Successful treatment of argyria using a low-fluence Q-switched 1064-nm Nd:YAG laser

Background Argyria is a rare skin disease caused by cutaneous deposits of silver granules as a result of exposure to silver substrates or ingestion of silver salt. This pigmentation change causes cosmetic problems, and there was previously no recognized effective treatments for argyria. Objective To evaluate the treatment effect of a low‐fluence Q‐switched 1064‐nm Nd:YAG laser on argyria. Subjects and Methods Case report of a 49‐year‐old with a history of ingestion of a colloidal silver solution daily for approximately one year as a traditional remedy. Results After seven sessions of treatment, the patient’s skin color returned to normal. Conclusion A low‐fluence Q‐switched 1064‐nm Nd:YAG laser provided safe and effective treatment for the skin discoloration associated with argyria     

Treatment of early-stage erythematotelangiectatic rosacea with a Q-switched 595-nm Nd:YAG laser

Erythematotelangiectatic rosacea presents as persistent erythema and telangiectasia with frequent flushing and blushing on the facial and extrafacial skin. Additionally, papulopustular rosacea shows acneiform papules, pustules, and nodules with persistent plaque-form edema. Despite garnering only grade-C or -D level recommendations, a 585-nm or 595-nm flashlamp-pumped pulsed-dye laser can be considered as an effective therapeutic modality for the treatment of rosacea in patients who are refractory to topical and/or systemic treatments. In this report, treatment with a Q-switched 595-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with low non-purpuragenic fluence proved to be safe and effective in treating early-stage erythematotelangiectatic rosacea in two female Korean patients. Laser treatment for rosacea was delivered with the settings of pulse energy of 0.4–0.5 J/cm², pulse duration of 5–10 ns, 5-mm spot size, 5 Hz, and 500 shots. Additionally, we found that remarkable therapeutic effects were achieved for both rosacea and melasma by combining Q-switched quick pulse-to-pulse 1,064-nm Nd:YAG and Q-switched 595-nm Nd:YAG laser treatments, which required only the changing of handpieces equipped with solid dye. In conclusion, we suggest that treatment with a Q-switched 595-nm Nd:YAG laser with low fluence may provide an additional therapeutic option for treating early-stage erythematotelangiectatic rosacea.     

Efficacy and safety of 1064‐nm Q‐switched Nd:YAG laser with low fluence for keloids and hypertrophic scars

Background Several treatment modalities using laser devices have been used for the treatment of keloids and hypertrophic scars with various therapeutic outcomes. Objective The purpose of this study was to describe the efficacy and safety of 1064‐nm Q‐switched (QS) Nd:YAG laser with low fluence on keloids and hypertrophic scars. Methods Keloids and hypertrophic scars located at 21 anatomic sites in 12 Korean patients (10 men and 2 women; mean age 23.8 years, range 21–33) were treated using 1064‐nm QS Nd:YAG laser with low fluence at 1–2 week intervals. Treatment settings were 1.8–2.2 J/cm², 7‐mm spot size and 5–6 passes with appropriate overlapping. Results Follow‐up data collected 3 months after the final treatment revealed decreases in the mean score for the following lesion characteristics: pigmentation from 1.8 to 1.2; vascularity from 1.4 to 1.0; pliability from 3.0 to 2.0 and height from 2.3 to 1.8. The modified Vancouver General Hospital Burn Scar Assessment score decreased from 8.6 to 5.9 (P < 0.0001). Observed side‐effects were a mild prickling sensation during treatment, and mild post‐treatment erythema, both of which resolved within few hours. Conclusion Our results demonstrate that QS Nd:YAG laser with low fluence may be used for the treatment of keloids and hypertrophic scars.     

Therapeutic options for management of Hori's nevus: A systematic review

Hori's nevus is a pigmentation disorder reported mainly in middle‐aged Asian women. There is no systematic review addressing its pharmacotherapy. The population for our systematic review was patients with a clinical/histological diagnosis of Hori's nevus (both sex, any age group). We screened five literature databases using relevant keywords. All RCTs, observational studies and case series mentioning at least one intervention and outcome of that intervention were included. Nineteen studies were included in the final systematic review from total 680 identified nonduplicate records. Different forms of laser (alexandrite laser [QSAL and PSAL], Nd:YAG laser [QSNYL high fluence, low fluence, 532 followed by 1064 nm], Er: YAG and Nd:YAG combination, ruby laser [QSRL], CO₂ laser followed by QSRL) and dermabrasion were found to be useful in treatment of Hori’ nevus. Among alexandrite lasers, PSAL is more efficacious and safe than QSAL. In case of high fluence QSNYL, hyperpigmentation rate is quite high while low fluence QSNYL requires more number of treatment sessions. The combined 1064 nm + 532 nm protocol is better in terms of efficacy and safety. Er:YAG + Nd:YAG combination have similar efficacy and added advantage of synergistic action and no adverse event.     

532-nm and 1064-nm Q-switched Nd:YAG laser therapy for reduction of pigmentation in macular amyloidosis patches

Background Macular amyloidosis is a primary form of skin amyloidosis with deposition of small to moderate amyloid material in the upper dermis and mild pigmentary incontinence with resultant clinical hyperpigmentation. Objectives To determine the efficiency of Q‐switched Nd:YAG laser (532 and 1064 nm) in reducing the pigmentations due to skin macular amyloidosis. Methods A prospective, side by side, controlled, clinical trial study was designed. Twenty subjects with clinical diagnosis and pathology confirmation of macular amyloidosis were treated with Q‐switched Nd:YAG laser: 532 nm in a part of their plaques and with 1064 nm in another part of their plaques. Assessment of efficiency was done by colorimetric scores based on Mexameter measurement and also digital photographs before laser therapy and 8 weeks after treatment. Results Mexameter‐based data analysis showed that the two lasers (Q‐switched 532 and 1064 Nd:YAG) are effective in reducing the degree of macular amyloidosis patches pigmentation, and 532 nm is meaningfully more effective than 1064 nm in this matter. Photograph‐based analysis showed that 90% of cases treated by 532 nm had good or very good response, and for the 1064 nm–treated patches, 60% of cases had the good or very good response. Conclusions The results of study showed the net positive effect of Q‐switched Nd:YAG laser, either 532 nm or 1064 nm, in pigment reduction of macular amyloidosis patches, but the 532‐nm laser was more effective than 1064 laser.     

A split axilla comparison study of axillary hair removal with low fluence high repetition rate 810 nm diode laser vs. high fluence low repetition rate 1064 nm Nd:YAG laser

Background A low fluence, high repetition rate 810 nm diode laser using constant motion technique has been recently introduced with advantages of less treatment discomfort and fewer side effects compared with traditional laser hair removal. Objective To compare hair reduction and side effects of low fluence high repetition rate 810 nm diode with high fluence low repetition rate 1064 nm Nd:YAG lasers. Methods Forty‐nine subjects were randomly received five monthly treatments with diode laser on one side of their axilla and long‐pulsed Nd:YAG laser on the other side. Hair count was recorded at baseline, 1‐ and 6‐month follow‐up visits. Results Percentage of axillary hair reduction at 1‐month follow‐up visit after receiving diode and Nd:YAG laser treatment were 71.0% and 82.3%, respectively, and at 6‐month follow‐up were 35.7% and 54.2%, respectively. There were significant differences in hair reduction between both laser systems at 1‐ and 6‐month follow‐ups (P < 0.001 and P < 0.001, respectively). Patients reported lower pain on the diode laser side (P < 0.001). Side effects of both laser systems were mild and transient erythema and swelling. Conclusions High fluence low repetition rate Nd:YAG laser was superior in hair reduction and provided higher patient satisfaction. However, low fluence high repetition rate diode laser was less painful.     

Hypopigmentation Induced by Frequent Low-Fluence,Large-Spot-Size QS Nd:YAG Laser Treatments

The Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser is increasingly used for nonablative skin rejuvenation or "laser toning" for melasma. Multiple and frequent low-fluence, large-spot-size treatments are used to achieve laser toning, and these treatments are associated with the development of macular hypopigmentation as a complication. We present a case series of three patients who developed guttate hypomelanotic macules on the face after receiving laser toning treatment with QS 1064-nm Nd:YAG.     

Intense Pulsed Light and Low-Fluence Q-Switched Nd:YAG Laser Treatment in Melasma Patients

Background

Recently, low fluence collimated Q-switched (QS) Nd:YAG laser has drawn attention for the treatment of melasma. However, it needs a lot of treatment sessions for the substantial results and repetitive laser exposures may end up with unwanted depigmentation.

Objective

We evaluated the clinical effects and safety of the combinational treatment, using intense pulsed light (IPL) and low fluence QS Nd:YAG laser.

Methods

Retrospective case series of 20 female patients, with mixed type melasma, were analyzed using medical records. They were treated with IPL one time, and 4 times of weekly successive low fluence Nd:YAG laser treatments. At each visit, digital photographs were taken under the same condition. Melanin index (MI) and erythema index (EI) were measured on the highest point on the cheekbones. Modified melasma area and severity index (MASI) scores were calculated by two investigators using digital photographs.

Results

The mean values of MI and EI decreased significantly after treatments. The modified MASI score has decreased by 59.35%, on average. Sixty percents of the participants did not require any more treatments, and no clinical aggravations were observed during the follow-up period (mean 5.9 months).

Conclusion

IPL and low fluence laser may elicit a clinical resolution in the mixed type melasma with long term benefits.     

Photorejuvenation using long-pulsed alexandrite and long-pulsed neodymium:yttrium-aluminum-garnet lasers: a pilot study of clinical outcome and patients' satisfaction in Koreans

Long-pulsed 755-nm alexandrite and long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers have been used for photorejuvenation of the face. The aim of this study was to investigate the safety and efficacy of long-pulsed alexandrite and long-pulsed Nd:YAG lasers for photorejuvenation in Korea. One hundred and sixteen Korean patients with photo-aged facial skin were enrolled. Sixty-two patients with facial pigmentation underwent long-pulsed alexandrite laser treatment. Eleven patients that wanted to improve facial pigmentation with minimal pain had quasi-long-pulsed alexandrite laser treatment. Forty three patients had long-pulsed Nd:YAG laser therapy. Outcome assessments included standard photographs and global evaluation by blinded investigators. The self-assessment grade was provided in questionnaires. Forty-four percent of patients reported excellent or good improvement of their pigmentary lesions (>50% improvement) using a long-pulsed alexandrite laser. Of patients who underwent long-pulsed Nd:YAG laser treatment, 36% reported excellent or good improvement in skin tightening, 50% in facial flushing and 45% in pigmentary lesions. We conclude that long-pulsed alexandrite and long-pulsed Nd:YAG lasers are safe and effective for facial photorejuvenation in Koreans.     

Cutaneous photoaging treated with a combined 595/1064 nm laser

Background and objectives: The pulsed dye laser (PDL) has been used for a variety of vascular changes associated with photoaging. The Nd:YAG laser has been shown to be effective in the treatment of deeper facial vessels, as well as to stimulate new dermal collagen deposition. This study was undertaken to evaluate the safety and efficacy of sequential dual‐wavelength PDL and Nd:YAG laser treatment of photoaged facial skin. Methods: Fifteen individuals, between the ages of 38 and 66 years old, with various stigmata of facial photoaging, were entered into the study. Five sequential combined PDL/Nd:YAG (Cynergy, Cynosure Inc., Westford, MA, USA) treatments were performed using a 10‐mm handpiece at monthly intervals. PDL parameters included a 10‐ms pulse duration and a fluence set at 1?J/cm² below the purpura threshold. Nd:YAG parameters were set at a 50‐ms pulse duration with fluences varying between 35 and 50?J/cm², depending on patient comfort. Improvement was determined by evaluation of photographs taken before the first treatment and at 1 and 3 months following the last treatment, as well as the individual's self‐assessment. Results: Individuals tolerated treatments well with no serious, long‐term, or permanent adverse effects. Improvement was most pronounced in telangiectasias and diffuse erythema, followed by epidermal dyspigmentation and lentigines. Some individuals were also noted to have improved smoothness, radiance, or pore size. The improvement was generally maintained at the 3‐month follow‐up. In addition, the average self‐reported improvement was 1.7 (on a 0–4 scale) at 1 month and 2.4 at 3 months following the last treatment. Conclusion: A novel combined sequential PDL/Nd:YAG laser can be used to treat a variety of cutaneous changes associated with photoaging. Further studies may determine the relative impact of each laser and whether the total effect is simply additive or synergistic.     

Combination 532-nm and 1064-nm lasers for noninvasive skin rejuvenation and toning

BACKGROUND: Noninvasive techniques for skin rejuvenation are quickly becoming standard in the treatment of mild rhytids and overall skin toning. Multiple laser wavelengths and modalities have been used with varying degrees of success, including 532-nm, 585-nm, 1064-nm, 1320-nm, 1450-nm, and 1540-nm wavelengths. OBJECTIVES: To evaluate a combination technique using a long-pulsed, 532-nm potassium titanyl phosphate (KTP) laser and a long-pulsed 1064-nm Nd:YAG laser, separately and combined, for noninvasive photorejuvenation and skin toning and collagen enhancement and to establish efficacy and degree of success. DESIGN: Prospective nonrandomized study with longitudinal follow-up. SETTING: Private dermatologic surgery and laser practice. METHODS: A total of 150 patients, with skin types I through V, were treated with long-pulsed KTP 532-nm and long-pulsed Nd:YAG 1064-nm lasers, separately and combined. For the KTP 532-nm laser, the fluences varied between 7 to 15 J/cm2 at 7- to 20-millisecond pulse durations with a 2-mm handpiece and 6 to 15 J/cm2 at 30- to 50-millisecond pulses with a 4-mm handpiece. The 1064-nm Nd:YAG laser fluences were set at 24 to 30 J/cm2 for a 10-mm handpiece. These energies were delivered at 30- to 65-millisecond pulse durations. All subjects were treated at least 3 times and at most 6 times, depending on patient satisfaction level, at monthly intervals and were observed for up to 18 months after the last treatment. MAIN OUTCOME MEASURES: All patients were asked to fill out a "severity scale" on which redness, pigmentation, rhytids, skin tone/tightness, texture, and patient satisfaction were noted before and after each treatment. Redness, pigmentation, rhytids, skin tone/tightness, and texture were also evaluated by the physician and another observer. RESULTS: After 3 to 6 treatments, 50 patients treated with the 532-nm KTP laser alone showed improvement of 70% to 80% in redness and pigmentation, 30% to 50% in skin tone/tightening, 30% to 40% in skin texture, and 20% to 30% in rhytids. Another 50 patients treated with the 1064-nm Nd:YAG laser alone showed improvement of 10% to 20% in redness, 0% to 10% in pigmentation, 10% to 30% in skin tone/tightening, 20% to 30% in skin texture, and 10% to 30% in rhytids. The third group of 50 patients treated with both KTP and Nd:YAG lasers showed improvement of 70% to 80% in redness and pigmentation, 40% to 60% in skin tone/tightening, 40% to 60% in skin texture, and 30% to 40% in rhytids. Skin biopsy specimens taken at 1-, 2-, 3-, and 6-month intervals demonstrated new collagen formation. CONCLUSIONS: All 150 patients exhibited mild to moderate improvement in the appearance of rhytids, moderate improvement in skin toning and texture, and great improvement in the reduction of redness and pigmentation. The KTP laser used alone produced results superior to those of the Nd:YAG laser. Results from combination treatment with both KTP and Nd:YAG lasers were slightly superior to those achieved with either laser alone.     

Clinical efficacy of the dual-pulsed Q-switched neodymium:yttrium-aluminum-garnet laser: Comparison with conservative mode

Abstract

The quality (Q)-switched neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is one of the first non-ablative lasers to be used for facial resurfacing and photorejuvenation. Recently, the method of low-fluence Q-switched Nd:YAG lasers known as ‘laser toning’ has been used for non-ablative skin rejuvenation and for the treatment of melasma in Asian countries. We report our experience of using a novel Q-switched Nd:YAG laser that was operated as a dual pulse at half fluence and 140-μs intervals compared with conservative mode laser.     

A split-tattoo randomized Q-switched neodymium-doped yttrium–aluminium–garnet laser trial comparing the efficacy of a novel three-pass,one-session method with a conventional method in the treatment of blue/black tattoos in darker skin types

Tattoos with blue/black ink show good lightening of pigment after treatment with 1064 nm Q-switched (QS) neodymium-doped yttrium–aluminium–garnet (Nd:YAG) laser. In this randomized trial, we compared the efficacy of a novel three pass, one session procedure (R15 method) with a conventional method for treating blue/black tattoos in darker skin types. Tattoos were treated with 1064 nm QS Nd:YAG Laser with a spot size of 4 mm, fluence of 5 J/cm² and frequency of 5 Hz. The tattoo pigment lightening was comparable with both methods. Thread-like tattoos had significantly better pigment lightening with fewer side effects than the broad band-like tattoos. We would like to recommend the R15 method of the QS Nd:YAG laser for thread-like tattoos, which can save patients’ time, cut short the frequency of their hospital visits and, more importantly, decrease the cost involved in it.     

Q开关Nd:YAG激光和585nm脉冲染料激光治疗色素性、血管性皮肤病1686例

目的评估Q开关Nd:YAG激光和585nm脉冲染料激光治疗色素性皮肤病和血管性皮肤病的疗效。方法分别采用Q开关Nd:YAG激光治疗色素性皮肤病400例、585nm脉冲染料激光治疗血管性皮肤病1177例,并采用二者治疗病毒疣109例,观察疗效。结果Q开关Nd:YAG激光对色素性皮肤病的有效率由高到低依次为:雀斑(100%)、文身(87.50%)、脂溢性角化(84.60%)、斑痣(46.70%)、咖啡斑(40.40%);585nm脉冲染料激光对血管性皮肤病的有效率由高到低为:蜘蛛痣(98.30%)、草莓状血管瘤(91.40%)、红斑期酒渣鼻(83.30%)及颜面毛细血管扩张(80.00%);二者对病毒疣的有效率分别为:寻常疣90.10%、尖锐湿疣66.70%、扁平疣52.60%。结论Q开关Nd:YAG激光治疗色素性皮肤病、585nm脉冲染料激光治疗血管性皮肤病及二者治疗病毒疣疗效较好。     

Paradoxical darkening of unperceived tattoo ink after relatively low fluence from a Q‐switched Nd:YAG (1064‐nm) laser in the course of treatment for melasma

Although Q‐switched (QS) lasers are the mainstay of modern tattoo removal, paradoxical darkening of tattoo ink may occur. This darkening of tattoo ink is dependent on laser wavelength, pulse duration and fluence, with high‐energy, nanosecond‐pulsed lasers more prone to induce tattoo‐ink darkening. Laser toning, consisting of multiple‐passed QS neodymium:yttrium–aluminum–garnet (Nd:YAG), 1064‐nm laser treatment with low fluence, short pulse duration (< 10 ns), and a repetition rate of 10 Hz has been successful in the treatment of melasma. A mistake commonly made during laser toning is to scorch scalp hair, eyebrows or eyelashes, but this phenomenon is reversible. A more problematic error is caused by treatment of eyeliner or eyebrow tattoos. We report a patient who experienced changes in unperceived, skin‐coloured tattoos, turning them blue after QS Nd:YAG laser treatment of melasma.     

Split-face comparison of radiofrequency versus long-pulse Nd-YAG treatment of facial laxity.

BACKGROUND AND OBJECTIVE: To improve photoaging skin with laser treatment, multiple sessions have been considered necessary to achieve results comparable with one radiofrequency (RF) treatment. We compared single-treatment improvements obtained by the long-pulse 1064 nm Nd:YAG laser and RF device. STUDY DESIGN/MATERIALS AND METHODS: In a split-face study, patients with sagging skin were treated once with laser (left side) and once with RF (right side) energy. RESULTS: Improvement judged by six blinded observers was greater for wrinkles and laxity (30% median) on the laser-treated side and essentially the same with both modalities (15% median) for texture, pores, and pigmentation. Improvement was maintained for at least 2-6 months on both facial sides without adverse effects. CONCLUSION: With a single treatment, both the long-pulse 1064 nm Nd:YAG laser and ThermaCool RF device provide a modest degree of improvement in both wrinkles and laxity of facial skin and similar improvement in texture, pores, and pigmentation.     

Cutaneous photoaging treated with a combined 595/1064 nm laser.

BACKGROUND AND OBJECTIVES: The pulsed dye laser (PDL) has been used for a variety of vascular changes associated with photoaging. The Nd:YAG laser has been shown to be effective in the treatment of deeper facial vessels, as well as to stimulate new dermal collagen deposition. This study was undertaken to evaluate the safety and efficacy of sequential dual-wavelength PDL and Nd:YAG laser treatment of photoaged facial skin. METHODS: Fifteen individuals, between the ages of 38 and 66 years old, with various stigmata of facial photoaging, were entered into the study. Five sequential combined PDL/Nd:YAG (Cynergy, Cynosure Inc., Westford, MA, USA) treatments were performed using a 10-mm handpiece at monthly intervals. PDL parameters included a 10-ms pulse duration and a fluence set at 1 J/cm2 below the purpura threshold. Nd:YAG parameters were set at a 50-ms pulse duration with fluences varying between 35 and 50 J/cm2, depending on patient comfort. Improvement was determined by evaluation of photographs taken before the first treatment and at 1 and 3 months following the last treatment, as well as the individual's self-assessment. RESULTS: Individuals tolerated treatments well with no serious, long-term, or permanent adverse effects. Improvement was most pronounced in telangiectasias and diffuse erythema, followed by epidermal dyspigmentation and lentigines. Some individuals were also noted to have improved smoothness, radiance, or pore size. The improvement was generally maintained at the 3-month follow-up. In addition, the average self-reported improvement was 1.7 (on a 0-4 scale) at 1 month and 2.4 at 3 months following the last treatment. CONCLUSION: A novel combined sequential PDL/Nd:YAG laser can be used to treat a variety of cutaneous changes associated with photoaging. Further studies may determine the relative impact of each laser and whether the total effect is simply additive or synergistic     

Comparison of biophysical properties of skin measured by using non-invasive techniques in the KM mice following 595 nm pulsed dye, 1064 nm Q-Switched Nd:YAG and 1320 nm Nd:YAG laser non-ablative rejuvenation

BACKGROUNDS/AIMS: The aim of the study was to compare the changes of the biophysical properties and to objectify the effects of 595 nm pulsed dye, 1064 nm Q-switched Nd:YAG and 1320 nm Nd:YAG lasers non-ablative rejuvenation by non-invasive techniques. METHODS: KM mice were used for the study. The 595 nm pulsed dye, 1064 nm Q-switched Nd:YAG and 1320 nm Nd:YAG laser treatments were evaluated with biophysical parameter measurements including skin elasticity, skin color, skin trans-epidermal water loss (TEWL) and skin hydration. RESULTS: All three lasers improved the biophysical properties in the skin of KM mice. In skin elasticity measurements, the 1064 nm laser treatment showed the lowest ratio (0.61+/-0.09) while the 1320 nm laser showed the highest one (0.76+/-0.07) on day 60. For erythema values, a significant increase was observed immediately after the 1064 nm laser treatment (196.67+/-19.17), but the lowest values occurred with the 1320 nm laser treatment (189.83+/-16.54). None of the three lasers resulted in obvious changes of skin melanin. TEWL increased immediately after laser irradiation, then began to recover and decreased 60 days after the 595 and 1064 nm laser treatments. With the 1320 nm laser treatment the TEWL began to decrease from day 7 and obtained the lowest mean values (5.23+/-1.13). The water-holding capacity increased initially for the 595 and 1320 nm laser irradiation, while decreased for the 1064 nm laser. At day 60 of the experiment, skin hydration values in all animals were superior to those of the controls. The 1320 nm laser treatment caused the highest ratio (1.29+/-0.26). Both the values of TEWL and skin hydration for the 1320 nm laser treated areas differed significantly from the other two lasers. CONCLUSIONS: Our data showed the 1064 nm Q-switched Nd:YAG laser treatment was most effective in improving the skins' mechanical properties, while the 1320 nm Nd:YAG laser can enhance greatly the skin barrier function and the water-holding capacity. Moreover, we demonstrated the biophysical properties differed considerably between different areas.     

Hair removal with an Athos Nd:YAG 3.5 ms pulse laser: a 3-month clinical study

INTRODUCTION/OBJECTIVE : This study aimed to evaluate the safety and efficacy of a 3.5 ms Nd:YAG laser for the removal of hair in subjects with Fitzpatrick skin types I-IV. Thanks to a pulse shorter than the hair Thermal Relaxation time (TRT), photothermolysis was thus achieved. METHODS : This study assessed the percentage of hair reduction at 1 month and at 3 months after a single Nd:YAG laser treatment (Athos; Quantel Médical, France); 3.5 ms pulse, single shot to 3 Hz, a maximum fluence of 80 J/cm 2 , 4 mm spot, no cooling system, no anaesthesia. The treatment sites consisted of three adjacent squares (optimum fluence, no treatment, -20% optimum fluence). Computerized hair counting was realized on digital pictures. The phototype, pain, side effects and patient's satisfaction were noted. Biopsies were performed 15 min after treatment. The enrolment consisted of 17 women, 22-60 years old, phototypes I-IV, with a follow-up at 1 month and 3 months of 25 sites. RESULTS : Counting at 1 month and at 3 months revealed a significant hair reduction compared with the control sites: 60% at 1 month ( P < 0.001) and 24% at 3 months ( P < 0.05) for optimal fluence (25-80 J/cm 2 ), compared with 31% and 0% on the control sites; values similar to those published for Nd:YAG or diode lasers. There were no adverse effects at all. Biopsies showed lesions from necrosis coagulation of the root sheaths and hair disruption to isolated apoptotic cells in the outer root sheath, depending on the fluence applied. CONCLUSION : Results from this study show that the Athos Nd:YAG is efficient and safe for removing pigmented hair in phototypes I-IV.     

Picosecond alexandrite laser is superior to Q-switched Nd:YAG laser in treatment of minocycline-induced hyperpigmentation: A case study and review of the literature

Background: Minocycline is a commonly prescribed tetracycline antibiotic used for the treatment of a number of dermatological conditions including acne and rosacea. Long-term adverse effects of minocycline include cutaneous hyperpigmentation. Various treatment options have been suggested for the treatment of minocycline pigmentation. We report a case of a patient on long-term low-dose minocycline for the treatment of rosacea with type III minocycline hyperpigmentation. A comparison was made between Q-Switch Nd:YAG and picosecond laser over a nine 9-period with treatments spaced 1 month apart, with a clearance in the patient pigmentation after four treatments with picosecond laser.