A Prospective Study of Axillary Hair Reduction in Patients Treated With Microwave Technology.

BACKGROUND: Removing unwanted body hair is a growing trend in society today, and there are many laser-based devices for hair reduction. There are some limitations to those methods, including the lack of efficacy for lighter color hair. OBJECTIVE: The objective was to quantify hair reduction in the axillae after treatment with a noninvasive microwave energy device. MATERIALS AND METHODS: A prospective, multicenter study was performed at 3 private dermatology clinics. Fifty-six adult subjects seeking axillary hair reduction were enrolled and treated with the device in 1 or 2 treatment sessions 3 months apart at various energy levels, and followed for 12 months. The primary analysis was monitoring reduction of hair counts from baseline to follow-up visits. A subject assessment of overall satisfaction, odor ratings, and sweat reduction ratings was provided at follow-up visits. RESULTS: Fifty-six subjects received treatment, with an average total underarm hair reduction of approximately 70% for both light and dark hair. Percentage of patients with hair reduction of 30% or more was significantly higher than 50% at all follow-up visits. Half of treated subjects reported expected mild transient post-treatment effects such as localized edema, discomfort, and bruising. Other reported events were mild. CONCLUSION: This clinical study provides evidence for safe and permanent axillary hair reduction, showing stable average reduction that lasted through the year of follow-up. Most notably, the study has shown the treatment's efficacy for reduction of light-colored axillary hair.

Low Level Light Therapy with Light-Emitting Diodes for the Aging Face.

Low level light therapy (LLLT) with light-emitting diodes (LEDs) is emerging from the mists of black magic as a solid medico-scientific modality, with a substantial buildup of corroborative bodies of evidence for its efficacy and elucidation of the modes of action. Reports are appearing from many different specialties; however, of particular interest to plastic surgeons treating the aging face is the proven action of LED-LLLT on skin cells in both the epidermis and dermis and enhanced blood flow. Thus, LED-LLLT is a safe and effective stand-alone therapy for patients who are prepared to wait until the final effect is perceived.

830 nm light-emitting diode (led) phototherapy significantly reduced return-to-play in injured university athletes: a pilot study.

BACKGROUND AND AIMS: For any committed athlete, getting back to conditioning and participation post-injury (return to play [RTP]) needs to be as swift as possible. The effects of near-infrared light-emitting diode (LED) therapy on pain control, blood flow enhancement and relaxation of muscle spasm (all aspects in the treatment of musculoskeletal injury) have attracted attention. The present pilot study was undertaken to assess the role of 830 nm LED phototherapy in safely accelerating RTP in injured university athletes. SUBJECTS AND METHODS: Over a 15-month period, a total of 395 injuries including sprains, strains, ligament damage, tendonitis and contusions were treated with 1,669 sessions of 830 nm LED phototherapy (mean of 4.3 treatments per injury, range 2 - 6). Efficacy was measured with pain attenuation on a visual analog scale (VAS) and the RTP period compared with historically-based anticipated RTP with conventional therapeutic intervention. RESULTS: A full set of treatment sessions and follow-up data was able to be recorded in 65 informed and consenting subjects who achieved pain relief on the VAS of up to 6 points in from 2-6 sessions. The average LED-mediated RTP in the 65 subjects was significantly shorter at 9.6 days, compared with the mean anticipated RTP of 19.23 days (p = 0.0066, paired two-tailed Student's t-test). A subjective satisfaction survey was carried out among the 112 students with injuries incurred from January to May, 2015. Eighty-eight (78.5%) were either very satisfied or satisfied, and only 8 (7.2%) were dissatisfied. CONCLUSIONS: For any motivated athlete, RTP may be the most important factor postinjury based on the resolution of pain and inflammation and repair to tissue trauma. 830 nm LED phototherapy significantly and safely reduced the RTP in dedicated university athletes over a wide range of injuries with no adverse events. One limitation of the present study was the subjective nature of the assessments, and the lack of any control groups. However, further controlled studies are warranted to enable confirmation and generalization of the very good results in the present study.

Multi-Center Pilot Study to Evaluate the Safety Profile of High Energy Fractionated Radiofrequency With Insulated Microneedles to Multiple Levels of the Dermis.

In this multi-center pilot study, the safety pro le of high intensity focused radiofrequency (RF) delivered to the dermis was evaluated for safety in the treatment of the aging neck and face. A newly designed insulated microneedle system delivers a signi cant coagulative thermal injury into the dermis while sparing the epidermis from RF injury. Thirty- ve healthy subjects from seven aesthetic practices were evaluated, and data from each were incorporated in this case report. The subjects received a single treatment using settings that delivered the highest RF energies suggested from the new recommended protocols. The depth of thermal delivery was adjusted before each pass and all subjects received a minimum of two to three passes to the treated areas. Before and after photographs along with adverse effects were recorded. This case report demonstrates the ability to deliver significant RF thermal injury to several layers of the dermis with insulated microneedles safely with little injury to the epidermis and minimum downtime.

Topical Treatment With Liposomal Sodium Copper Chlorophyllin Complex in Subjects With Facial Redness and Erythematotelangiectatic Rosacea: Case Studies.

Physicians are often presented with patients complaining of facial redness and difficult to control rosacea. The water soluble sodium copper chlorophyllin complex has been shown to have anti-oxidant, anti-inflammatory, and anti-bacterial activities in vitro and anti-redness, pore reduction, and anti-acne activities in pilot clinical studies. In these case studies, the safety and efficacy of a topical gel containing a liposomal suspension of sodium copper chlorophyllin complex was assessed in subjects with facial redness and erythematotelangiectatic rosacea.

In vitro inhibition of hyaluronidase by sodium copper chlorophyllin complex and chlorophyllin analogs.

BACKGROUND: Inhibitors of hyaluronidase are potent agents that maintain hyaluronic acid homeostasis and may serve as anti-aging, anti-inflammatory, and anti-microbial agents. Sodium copper chlorophyllin complex is being used therapeutically as a component in anti-aging cosmeceuticals, and has been shown to have anti-hyaluronidase activity. In this study we evaluated various commercial lots of sodium copper chlorophyllin complex to identify the primary small molecule constituents, and to test various sodium copper chlorophyllin complexes and their small molecule analog compounds for hyaluronidase inhibitory activity in vitro. Ascorbate analogs were tested in combination with copper chlorophyllin complexes for potential additive or synergistic activity. MATERIALS AND METHODS: For hyaluronidase activity assays, dilutions of test materials were evaluated for hydrolytic activity of hyaluronidase by precipitation of non-digested hyaluronate by measuring related turbidity at 595 nm. High-performance liquid chromatography and mass spectroscopy was used to analyze and identify the primary small molecule constituents in various old and new commercial lots of sodium copper chlorophyllin complex. RESULTS: The most active small molecule component of sodium copper chlorophyllin complex was disodium copper isochlorin e4, followed by oxidized disodium copper isochlorin e4. Sodium copper chlorophyllin complex and copper isochlorin e4 disodium salt had hyaluronidase inhibitory activity down to 10 µg/mL. The oxidized form of copper isochlorin e4 disodium salt had substantial hyaluronidase inhibitory activity at 100 µg/mL but not at 10 µg/mL. Ascorbate derivatives did not enhance the hyaluronidase inhibitory activity of sodium copper chlorophyllin. Copper isochlorin e4 analogs were always the dominant components of the small molecule content of the commercial lots tested; oxidized copper isochlorin e4 was found in increased concentrations in older compared to newer lots tested. CONCLUSION: These results support the concept of using the hyaluronidase inhibitory activity of sodium copper chlorophyllin complex to increase the hyaluronic acid level of the dermal extracellular matrix for the improvement of the appearance of aging facial skin.

Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures.

BACKGROUND: Aggressive, or even minimally aggressive, aesthetic interventions are almost inevitably followed by such events as discomfort, erythema, edema and hematoma formation which could lengthen patient downtime and represent a major problem to the surgeon. Recently, low level light therapy with light-emitting diodes (LED-LLLT) at 830 nm has attracted attention in wound healing indications for its anti-inflammatory effects and control of erythema, edema and bruising. RATIONALE: The wavelength of 830 nm offers deep penetration into living biological tissue, including bone. A new-generation of 830 nm LEDs, based on those developed in the NASA Space Medicine Laboratory, has enabled the construction of planar array-based LED-LLLT systems with clinically useful irradiances. Irradiation with 830 nm energy has been shown in vitro and in vivo to increase the action potential of epidermal and dermal cells significantly. The response of the inflammatory stage cells is enhanced both in terms of function and trophic factor release, and fibroblasts demonstrate superior collagenesis and elastinogenesis. CONCLUSIONS: A growing body of clinical evidence is showing that applying 830 nm LED-LLLT as soon as possible post-procedure, both invasive and noninvasive, successfully hastens the resolution of sequelae associated with patient downtime in addition to significantly speeding up frank wound healing. This article reviews that evidence, and attempts to show that 830 nm LED-LLLT delivers swift resolution of postoperative sequelae, minimizes downtime and enhances patient satisfaction.

Characterization of an optimized light source and comparison to pulsed dye laser for superficial and deep vessel clearance.

BACKGROUND AND OBJECTIVE: An arc lamp-based device providing optimized spectrum and pulse shape was characterized and compared with two pulsed dye laser (PDL) systems using a vascular phantom. Safety and effectiveness for facial telangiectasia are presented in clinical case studies. STUDY DESIGN/MATERIALS AND METHODS: An optimized pulsed light source's (OPL) spectral and power output were characterized and compared with two 595 nm PDL devices. Purpuric threshold fluences were determined for the OPL and PDLs on Fitzpatrick type II normal skin. A vascular phantom comprising blood-filled quartz capillaries beneath porcine skin was treated by the devices at their respective purpuric threshold fluences for 3 ms pulse widths, while vessel temperatures were monitored with an infrared (IR) camera. Patients with Fitzpatrick skin types II-III received a split-face treatment with the OPL and a 595 nm PDL. RESULTS: The OPL provided a dual-band output spectrum from 500 to 670 nm and 850-1,200 nm, pulse widths from 3 to 100 ms, and fluences to 80 J/cm(2). The smooth output power measured during all pulse widths provides unambiguous vessel size selectivity. Percent energy in the near infra-red increased with decreasing output power from 45% to 60% and contributed 15-26% to heating of deep vessels, respectively. At purpuric threshold fluences the ratio of OPL to PDL vessel temperature rise was 1.7-2.8. OPL treatments of facial telangiectasia were well-tolerated by patients demonstrating significant improvements comparable to PDL with no downtime. CONCLUSIONS: Intense pulsed light (IPL) and PDL output pulse and spectral profiles are important for selective treatment of vessels in vascular lesions. The OPL's margin between purpuric threshold fluence and treatment fluence for deeper, larger vessels was greater than the corresponding margin with PDLs. The results warrant further comparison studies with IPLs and other PDLs.

National athletic trainers' association position statement: skin diseases.

OBJECTIVE: To present recommendations for the prevention, education, and management of skin infections in athletes. BACKGROUND: Trauma, environmental factors, and infectious agents act together to continually attack the integrity of the skin. Close quarters combined with general poor hygiene practices make athletes particularly vulnerable to contracting skin diseases. An understanding of basic prophylactic measures, clinical features, and swift management of common skin diseases is essential for certified athletic trainers to aid in preventing the spread of infectious agents. RECOMMENDATIONS: These guidelines are intended to provide relevant information on skin infections and to give specific recommendations for certified athletic trainers and others participating in athletic health care.

Non-ablative fractional resurfacing of surgical and post-traumatic scars.

OBJECTIVE: Non-ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, the authors examined the efficacy and safety of the non-ablative 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. METHODS: Clinical studies were conducted on a range of surgical and post-traumatic scars with a 1540 nm erbium:glass fractional laser varying energy, pulse widths, treatment passes, and number of treatments. A histological study was conducted on a postsurgical scar to follow the time course of healing post-treatment and the impact of the fractional treatment on normalization of scar tissue, as compared to baseline histology of the scar. RESULTS: Histologic findings demonstrated rapid re-epithelialization of the epidermis within 72 hours of treatment. Remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Clinical subjects, with Fitzpatrick skin types II-V, received three to seven treatments with microbeam energies up to 60 mJ/pb and five passes. Relative to baseline, 73% of treated scars improved 50% or more and 43% improved 75% or more. Side effects included mild swelling (95% of subjects), erythema (94%) and purpura (5%), which all resolved within two to three days. Downtime was minimal-to-none for all subjects. CONCLUSION: These data illustrate the safety and efficacy of the 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Practitioners can vary energy and microbeam density in order to tailor the treatment to reflect the individual scar characteristics.

Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study.

OBJECTIVE: Our purpose was to demonstrate the efficacy of the 308-nm excimer laser for treatment of psoriasis. METHODS: This study was a multicenter open trial from 5 dermatology practices (one university-based and 4 private practices). Up to 30 patients per center with stable mild to moderate plaque-type psoriasis constituted the study population. Patients received 308-nm ultraviolet B doses to affected areas. The initial dose was based on multiples of a predetermined minimal erythema dose. Subsequent doses were based on the response to treatment. Treatments were scheduled twice weekly for a total of 10 treatments. The main outcome measure was 75% clearing of the target plaque. Time to clearing was analyzed by Kaplan-Meier methods, accounting for truncated observations. RESULTS: One hundred twenty-four patients were enrolled in the study, and 80 completed the entire protocol. The most common reason for exiting from the study was noncompliance. Of the patients who met the protocol requirements of 10 treatments or clearing, 72% (66/92) achieved at least 75% clearing in an average of 6.2 treatments. Eighty-four percent of patients (95% confidence interval [CI], 79%-87%) reached improvement of 75% or better after 10 or fewer treatments. Fifty percent of patients (95% CI, 35%-61%) reached improvement of 90% or better after 10 or fewer treatments. Common side effects included erythema, blisters, hyperpigmentation, and erosions, but they were well tolerated. CONCLUSIONS: Monochromatic 308-nm excimer laser treatment appears to be effective and safe for psoriasis. It requires fewer patient visits than conventional phototherapy, and, unlike those treatments, the laser targets only the affected areas of the skin, sparing the surrounding uninvolved skin.