Novel 755-nm diode laser vs. conventional 755-nm scanned alexandrite laser: Side-by-side comparison pilot study for thorax and axillary hair removal

Background: Alexandrite (755 nm) and diode lasers (800–810 nm) are commonly used for hair removal. The alexandrite laser technology is somewhat cumbersome whereas new diode lasers are more robust. Recently, alexandrite-like 755 nm wavelength diodes became available. Objectives: To compare the efficacy, tolerability, and subject satisfaction of a 755 nm diode laser operated in conventional (HR) and non-conventional in-motion (SHR) modes with a conventional scanned alexandrite 755 nm laser for chest and axillary hair removal. Materials and methods: A prospective, single-center, proof of principle study was designed to evaluate the safety, efficacy and handling of a 755 nm diode laser system in comparison to a standard alexandrite 755 nm scanning hair removal laser. Results: The new 755 nm diode is suitable to be used in SHR and HR mode and has been tested for its safety, efficacy and handling in a volunteer with success. Overall, both systems showed a high efficacy in hair reduction (88.8% 755 nm diode laser vs. 77.7% 755 nm alexandrite laser). Also, during the study period, no severe adverse effects were reported. Conclusion: The new 755 nm diode laser is as effective and safe as the traditional 755 nm alexandrite laser. Additionally, treatment with the 755 nm diode laser with HR and SHR modes was found to be less painful.     

Dual wavelength treatment protocol with a picosecond laser for the reduction of facial wrinkles

Introduction: The potential of a dual wavelength picosecond laser, as a new modality for treating photoaged skin, was investigated in this clinical study.

Material and Methods: Subjects with bilateral mild-to-moderate facial wrinkling received four picosecond laser treatments, at 3–8 weeks apart, with a double-pass of both 532-nm and 1064-nm split-beam handpieces. Blinded evaluation of clinical photography, by two independent physicians, using the Fitzpatrick Elastosis Scale, was performed at 12 weeks after the fourth treatment.

Results: Twenty subjects (19 females; mean age 55 ± 7 years, Fitzpatrick Skin Types II–IV) were treated. Blinded evaluation demonstrated 75% (15/20) of the treated faces had improvement of at least one point. Investigator assessments showed a 100% improvement rate in the appearance of wrinkles and a mean elastosis score (ES) improvement of 2.1 ± 0.8 points. Subject satisfaction rate was 74%. Treatments were associated with no to mild discomfort with a mean score of 3.7 ± 1.9 on a scale of 0 (no pain) to 10. Common treatment responses included erythema (98%) and edema (7.5%) that generally resolved within several hours of treatment.

Conclusion: In this study, picosecond laser treatments resulted in significant improvement in facial wrinkles. There were no complications with treatment and minimal downtime.     

Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma

Background: Picosecond laser is a novel modality for pigmented skin disorders with extremely short pulse duration. Little is known about the effects of the picosecond laser in melasma. Objective: This study aimed to investigate the efficacy of fractional picosecond 1,064?nm laser in melasma treatment. Study design: A prospective, randomized, assessor-blinded, intra-individual split face comparative study. Methods: Female subjects with melasma were enrolled and received fractional picosecond 1,064?nm laser plus 4% hydroquinone cream on one randomly assigned side of the face; the results were compared to the use of hydroquinone cream only on the contralateral side. The modified melasma area severity index (mMASI) score, melanin index by Mexameter MX18®, participant satisfaction score by quartile rating scale, and the quality of life by the dermatology life quality index (DLQI) were evaluated over 12 weeks. Results: Thirty female subjects completed the protocol. The mean (± standard deviation, SD) mMASI score at the 12-week visit was significantly reduced in the picosecond laser-treated areas compared to controls (3.52 ± 1.4 and 4.18 ± 2.03 respectively; p = 0.035). No differences were observed in the mean Mexameter melanin index, participant satisfaction score, and DLQI score. The observed adverse effects included transient mild erythema and mild skin desquamation. Conclusion: The addition of fractional picosecond 1,064?nm laser to 4% hydroquinone was effective and significantly better than 4% hydroquinone alone for the treatment of melasma.     

A prospective,split-face,randomized study of the efficacy and safety of a novel fractionated intense pulsed light treatment for melasma in Asians

Background: Intense pulsed light (IPL) has been reported to effectively treat melasma in previous studies, but an aggravation of pigmentation was noted. Fractionated IPL is a novel technique in which microsecond-domain fractionated pulses are delivered to the target area. Objective: To compare the safety and efficacy of low-fluency, frequently scheduled fractionated IPL and conventional IPL for melasma treatment. Materials and Methods: This was a 14-week, split-face study in which 30 Asian women were treated with weekly fractionated IPL on one side of the face and biweekly conventional IPL on the other side. Results: The non-inferiority of a weekly fractionated IPL regimen to a biweekly conventional IPL regimen was verified by a lower margin of the 95% confidence interval for the difference in the Melasma Area and Severity Index (MASI) change from baseline of 2.61 for each side. This value was greater than the previously determined non-inferiority margin of –2.68 (P < 0.025). On the fractionated IPL side, the modified MASI score decreased continuously, but in the conventional IPL group, the MASI score rebounded during the treatment course. Conclusion: Fractionated IPL shows moderate efficacy as a melasma treatment and is therefore a good alternative to conventional IPL as there is no indication of melasma exacerbation. Fractionated IPL can also be used as a maintenance treatment for melasma.     

595 nm染料激光联合外用0.5%马来酸噻吗洛尔溶液治疗浅表型婴儿血管瘤的疗效评价

目的 评价595 nm染料激光联合0.5%马来酸噻吗洛尔溶液局部治疗浅表型婴儿血管瘤的疗效和安全性。方法 回顾性分析2015年7月至2016年7月在温州医科大学附属第二医院育婴儿童医院皮肤科门诊接受595 nm染料激光联合0.5%马来酸噻吗洛尔溶液治疗且资料完整的156例浅表型婴儿血管瘤患儿的临床资料。男44例,女112例,年龄（3.8 ± 0.7）个月（范围24 d至1岁）。激光治疗间隔为5周,噻吗洛尔溶液每天外敷2次,每次30 min,瘤体基本消退时停止激光及噻吗洛尔治疗。分别于第5、10、15、30周每次治疗前,用视觉模拟评分（VAS）评价疗效,记录不良反应,随访至治疗结束后6个月。分析血管瘤面积和厚度与治疗时间、次数和VAS之间的关系。结果 156例患儿经5 ~ 30周治疗后,血管瘤均有不同程度缓解,治愈率为93.59%（146/156）。治疗第5、10、15、30周时,VAS分别为3.12 ± 0.23、4.45 ± 0.52、5.45 ± 0.71、7.59 ± 1.64。重复测量数据的方差分析显示,血管瘤初始厚度 < 1 mm组、1 ~ 3 mm组和 > 3 mm组VAS随时间延长而逐渐增加（F = 189.35,P < 0.05）,各个时间点不同厚度血管瘤组间VAS存在组间差异（F = 215.56,P < 0.05）,其中血管瘤厚度 < 1 mm组VAS更高。< 1 mm组总治疗时间（2.71 ± 0.58个月）分别短于1 ~ 3 mm组（8.22 ± 0.67个月,P < 0.05）和 > 3 mm组（11.03 ± 0.72个月,P < 0.05）。血管瘤初始面积 < 3 cm2组、3 ~ 9 cm2组和 > 9 cm2组VAS亦有不同,且随治疗时间变化,Kruskal?Wallis H检验显示,3组间治疗次数差异有统计学意义（H = 10.45,P < 0.01）, < 3 cm2组治疗次数最少。不良反应轻微,且未发现心血管、呼吸系统方面的不良反应。结论 595 nm染料激光联合0.5%马来酸噻吗洛尔溶液局部治疗浅表型婴儿血管瘤疗效确切,安全性好。     

A prospective,split-face,double-blinded,randomized study of the efficacy and safety of a fractional 1064-nm Q-switched Nd:YAG laser for photoaging-associated mottled pigmentation in Asian skin

Background: Laser toning using low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum laser (QSNY) has gained popularity in the treatment of photoaging-associated mottled pigmentation (PMP). However, hypopigmentation or lack of efficacy has been reported depending on the fluences used. Objective: To compare a novel fractional 1064-nm QSNY with conventional 1064-nm QSNY for the treatment of photoaging-associated mottled pigmentary lesions except epidermal lesions of lentigines and freckles through a randomized, split-face, double-blind study. Materials and methods: Thirteen Asian women were treated every week for 6 weeks with fractional 1064-nm QSNY on one side of the face and conventional 1064-nm QSNY on the other side. We evaluated the pigmentation area and severity index (PSI), melanin index, erythema index, and the patient's global assessment of improvement. Results: At three months post-treatment, the PSI score improved compared with baseline, by 14.48% on the conventional 1064-nm QSNY side and 21.81% on the fractional 1064-nm QSNY side. Both groups showed improvements in the melanin index. Conclusion: Both fractional 1064-nm QSNY and strictly low-fluence conventional 1064-nm QSNY are moderately effective against PMP and other photoaging signs. Fractional laser toning shows better subjective outcomes than conventional toning.     

Long‐pulsed dye laser vs. intense pulsed light for the treatment of facial telangiectasias: a randomized controlled trial

Objective This study aims to compare the efficacy and adverse effects of long‐pulsed dye laser (LPDL) and intense pulsed light (IPL) in the treatment of facial telangiectasias. Methods We used intra‐individual, randomized, controlled trial with split‐face treatments and single‐blind outcome evaluations in this study. Forty patients with symmetrically located facial telangiectasias received a series of three LPDL (V‐beam, 595 nm, Candela Laser Corp.) and three IPL treatments (Ellipse Flex, PR and VL2 applicators, Danish Dermatologic Development) at 6‐week intervals. Patients were evaluated 3 months after the final treatment. Outcome measures were clinical efficacy (five‐point ordinal scale), pain (10‐point numerical scale), adverse effects, patient satisfaction (10‐point numerical scale) and preferred treatment. Results Thirty‐nine of 40 patients completed the study. All but 2 patients obtained a reduction in facial telangiectasias from both IPL and LPDL treatments. Both treatments were effective with good or excellent response in 30 of 39 patients. The LPDL was superior in the overall reduction of telangiectasias by blinded photographic evaluations: Excellent clearance (75% to 100% vessel clearance) was found in 18 patients treated with LPDL (46%) and in 11 patients treated with IPL (28%) (P = 0.01). Patients experienced less pain from LPDL [4 (2–6)] than IPL treatments [7 (3–9)] (P < 0.001). No adverse effects (hypo‐/hyperpigmentation or scarring) were seen from any of the treatments. Patients were satisfied with both LPDL [8 (2–10)] and IPL treatments [7 (2–10)] (P = 0.05). Twenty‐five patients preferred the LPDL (64%), 8 patients preferred IPL (21%) and 6 patients had no preference (15%) (P < 0.001). Conclusion This study was based on two specific types of laser and IPL equipment, which effectively clear telangiectasias; however, the most beneficial outcome was from the LPDL.     

Intense pulsed light vs. pulsed‐dye laser in the treatment of facial acne: a randomized split‐face trial

Background Various laser and light therapy have been increasingly used for the treatment of acne vulgaris. Patients and methods Twenty patients with facial acne were treated using intense pulsed light (IPL) on one side of the face and pulsed dye laser (PDL) on the other to compare the efficacy and safety of IPL and PDL. Treatment was performed 4 times at 2‐week intervals. Treatment effectiveness was determined using lesion counts, acne severity, patient subjective self‐assessments of improvement, and histopathological examinations, which included immunohistochemical staining for transforming growth factor‐β (TGF‐β). Results Numbers of total acne lesions decreased following both treatments. For inflammatory lesions such as papules, pustules and nodules, IPL‐treated sides showed an earlier and more profound improvement than PDL‐treated sides. However, at 8 weeks after the 4th treatment, a rebound aggravation of acne was observed on IPL‐treated sides. On the contrary, PDL produced gradual improvements during the treatment sessions and these improvements lasted 8 weeks after the 4th treatment. Non‐inflammatory lesions as open and closed comedones also showed improvement following both treatments and PDL‐treated sides showed better improvement as the study proceeded. Histopathological examinations showed amelioration in inflammatory reactions and an increase in TGF‐β expression after both treatments, which were more prominent for PDL‐treated sides. Conclusion Both PDL and IPL were found to treat acne effectively, but PDL showed a more sustained effect. TGF‐β might play a key role in the resolution of inflammatory acne lesions.     

A prospective,randomized, double-blinded,split-face pilot study comparing Q-switched 1064-nm Nd:YAG versus 532-nm Nd:YAG laser for the treatment of solar lentigines

Treating photoaging with laser technologies has increased in popularity due to their efficacy, minimal downtime, and side effects. New Q-Switched (QS) Nd:YAG lasers’ frequency doubled with 532 nm wavelength can both target epidermal chromophores as well as stimulate collagen production. The objective of this study was to compare single-pulsed 1064-nm Nd:YAG with dual-pulsed 532-nm/1064-nm QS laser for reducing solar lentigines. Ten subjects with solar lentigines were enrolled in this prospective, randomized, double-blind, split-face study. Subjects received six laser treatments (half-face dual, half single) at 2-week intervals. Blinded investigator and subject assessments were conducted 1 month posttreatment to evaluate global skin improvement, safety, and patient satisfaction. Blinded investigator assessments showed statistically significant improvement in the dual-treated side. Patient satisfaction was also statistically significantly increased in the dual-treated side. In conclusion, dual laser treatment can result in superior and safe global improvement of photoaging.