Fractional treatment of aging skin with Tixel, a clinical and histological evaluation.

OBJECTIVE: This study presents clinical results of Tixel, a new fractional skin resurfacing system based on thermo-mechanical ablation technology. Tixel employs a hot (400°C) metallic tip consisting of 81 pyramids. Treatment is performed by rapidly advancing the tip to the skin for a preset tip-skin contact duration. Thermal energy transfer to the skin creates micro-craters by evaporation. METHODS: Treatment results with tip types, D and S, with high and low thermal conductivity, were evaluated. Twenty-six subjects received three facial treatments, with 4-5-week intervals between treatments, without analgesia or cooling. In addition, histopathologies of Tixel and CO2 laser were performed. RESULTS: Crater properties are related to contact duration and to thermal conductivity. The D tip created char-free ablative craters 100-320 µm wide with a thermal zone 100-170 µm deep. The S tip created non-ablative coagulation preserving the epidermis. Skin complexion improvement was achieved in all subjects; average treatment pain of 3.1/10, downtime of 0-1 days, and erythema clearance of 3.5 days. Subject's satisfaction was 75% and wrinkle attenuation was achieved in 75% of the cases. There was no incidence of bleeding, scarring, or post-inflammatory hyperpigmentation. CONCLUSIONS: Tixel may be used safely for ablative and non-ablative resurfacing with low pain, low downtime, and quick healing.

Reduction in thigh circumference and improvement in the appearance of cellulite with dual-wavelength, low-level laser energy and massage.

OBJECTIVES: This study evaluated the efficacy and safety of a low-level, dual-wavelength laser energy and massage device for improving the appearance of cellulite and reducing thigh circumference. METHODS: Subjects (n = 83) with mild to moderate cellulite enrolled in this IRB-approved, open-label, multicenter study. Their right or left thighs received eight treatments with a low-level, dual-wavelength laser and massage device. The untreated contralateral thigh served as a control. Circumferences of the upper, middle, and lower thighs (treated and untreated) were measured before the fifth and eighth treatments and 1 month after the final treatment. RESULTS: Reduction in thigh circumference of the treated areas exceeded those of the control areas for the upper, middle, and lower thigh in most subjects. The maximum reduction (-0.82 cm) occurred in the upper thigh at 1 month. The mean reduction of the upper, middle, and lower thigh circumferences was -0.64 cm for the treated thighs compared to -0.20 cm for untreated thighs. The difference was significant (p < 0.0001). Fifty-nine (71.1%) treatment thighs lost circumference compared to 44 (53.0%) control thighs. Resolution of adverse effects including erythema, swelling, and increased urination was seen within 30 minutes after treatment. All were resolved without sequelae and within the expected duration. CONCLUSION: The low-level, dual-wavelength laser energy and massage device safely improves the appearance of cellulite while reducing thigh circumference.

Characterization and expression analysis under bending and other abiotic factors of PtaZFP2, a poplar gene encoding a Cys2/His2 zinc finger protein.

In plants, mechanoperception and transduction of mechanical signals have been studied essentially in Arabidopsis thaliana L. and Lycopersicon esculentum L. plants, i.e., in nonwoody plants. Here, we have described the isolation of both the full-length cDNA and the regulatory region of PtaZFP2, encoding a member of Cys2/His2 zinc finger protein (ZFP) family in Populus tremula L. x Populus alba L. Time course analysis of expression demonstrated that PtaZFP2 mRNA accumulated as early as 5 min in response to a controlled stem bending and is restricted to the organ where the mechanical stimulus is applied. The real-time quantitative Reverse Transcriptase Polymerase Chain Reaction experiments showed that PtaZFP2 was also rapidly up-regulated in poplar stems in response to gravitropism suggesting that PtaZFP2 is induced by different mechanical signals. Abundance of PtaZFP2 transcripts also increased highly in response to wounding and to a weaker extent to salt treatment and cold, which is consistent with the numerous putative cis-elements found in its regulatory region. As in other species, these data suggest that Cys2/His2 ZFPs could function in poplar as key transcriptional regulators in the acclimation response to different environmental factors.

Hair removal on dark-skinned patients with pneumatic skin flattening (PSF) and a high-energy Nd:YAG laser.

BACKGROUND: Permanent laser hair removal is normally performed with high-energy densities and associated with acute pain. Pneumatic skin flattening (PSF) is a new technology, which helps to control the pain during laser aesthetic treatments. Based on the gate theory of pain transmission, it activates tactile and pressure skin receptors just before the laser shot to naturally block the transmission of pain to the brain while the laser is activated. OBJECTIVE: To test the safety, pain reduction, as well as the efficacy of PSF in hair removal on patients with dark skin (mainly skin types IV, V and VI) with a high-energy Nd:YAG laser and without skin chilling. METHODS: Patients were treated for hair removal with a 1064-nm laser (GentleYAG, Candela) at energy densities of 40-44 J/cm(2). Each patient was treated on both axillae: PSF on one side and without PSF (but with a chiller) on control sites. Pain was evaluated on a 1-10 scale. Hair re-growth was counted after 12 weeks. A second treatment was delivered at that time for additional evaluation of pain and further efficacy evaluation. Post-treatment erythema and adverse effects were also noted. RESULTS: Pain reduction was demonstrated in all 28 patients: the average was 2.6 with PSF and 4.5 without PSF. Hair removal efficacy with and without PSF was identical: 78-79% hair reduction after 12 weeks (standard deviation 14% and 10% respectively, t-test: 0.78). There were no cases of adverse effects and post-treatment erythema was consistently lower with PSF. All patients preferred PSF over non-PSF treatment. CONCLUSION: The PSF technology considerably reduces pain in hair removal with high-energy Nd:YAG lasers on dark skins without side effects, while preserving efficacy. Analgesic creams and skin chilling are not required.

Jr-ZFP2, encoding a Cys2/His2-type transcription factor, is involved in the early stages of the mechano-perception pathway and specifically expressed in mechanically stimulated tissues in woody plants.

Plants respond to environmental mechanical stimulation, such as wind, by modifying their growth and development. To study the molecular effects of stem bending on 3-week-old walnut trees, a cDNA-AFLP approach was developed. This study allowed the identification of a cDNA, known as Jr-ZFP2, encoding a Cys2/His2-type two-zinc-fingered transcription factor. Reverse transcriptase-polymerase chain reaction analysis confirmed that Jr-ZFP2 mRNA accumulation is rapidly and transiently induced after mechanical stimulation. After bending, Jr-ZFP2 transcript increase was restricted to the stem, the organ where the mechanical solicitation was applied. Furthermore, other abiotic factors, such as cold or salt, did not modify Jr-ZFP2 mRNA accumulation in walnut stems under our experimental conditions, whereas growth studies demonstrated that salt stress was actually perceived by the plants. These results suggest that the regulation of Jr-ZFP2 expression is more sensitive to mechanical stimulus. This gene will be a good marker for studying the early stages of mechanical perception in woody plants.

Reduction of pain and side effects in the treatment of solar lentigines with pneumatic skin flattening (PSF).

BACKGROUND: Energy densities utilized in the treatment of pigmented lesions such as solar lentigines with intense pulsed light systems are often limited by pain and post-treatment erythema and edema. The sensation of pain associated with the treatment is immediate and acute. Application of topical anesthesia is time-consuming, with only very moderate pain relief. OBJECTIVE: (a) To test pain reduction as well as the reduction of post-treatment erythema and edema when using pneumatic skin flattening (PSF). This new technology utilizes an evacuation chamber to generate skin compression and activates tactile neural receptors in the skin. The result is an afferent inhibition of pain transmission in the dorsal horn (the 'gate theory'). (b) To test the efficacy of PSF. METHODS: Twenty patients were treated for solar lentigines. The patients were treated by three different IPLs. The evaluation of acute pain and post-treatment erythema and edema was performed on all 20 patients: one to three sites per patient treated with PSF and the same number of control sites without PSF. Identical energies and IPL were applied to both sites on each patient. The pain evaluation was performed on a 10-level scale modified McGill Pain Questionnaire. The clinical response to treatment was also evaluated. RESULTS: All 20 patients completed the study and preferred the PSF treatment side over the non-PSF side. Substantial pain reduction was observed in 19/20 patients (95%). The average reduction of pain was by two levels, from very painful to very mild pain. Erythema reductions were observed on 14/18 (77%) patients and edema reduction on 8/9 (88%) patients. Treatment efficacy on PSF sites was identical to that of non-PSF sites. CONCLUSION: The pneumatic skin flattening (PSF) technology considerably reduces pain, erythema and edema in the treatment of solar lentigines by IPLs. Treatment efficacy is preserved. The enhanced safety of PSF enables the increase of energy density and the acceleration of results.

Use of nonthermal blue (405- to 420-nm) and near-infrared light (850- to 900-nm) dual-wavelength system in combination with glycolic acid peels and topical vitamin C for skin photorejuvenation.

BACKGROUND AND OBJECTIVES: A major cause of skin aging is a chronic microinflammation created by environmental conditions and ultraviolet exposures. The hand-free application on the skin of a new intense light combining a narrowband blue-light (405- to 420-nm) antiinflammatory emission and a near-infrared (850- to 890-nm) emission inducing self-defense mechanisms provides a new component to photorejuvenation and antiaging treatment protocols. STUDY DESIGN: An innovative skin rejuvenation schedule is presented in this study. It includes skin exposure to the light, with concomitant glycolic peels and daily vitamin C cream regimen for group A and only topical vitamin C cream and glycolic peels for control group B. RESULTS: Results show a significant improvement on pore size, rhytids, and radiance in group A. Conversely no improvement is noticed in group B except for a brief increase of skin radiance. Mechanisms of action of that specific light source are discussed. CONCLUSION: The exposure to this device can clinically enhance conventional antiaging protocols in skin rejuvenation.

The utilization of nonthermal blue (405-425 nm) and near infrared (850-890 nm) light in aesthetic dermatology and surgery-a multicenter study.

BACKGROUND: A major cause of skin aging is a chronic micro-inflammation triggered by UV radiation and external pollutants. It has been demonstrated that blue light diminishes inflammatory conditions and near infrared light enhances circulation. OBJECTIVES: To assess the effectiveness of a non thermal dual wavelength -- blue (405 - 420 nm) and near infrared (850 - 900 nm) -- light source in skin rejuvenation, in the reduction of the duration of post skin resurfacing erythema and in the acceleration of healing of post surgical conditions (face lift and breast augmentation). METHODS: We have utilized a non contact, hand free dual wavelength light source (iClearXL and Clear100XL, Curelight Ltd) to treat over 60 patients and perform three controlled studies in four centers. Follow up duration was three months. Control group for photo-rejuvenation consisted of patients treated with Glycolic peeling and daily appliance of vitamin C Control group for post skin resurfacing erythema duration consisted of patients untreated by the light source and control group for post surgical healing consisted of patients untreated by the light source or treated by the light source on one side only. RESULTS: Post skin resurfacing erythema duration is reduced by 90%. The healing of post surgical conditions is substantially accelerated and discomfort is reduced. The anti aging effect of the light source includes: reduction of pore size in 90% of patients with stable results at three months follow up, enhanced skin radiance in 90% of patients with stable results at three months follow up and smoothing of fine wrinkles in 45% of patients with stable results at three months follow up. The control group showed poor results which were stable for a duration of less than one month. CONCLUSIONS: A non thermal, non contact / hand free light source emitting at 405-420 nm and 850-900 nm considerably enhances aesthetic and surgical aesthetic procedures without consuming user time.