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1.
Lasers Surg Med ; 54(3): 348-354, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34233039

RESUMEN

BACKGROUND: Enlarged facial pores are one of the common skin signs of photoaging that patients seek treatment for. However, objective data and long-term assessment on the efficacy and safety of therapeutic procedures for this condition are limited. OBJECTIVE: To objectively evaluate the efficacy and safety of a 1064-nm picosecond laser with microlens array (MLA) for pore tightening. METHODS: Twenty-five patients with enlarged pores received three treatments with a 1064-nm picosecond laser coupled with MLA at 4-week intervals. Patients were evaluated using objective (measurement of pore volume using three-dimensional photography) and subjective (clinical evaluation by two blinded dermatologists) assessments at baseline and at the 1-, 3-, and 6-month follow-ups. Adverse effects were also recorded during each visit. RESULTS: After three treatments, there was a significant reduction of pore size from baseline (p < 0.001). The improvement in pore size appearance significantly continued from the 1-month to the 6-month follow-up visits (p = 0.013). The total average pore size was 1.15652 ± 0.614322 and 0.8087 ± 0.50515 at baseline and at 6 months after the final treatment, respectively, resulting in an average of 30% reduction in pore size. No cases of dyspigmentation, textural alteration, or scarring were documented. CONCLUSION: Fractional 1064-nm picosecond laser appears to be effective and safe for reducing pore size in Asians with minimal transient side effects.


Asunto(s)
Láseres de Estado Sólido , Envejecimiento de la Piel , Pueblo Asiatico , Estudios de Casos y Controles , Humanos , Láseres de Estado Sólido/uso terapéutico , Resultado del Tratamiento
2.
Lasers Surg Med ; 53(8): 1080-1085, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33538345

RESUMEN

BACKGROUND AND OBJECTIVE: Phototherapy for acne with a combination of blue and red light-emitting diodes (LEDs) appears to have excellent potential in treating inflammatory acne. However, a standard twice-weekly protocol administered 3 days apart may not be practical for patients. This study aims to seek the efficacy of LED treatment in moderate to severe acne, comparing between once and alternating twice-weekly regimens. STUDY DESIGN/MATERIALS AND METHODS: Thirty subjects with moderate to severe acne, as defined by Burton's grading score, were recruited in the study. The subjects were randomly divided into two groups- one group received alternating blue (470 nm) and red (640 nm) light in two visits per week for 4 consecutive weeks, while the other group got blue and red light treatments consecutively on the same visit for 4 consecutive weeks. During the study period, conventional treatments were prohibited. Clinical assessments were performed by lesion counts and blinded comparative photographs before treatment and at 1, 4, and 8 weeks after the final treatment. RESULTS: There was no statistically significant difference between once- and alternating twice-weekly regimens. Both regimens provided marked improvement only for inflammatory lesions. The median percentage of acne reduction was significantly demonstrated for 1 week after finishing the course of treatment and was sustained until the end of the study. There were no side effects noted throughout the study period. CONCLUSION: LED therapy is safe and effective for treatment of inflammatory acne. The treatment outcomes of once and alternating twice-weekly regimens were comparable, hence, once-weekly treatment could be considered as an alternative choice for patient's convenience. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.


Asunto(s)
Acné Vulgar , Fototerapia , Acné Vulgar/terapia , Protocolos Clínicos , Humanos , Luz , Resultado del Tratamiento
3.
Lasers Surg Med ; 53(7): 899-905, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33326626

RESUMEN

BACKGROUND AND OBJECTIVE: Fractional 1064-nm picosecond-domain laser has recently been utilized for the treatment of atrophic acne scars and showed promising results. However, data on the safety and efficacy of this procedure in dark-skinned patients are limited. This prospective, self-controlled study was conducted to objectively evaluate the safety and efficacy of a 1064-nm picosecond laser coupled with a microlens array (MLA) for the treatment of atrophic acne scars on Asian skin. STUDY DESIGN/MATERIALS AND METHODS: Twenty-six subjects of Fitzpatrick skin types (FSTs) III and IV with atrophic acne scars were enrolled. All subjects were treated with a 1064-nm picosecond laser (spot size of 8 mm, fluence of 1.0 J/cm2 , a repetition rate of 10 Hz) in combination with the MLA handpiece for an average of three passes, for 6 monthly sessions. Objective (measurement of scar volume using three-dimensional (3D) photography and skin roughness analysis using ultraviolet A-light video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline and at 1, 3, and 6 months after the final treatment. RESULTS: Statistically significant reduction of the scar volume from baseline at 1, 3, and 6 months after the final treatment were observed by 3D photography and ultraviolet A-light video camera. At the 6-month follow-up, 50% (13 of 26) of the subjects were rated as having at least 50% improvement of the scars. The rate of improvement significantly increased from the 1-month follow-up to the 6-month follow-up (P = 0.013). Similarly, at the 6-month follow-up, the scar volume (P = 0.024) and skin roughness (P = 0.001) also significantly improved, in comparison with the baseline. Mild postinflammatory hyperpigmentation (PIH) was observed to develop in approximately 18% of all the treatment sessions. All cases of PIH were temporary and resolved within 4 weeks on average. CONCLUSIONS: The 1064-nm picosecond laser with MLA is a safe therapeutic alternative for the treatment of atrophic acne scars in dark-skinned individuals. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.


Asunto(s)
Acné Vulgar , Láseres de Estado Sólido , Acné Vulgar/complicaciones , Pueblo Asiatico , Cicatriz/etiología , Cicatriz/patología , Humanos , Rayos Láser , Láseres de Estado Sólido/uso terapéutico , Estudios Prospectivos , Resultado del Tratamiento
4.
Lasers Surg Med ; 53(5): 616-621, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33161583

RESUMEN

BACKGROUND AND OBJECTIVES: Enlarged pores are one of the most common causes of skin surface irregularities. Existing studies supporting the benefit of lasers and energy-based devices (EBD) for this condition are limited, with a short duration of follow-up period. We aimed to evaluate the efficacy and adverse effects of Er:YAG laser for treatment of enlarged pores in dark-skinned patients. STUDY DESIGN/MATERIALS AND METHODS: Nineteen subjects (aged 26-47 years) with skin phototypes III (21.1%) and IV (78.9%) and enlarged pores were treated with 4 monthly sessions of Erbium:YAG laser. Objective (ultraviolet light A video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline, 1-month after each treatment and at 1, 3, and 6 months after the final treatment. RESULTS: The weighted mean score of quartile grading scales showed significant improvement in pore size from baseline starting at 1-month after the third treatment and continued until 3 months after the fourth (final) treatment (P < 0.001). However, the improvement dropped significantly at 6 months after the final treatment. Objective measurements of the improvements in skin surface smoothness and wrinkles corresponded with the physician raters' clinical evaluation. CONCLUSIONS: Erbium:YAG laser is a safe and effective treatment for enlarged pores in dark-skinned individuals. Maintenance treatments are recommended to achieve a longer-lasting outcome. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Envejecimiento de la Piel , Pueblo Asiatico , Erbio , Humanos , Láseres de Estado Sólido/uso terapéutico , Resultado del Tratamiento
5.
Lasers Surg Med ; 53(1): 95-103, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32865858

RESUMEN

BACKGROUND AND OBJECTIVES: Treatment of melasma with lasers remains a challenge due to its limited clinical efficacy in addition to high rates of recurrence and side effects. Recently, picosecond lasers have shown favorable results in treatment of benign pigmented lesions. To compare the efficacy and safety of using a 755-nm picosecond laser for the treatment of melasma in a split-face manner, having one side treated with a fractionated beam (diffractive lens array [DLA] coupling) and with a full-beam (flat optics) on the other side. STUDY DESIGN/MATERIALS AND METHODS: Eighteen subjects presenting with mixed-type melasma were enrolled. Each patient was randomly treated with a 755-nm picosecond laser coupled with DLA on one side of the face and without DLA (flat optics) on the other side. The laser was delivered through an 8-mm spot size with an average fluence of 0.4 J/cm2 at 2.5 Hz for a total of two passes without pulse overlapping. All subjects received five monthly treatments. Subjective (clinical evaluation) and objective (color readings) assessments on the degree of pigment clearance and adverse effects were obtained at 1-, 3-, and 6-month after the final treatment. RESULTS: At 6 months after the last treatment, physician-rating scores were 1.50 ± 0.76 and 1.50 ± 0.65 of the DLA and flat-optics sides, respectively. Pigment clearance significantly improved from 1 to 6 months after the treatment on each side (P = 0.019 on DLA and P = 0.023 on flat-optics sides). No statistically significant differences in physician-rating scores between the two treatment techniques were observed at all follow-up visits. Objective assessments of melasma clearance corresponded to the clinical evaluation. However, the full-beam (flat optics) provided lower incidence of pos-tinflammatory hyperpigmentation than the fractioned one. CONCLUSIONS: A 755-nm picosecond laser is safe and effective for the treatment of melasma in dark-skinned individuals. The use of DLA does not provide additional benefit over the flat optics in clearing pigmentation. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.


Asunto(s)
Láseres de Estado Sólido , Terapia por Luz de Baja Intensidad , Melanosis , Pueblo Asiatico , Humanos , Láseres de Estado Sólido/uso terapéutico , Estudios Prospectivos , Resultado del Tratamiento
7.
Dermatol Ther (Heidelb) ; 10(4): 779-789, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32591944

RESUMEN

INTRODUCTION: Intradermal injection of botulinum toxin type A (BoNT/A) has been used off-label by many clinicians for face-lifting. Previous studies on abobotulinumtoxinA (ABO) (Dysport®; Ipsen Biopharm Ltd.) have demonstrated clinical efficacy in face-lifting when compared to normal saline solution (NSS). However, few clinical studies have evaluated ABO in terms of duration of sustained effects for face-lifting. METHODS: Thirty subjects were enrolled, and their face was injected with ABO at a dilution of 1 vial:7 mL (500 U in 7 mL of NSS) using an intradermal injection technique. Standardized photographic documentation was obtained using a two-, and three-dimensional imaging system (Vectra H1, Canfield Scientific, Inc, Fairfield, NJ) at baseline, immediately after injection, 2 weeks after injection and at 1 , 2 , 3 , 4 , 5 and 6 months of follow-up after treatment. The face-lifting effects were graded by both the subjects and two blinded dermatologists who compared photographs taken at the different time points. Side effects were also recorded at the end of the study. RESULTS: Of the 30 subjects, 28 completed treatment and attended every follow-up visit. All subjects were female with Fitzpatrick skin type II to IV. The average age of the subjects was 27.6 ± 3.4 (range 22-34) years. The total number of ABO units used varied for each subject (range 200-250 U), with the average (± standard deviation) dose being 237 ± 19 units. Most of the subjects reported significant face-lifting up to 3 months post-procedure. However, face-lifting assessed by blinded dermatologists was notably lower than that of each patient's evaluation. The difference in the facial contouring volume of the nasolabial fold and jawline, as measured by the Vectra H1 imaging system, was statistically significant from baseline up until 3 months after injection (p = 0.001 and p = 0.001, respectively). The only side effect found in this study was minimal bruising, which was seen in 13.8% of subjects. None of the subjects reported facial asymmetry, either at rest or during facial expression. CONCLUSION: The results of this study demonstrate the face-lifting effect of ABO intradermal injection. The results show sustained effects up to 3 months after injection.

8.
J Cosmet Dermatol ; 19(8): 1826-1827, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32502318

RESUMEN

The rapidly increasing number of COVID-19-infected patients and evidence of human-to-human transmission even within the asymptomatic incubation period prompted the attention of the entire world. The field of dermatology and procedural dermatology is not exempt from this global issue. We cannot deny the fact that this situation will have a lasting impact on the health-seeking behaviors of our patients. It is necessary for dermatologists and dermatologic surgeons to be aware of the potential risks and precautions when re-emerging their practices after COVID-19.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/prevención & control , Dermatología/tendencias , Control de Infecciones/normas , Pandemias/prevención & control , Neumonía Viral/prevención & control , Enfermedades de la Piel/terapia , Telemedicina/tendencias , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Técnicas Cosméticas/economía , Técnicas Cosméticas/normas , Técnicas Cosméticas/tendencias , Dermatología/economía , Dermatología/organización & administración , Dermatología/normas , Diagnóstico Diferencial , Humanos , Control de Infecciones/economía , Control de Infecciones/organización & administración , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , SARS-CoV-2 , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/economía , Enfermedades de la Piel/virología , Telemedicina/economía , Telemedicina/organización & administración , Telemedicina/normas
9.
J Cosmet Dermatol ; 19(7): 1642-1647, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32384205

RESUMEN

BACKGROUND: Postacne erythema (PAE) is a common sequela of inflammatory acne vulgaris, treatment of which has been challenging due to limited options available and the variability of results for each modality. Recently, a 577-nm high-power optically pumped semiconductor laser (HOPSL) initially developed for vascular lesions has shown promising results for the treatment of PAE. AIMS: To evaluate the efficacy and safety of 577-nm HOPSL in the treatment of postacne erythema. METHODS: This was a split-face, randomized controlled trial pilot study. Twenty-one patients with PAE on both sides of their face were enrolled. Each subject's face sides were randomly assigned to either receive 577-nm HOPSL treatment (QuadroStar PRO™, Asclepion Laser Technologies) using the scanner handpiece, 1mm spot size, 80% coverage, 12-15 J/cm2 , 30 ms, 2 passes for 3 sessions at 1-month intervals, or no treatment at all. Outcome measures such as overall improvement, the Erythema Index (EI), and Melanin Index (MI) from 3 different areas on both treatment and control sides were assessed at baseline, and 1-month follow-up after each treatment session. Side effects including pain, erythema, swelling, and crusting were also recorded. RESULTS: Upon completion of the treatment period, the mean EI was significantly decreased in both treated and nontreated sides of the face (P < .001 and P = .001, respectively). The laser-treated sides already demonstrated significant reduction in the mean EI compared with nontreated sides at 1 month after the 2nd treatment (P = .007). The mean MI of both sides, however, did not show any statistically significant differences from baseline, and likewise when comparing between sides. Patients reported more improvement on laser-treated sides compared with nontreated sides. Reported side effects were limited to mild discomfort during treatment and transient facial erythema lasting approximately 30 minutes. CONCLUSION: Patients who received treatment with the 577-nm HOPSL had better outcomes with minimal side effects at 1 month after 2 treatments as compared to those who did not receive any treatment. Therefore, the 577-nm HOPSL may be considered as an effective adjuvant treatment for PAE and early erythematous atrophic scars.


Asunto(s)
Acné Vulgar , Terapia por Luz de Baja Intensidad , Eritema/etiología , Humanos , Láseres de Semiconductores/efectos adversos , Proyectos Piloto , Resultado del Tratamiento
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