A Prospective, Split-Face, Comparative Study of Combined Treatment With Fractional Microneedle Radiofrequency and Nonablative 1927-nm Fractional Thulium Fiber Laser for Wrinkle Treatment.

BACKGROUND: Fractional microneedle radiofrequency (FMR) and nonablative 1927-nm fractional thulium fiber laser (TFL) are widely used for skin rejuvenation treatment. OBJECTIVES: To investigate the efficacy and safety of combined treatment with both devices for wrinkles. PATIENTS AND METHODS: Twenty-five patients with wrinkles were enrolled. One side of the face was treated with FMR alone, while the other side was treated with a combination of FMR and TFL. Each treatment consisted of 3 sessions at four-week intervals and patients were followed up 12 weeks after the last treatment. Overall improvement was assessed by patient global assessment (PGA) and investigator global assessment (IGA). Depression scores for the evaluation of wrinkles were objectively assessed by Antera 3D system. RESULTS: Both sides of the face led to clinical improvement in both mean PGA and IGA. Combination treatment demonstrated a greater improvement in both mean PGA and IGA compared with FMR alone. In addition, wrinkle grading scales and depression scores showed greater improvement in the combination group than in FMR alone. CONCLUSION: This study demonstrated that FMR and TFL comprise a good combination treatment for the treatment of wrinkles because both treatments have a synergistic effect on wrinkle improvement.

A Novel Treatment of Acne Vulgaris Using a 1927 nm Fractional Thulium Laser: A Case Series.

Background and Aims: Acne vulgaris remains one of the most common and problematic dermatological conditions. Recently, a fractional 1927 nm thulium laser has been developed with specific water absorption characteristics which may be of interest in the treatment of acne. Subjects and Methods: Nine consecutive Korean subjects, 6 females and 3 males, ages ranging from 13 to 33 yr, presented with a mixture of inflammatory and noninflammatory acne. Baseline clinical photography, image analysis and lesion counts were performed. A fractional 1927 nm thulium laser (FTL) delivered 6 treatment sessions in 5 subjects and 5 sessions in 4 subjects, 4 weeks between sessions. Pain during treatment was assessed. At 32 weeks after the last treatment session, an independent Investigator Global Assessment (IGA) performed lesion counts and graded the severity of the acne at baseline and the final assessment on a quintile scale. Data were analyzed statistically. Results: All 9 subjects completed the study with significant reductions in the inflammatory and noninflammatory lesions (P values 0.0012 and 0.0081, respectively) with overall lesion counts at the final assessment ranging from 60% to 97.1%, and acne grades in the IGA dropping by an average of 1.67 (range 1 to 3 grades). There was no significant difference in lesion counts or acne grades between the subjects who had 6 treatments and those who had 5 (P = 0.7695). Mild pain was reported during treatment, and no adverse events were reported by either the subjects or investigator. Conclusions: The FTL at the parameters used in the present study caused disruption to the upper portion of the affected follicles and sebaceous glands under an intact stratum corneum, thereby destroying or damaging the causative Cutibacterium acnes. The superficial controlled coagulation additionally induced follicular remodeling and tissue regeneration, potentially contributing to the noticeable results in inflammatory and noninflammatory acne lesions.

Monopolar radiofrequency for dermal temperature regulation and remodeling: A porcine model study.

BACKGROUND: Noninvasive monopolar radiofrequency (NMRF) is widely used for dermal and subdermal volumetric heating, yet detailed research on its effects on dermal temperature is scarce. AIMS: This study evaluates the impact of NMRF on dermal temperature and its potential for dermal remodeling using a porcine model. METHODS: Noninvasive monopolar radiofrequency was applied to porcine skin with temperature monitoring via optic fiber technology and forward-looking infrared thermal imaging. Safety was evaluated using nitro blue tetrazolium chloride assessments, and effectiveness was determined through histological examinations before and after treatment. RESULTS: Noninvasive monopolar radiofrequency treatment in a porcine model achieved effective dermal remodeling with no thermal damage, recording peak temperatures of 50°C, 60°C, and 70°C. Histological analysis showed increased collagen density, indicating successful tissue remodeling. CONCLUSION: Noninvasive monopolar radiofrequency is effective in delivering controlled dermal heating and enhancing collagen synthesis, promoting safe and efficient skin tightening and dermal remodeling in a porcine model. It presents a viable option for skin rejuvenation therapies.

Histometric changes and epidermal FGF9 expression in carbon photoenhancer-assisted Nd:YAG laser treatment.

Fibroblast growth factor (FGF)-9 plays an important role in wound healing. However, the effects of non-ablative laser treatment on the expression of FGF9 have not been fully investigated. Non-ablative 1064-nm quasi-long pulsed and Q-switched Nd:YAG laser treatments were delivered to hairless mice with and without a carbon photoenhancer. For histological and immunohistochemical analyses, sections were stained with hematoxylin and eosin as well as FGF9 antibody. Significantly, increased epidermal and dermal thickness was noted in mice treated with carbon photoenhancer-assisted quasi-long pulsed or Q-switched laser treatments compared to those treated without a carbon photoenhancer. Expression of FGF9 was observed in both the epidermis and dermis in all groups of mice during the healing process. Earlier and more pronounced expression of FGF9 was detected in mice treated with carbon photoenhancer-assisted quasi-long pulsed laser therapy. In addition, two peaks of pronounced FGF9 expression were observed, especially in mice that underwent carbon photoenhancer-assisted 1064-nm quasi-long pulsed Nd:YAG laser treatment. A carbon photoenhancer seems to enhance the effect of quasi-long pulsed and Q-switched Nd:YAG laser treatment. In addition, expression of FGF9 may play an important role in the healing process after laser treatments and could contribute to histometric changes.

Carbon assisted Q-switched Nd:YAG laser treatment with two different sets of pulse width parameters offers a useful treatment modality for severe inflammatory acne: a case report.

BACKGROUND AND AIMS: The treatment of inflammatory and noninflammatory acne still presents problems to patients and dermatologists. A new technique using two different sets of 1064 nm Nd:YAG laser parameters has been developed in combination with a topical carbon lotion. A preliminary test of the efficacy of this new treatment technique is reported. SUBJECT AND METHODS: A 14-y-old girl presented with moderate to severe pustular and cystic acne over the bilateral cheeks and chin. Following topical local anesthesia, a topical carbon lotion was applied to the face, and a Q-switched frequency-doubled Nd:YAG laser was used first in a quasi-long pulsed mode (a 300-µs pulse width at 1.1-1.5 J/cm(2)) followed immediately by a Q-switched mode (5-nsec pulse width, 1.5-2.0 J/cm(2)) using a 7-mm handpiece for both modes. Six treatments were given, 2 weeks apart. RESULTS: The procedure was well-tolerated. By the fourth treatment significant improvement was observed, and by the sixth treatment, better than 90% clearance of inflammatory lesions was achieved. At the 8-week follow-up after the last treatment, long-lasting improvements in the patient's acne were noted. Improvement was also noted in closed comedones and in the general skin condition, especially pores, sebum reduction, and the red spots seen after inflammatory acne. The patient was satisfied with the result. CONCLUSIONS: This new, minimally invasive technique as a stand-alone treatment gave very good clearance of inflammatory acne with minimal patient down time. Marked reduction in active acne was observed during treatments and at the 2-month follow-up visit. Further improvement could probably be achieved with other adjunctive therapeutic modalities.