Comparison of hair reduction with three lasers and light sources: Prospective,blinded and controlled study

Abstract

Objective: The main goal of this study was to compare the hair removal efficacy of three methods: intense pulsed light (IPL), a combination of IPL and radio frequency (RF) and diode laser (810 nm). Methods: Forty participants were treated within three standardized squares on lateral sites on their legs. Each of these squares was treated twice with an interval of 4–6 weeks. The fourth square was left as a control. A blinded physician counted the hairs in each square before the first treatment and 8 months after the second treatment. Immediate and delayed side effects as well as pain scores were recorded. Results: The mean hair count reduction achieved by the diode laser, IPL and IPL+RF was 49.90%, 39.16% and 47.15%, respectively. This study did not show any serious side effects and the number of side effects was minimal. The mean pain scores for the first and second treatments by diode laser, IPL and IPL+RF were 4.65 and 4.58, 2.43 and 2.53, and 3.95 and 4.03, respectively. At the end of the study, a free hair removal treatment for both legs was chosen by patients in the proportion 20 diode laser, 10 IPL and eight IPL+RF. Conclusions: The combination of RF and optical energies proved its safety and efficacy for hair removal, which is comparable with diode lasers and approximately 20% more efficient than ‘pure’ IPL.     

Hair Removal Using a New Intense Pulsed Light Source in Chinese Patients

Background: Unwanted hair is a widespread cosmetic problem. Several lasers and intense pulsed light (IPL) have been utilized for this purpose. A new IPL device (Lumenis One^?) with OPT is one of the newer modalities to be studied in Chinese patients. Objective: This study evaluates the short-term efficacy and side effects of the new IPL device for epilation in Chinese patients. Methods: Eighteen Chinese women with Fitzpatrick skin types III–V and black hair, were treated four times at 4 to 6-week intervals using IPL (Lumenis One^?) on the axillae (n=13) and the upper lip (n=5). The energy density for treatment ranged from 14 to 22 J/cm². Parameters utilized were 695-/755-nm filters, triple pulse for patients on the axillae, and 640-/695-nm filters, double pulse for patients on the upper lip (3.5- to 7-ms pulse, 30- to 90-ms pulse delay, 15×35 mm spot size). Hair reduction was assessed at baseline, immediately before each treatment session, and at 4 weeks after the fourth treatment. Patient's satisfaction on a 5-point scale was also evaluated. Results: The average hair reduction for all sites was 49.9% after one session, 58.6% after two sessions, 79.3% after three sessions, and 83.8% after four sessions (p=0.001). The hair reduction of 44.1%, 52.1%, 81.1%, and 86.0% were achieved after each treatment for axillae, with 65.1%, 75.7%, 74.6%, and 78.0% for upper lip. Patients got more satisfaction after four sessions (score 3.1) than that after two sessions (2.0) (p=0.001). In both the assessments, upper lip appeared to show a better response than axillae after two IPL treatments, which reversed after four treatments. No significant complications or adverse events were reported. Conclusion: The new IPL device provides a safe and effective means of hair removal for Chinese patients. Treatment efficacy varies with the anatomic location and number of treatments. However, further study is necessary to determine the long-term clinical efficacy in Chinese patients.     

A split-face comparison of facial hair removal with the long-pulsed alexandrite laser and intense pulsed light system

Background: Undesirable hair growth presents a significant problem for many patients. Photoepilation has become a very popular procedure in esthetic and cosmetic practice. Among the systems used are the long-pulsed alexandrite laser (755 nm) (ALX) and intense pulsed light (IPL). Objective: To compare the safety and efficacy of long-pulsed ALX and IPL for hair removal. Patients and methods: This comparative study was carried out in the outpatient Department of Dermatology and Venereology, Al-Sadir Teaching Hospital, Al Najaf City during the period from June 2009 to July 2010. Thirty-five patients were included; thirty of them completed the study. They received six treatment sessions with the ALX on the left side of the face and IPL on the right side of face with 4-week intervals between sessions. Response to treatment on both sides of the face was assessed at 1, 3, and 6 treatment sessions. Hair-free intervals and patient's satisfaction were recorded in each visit. Results: After six treatment sessions, IPL-treated sides showed longer median hair-free intervals compared with ALX-treated sides. Reduction in hair counts was significantly larger on the IPL compared with that on the ALX-treated sides at 1, 3, and 6 sessions. Three patients (10%) developed postinflammatory hyperpigmentation, one of them on the left side and the others on the right side. It was more severe on the right side and both the patients were of skin type IV. Slight stinging and burning sensation at time of the treatment were recorded in all patients. All reported side effects were transient and tolerated by the patients except postinflammatory hyperpigmentation which persisted and was decreasing gradually toward the end of the study. Conclusions: The results of this study suggested that IPL is more effective in reducing excessive facial hair growth, with longer hair-free intervals and greater patient satisfaction than the ALX.     

Comparative efficacy of short-pulsed intense pulsed light and pulsed dye laser to treat rosacea

Background: Laser and light-based therapies have often been used successfully to treat rosacea. Recently, short-pulsed intense pulsed light (IPL) that emitted pulse durations down to 0.5 ms was found to be effective for rosacea treatment.

Objective: This study evaluated the efficacy of short-pulsed IPL in the treatment of rosacea compared with pulsed dye laser (PDL) using same pulse duration and fluence.

Materials and Methods: Nine patients with rosacea were enrolled in a randomized, split-face trial. Each treatment consisted of four sessions at three-week intervals and followed up until three weeks after the last treatment. Efficacy was assessed by erythema, melanin index, physician’s subjective evaluation, and patient’s satisfaction.

Results: The mean change in erythema index was ?4.93 ± 1.59 for the short-pulsed IPL group and ?4.27 ± 1.23 for the PDL group. The mean change in melanin index was ?2.52 ± 2.45 for the short-pulsed IPL group and ?1.95 ± 1.41 for the PDL group. There was no significant difference in either melanin or erythema index between short-pulsed IPL and PDL treatments, and there were no noticeable adverse events.

Conclusions: There was no significant difference between PDL and short-pulsed IPL treatment using the same energies and pulse. Both PDL and short-pulsed IPL were satisfactory and safe for rosacea treatment.     

Long-pulsed Nd:YAG laser vs. intense pulsed light for hair removal in dark skin: a randomized controlled trial

Background Although several lasers meet the wavelength criteria for selective follicular destruction, the treatment of darker skin phototypes is particularly challenging because absorption of laser energy by the targeted hairs is compromised by an increased concentration of epidermal melanin. Objectives To compare satisfaction level, safety and effectiveness of a long‐pulsed Nd:YAG laser and intense pulsed light (IPL) in axillary hair reduction in subjects with dark skin. Methods The study design was a within‐patient, right‐left, assessor‐blinded, comparison of long‐pulsed Nd:YAG laser and IPL. Fifty women (skin phototypes IV–VI) volunteered for removal of axillary hair. Five sessions at 4‐ to 6‐week intervals were performed. Hair counts at both sides were compared at baseline and 6 months after the last session. Final overall evaluations were performed by subjects and clinician at the end of the study. Satisfaction was scored for both devices. Results Thirty‐nine women completed the study. At 6 months, the decrease in hair counts on the laser side (79·4%, P < 0·001 vs. pretreatment) was significantly (P < 0·01) greater than that on the IPL side (54·4%, P < 0·01 vs. pretreatment). Only temporary adverse effects were reported at both sides. Higher pain scores and more inflammation were reported with Nd:YAG laser; however, it was preferred by 29 volunteers (74%). Volunteers reported higher satisfaction score with Nd:YAG laser (P < 0·01). Conclusions Dark skin can be treated by both systems safely and effectively; however, long‐pulsed (1064 nm) Nd:YAG laser is more effective as reported by both subjects and clinician.     

Effective epilation of white and blond hair using combined radiofrequency and optical energy

OBJECTIVE: The present study examined the long‐term photoepilatory effect on blond and white hair of a combined intense pulsed light (680–980?nm) device with a bipolar radiofrequency component producing electrical current at a depth of 4?mm.

MATERIALS AND METHODS: Thirty‐six adult women with white and blond hair (skin phenotypes I–V) were included in the study. The chin and upper lip were treated with four treatment sessions over 9–12 months with long‐term follow‐up performed at month 18 (6 months after the last treatment). The level of RF energy was 20?J/cm³, while optical fluences varied from 24 to 30?J/cm². Hair counts and photographic evaluation of some sites were obtained at baseline, months 1, 3 and 5 and the final treatment session.

RESULTS: An average hair removal of 48% was observed at month 18 (6 months following the final treatment session). A slightly higher photoepilatory efficiency was noted for blond hair (52%) versus white hair (44%) treatment sites.

CONCLUSION: Combined radiofrequency and optical energy technology may produce effective photoepilation of blond and white hair phenotypes.     

Efficacy of a novel intense pulsed light system for the treatment of port wine stains

Abstract

Background and objectives: Port wine stains (PWS) are capillary malformations typically treated with lasers or with intense pulsed light (IPL). This paper summarizes our safety and efficacy findings for a new IPL designed to target the dermal vessels of PWS. Methods: The PWS received three to four treatments with a novel IPL containing a vascular-specific handpiece (LuxG?, dual wavelength band of 500–670 nm and 870–1400 nm; Palomar Medical Technologies, Inc.). Clinical benefit was assessed qualitatively with a quartile-assessment scale and quantitatively with a skinphotometer. Results: Three months post-treatment, over 50% of PWS exhibited statistically significant improvements of 51–75% or higher. The pre-treatment PWS mean erythema value of 189.72±18.40 (95% Confidence Interval [CI]) was reduced to 147.22±16.15 post-treatment, thereby approaching the normal skin erythema value of 117.61 ± 15.90. The mean percent reduction in vascularity at 3 months was statistically significant at ?55.4 (p=0.0000003). Treatments were well-tolerated with minimal to no subject downtime and limited side effects of transient erythema (all subjects) or mild crusting and mild purpura (n=1). Conclusion: These results demonstrate the efficacy and safety of this novel IPL in providing therapeutic benefit to patients suffering from PWS.     

Split-leg comparison of low fluence diode laser and high fluence intense pulsed light in permanent hair reduction in skin types III to IV

Background/Objectives: All the standard light‐based techniques for permanent hair reduction, like laser and intense pulsed light (IPL) employ the highest tolerable fluence with a single pass. As opposed to standard techniques, a new diode laser technique employs low fluence with multiple passes. Here we evaluate and compare the efficacy, treatment time, comfort and safety of the low fluence multiple pass diode laser with high fluence single pass IPL for permanent hair reduction in Type III to IV Asian patients. Methods: Thirty Asian patients with Type III to IV black hair were enrolled and received three sessions of treatments at 6‐weekly to 8‐weekly intervals. A split‐leg study was performed in which the IPL was applied to one leg of each patient while the laser was applied to the other. The patients were followed up for 12 months. Results: All patients were satisfied with the results of the long‐term hair reduction without long‐term side effects. There was no statistically significant difference in hair reduction and treatment time between the laser (76.85%, 21.39 min) and the IPL (74.53%, 22.17 min) (P > 0.05). The visual analogue scale (VAS) pain score of the IPL (5.96) was higher than that of the laser (3.10) (P < 0.01). Conclusions: A series of high fluence single pass IPL and low fluence multiple pass diode laser treatments were performed with similar efficacy, speed and safety for permanent hair reduction. However, low fluence multiple pass diode laser treatment was less painful than high fluence single pass IPL.     

Photoepilation with a diode laser vs. intense pulsed light: a randomized,intrapatient left‐to‐right trial

Background Safe and efficient options for removing unwanted hair are in great demand. Laser devices and intense pulsed light (IPL) sources are the most commonly used treatment modalities. Yet, only a few randomized controlled trials (RCTs) comparing laser and IPL devices are available, and RCTs with long‐term results are missing from the literature. Objectives To compare the safety and long‐term efficacy of diode lasers (DL) and IPL sources for axillary hair removal, we conducted an intrapatient, left‐to‐right, assessor‐blinded and controlled trial. Methods IPL (Ellipse Flex PPT; Danish Dermatological Development, Hoersholm, Denmark; λ_em = 600–950 nm) and DL (LightSheer XC system; Lumenis Inc., Santa Clara, CA, U.S.A.; λ_em = 800 nm) treatments were evaluated in 30 study participants (skin type II–III) with unwanted axillary hair growth. Six treatments with each device were carried out at 4‐week intervals. Final assessment was conducted 12 months after the last treatment by means of hair counts using close‐up photographs. The primary endpoint was reduction in hair growth, analysed on an intention‐to‐treat and last‐observation‐carried‐forward basis (n = 30), and secondary endpoints were patient‐rated efficacy, treatment‐related pain, adverse effects and treatment duration. Results Both devices significantly reduced hair counts. Mean reductions from baseline (3 and 12 months after the last treatment) were 59·7% and 69·2% for DL and 42·4% and 52·7% for IPL treatment (P < 0·01), respectively. DL treatment induced significantly more pain [3·7 ± 2·1 (DL) vs. 1·6 ± 1·4 (IPL); P < 0·01; visual analogue scale] but could be conducted faster [33·1 ± 3·8 s (DL) vs. 40·1 ± 5·0 s (IPL); P < 0·01]. No severe side‐effects were observed for either therapy. Conclusions Both DL and IPL treatments are highly effective, long lasting and safe. DL was found to be more effective than IPL treatment. DL treatment was more painful but less time‐consuming than IPL therapy.     

Comparison of effectiveness of 1,064-nm Nd:YAG laser and Nd:YAG laser–IPL combination treatments in hand skin rejuvenation

Objective: Evaluation of the efficacy and side effects of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and Nd:YAG laser–intense pulsed light (IPL) combination treatments in photorejuvenations of skin of the hand, and determining their impacts on patient satisfaction. Materials and Methods: Thirty-five female patients with signs of photoaging on the skin of their hands were included in the study. Three sessions of IPL and four sessions of Nd:YAG laser treatment were applied to the right hand in total with 2-week intervals between each session, whereas six sessions of Nd:YAG laser treatment were applied to the left hand of patients with 2-week intervals between each session. Results: The patients’ ages ranged between 31 and 78, and mean age was 60.77 ± 9.48. While there was no difference in pigment distribution, fine wrinkles, coarse wrinkles, and global scores between the right and left hand prior to treatment (p > 0.05), average pigment tone score was higher in the right hand with a statistically significant difference (p < 0.05). There was greater improvement in scores of pigment distribution, fine wrinkles, sallowness, pigment tone parameters, and global score on the right hand compared to left hand, which was statistically significant (p <0.001). Conclusion: In rejuvenation of photoaged dorsal skin of the hand, IPL–Nd:YAG laser combination treatment surpasses Nd:YAG laser treatment.     

Hair removal with a novel,low fluence,home-use intense pulsed light device

Objective: To evaluate the reduction in unwanted body and facial hair at various body sites of Fitzpatrick skin types I–III and the efficacy, comfort and safety of this treatment intended for home-use by the general public. Methods: In this non-randomized study, 29 individuals were given three sequential weekly treatments on a total of 31 body and facial areas including the axilla, bikini area, abdomen, neck, chin and upper lip using a novel intense pulsed light device. All participants completed a simple self-assessment questionnaire, as well as an evaluation of pain/discomfort. Results: The mean reduction in terminal hair counts was 47% at 4 weeks' follow-up and 41% at 6 months' follow-up after completing three sequential weekly treatments. Overall, 84% of participants showed a significant percentage of hair reduction (p<0.01) at the 6-month follow-up, with a mean of 51% (range 25–86%). No treatment-related side effects were reported, with little or no discomfort reported during the treatment. Only mild erythema was noted immediately post-treatment. In total, 85% of the participants were either pleased or very pleased with the results 1 month after the third treatment. Conclusions: In simulated consumer use, this home-use IPL demonstrated a significant, quantifiable and sustainable reduction in unwanted body and facial hair with minimal side effects.     

Efficacy of long‐ and short pulse alexandrite lasers compared with an intense pulsed light source for epilation: a study on 532 sites in 389 patients

BACKGROUND: Undesirable hair growth presents a significant problem for many patients, and photoepilation has become a very popular procedure in aesthetic and cosmetic practice. Among the systems used are the long‐ and short‐pulsed alexandrite lasers (LP‐Alex, SP‐Alex) and intense pulsed light (IPL) sources. The present study retrospectively examined the outcome of these systems from the viewpoint of efficacy and side effects.

PATIENTS AND METHODS: Three hundred and eighty‐nine patients (370 females and 19 males, mean age 36.4?yrs, skin types II–V) were admitted to the study, with a total of 532 treated sites. They were treated either with the LP‐Alex, SP‐Alex or IPL. Subjective evaluation and interview of the patients was held prior to every treatment session. Six to eight treatments were required with the alexandrite lasers, 2.4–2.8 months between treatments, and the IPL source required 8–9 treatments, 2–2.5 months apart.

RESULTS: No significant difference was seen between the LP‐ and SP‐Alex, or between both of them and the IPL source, although the period to regrowth was longer for the lasers. Erythema and oedema were more noticeable with the LP‐Alex, as were crusting and hyper‐ and hypopigmentation. Discomfort was greatest with the LP‐Alex and the IPL source. Hair induction at the borders of the treated area on the face and neck was seen only with the LP‐Alex, and correlated statistically significantly with any episode of severe erythema, crusting or hyperpigmentation.

CONCLUSIONS: There was no statistically significant difference between the LP‐, SP‐Alex and IPL photoepilation with regard to efficacy. Transient side effects were highest with the LP‐Alex, and least with the IPL system. In the LP‐Alex treated face and neck sites, 3.1% had hair induction in the borders of the treated areas.     

Evaluation of safety and efficacy of variable pulsed light in the treatment of unwanted hair in 77 volunteers

Background Several studies on hair removal with intense pulsed light (IPL) and various laser sources have been done, but adequate data on long‐term follow up are scarce. The present uncontrolled prospective pilot study evaluated safety and long‐term efficacy of variable pulsed light (VPL?) on hair removal in the face for medical and/or cosmetic indications. Study design/material and methods The VPL? system (Energist Ltd, UK) was used for the treatment of hypertrichosis in the face, mainly hirsutism, in 77 female volunteers. The minimum follow‐up time after the last treatment was 9 months (mean: 12.74 ± 2.87 months). Results Over 50% of hair clearance was observed in 68 (88.3%) of all cases. Erythema and leucotrichia were the most often associated side‐effects encountered. Transient pigmentary changes were not reported. Conclusion The VPL? System presents as a relatively efficient and safe treatment alternative for long‐term removal of unwanted hair. It seems to be particularly effective in fair‐skinned patients with dark hair (skin types II–III–IV). Adverse effects were minimal and transient and, in no patient, significant enough to interrupt treatment.     

Treatment of ulcerated haemangiomas with a non‐coherent pulsed light source: Brief initial clinical report

Background: Ulceration is the most common complication of infantile haemangiomas and constitutes an authentic therapeutic challenge because of associated pain, infection, haemorrhage and subsequent scarring. Objective: To report our experience with an intense pulsed light (IPL) system in the treatment of ulcerated haemangiomas. Methods: Case 1: A 4‐month‐old girl, with haemangioma affecting the entire cutaneous surface of the left limb, developed four ulcerations on the inner aspect of this extremity. Two sessions with an IPL system using a triple pulse mode, a 570‐nm lower cut‐off filter and a fluence of 38?J/cm² were performed. Case 2: A 5‐month‐old girl with ulcerated labial haemangioma that previously failed to respond to intralesional corticoids was treated with an IPL system device. Three sessions using a triple pulse mode with a 570‐nm lower cut‐off filter and a fluence of 48?J/cm² were realized. Results: Good results were rapidly obtained after two and four sessions of IPL treatment, respectively. Pain was soon relieved and complete epithelization was obtained by between 1 and 2 months in both patients. Conclusion: Although our experience is rare, we believe that IPL devices may be an effective alternative treatment of ulcerated haemangiomas.     

Effectiveness of low-fluence and short-pulse intense pulsed light in the treatment of melasma: A randomized study

Background: Various treatment protocols for melasma have been suggested in the literature, but the efficacy and safety of treatment varies according to the report. Objective: To investigate the selective photothermolytic effect of fluence-dependent intense pulsed light (IPL) in the treatment of melasma. Methods: Twenty Korean adults with melasma were enrolled, randomly assigned to two groups and treated at fluences of 10 or 13 J/cm² of IPL weekly over 6 weeks. Subjects were evaluated at baseline and weekly during the 6 weeks of treatment and at 3 weeks following the final treatment. Melanin and erythema indices were scored using a spectrophotometer. Results: The modified Melasma Area Severity Index (MASI) score of 20 patients at inclusion was 11.6 (± 0.9). Both 10J and 13J IPL treatment groups had decreased modified MASI scores from 2 weeks onward at statistically significant levels. Both 10J and 13J IPL treatment groups showed decreased melanin indices with statistically significant differences from 3 weeks onward. The effect of IPL on melasma was slightly greater in patients treated with 13J of IPL than in those treated with 10J over the entire duration of the study. The erythema index was transiently increased in weeks 1–3, but after 4 weeks it decreased to sub-baseline levels. Conclusion: We suggest that a low-fluence IPL protocol could provide more effective treatment for melasma with minimal side effects in Asian skin.     

Use of light-emitting diode photomodulation to reduce erythema and discomfort after intense pulsed light treatment of photodamage

Objectives This study evaluates the use of light‐emitting diode (LED) photomodulation therapy to accelerate resolution of post–intense pulsed light (IPL) erythema. Methods In this split‐face study, 15 subjects were randomized to receive LED treatment to one side of the face as determined by computer‐generated randomization numbers. All 15 subjects received a single IPL treatment for facial photodamage. Immediately after IPL treatment, one side of the face was treated for 35 s with the LED device. The other side was not treated. Subjects returned 24 h later for a second LED treatment on the same side of the face. Posttreatment erythema was rated on both sides of the face by the blinded investigator and by subjects immediately after IPL treatment, 24 h later, and 1 week later on a scale of 0% (no erythema) to 100% (severe erythema). Patients commented on posttreatment discomfort immediately after IPL treatment. Results Mean erythema scores on the first visit were significantly higher (P = 0.0054) on the side not treated with LED (52.7 ± 24.6) than on the LED‐treated side (43.3 ± 21.9). Visit 2 data showed a similar trend (P = 0.0281). The subjects reported similar findings with mean erythema scores on the first visit on the LED‐treated side (46.7 ± 25.3) compared with the untreated side (60.0 ± 23.3); the difference was significant (P = 0.0382). On the second visit, the mean erythema scores trended lower on the LED‐treated side (24.3 ± 22.1) than on the untreated side (27.9 ± 25.8), but the difference did not reach statistical significance (P = 0.1365). Erythema scores on both facial sides were 0 for all subjects 1 week after IPL treatment. Four patients commented that posttreatment discomfort was considerably less on the LED‐treated side immediately after treatment. Conclusion LED photomodulation treatment may accelerate the resolution of erythema and reduce posttreatment discomfort in IPL‐treated patients with photodamage.     

810 nm diode laser for hair reduction with Chill-tip technology: prospective observational analysis of 55 patients of Fitzpatrick skin types III,IV,V

ABSTRACT

Background: Various light based technologies like Diode, long pulsed Nd:Yag and Intense Pulsed Light are used commonly for long-term hair reduction. The commonest indication is hirsutism.

Aim: 1. To evaluate efficacy and safety of 810 nm Diode laser in Fitzpatrick skin types III, IV and V.

2. To assess percentage of cases on the basis of indications, average number of sessions, fluence required, the long-term results and complications using diode laser in darker skin types.

Methods: A prospective observational study of 55 consecutive patients who came for laser hair reduction by 810 nm Light Sheer Diode laser with Chill tip technology was carried out. The sessions were conducted at an interval of 4–6 weeks and the patients were followed up over a period of 2 years. Data was analyzed using software SPSS (Statistical Package for Social Science. Ver.12, Inc. Chicago, USA).

Results: Fifty-five patients (51 females and 4 males) were studied. 67.3% (n = 37) had skin type IV. The most common area treated was chin (n = 23). The average growth reduction of terminal hair at the end of three sessions was 61.25%. Only 8% (n = 4) had short-term side effects.

Conclusion: Diode laser is highly effective for long-term hair reduction of terminal hair growth in Fitzpatrick skin type III, IV and V with no permanent side effects.

Abbreviations: LHR (Laser Hair Reduction)     

Comparative efficacy of intense pulsed light for different erythema associated with rosacea

Abstract

Objective: To compare the efficacy of intense pulsed light (IPL) (540–950nm) in treating different erythema associated with rosacea. Methods: Thirty-two patients with erythematotelangiectatic rosacea (ETR) (n = 16) and papulopustular rosacea (PPR, n = 16) were recruited. Three treatments of IPL (540–950nm) were administered on the face at 3-week intervals. Clinical improvement in erythema was independently assessed by two dermatologists using a quartile grading scale [0, ≤ 25% improvement (poor); 1, 26–50% improvement (fair); 2, 51–75% improvement (good); and 3, 76–100% improvement (excellent)]. Patient satisfaction was evaluated using a 10-point visual analog scale (VAS: 0, lowest; and 10, highest). Results: Thirty patients were involved in this study. All patients showed improvement in erythema after three sessions of IPL (540–950nm) treatment. Based on physician's assessment, the overall clinical improvement in PPR group was significantly higher (mean ± SD of PPR group, 2.167 ± 0.748 vs. ETR group, 1.400 ± 0.541; P = 0.003) and patient satisfaction was also higher in PPR group (mean ± SD of PPR group, 6.867 ± 1.457 vs. ETR group, 5.600 ± 1.502; P = 0.026). The proportion of patients showing > 75% clinical improvement among PPR group was also higher than that among ETR group (5/15 and 0/15, respectively; P = 0.021). Side effects were minimal and transient (erythema and/or edema) for patients. Conclusions: IPL (540–950nm) is a safe and effective treatment for rosacea-associated erythema, especially for perilesional erythema.     

The use of synchrotron infrared microspectroscopy to demonstrate the effect of intense pulsed light on dermal fibroblasts

Abstract

Intense pulsed light (IPL) has been used extensively to treat striae distensae (SD). Twenty-four patients (21 females and 3 males) with age ranging between 15–42 years with a mean of 24.2 ± 5.89 years were included in this study. All patients were treated with IPL for five sessions and were given 4-week interval between the sessions. Formalin-fixed, paraffin- embedded skin biopsies were cut into 5-μm-thick sections from patients before and after treatments. They were stained with hematoxylin and eosin (H&E) and collagen with Masson trichrome stain. Histological examination of SD revealed epidermal thinning, flattened rete ridges, and fragmentation with degeneration of the collagen and elastic fibers. After IPL treatments, collagen expression was found also to be increased in a highly significant manner and P values were < 0.001 after IPL treatments. The use of synchrotron infrared (IR) microspectroscopy also revealed that amide1and beta sheets were expressed in a significant manner after IPL treatment. In conclusion, it was demonstrated that IPL can treat striae through fibroblast stimulation which led to protein expression especially collagen stimulation, and it seems that it is a promising therapeutic modality for striae with minimal side effects.     

Mexametric and cutometric assessment of the signs of aging of the skin area around the eyes after the use of non‐ablative fractional laser,non‐ablative radiofrequency and intense pulsed light

The assessment of the signs of aging within eyes area in cutometric (skin elasticity) and mexametric (discoloration and severity of erythema) examination after the treatment with: non‐ablative fractional laser, non‐ablative radiofrequency (RF) and intense light source (IPL). This study included 71 patients, aged 33–63 years (the average age was 45.81) with Fitzpatrick skin type II and III. 24 patients received 5 successive treatment sessions with a 1,410‐nm non‐ablative fractional laser in two‐week intervals, 23 patients received 5 successive treatment sessions with a non‐ablative RF in one‐week intervals and 24 patients received 5 successive treatment sessions with an IPL in two‐week intervals. The treatment was performed for the skin in the eye area. The Cutometer and Mexameter (Courage + Khazaka electronic) reference test was used as an objective method for the assessment of skin properties: elasticity, skin pigmentation and erythema. Measurements of skin elasticity were made in three or four sites within eye area. The results of cutometric measurements for R7 showed the improvement in skin elasticity in case of all treatment methods. The largest statistically significant improvement (p < .0001) was observed in case of laser and RF, during treatment sessions, at sites at upper and lower eyelid. The smallest change in skin elasticity for the laser, RF and IPL – p = .017, p = .003 and p = .001, respectively—was observed in a site within the outer corner of the eye. In all sites of measurements and for all methods, the greatest improvement in skin elasticity was demonstrated between the first and second measurement (after 3rd procedures). The majority of the results of mexametric measurements—MEX (melanin level) and ERYT (the severity of erythema) are statistically insignificant. Fractional, non‐ablative laser, non‐ablation RF and intense light source can be considered as methods significantly affecting elasticity and to a lesser extent erythema and skin pigmentation around the eyes. Fractional non‐ablative laser is a method which, in comparison to other methods, has the greatest impact on skin viscoelasticity. These procedures are well tolerated and are associated with a low risk of side effects.