Sound levels and safety in cosmetic laser surgery.

OBJECTIVES: Measure the sound levels produced by various lasers commonly used during routine outpatient cosmetic surgery to determine whether or not their use exceeds exposure levels set forth by the US National Institute for Occupational Safety and Health (NIOSH) and the US Occupational Safety and Health Administration (OSHA). MATERIALS AND METHODS: Using two different meters, the sound levels of lasers commonly used in cosmetic surgery were recorded during various procedures for several indications: tattoo removal, treatment of lentigines and pigmented lesions, facial erythema and vascular lesions, hair removal and resurfacing of acne scars, and photoaging. RESULTS: All but five lasers had a maximum sound level below 85 dBA, the limit proposed by NIOSH. The loudest laser examined was a fully ablative 2,940 nm Er:YAG during facial resurfacing, with an average maximum sound level of 101.5 decibels (dBA). Two other lasers used for resurfacing exceeded 85 dBA including a fractional ablative 1064 Nd:YAG with an average maximum of 97.8 and a different fully ablative 2,940 nm Er:YAG which had an average maximum of 96.3 nm. The two other lasers that exceeded 85 dBA were picosecond lasers used to treat black tattoos, including a 1,064 nm Nd:YAG with an average maximum of 93.7 dBA and a 755 nm alexandrite with an average maximum of 93.6 dBA. CONCLUSION: Although some lasers in cosmetic surgery may be perceived as being quite loud, they remain safe. Even the loudest laser studied would have to be used for nearly 2 hours before exceeding the OSHA recommended exposure limit. Even physicians who spend a large amount of time using lasers in clinical practice should be reassured that these devices are not likely to produce noise-induced hearing loss (NIHL) hearing loss. Lasers Surg. Med. 51:491-494, 2019. © 2019 Wiley Periodicals, Inc.

Eruptive vellus hair cysts in identical triplets with dermoscopic findings.

Eruptive vellus hair cysts (EVHCs) are asymptomatic, follicular, flesh-colored to hyperpigmented papules that are typically located on the chest and extremities with an unclear inheritance pattern and pathogenesis. We report a case of EVHCs in 4-year-old identical triplet girls. Our aim is to present another rare case of autosomal-dominant inheritance of EVHCs and to emphasize the utility of dermoscopy as a diagnostic aid for EVHCs that may be misdiagnosed clinically.

Successful treatment of Ota nevus with the 532-nm solid-state picosecond laser.

Laser treatment of Ota nevi can be complicated, particularly in darker skin types, as there is a higher risk for adverse effects if the laser is not carefully employed. We report a case of successful treatment of an Ota nevus in a patient with Fitzpatrick skin type IV with the novel 532-nm solid-state picosecond laser after 2 treatments.

A noninvasive approach to off-face skin laxity and tightening: a review of the literature.

Off-face skin scales tailored to each anatomical site can measure laxity and tightening of the neck, chest, arms, hands, abdomen, buttocks, and medial thighs. Although surgery may be indicated for major weight loss patients, other noninvasive modalities may be considered including: CO2 laser, bipolar radiofrequency, monopolar radiofrequency, microfocused ultrasound, and combination therapies. We provide a review of the literature for each modality and relevance to the off-face anatomical sites.