深层补水在红蓝光治疗痤疮中作用的定量评价

目的评价深层补水在红蓝光治疗寻常痤疮中的作用。方法 60例患者随机分为单纯照光对照组:红蓝光交替照射,每周2次,共8次;联合补水治疗组,照光方法同前,并于每次红蓝光照射后给予补水治疗1次。两组分别于治疗前、末次治疗和治疗结束后1个月用VISIA皮肤图像分析仪和SOFT5.5皮肤性质测试仪对患者皮肤性质进行分析评价。结果 VISIA数据显示联合治疗组与对照组末次治疗后比较,患者皮肤纹理、毛孔、紫质相比差异均有统计学意义(P0.05);SOFT5.5数据显示,水分明显增多、油脂明显减少,均有统计学意义(P0.05),于治疗结束后1个月比较,皮肤水分、油脂、纹理、毛孔和弹性相比差异均有统计学意义(P0.05)。结论深层补水联合红蓝光治疗可以明显提高皮肤水分,对皮肤纹理和毛孔、油脂分泌持续改善,并可增加皮肤的弹性。     

寻常痤疮患者面部皮肤特征的定量评价

目的了解寻常痤疮患者面部皮肤特征表现,并进行定量评价。方法随机选取2011年1月～2012年6月在北京军区总医院激光美容中心进行痤疮治疗的180例痤疮患者和同一时期进行美容咨询的50名健康者,应用VISIA皮肤图像分析仪和SOFT5.5皮肤性质测试仪对患者和健康者皮肤性质进行定量分析和评价。结果 VISIA数据显示与男性健康者相比,男性痤疮患者在纹理、毛孔和紫质均有明显差异性（P〈0.05）,与女性健康者相比,女性痤疮患者在皱纹、毛孔、紫质和红色区均有明显差异性（P〈0.05）;与女性痤疮患者相比,男性痤疮患者在色素斑、毛孔和紫质均有明显差异性（P〈0.05）,与女性健康者相比,男性健康者在色素斑、皱纹、纹理、毛孔和紫质均有明显差异性（P〈0.05）,而红色区未见明显差异性（P〉0.05）;不同严重程度的痤疮患者差别主要在紫质和红色区;SOFT数据显示与男性健康者相比,男性痤疮患者在油脂有明显差异性（P〈0.05）,与女性健康者相比,女性痤疮患者水分和油脂均有明显差异性（P〈0.05）;与女性痤疮患者相比,男性痤疮患者在pH和油脂均有明显差异性（P〈0.05）,与女性健康者相比,男性健康者在水分和油脂均有明显差异性（P〈0.05）,而pH和弹性未见明显差异性（P〉0.05）;不同严重程度的痤疮患者差别主要在水分和油脂。结论寻常痤疮患者面部皮肤特征较健康皮肤表现为皮肤pH、水分和油脂等肤质的差异性且具有明显的性别差异性。     

2940 nm 铒激光治疗凹陷性痤疮瘢痕的疗效与安全性观察

目的：观察2940 nm铒玻璃激光治疗痤疮凹陷性瘢痕的疗效与安全性。方法：选取25例诊断为凹陷性痤疮瘢痕的患者,使用2940 nm铒激光治疗,每4周1次,共3次。治疗前后拍照并使用EC-CA权重评分、VISIA皮肤图像分析仪评估疗效,使用CK皮肤检测仪评估皮肤屏障功能。结果：治疗结束后,所有病例均有改善,临床有效率为28％。痤疮凹陷性瘢痕ECCA权重评分明显下降,与治疗前比较,差异有统计学意义（P＜0.05）,毛孔、紫质显著减少（P＜0.05）;治疗后1周与治疗前相比,经皮水分丢失量、油脂增多（P＜0.05）,含水量减少（P＜0.05）,治疗前与治疗1月后相比,经皮水分丢失量、含水量、油脂无明显差异（P值均＞0.05）。结论：2940 nm铒激光治疗痤疮凹陷性瘢痕有效,术后1月后皮肤屏障功能恢复。     

2940nm铒激光治疗凹陷性痤疮瘢痕的疗效与安全性观察

目的:观察2 940 nm铒玻璃激光治疗痤疮凹陷性瘢痕的疗效与安全性。方法:选取25例诊断为凹陷性痤疮瘢痕的患者,使用2 940 nm铒激光治疗,每4周1次,共3次。治疗前后拍照并使用ECCA权重评分、VISIA皮肤图像分析仪评估疗效,使用CK皮肤检测仪评估皮肤屏障功能。结果:治疗结束后,所有病例均有改善,临床有效率为28%。痤疮凹陷性瘢痕ECCA权重评分明显下降,与治疗前比较,差异有统计学意义(P<0.05),毛孔、紫质显著减少(P<0.05);治疗后1周与治疗前相比,经皮水分丢失量、油脂增多(P<0.05),含水量减少(P<0.05),治疗前与治疗1月后相比,经皮水分丢失量、含水量、油脂无明显差异(P值均>0.05)。结论:2 940 nm铒激光治疗痤疮凹陷性瘢痕有效,术后1月后皮肤屏障功能恢复。     

VISIA皮肤检测仪定量评价CO_2点阵激光两种模式治疗痤疮萎缩性瘢痕疗效的分析

目的 VISIA皮肤检测仪定量评价CO_2点阵激光两种模式治疗痤疮萎缩性瘢痕的长期疗效。方法对20例面部痤疮萎缩性瘢痕患者进行自身对照试验,随机选择患者一侧面部痤疮萎缩性瘢痕进行局灶高能量治疗,另一侧采用大面积低能量平扫技术。共治疗5次,每次治疗间隔3个月。每次治疗后3个月均使用VISIA皮肤检测仪采集皮肤色素斑、红斑、毛孔、纹理、紫质数据分析,同时对ECCA痤疮瘢痕评分、患者满意度评分资料进行分析。结果两种模式治疗后ECCA痤疮瘢痕评分随治疗次数增加逐渐下降,患者满意度评分逐渐增加。VISIA数据分析示前3次治疗局灶侧纹理计数低于平扫侧(P0.05),同ECCA评分结果一致说明采用局灶高能量模式治疗,较少治疗次数即可见痤疮萎缩性瘢痕明显改善;5次治疗中平扫侧色素斑、红斑、毛孔、紫质计数均低于局灶侧(P0.05),说明采用大面积平扫技术可以改善皮肤整体状况。结论 VISIA皮肤检测仪可以较客观全面评价两种模式的治疗效果,纹理计数显示局灶侧瘢痕改善明显,色素斑、红斑、毛孔、紫质计数显示大面积平扫侧皮肤改善明显。     

2940nm与1550nm点阵激光治疗凹陷性痤疮瘢痕自身前后疗效及安全性对照观察

目的探讨比较2 940nm铒激光与1 550nm铒玻璃激光治疗痤疮凹陷性瘢痕的疗效与安全性。方法选取10例诊断为痤疮凹陷性瘢痕患者,左右半侧面部分别使用2 940nm铒激光与1 550nm铒玻璃激光治疗。每4周治疗1次,共3次。通过治疗前后拍照、VISIA皮肤图像分析仪、CK皮肤检测仪评估疗效与皮肤屏障功能。结果 3次治疗后与治疗前比较,毛孔显著缩小,且1 550nm治疗侧毛孔缩小量大于2 940nm治疗侧(P0.05);紫质、棕色斑减少(P0.05),但1 550nm与2 940nm两侧差异无统计学意义(P0.05);每次治疗前与治疗后1周相比,经皮水流失量增多(P0.05),且2 940nm治疗侧大于1 550nm治疗侧(P0.05)。结论使用推荐能量的中低档时,1 550nm铒玻璃激光治疗冰锥型痤疮凹陷性瘢痕疗效优于2 940nm铒激光,并且皮肤屏障的损伤小于2 940nm铒激光。     

胶原贴敷料对点阵激光术后皮肤修复作用的临床评价

目的评价胶原贴敷料在点阵激光术后创面修复中的临床疗效和安全性。方法纳入面部行点阵激光治疗后的受试者97例,采用半边脸自身对照方法随机分成治疗组和对照组,分别给予胶原贴和空白基质敷料,治疗后即刻给予敷料外用,连续使用7 d。通过问卷调查观察该敷料对点阵激光术后皮肤各种症状的改善作用,同时采用皮肤图像分析仪(VISIA)及皮肤性质测试仪(SOFT5.5)检测并进行客观评价其疗效。结果 97例激光术后受试者经过胶原贴敷料治疗后,红斑、疼痛、干燥、脱屑症状均明显改善,两组比较差异有统计学意义(P0.05);VISIA结果显示斑点、皱纹、纹理、棕色斑、红质及紫质的改善治疗组优于对照组(P0.05);SOFT结果显示治疗组水分、油脂得到改善(P0.05)。1例受试者出现轻微过敏反应,停用后恢复。结论胶原贴敷料用于点阵激光术后是一种安全、有效的护理策略。     

微等离子体射频治疗萎缩性痤疮瘢痕临床疗效及安全性观察

目的:观察微等离子体射频治疗面部萎缩性痤疮瘢痕的临床疗效及安全性。方法:采用微等离子体射频治疗面部萎缩性痤疮瘢痕40例。每2个月治疗1次,共5次,分别于末次治疗结束后第1、3、6个月随访观察临床疗效及不良反应。通过分析治疗前、后的数码照片、VISIA皮肤图像评估疗效。结果:所有患者痤疮瘢痕均有不同程度的改善,痤疮瘢痕权重评分(伢chelle devaluation clinique descicatrices dacn伢,ECCA)均有下降(P0.05);治疗后患者斑点、毛孔、皮肤纹理、紫外线色斑、红色区、紫质减少(P0.05),皱纹、棕色斑无明显差异(P0.05)。治疗时的主要不良反应是疼痛,平均疼痛评分为6.15分;治疗后会出现一过性红肿、渗出、结痂,平均红斑持续时间为6.58 d,平均结痂持续时间为5.3 d。结论:微等离子体射频是一种安全、有效的治疗萎缩性痤疮瘢痕的方法。     

LuxG柔脉冲强光对敏感性皮肤修复的临床疗效观察

目的:观察应用Lux G柔脉冲强光对敏感性皮肤修复的临床疗效。方法:采用Lux G柔脉冲强光对50例敏感性皮肤患者进行治疗,每4周1次,治疗3次。采用自身前后对照观察治疗疗效,VISIA检测患者皮肤斑点、皱纹、纹理等,并检测患者每次治疗后1月经皮水分丢失(TEWL)数值及角度层含水量,进行统计比较。结果:治疗总有效率为90%。VISIA皮肤检测示:Lux G治疗3次术后较治疗前斑点、皱纹、纹理及红色区特征计数减少,差异有统计学意义(P0.05),而毛孔、紫质与治疗前相比差异无统计学意义(P0.05)。TEWL值在Lux G术后第1月迅速下降,治疗3次后接近正常值,与治疗前比较差异均有统计学意义(P0.05)。角质层含水量在Lux G术后第1月明显升高,治疗3次后显著提升,差异均有统计学意义(P0.05)。结论:Lux G柔脉冲强光对敏感性皮肤疗效确切,未观察到不良反应,损伤小。     

强脉冲光对31例重度痤疮患者面部疗效及皮肤油脂的影响

目的:观察强脉冲光治疗痤疮的疗效以及对皮肤油脂的影响。方法:对31例面部重度痤疮患者,采用420 nm强脉冲光治疗2次,治疗结束后随访6周,计数皮损判定疗效,同时采用皮肤生理测试仪器测量皮肤油脂变化。结果:2次治疗后,患者面部皮损明显减少,疗效从第1周到第6周保持稳定(2=0.42,P=0.937);无论男女、皮肤型别,患者皮脂分泌均较治疗前减少(P值均0.05)。结论:420 nm强脉冲光治疗重度痤疮疗效肯定,并可以减少面部皮脂分泌。     

Clinical studies of the treatment of facial atrophic acne scars and acne with a bipolar fractional radiofrequency system

Few clinical studies have examined the utility of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars and active acne in people with darker skin. This study was designed to compare the safety and efficacy of bipolar FRF therapy as a treatment for atrophic acne scars and acne vulgaris. Twenty‐three Japanese patients with atrophic acne scars and mild to severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron, Yokneam Illit, Israel). Five treatment sessions were carried out at 1‐month intervals, and the patients were followed up for 3 months after the final treatment. Assessments of scar severity and the number of acne lesions and 3‐D in vivo imaging analysis were performed. Evaluations of the treatment outcomes and their effects on the patients’ quality of life (QOL) were also carried out. We demonstrated that the improvement in scar volume was marked in the patients with mild scars and was at least moderate in 23 (57.5%) of the treated areas. With regard to the number of acne lesions, the treated areas exhibited significantly fewer lesions compared with the baseline at each time point (P < 0.05). The patients’ assessments of the treatment outcomes and their QOL indicated that both had improved significantly by the end of the study. Furthermore, significant reductions in the patients’ sebum levels, skin roughness and scar depth were observed. Bipolar FRF treatment significantly improved the atrophic acne scars and acne of Japanese patients and had minimal side‐effects.     

铒激光联合E光治疗痤疮凹陷性瘢痕的临床效果评价

目的：评价铒激光联合E光治疗痤疮凹陷性瘢痕的临床疗效和安全性。方法：将大连市皮肤病医院美容皮肤科2013年1月至2016年6月就诊患者采用双色球方法随机分成治疗组和对照组,治疗组为铒激光联合E光治疗组;对照组为铒激光治疗组,每个月治疗一次,共3次。对照组与治疗组均于疗程结束1个月后比较两组患者治疗前后皮肤红斑、色沉,瘢痕,皱纹,粗糙度,光滑度的变化。结果：共就诊62例痤疮凹陷性瘢痕患者,治疗组31例,对照组31例,治疗组与对照组患者皮损治疗前光滑度、瘢痕、皱纹、粗糙度、色沉、红斑比较,差异无统计学意义(P＞0.05)。治疗后,治疗组,患者皮肤的光滑度,瘢痕,皱纹,粗糙度,红斑,色沉评分分别为73.32±0.236、2.21±0.152、168.6±0.177、63±0.128、8.63±0.122、5.20±0.232,对照组分别为70.45±0.354、3.28±0.138、180.6±0.412、66±0.422、13.62±0.121、11.22±0.121,两组比较差异有统计学意义(均P<0.05)。所有患者未见严重不良反应。结论：铒激光联合E光治疗痤疮凹陷性瘢痕较单独应用铒激光治疗组疗效明显提升。     

Efficacy of Punch Elevation Combined with Fractional Carbon Dioxide Laser Resurfacing in Facial Atrophic Acne Scarring: A Randomized Split-face Clinical Study

Background:

A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO₂) laser resurfacing combined with punch elevation with fractional CO₂ laser resurfacing alone in the treatment of atrophic acne scars.

Materials and Methods:

Forty-two Iranian subjects (age range 18–55) with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO₂ laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO₂ laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment.

Results:

The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56). Their evaluation found that fractional CO₂ laser treatment combined with punch elevation had greater efficacy than that with fractional CO₂ laser treatment alone, assessed 4 months after treatment (P = 0.02). Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO₂ laser treatment was significant on both treatment sides (P < 0.05).

Conclusion:

Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring.     

Efficacy and safety of a single treatment using a 10,600-nm carbon dioxide fractional laser for mild-to-moderate atrophic acne scars in Asian skin

BackgroundAblative laser therapy with carbon dioxide is effective for acne scars; however, the long downtime limits its use, especially in types III and IV skin. The fractional ablative 10,600-nm carbon dioxide laser system reportedly maximizes efficacy and minimizes side effects. The goal of this study was to evaluate the efficacy and safety of an ablative 10,600-nm carbon dioxide fractional laser system in a single treatment session on atrophic acne scars in Asian patients.MethodsTwenty-five patients with atrophic acne scars were enrolled. The laser fluences were delivered using the Deep FX mode. Comparative photographs were taken with VISIA complexion analysis. Physician evaluation and patient satisfaction were graded on a four-point scale.ResultsAt follow-up 1 month after treatment, four patients showed 51–75% improvement, 16 had 26–50% improvement, and five had minimal or no improvement. At 3 months, two patients had excellent results (76% and 100% improvement). Postinflammatory hyperpigmentation was present in six of the 25 (24%) patients; by 3 months' follow-up, this had faded in five of six cases.ConclusionA single treatment with the carbon dioxide fractional laser system is effective for acne scars in Asian patients, with minimal and acceptable side effects.     

Treatment of atrophic facial acne scars with fractional Er:YAG laser in skin phototype III–IV: A pilot study

Background: Fractional ablative lasers have recently been used for the treatment of skin scars. The objective of this study was to assess the efficacy and safety of the fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser (2940 nm) in the treatment of skin scars. Materials and methods: A total of 9 patients (8 female, 1 male) with Fitzpatrick skin types III and IV suffering from atrophic facial acne scars were treated with a fractional Er:YAG laser for 2–5 (mean 3.3) sessions 4–6 weeks apart. One independent investigator assessed the efficacy, using standardized photographs, before and 1 month after the last treatment. The patients’ satisfaction rate was also evaluated. Results: The treatment was well tolerated by all patients without any anesthesia. The downtime was 2–3 days. All patients showed improvement in scars: excellent in 1, good in 1, and fair in 7 patients. Six patients were highly satisfied and 3 were satisfied with treatment. No adverse effect was noted. Conclusion: A fractional Er:YAG laser can deliver an effective and minimally invasive treatment for acne scars.     

Efficacy and safety of 1550-nm fractional laser in the treatment of acne scars in Chinese patients: A split-face comparative study

Objective: To evaluate the efficacy and side effects of 1550-nm fractional Er:Glass laser in treating atrophic acne scar. Materials and methods: Thirty Chinese patients aged 18–65 with atrophic acne scars on both cheeks received a split-face treatment, one side with four sessions of treatment with fractional 1550-nm Er:Glass laser at 20-day interval and the other with topical asiaticoside cream application three times daily as control. Clinical response and side effects were evaluated by a dermatologist three weeks after each treatment and again 12 weeks after the last laser treatment. In addition, self-evaluation of satisfaction by the patients was done at the end of treatment. Results: The study found that mean scores decrease after treatment was 5.65 ± 4.34 for the treated side and 1.23 ± 3.41 for the control side. The improvement in acne scars after the fractional Er:Glass laser 1550-nm treatment was more significant than the control side (p = 0.0001). The side effects were mainly local skin irritation and erythema, which disappeared within one week. Conclusion: The research results show that the fractional 1550-nm Er:Glass laser is an effective and safe treatment device for atrophic acne scars.     

超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕40例分析

目的：评价超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效.方法：面部萎缩性痤疮瘢痕40例,根据患者皮肤类型、痤疮瘢痕形状、深度、密度选用超脉冲CO2点阵激光的参数治疗,并进行治疗前后对比.结果：与治疗前相比,总有效率为92.5%,治疗中未观察到严重不良反应.结论：超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕疗效显著,副作用小,安全性高.     

The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation

Objective: To evaluate the effects of conditioned medium of adipose-derived stem cells (ADSC-CM) on efficacy and side effects after fractional carbon dioxide laser resurfacing (FxCR) when treating subjects with facial atrophic acne scars or with skin rejuvenation needs. Materials and methods: Twenty-two subjects were enrolled in the study and divided into two groups. Nine subjects were included in skin rejuvenation group and thirteen subjects were included in acne scar group, and all subjects underwent three sessions of FxCR. ADSC-CM was applied on FxCR site of one randomly selected face side. Evaluations were done at baseline, 1 week after first treatment, and 1 month after each treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Biopsies taken from one subject in skin rejuvenation group were analyzed using hematoxylin and eosin, Masson's Trichrome, and Gomori's aldehyde fuchsin staining. Results: ADSC-CM combined with FxCR increased subject satisfaction, elasticity, skin hydration, and skin elasticity and decreased TEWL, roughness, and the melanin index in both acne scars and skin rejuvenation groups. Histologic analysis showed that ADSC-CM increased dermal collagen density, elastin density, and arranged them in order. Conclusion: ADSC-CM with FxCR is a good combination therapy for treating atrophic acne scars and skin rejuvenation.

Trial registration: JSPH2012-082 – Registered 14 Feb 2012