Côté d'Azur Nice France
| | - R. Genedy
- Faculty of Medicine Department of Dermatology Alexandria University Alexandria Egypt
| | - L. Salah
- Ministry of Health Jeddah Saudi Arabia
| | | | - G. Kositratna
- Department of Dermatology Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - H.‐J. Laubach
- Department of Dermatology Hôpitaux Universitaires de Genève Geneva Switzerland
| | - L. Marini
- The Skin Doctors Center Trieste Italy
| | - A. Badawi
- National Institute of Laser Enhanced Sciences Cairo University Giza Egypt
- Department of Dermatology Faculty of Medicine University of Szeged Szeged Hungary
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16
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Huu SN, Van CL, Van TN, Manh TN, Minh PPT, Hong SN, Huu ND, Cam VT, Cao KP, Hau KT, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Successful Treatment of Freckles by Alex Trivantage Laser Wavelight 755 nm in Vietnamese Patients. Open Access Maced J Med Sci 2019; 7:287-290. [PMID: 30745982 PMCID: PMC6364722 DOI: 10.3889/oamjms.2019.096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the effectiveness of Alex Trivantage laser wavelength 755 nm (ATL) in the treatment of freckles at Hanoi Hospital of Dermatology and Venereology, Vietnam. PATIENTS AND METHODS A group of 30 patients with freckles were treated by ATL (Alex Trivantage-Candela Co America) with spots size 3 mm, wavelength 755 mm, and energy 5-6 j/cm2. All the patients were treated 2 times with 4-weeks interval. The results were evaluated at 4, 8, and 12 weeks after treatment. The colour of the lesions was evaluated by using Von-Luchan's chromatic scale and Visia® complex analysis system. Brown spot index (BSI) was calculated by the VISA complexion analysis system devices. The data was analysed by SPSS 16.0. RESULTS After 2 times of treatment, the lesion colour of all of the patients had been improved. The good and very good levels of improvement were noted in 63.3% of patients; there was 26.7% of them had partial improvement. Brown spots index was significantly improved (39.13 ± 20.66 before and 54.23 ± 16.78 after treatment; p < 0.001). Hyperpigmentation was noted in 6.7% of patients. CONCLUSION freckles have been improved by treatment with Alex trivantage laser wavelength 755 nm with safety.
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Affiliation(s)
- Sau Nguyen Huu
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | | | | | - Tan Nguyen Manh
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | | | - Son Nguyen Hong
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Nghi Dinh Huu
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Van Tran Cam
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Kiem Pham Cao
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Khang Tran Hau
- National hospital of Dermatology and Venereology, Hanoi, Vietnam
| | | | | | | | - Michael Tirant
- University of Rome G. Marconi, Rome, Italy
- Psoriasis Eczema Clinic, Melbourne, Australia
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
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17
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Friedmann DP, Peterson JD. Efficacy and safety of intense pulsed light with a KTP filter for the treatment of solar lentigines. Lasers Surg Med 2019; 51:500-508. [DOI: 10.1002/lsm.23056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2018] [Indexed: 01/20/2023]
Affiliation(s)
- Daniel P. Friedmann
- Westlake Dermatology Clinical Research CenterWestlake Dermatology and Cosmetic SurgeryAustinTexas
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18
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Negishi K, Akita H, Matsunaga Y. Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser. Lasers Surg Med 2018; 50:851-858. [DOI: 10.1002/lsm.22820] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Kei Negishi
- Institute of Geriatrics; Tokyo Women's Medical University; Tokyo Japan
| | - Hirotaka Akita
- Department of Dermatology; Fujita Health University Banbuntane Hotokukai Hospital; Aichi Japan
| | - Yukiko Matsunaga
- Department of Dermatology; Toho University School of Medicine; Tokyo Japan
- Shiseido Co., Ltd.; Tokyo Japan
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19
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Chemical Peeling with a Modified Phenol Formula for the Treatment of Facial Freckles on Asian Skin. Aesthetic Plast Surg 2018; 42:546-552. [PMID: 29279953 DOI: 10.1007/s00266-017-1048-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/25/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chemical peeling is an efficient method for the treatment of pigment disorders. For freckles, medium-depth to deep peeling using a phenol solution is one of the most effective chemical peels, and modifications of facial skin can be observed up to 20 years after peeling. However, applying phenol to the skin may cause serious side effects. Phenol peeling has been rarely used in Asia due to its tendency to cause permanent pigmentary changes and hypertrophic scars. METHODS In total, 896 Chinese inpatients with facial freckles were enrolled in this study. The phenol formula was modified with crystalline phenol, dyclonine, camphor, anhydrous alcohol and glycerin and adjusted to a concentration of 73.6-90.0%. The entire peeling treatment was divided into two procedures performed separately on 2 days. RESULTS All patients exhibited 26% or greater improvement, and 99.66% of patients exhibited 51% or greater improvement (good and excellent). Scarring and systemic complications were not observed in any patient. CONCLUSIONS The modified phenol formula is very effective and safe for the treatment of facial freckles in Asian patients. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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20
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Nam JH, Kim HS, Lee GY, Kim WS. Beneficial Effect of Low Fluence 1,064 nm Q-Switched Neodymium:Yttrium-Aluminum-Garnet Laser in the Treatment of Senile Lentigo. Ann Dermatol 2017; 29:427-432. [PMID: 28761290 PMCID: PMC5500707 DOI: 10.5021/ad.2017.29.4.427] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/30/2016] [Accepted: 09/21/2016] [Indexed: 11/08/2022] Open
Abstract
Background Low fluence 1,064 nm Q-switched (QS) Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser treatment, also known as laser toning, is widely used for pigmentary disorders. There has been no reliable evaluation of the effect of low fluence 1,064 nm QS Nd:YAG laser for senile lentigo. Objective To investigate the beneficial effect of low fluence 1,064 nm QS Nd:YAG laser in the treatment of senile lentigo on the face. Methods A retrospective review was conducted on patients treated only with repetitive low fluence 1,064 nm QS Nd:YAG laser. Among them, 12 patients with multiple senile lentigines before treatment were included. All side effects were recorded to assess the safety of the modality. Results Mean age was 56.1±7.8 years old and male-to-female ratio was 1:11. Mean treatment fluence was 1.62±0.16 J/cm2 and mean total treatment session was 8.8±2.6. Mean interval period between each session was 28.0±11.4 days and mean treatment session to reach marked and near total improvement was 8.7±2.8. At the final visit, seven of 12 (58.3%) patients reached marked and near total improvement, and three of 12 (25.0%) reached moderate improvement. No side effects occurred. Conclusion Repetitive low fluence 1,064 nm QS Nd:YAG laser treatment may be an effective and safe optional modality for senile lentigo.
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Affiliation(s)
- Jae-Hui Nam
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Han-Saem Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ga-Young Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won-Serk Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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21
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Picosecond 532 nm Neodymium-Doped Yttrium Aluminium Garnet Laser for the Treatment of Solar Lentigines in Darker Skin Types: Safety and Efficacy. Dermatol Surg 2017; 43:456-459. [DOI: 10.1097/dss.0000000000000922] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Negishi K, Tanaka S, Tobita S. Prospective, randomized, evaluator-blinded study of the long pulse 532-nm KTP laser alone or in combination with the long pulse 1064-nm Nd: YAG laser on facial rejuvenation in Asian skin. Lasers Surg Med 2016; 48:844-851. [DOI: 10.1002/lsm.22582] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Kei Negishi
- Institute of Geriatrics; Tokyo Women's Medical University; Tokyo 150-0002 Japan
- Aoyama Institute of Women's Medicine; Tokyo Women's Medical University; Tokyo 107-0061 Japan
| | - Shiho Tanaka
- Aoyama Institute of Women's Medicine; Tokyo Women's Medical University; Tokyo 107-0061 Japan
| | - Saori Tobita
- Aoyama Institute of Women's Medicine; Tokyo Women's Medical University; Tokyo 107-0061 Japan
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23
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24
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Wanner M, Sakamoto FH, Avram MM, Anderson RR. Immediate skin responses to laser and light treatments. J Am Acad Dermatol 2016; 74:807-19; quiz 819-20. [DOI: 10.1016/j.jaad.2015.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 12/23/2022]
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25
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Köse O. Successful removal of freckles with the bipolar radiofrequency and optical energy. J COSMET LASER THER 2016; 18:230-3. [DOI: 10.3109/14764172.2016.1157358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Chan JCY, Shek SYN, Kono T, Yeung CK, Chan HHL. A retrospective analysis on the management of pigmented lesions using a picosecond 755-nm alexandrite laser in Asians. Lasers Surg Med 2015; 48:23-9. [DOI: 10.1002/lsm.22443] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Johnny Chun-yin Chan
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Samantha Yee-nam Shek
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Taro Kono
- Department of Plastic Surgery; Tokai University; Kanagawa Japan
| | - Chi Keung Yeung
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Henry Hin-lee Chan
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
- Wellman Center for Photomedicine; Massachusetts General Hospital; Boston Massachusetts
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27
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Efficacy and safety of fractional carbon dioxide laser for treatment of unwanted facial freckles in phototypes II-IV: a pilot study. Lasers Med Sci 2014; 29:1937-42. [PMID: 24917080 DOI: 10.1007/s10103-014-1610-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
Abstract
Facial freckles are a cosmetic concern to Egyptians, particularly young females. Several therapeutic lines exist with variable response rates and limitations. Fractional carbon dioxide (FCO2) laser provides minimal ablation and therefore less down time and less side effects. The efficacy and safety of this laser technology have still not been studied in freckles. The aim of this study is to assess the efficacy and safety of FCO2 laser in the treatment of unwanted facial freckles in Egyptians. Twenty patients undergone a single session of FCO2 laser and then were followed up clinically a month later. Photographs were taken before treatment and at follow-up visit and were assessed by three blinded investigators. Percent of global improvement was measured on a 4-point grading scale. Patient's satisfaction and adverse events were recorded. Two patients (10 %) showed grade 1 improvement, while eight patients (40 %) showed grade 2 improvement. Nine patients (45 %) showed grade 3 improvement, and only one patient (5 %) showed grade 4 improvement. FCO2 laser resurfacing is effective and safe in treatment of facial freckles in skin phototypes II-IV. It can offer a more practical alternative to topical treatments, and a cheaper alternative to Q-switched lasers.
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28
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Alexis AF. Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI. Br J Dermatol 2014; 169 Suppl 3:91-7. [PMID: 24098905 DOI: 10.1111/bjd.12526] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2013] [Indexed: 01/21/2023]
Abstract
Ethnic skin or 'skin of colour', which is characterized by increased epidermal melanin, labile melanocytes and reactive fibroblast responses, poses special challenges for the use of laser and light-based therapies. These therapies are associated with a greater risk of dyspigmentation and scarring in ethnic skin and therefore require careful selection of device and treatment parameters to minimize complications. Whereas early-generation lasers for hair removal and resurfacing were generally contraindicated for individuals with Fitzpatrick skin phototypes (SPT) IV-VI, advances in the past decade have given rise to a range of devices that can be safely used in ethnic skin. Longer wavelength lasers such as the 810 and 1064 nm Nd:YAG; intense pulsed light and monochromatic excimer light (308 nm); fractional lasers; and radiofrequency devices have all been used safely for hair removal, pigmentary abnormalities, resurfacing and skin tightening in ethnic skin, respectively. Notwithstanding these advances, nuances in the laser or light treatment of darker skin types remain and must be considered to ensure safe therapeutic outcomes. The vast majority of published data pertaining to lasers and light treatments in nonwhite skin involve patients of East Asian ethnicity (e.g. Korean, Japanese, Chinese, Thai). By contrast, there is a paucity of studies involving individuals of African ancestry or those with SPT V or VI. This article will review laser and light-based modalities that are considered safe and effective for individuals with richly pigmented skin.
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Affiliation(s)
- A F Alexis
- Skin of Color Center, St Luke's Roosevelt Hospital, 1090 Amsterdam Avenue Suite 11B, New York, NY, 10025, U.S.A; Department of Dermatology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 12th Floor, New York, NY, 10032, U.S.A
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29
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Eimpunth S, Wanitphadeedecha R, Manuskiatti W. A focused review on acne-induced and aesthetic procedure-related postinflammatory hyperpigmentation in Asians. J Eur Acad Dermatol Venereol 2012. [DOI: 10.1111/jdv.12050] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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30
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Chan NPY, Lee Chan HH. Lasers for Treatment of Ethnic Skin. Dermatol Surg 2012. [DOI: 10.1002/9781118412633.ch57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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