Efficacy and Safety of Q-Switched 1064/532 nm Nd:YAG Lasers on Benign Hypermelanosis in Dark-Skinned Individuals-A Preliminary Study.

Background: Facial hypermelanosis is a major cosmetic issue that causes severe social embarrassment and psychological pain, particularly among Asians and dark-skinned individuals. Aim: This study assesses the safety and effectiveness of Q-switched 1064/532 nm nanosecond/picosecond lasers in removing benign hypermelanosis in dark-skinned individuals, evaluating the possible associated side effects. Material and methods: A total of 30 participants (80% females and 20% males) with Fitzpatrick skin types IV-V-VI who presented superficial benign hypermelanoses on the facial and décolleté area were enrolled. All patients underwent to one to two laser treatment sessions with a 1064/532 nm Q-switched laser system. Three months after the final laser session, results were assessed by comparing before- and after-treatment photos and using a quartile scale for lesion clearance (4-point Investigator Global Assessment scale). Results: All patients observed global improvements in their pigmented lesions: 53% of patients achieved excellent clearance, 30% of patients achieved good to moderate clearance, 10% of patients achieved slight clearance, and 7% of patients did not respond to the therapy. No serious adverse event occurred. Photos showed the clinical improvement achieved at 3 months follow-up. Conclusions: The Q-switched 1064/532 nm laser proved to be a key tool for treating benign hypermelanosis in all skin types, including dark-skinned persons.

Effective Treatment of Rosacea and Other Vascular Lesions Using Intense Pulsed Light System Emitting Vascular Chromophore-Specific Wavelengths: A Clinical and Dermoscopical Analysis.

Background: Facial telangiectasias is a prevalent cosmetic disorder that can be associated with several conditions such as rosacea. IPL (intensity pulsed light) therapy is commonly used for the treatment of vascular lesions. This study tested the efficacy of an IPL system emitting selected vascular chromophore-specific wavelengths in the range of 500-1200 nm for the treatment of vascular lesions. Materials and Methods: A total of 39 patients affected by different vascular lesions on their face were enrolled. The procedure consisted of three treatment sessions, spaced 1 month apart, using the IPL system with a 500-677 and 854-1200 nm filter. Follow-up was performed at 21-90 days (3 weeks-3 months) after the last IPL session. Three-dimensional and dermoscopic clinical photographs were captured and evaluated using a five-point scale. Adverse events were checked. Results: In total, 21 patients achieved excellent improvement, 13 patients achieved good improvement, 3 patients achieved moderate improvement, 2 patients achieved mild improvement, and 0 patients achieved no improvement, with an overall good response to treatment. The photographic evaluation showed good results as soon as 3 days after the last IPL session. Relevant side effects were absent. Conclusions: The study device may represent a successful treatment to improve vascular lesions that are resistant to laser therapy.

Fractional CO2 Laser Therapy for Effective Treatment of Facial Traumatic Hypertrophic Scar: A Case Report.

BACKGROUND Hypertrophic scars occur when there is an excessive wound-healing response in the skin. Fractional, or fractionated, carbon dioxide (CO2) laser therapy uses narrow shafts of light to smooth the skin surface and stimulate dermal collagen, which tightens the skin. This case report describes a 57-year-old woman with a traumatic hypertrophic scar of the face treated with fractional carbon dioxide laser therapy. The purpose of this case report was to highlight the role of fractional CO2 laser therapy in treatment of a facial traumatic hypertrophic scar in a patient after a motor vehicle crash. CASE REPORT A 57-year-old female patient presented with a hypertrophic, rigid, post-traumatic scar on the left side of her face following a motor vehicle crash. For the hypertrophic scar removal, the patient underwent 1 treatment session with fractional CO2 laser using the µ-Scan DOT scanning system. After 1 laser treatment session, the photographic documentation, which permits monitoring the treatment's effectiveness in esthetic improvement, showed a significant improvement in scar texture and color. In addition, a significant reduction in scar height was observed following laser therapy. Fractional laser treatment with the device was very well tolerated by the patient, who reported no pain or discomfort, complications, or adverse effects either during treatment or in the follow-up period (3 months). CONCLUSIONS This report demonstrates the cosmetic application of fractional carbon dioxide laser therapy in a case of hypertrophic scar with the use of an effective therapeutic protocol that did not require the use of suturing.

An Innovative Dual-Wavelength Laser Technique for Atrophic Acne Scar Management: A Pilot Study.

Background and Objectives: Acne scars are one of the most disturbing and long-term symptoms of acne vulgaris, having a negative impact on a person's physical, emotional, and social well-being. Aim: the purpose of the study was to evaluate the efficacy and post-treatment outcomes of a dual-wavelength system combining the irradiation of two wavelengths at 10,600 nm and 1540 nm in the management of facial atrophic acne scars. Materials and Methods: Four healthy adult volunteers aged 24-53 years were enrolled. The areas treated were the full face (two patients), cheeks (one patient), and forehead (one patient). A dual-wavelength system (1540 nm and 10,600 nm) was used for this study. Patients underwent 2-4 treatment sessions, and the treatments were performed once every 45-90 days. All possible side effects such as burning sensation, dyschromia, mild to moderate post-treatment erythema, bleeding, itching, edema, and crusting were checked. The index to assess edema and erythema was based on a four-point scale (none, mild, moderate, and severe) and was applied before and at 3-month follow-up (3 MFU) after the last treatment session. In addition, a patient assessment was conducted before treatment and at 3 MFU after the last treatment session. Results: For all patients examined, the edema index was mild, while for the erythema index, 3/4 patients experienced moderate and 1/4 patients experienced mild symptoms. The mean patient downtime was 5.8 ± 0.5 days. Concerning the patient assessment, 2/4 subjects showed excellent improvement, 1/4 patients showed good improvement, and 1/4 patients showed slight improvement. As shown by the photographic assessment, a noticeable improvement in skin texture and a substantial reduction in acne scars were observed at the end of treatment. Conclusions: This dual-wavelength laser technology has the potential to be an interesting and safe approach for acne scar treatment, with a low risk of scarring/hypopigmentation and a shorter healing time.

Efficacy of a multimodal approach of laser therapy for earlobe keloids management in dark population.

BACKGROUND: Patients with keloids are often younger than 30 years old and have darker skin. AIM: To evaluate the efficacy and safety of CO2 laser therapy in the management of earlobe and helix keloids in dark subjects. METHODS: A total of 21 dark patients (five men and 16 women) presented with the earlobe and ear helix keloids, with a mean age of 30.5 (±6.7) years and with phototype between III-VI, were enrolled. In order to improve their earlobe and helix keloids, all patients underwent a single session of CO2 laser therapy immediately followed by a pulsed Dye laser procedure. A single well-experienced doctor performed all treatment sessions and the response to treatment. Patients were followed-up for 6 months after termination of therapy. Clinical images were examined and collected: all patients were examined clinically and with Dermoscopy. RESULTS: The majority of the patients treated show complete remission of keloid lesions. Clinical photographs show a visible aesthetic improvement of several types of keloids in dark subjects. CONCLUSIONS: Our data demonstrate that this combined laser therapeutic protocol appears to be effective and well tolerated for the management of earlobe and helix keloids in dark subjects, with no high recurrence rate and avoiding the adverse effects and lengthy recovery time.

Laser Impacts on Skin Rejuvenation: The Use of a Synergistic Emission of CO2 and 1540 nm Wavelengths.

Background and Objectives: For nearly 15 years, carbon dioxide (CO2) laser has been the gold standard in skin rejuvenation. Aim: The purpose of this study was to assess the efficacy of a new laser device which combines CO2 and 1540 nm wavelengths in wrinkles reduction, using a recently developed scanning unit named the µScan DOT scanner. Materials and Methods: A total of 20 female patients underwent from two to four laser treatment sessions performed once every 45-90 days. Wrinkles reduction was evaluated using the Fitzpatrick Wrinkle Classification System (FWCS). Evaluations of five-point Global Patient's Assessment (PGA) and an Oedema and Erythema index based on a four-point scale were carried out. A careful photographic evaluation was performed to observe the patients' aesthetic improvements. All the assessments were performed before and at 3 months follow up (3 MFU) after the last treatment session. Results: The mean FWCS score significantly (p < 0.01) decreased from 5.45 ± 2.21 at baseline to 3.3 ± 1.78 at 3 MFU after the last treatment session. In total, 8/20 (40%) subjects reported excellent improvement, 7/20 (35%) subjects showed good improvement, 5/20 (25%) subjects showed slight improvement, and 0/20 (0%) subjects showed no improvement. Concerning the Oedema index, 15/20 subjects experienced a mild one, 5/20 subjects experienced a moderate one, and none of 20 experienced a severe one, while for the Erythema index, 1/20 patients experienced mild, 18/20 patients experienced moderate, and only 1/20 patient experienced severe erythema. No severe adverse events were observed. Conclusions: This dual-wavelength laser technique may become a promising new option for safe, nonsurgical improvement for skin rejuvenation with an extremely low risk of scarring or hypopigmentation and shorter healing times.

Clinical application of 675 nm laser therapy for dorsal hand skin hyperpigmentation.

BACKGROUND: Noninvasive skin rejuvenation treatment is growing in recognition to aesthetic medicine. AIM: The objective of the study was to assess the efficacy and the safety of the 675-nm laser source treatment of photodamaged hands. MATERIALS AND METHODS: The study included 21 patients (6 males and 15 females) with a mean age of 63 (± 9) years. Patients were treated with -two to three sessions of the 675-nm laser with a 1-month interval between sessions. Photos of each patient were collected at baseline, and 3 months after the last laser session. The 5-point Global Aesthetic Improvement Scale (GAIS) was recorded with their final assessment session (3 months). RESULTS: The total GAIS scores showed satisfactory results: 15 patients (71%) experienced 4 score (excellent improvement) changes and 6 patients (29%) experienced 3 score (good improvement) changes. Clinical images showed good efficacy and visible aesthetic results for the management of photodamaged skin. No serious adverse effects were recorded. CONCLUSION: This study demonstrates the safety and efficacy of for the aesthetic improvement of skin pigmentation and texture for photodamaged hands.

Assessment of the efficacy of 595 nm pulsed dye laser in the management of facial flat angiomas. Results of a case series.

BACKGROUND: Studies on pulsed dye laser (PDL) have shown the best efficacy and safety data for treating vascular anomalies among the various lasers used and the 595-nm PDL has been used to treat cutaneous vascular anomalies for about 30 years. The purpose of this study was to assess the efficacy of 595 nm Pulsed Dye Laser in the management of facial flat angiomas present in the form of Port-Wine Stain. MATERIALS AND METHODS: Seven cases of PWS in Fitzpatrick skin type ranged from I to III and colour ranging from pink to purple, were treated with 595 nm pulse Dye Laser. Patients underwent to 6-8 laser sessions at 20-30 days intervals. Results obtained were judged by dermatologist, by comparing pre-treatment and post-treatment photographs, 6 months after the last session and a quartile scale of lesion clearance (4-point Investigator Global Assessment scale): 1 = no or low results (0%-25% of the lesion area improved), 2 = slight improvement (25%-50% of the lesion area cleared), 3 = moderate-good improvement (50%-75%), and 4 = excellent improvement (75%-100%) was used. Possible side effects such as blisters, hyper/hypopigmentation, and scarring were monitored. RESULTS: All patients observed global improvements. 71% of patients achieved excellent clearance and 29% patients achieved good-moderate clearance of their angioma. Patients were asked for a subjective evaluation of the results: 57% of patients were very satisfied, 29% were satisfied, and 14% patients were not very satisfied with the results. No patients were dissatisfied. No significant side effects were noted. CONCLUSION: This research confirms the efficacy of the 595 nm PDL for flat angioma management, without considerable side effects.

Removal of Unwanted Hair: Efficacy and Safety of 755-nm Alexandrite Laser Equipped with a 30 mm Spot Handpiece.

Background: Alexandrite 755 nm laser has been currently recognized one of the gold standards for the permanent hair removal business because of its sufficient tissue penetration and higher affinity for melanin compared with Nd:YAG, making the treatment more incisive and effective. Objective: In this study, we evaluated an Alexandrite 755 nm laser with a 30-mm spot for a new and fast hair removal treatment. Methods: Patients of both genders, with skin Fitzpatrick's types, ranging from II to III, were asked to avoid any epilation techniques 4 weeks before the laser hair removal session. Participants underwent a minimum of three to a maximum of eight sessions of treatment, every 6 weeks. Six months after the last treatment, the final evaluation was completed. The treated body areas included arms, legs, axillae, and trunk. The subjects used a numeric scale with a range of 0 to 10 (0: no pain, 10: unbearable), to indicate the associated pain level experienced. By comparing the percentage of terminal hairs before and after laser treatment, hair reduction was determined. Results: The patients reported only slight post-treatment erythema that disappeared after a few hours and only two patients showed persistent erythema lasting a few weeks. The pain was found to be 4.9 ± 0.9 after single pass emission. Conclusions: The 755 nm laser with the new handpiece has proven to be an ideal wavelength for hair removal, allowing efficient, safe, and faster treatments to be performed for the patient.

Approach of Chronic Pelvic Pain with Top Flat Magnetic Stimulation.

Materials and Methods: Vulvar Functional Status Questionnaire (VQ) was used for the evaluation of patient's chronic pelvic pain and muscle hypertone improvements. The interstitial cystitis was assessed by the Leary-Sant symptom and problem indexes (ICSI and ICPI). In this study, the scores resulting from the sum of the two indexes were evaluated as OSS (ICSI + ICPI). Results: Women with chronic pelvic pain and muscle hypertone showed VQ mean values significantly lower than the controls (p < 0.005) from the second treatment up to the sixth one. In 6 patients affected by interstitial cystitis, the mean score of OSS was significantly lower than the controls (p < 0.005) from the second treatment up to 2 months follow-up after the last treatment session. No side effects were observed. Conclusion: Based on these results, this technology may successfully manage muscle hypertonicity condition, the chronic pelvic pain, and interstitial cystitis.

Clinical evidence of 595 nm pulse dye laser treatment for viral warts on hands and feet.

BACKGROUND: Viral warts, induced by infection by different HPV genotypes, are highly frequent in the general population, particularly during infancy and among adolescents. The effectiveness of the 595 nm Pulse dye-laser in treating viral warts on the hands and feet in both adults and children was investigated in this study. MATERIALS AND METHODS: A selection of 203 patients with multiple viral warts was made. All patients underwent 4-5 treatment sessions with a 595 nm pulse Dye Laser (PDL). Treatment outcome was assessed by a quartile scale: 1 indicates no or low results (0%-25% of the lesion area cleared), 2 indicates slight clearance (25%-50% of the lesion area cleared), 3 indicates moderate-good clearance (50%-75%), and 4 indicates excellent clearance (75%-100%). Patients were asked for a subjective evaluation of the perceived overall results by means of the following score: unsatisfied (1), not very satisfied (2), satisfied (3), and very satisfied (4). Possible side effects were monitored. Results obtained were judged with a photographic evaluation, immediately and at the control visit (6 months after the last laser session). RESULTS: All patients observed global improvements. Most of the lesions were completely removed after laser therapy. A total of 95% of patients achieved excellent clearance and they were very satisfied following the laser treatment. Relevant side effects were absent in all patients. CONCLUSION: PDL treatment with the study device using a wavelength of 595 nm has proven to be a tolerable and safe therapy for viral warts management.

Efficacy and Safety of Carbon Dioxide Laser System in the Treatment of Scalp Sebaceous Adenoma With the Use of a New Scanner Unit.

Sebaceous adenoma (SA) is a rare solitary tumor that preferentially affects the forehead and scalp. The objective of this case report was to determine the efficacy and safety of a 10,600-nm carbon dioxide (CO2) laser device in the treatment of large scalp SA, using a new scanning system which allows to speed up the removal of the lesion. A 65-year-old male with SA on the scalp area underwent one session with the CO2 laser system. For this procedure, a new scanner system with 7-inch or 4-inch focal handpieces were used. A local anesthesia with lidocaine was performed before laser treatment. Some possible side effects such as dyschromia, burning sensation, bleeding and mild to moderate post-treatment erythema, itching, crusting, and edema, were checked. In order to monitor the effectiveness of the treatment, clinical photos that documented the patient lesion were captured before treatment and at 1 month of follow-up. The clinical and aesthetic results observed after laser procedure were excellent, with a complete remission of patient's scalp SA lesion at 4 weeks' follow-up. Patient satisfaction was very high, and no side effects were observed. This laser system technology allows for precise, effective, and targeted action on the lesions treated while simultaneously protecting the surrounding areas, ensuring the best possible re-epithelialization.

Microwave Therapy for Frostbite Management: A Case Series.

Microwave body tightening and contouring is a common and efficient cosmetic medical procedure. The current study presents preliminary data about microwave treatment for body contouring where an innovative and unexpected benefit on frostbites was shown. This is a case series on two patients with frostbite treated with microwave therapy. The participants received the treatment for five sessions at 20-day intervals, including the beginning of the study. In addition to being satisfied with the treatment of their skin imperfections, the patients noticed a remarkable and progressive improvement in frostbite on their limbs. Both patients experienced a significant improvement in skin sensation and appearance and no side effects were observed. Our findings confirmed the safety and efficacy of microwave therapy in treating cellulite and skin laxity but rather a positively effect and a significant improvement in the treatment of frostbite as a secondary intention.

Facial and body contouring with 1444 nm Nd:YAG laser-assisted lipolysis: Clinical evidence.

BACKGROUND: Body contouring is a significant area of dermatologic and plastic surgery. Surgical procedures, like surgical lipectomy, and less invasive procedures, such as various liposuction techniques, are the two main ways to reduce fat. AIM: Our study showed that 1444 nm Nd:YAG laser-assisted lipolysis used with appropriate and specific parameters effectively destroys adipose tissue avoiding these risks and determining a safe clinical application. METHOD: A subcutaneous, 1444 nm Nd:YAG laser was used on 132 patients (range, 18-73 years; 109 women and 23 men with Fitzpatrick skin phototypes ranging between II and V) requiring body and face contouring. All patients were photographed for documentation. Digital clinical photography was taken under as near identical conditions as possible at baseline (pre-treatment), and 16 weeks post-treatment. The 5-point Global Aesthetic Improvement Scale (GAIS) was recorded immediately after treatment and at their final assessment session (4 months). Adverse events were monitored. RESULTS: On the basis of the investigator-evaluated GAIS scale, the total GAIS scores showed satisfactory results. Clinician assessment from the clinical photography showed good efficacy and visible aesthetic results for body and face areas. No serious or unexpected adverse side effects were recorded, and transient pain, oedema, erythema and slight induration resolved within the first week of treatment. CONCLUSIONS: The 1444 nm Nd:YAG laser is a new tool for performing lipolysis, and this study reports its effectiveness and safety.

Use of a microwave device for the treatment of cellulite and localized fat adiposity: a 1-year follow-up study.

BACKGROUND: The body contour market has grown steadily over the last years, due to the persistent demand for non-invasive treatments for localized fat adiposities, cellulite, and skin laxity. MATERIALS AND METHODS: The purpose of this observational study was to evaluate the efficacy and safety of a new device delivering microwaves (MWs) energy for unwanted fat and cellulite reduction after a full cycle of treatments and 1 year later. A total of 45 patients with localized adiposity and/or cellulite in different body areas (inner thigh, upper arm, abdomen, culotte de cheval, buttocks), received four treatment sessions, 4 weeks apart. Photographic records and global aesthetic improvement scale (GAIS) score were performed. RESULTS: For the treatment of cellulite the average GAIS score passed from 3.65 ± 0.49 at 1-month follow-up (1MFU) to 2.7 ± 0.66 at 1-year follow-up (1YFU). For the treatment of localized adiposity, the average GAIS score passed from 3.52 ± 0.51 at 1MFU to 2.82 ± 0.88 at 1YFU. No particular red area was detected either during or after the treatment. There was no mention of assessment of pain or side effects. CONCLUSIONS: The study findings showed that MWs allow for the treatment of cellulite and localized fat adiposity in a safe and effective way, with results lasting over time up to 1 year after the end of the treatment.

New 675 nm Laser Device: The Innovative and Effective Non-Ablative Resurfacing Technique.

Background and Objectives: Photo/chrono-aging is usually expressed as facial discolouration, wrinkles, redness, elastosis, laxity, and dehydration, thus representing major signs of ageing that often lead to a negative phycological impact on a patient's quality of life. Several types of treatment have been tested during the last decade, especially laser treatments. This article aims to share our experience in the treatment of photoaging with a new 675 nm laser source system on facial chrono-ageing. Materials and Methods: Thirty-five (35) patients were treated with the 675 nm laser device: 32 females (mean age 49 years) and 3 men (mean age 57 years), with Fitzpatrick skin types I-III (9% type I, 43% type II, 48% type III), facial wrinkles and hyperpigmented spots. The efficacy of this treatment was assessed using the Modified Fitzpatrick Wrinkles Scale (FWS), which was calculated before starting the treatment and after 6 months. The pain was evaluated using the VAS Pain Scale. Results: All 35 patients showed a significant improvement in facial wrinkles according to the FWS (from 1.96 to 1.73 at the 3-month follow-up, up to a value of 1.43 at 6 months). In a small group of patients, it was observed that 44% of them showed vascular moderate improvement and that 13% showed a vascular marked improvement after treatment. No side effects were detected except a mild erythematous rash in two patients, and the VAS Pain scale was assessed at 1.17. Conclusions: Red Touch allows a uniform and stable result to be achieved over time with minimum discomfort.

Microwave System: A Novel Treatment for Localized Adiposity Reduction in a Latin American Population.

Background: The microwave body remodeling system is indicated for people who want to improve their physical appearance as it can penetrate deep tissues, causing thermic stress on adipocytes to produce adipolysis while in superficial tissues, it dissolves fibrous tracts and stimulates new collagen. Objectives: The aim of this study was to assess the localized adiposity reduction in Latin American patients using a microwave system. Methods: A total of 35 patients with a mean age of 47.5 (±9.0) years received body remodeling treatment, using the microwave system between the years 2019-2022 in a Bogota, Colombia reference center. Data descriptive analysis was made as well as single-factor repeated measures ANOVA to show pre- and post-treatment difference, and mixed ANOVA for body mass index (BMI) subgroup analysis was performed. Results: In all patients examined, statistical significant differences were found in pre- and post-treatment skinfold test for each body area: superior abdomen (F(1,27) = 63.13; p=0.001), iliac crest (F(1, 23) = 114.33; p < 0.001), posterior waist (F(1, 20) = 27.36; p < 0.001), trochanter (F(1, 17) = 26.94; p < 0.001), among others. Conclusions: According to the study's findings, this microwave system is an innovative and effective technique for body remodeling and cellulite and localized fat reduction.

A Multimodal Approach to Laser Treatment of Extensive Hypertrophic Burn Scar: A Case Report.

BACKGROUND Hypertrophic scars from severe burns cause physical and psychological stress. Proper treatment, including CO2 laser systems, can alleviate these burdens by enabling skin remodeling and collagen production. This study assessed the efficacy of a new laser device with 2 wavelengths (10 600 nm/1540 nm) and 2 scanning units on hypertrophic burn scar management. CASE REPORT A 34-year-old African woman sought treatment for a large hypertrophic burn scar on her right foot. The scar, formed at age 9, was complicated by infection. She underwent 2 CO2 sessions (Scar3 scanner), followed by 3 cycles of fractional CO2 +1540 nm laser (µScan DOT scanner) once a month, combined with topical hyaluronic acid. She also had 2 maintenance sessions with a 595-nm dye laser to prevent scar reactivation. The CO2 and 1540 nm laser synergy improved laxity through volumetric thermal effects, causing contraction and stimulation. This led to a softer, smaller scar with less consistency. The patient experienced significant improvement in quality of life due to alleviation of pain and restored footwear comfort. CONCLUSIONS The hypertrophic burn scar was effectively treated using 10 600 nm and 1540 nm wavelengths, along with dye laser treatment for recurrence prevention.

Ex Vivo Human Histology Fractional Treatment with a New CO2 Scanner: A Potential Application on Deep Scarring.

Background and Objectives: For many years, fully ablative laser treatments, particularly those performed with a carbon dioxide (CO2) laser, were regarded as the gold standard for resurfacing. This study's goal is to assess the depth that can be reached by a new CO2 scanner system, through a skin model with greater dermal thickness, to use in the treatment of deep scarring. Materials and Methods: Male human skin tissue was laser-treated using a CO2 fractional laser and a new scanning system, and all samples were fixed in 10% neutral buffered formalin, dehydrated using a series of crescent alcohol, embedded in paraffin, sectioned in series (4-5 µm thick), stained with haematoxylin and eosin (H&E), and then analysed under an optical microscope. Results: From the epidermis through the underlying papillary and reticular dermis to various depths of the dermis, microablation columns of damage and coagulated microcolumns of collagen were observed. The reticular dermis was fully penetrated up to 6 mm at higher energy levels (210 mJ/DOT), resulting in deeper tissue injury. Although the laser might penetrate further, the skin stops there, leaving just the fat and muscular tissue. Conclusions: The deep layers of the dermis can be penetrated by the CO2 laser system throughout the entire dermal thickness when using the new scanning system, suggesting that this laser's potential impact, at the selected settings, covers all skin targets required to perform superficial or deep treatments on any dermatological issue. Finally, patients who have problems, such as morbid scar-deep complications, which affect their quality of life, are more likely to profit from this innovative technique.