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J Drugs Dermatol ; 10(11): 1235-9, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22052301


Laser hair removal, previously contraindicated in patients with ethnically dark (phototypes IV-VI) or sun-tanned skin, is now recognized as a safe and effective method of permanent hair reduction in all patients. Longer wavelengths, conservative fluences, longer pulse durations and appropriate cooling methods are necessary to minimize untoward side effects and maximize efficacy. The longer wavelength Nd:YAG laser is considered safest in treating darker skin of color. An added benefit of laser epilation is that side effects of conventional hair removal such as pseudo-folliculitis barbae and post inflammatory dyspigmentation, more commonly seen in skin of color, may also respond favorably to the laser, thus increasing the potential for patient satisfaction.

Remoção de Cabelo/métodos , Terapia a Laser/métodos , Pigmentação da Pele , Grupos de Populações Continentais , Humanos , Terapia a Laser/efeitos adversos , Satisfação do Paciente
Semin Cutan Med Surg ; 28(2): 130-40, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19608064


The demographics of the US population continue to change at an extremely rapid pace. As of 2008, Asians, Hispanics, and African Americans accounted for 31% of the US population, and it is estimated that by the year 2050 half of the population of America will be represented by darker ethnic skin types. With the increase in the total number of individuals of skin of color, the demand for safe and effective laser therapy in darker skin types continues to increase. However, despite the increase in demand, the current literature regarding the use of lasers in darker skin remains limited. Most of the treatment parameters defined for laser platforms have been established primarily through extensive testing on skin phototypes I to III, and those studies that have been conducted on darker skin phototypes have been overwhelmingly conducted on Asian skin. Nevertheless, it has become clear that effective cutaneous laser surgery in darker skin types can be accomplished despite a relative overall greater risk for complications. Therefore, as the diversity of America continues to grow, the laser surgeon needs to maintain a clear understanding of the complexities associated with treating ethnic skin and remain mindful of the current, and ever-changing, therapeutic modalities available. This will allow the conscientious physician to maximize outcome and minimize risk when performing laser surgery on darker skin types.

Procedimentos Cirúrgicos Dermatológicos , Grupos Étnicos , Terapia a Laser , Humanos , Hiperpigmentação/cirurgia , Terapia a Laser/métodos , Fototerapia , Transtornos da Pigmentação/terapia , Pele/efeitos da radiação , Envelhecimento da Pele
J Drugs Dermatol ; 5(8): 771-8, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16989192


Modalities for skin tightening include radiofrequency (RF) energy, lasers, and combination RF and diode lasers. A new broadband infrared light device (BILD) (Titan, Cutera, Inc, Brisbane, CA) targets water to achieve dermal heating and collagen remodeling for skin tightening. Although thousands of procedures have been performed worldwide with this device, only one article (to the author's knowledge) describing its performance in skin tightening has been published. Three US dermatologists report their experience with and provide their perspective on facial skin tightening with the BILD system. As early adopters, they each have 12 to 18 months experience with this system. One author (A.F.T.) treated 42 patients twice at 1-month intervals over 18 months. The mean improvement score was 1.83 (scale 0 to 4, with 4 denoting maximum improvement) with an average follow-up time of 3.7 months. More than 90% of treated patients showed visible improvement. No complications were observed and patient satisfaction was high. This paper presents the general consensus of the authors on patient selection and treatment protocol, their modifications of the manufacturer's treatment protocol, and the outcomes of 42 patients treated by one author (A.F.T.). The observations were gathered separately and turned out to be very similar. The recommendations are presented to help practitioners achieve consistently good results and avoid complications with the BILD procedure.

Raios Infravermelhos/uso terapêutico , Terapia por Radiofrequência , Ritidoplastia , Envelhecimento da Pele/efeitos da radiação , Técnicas Cosméticas , Humanos , Envelhecimento da Pele/patologia
Dermatol Ther ; 17(2): 177-83, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15113285


Before the advent of longer wavelengths, longer pulse durations and more efficient cooling devices, laser-assisted hair removal was best suited for phototypes I-III with dark terminal hairs. Now, laser-assisted hair removal can be performed safely and efficaciously on darker skin types. The long-pulsed diode and Nd:YAG-wavelength-based laser systems are best suited to safely and effectively treat patients with darker skin types. By using conservative fluences, longer pulse durations and multiple treatments, safe and effective laser-assisted hair removal is possible for darker skin types. Patients with darker skin who suffer from hirsutism, hypertrichosis, and pseudofolliculitis barbae can finally be treated safely and effectively.

Grupo com Ancestrais do Continente Africano , Remoção de Cabelo/métodos , Hipertricose/genética , Hipertricose/cirurgia , Terapia a Laser/métodos , Humanos
Dermatol Clin ; 21(4): 713-23, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14717412


Like all medical procedures laser therapy comes with inherent risks and complications. Because of the increased risk in epidermal side effects when performing laser therapy on patients with darker skin, a higher level of laser expertise and clinical experience in treating darker ethnic skin is recommended to ensure that patients are treated safely. Test spots should always be done as an aid to selecting safe and efficacious treatment parameters. Because of the limited experience in treating patients with darker skin a conservative approach should always be used. Unfortunately, there are no national policies establishing credentialing requirements for those planning to practice laser surgery. The US Food and Drug Administration are responsible for granting individual laser manufacturers' permission to market their lasers for specific indications. The Food and Drug Administration also recommends operator training to use these lasers, but credentialing is a state function and consequently standards for laser therapy vary greatly from state to state. Until the bar is raised and national credentialing polices on laser therapy are established clinicians must police themselves and fully be aware of their capabilities and limitations to ensure that all patients regardless of skin color or ethnicity receive safe and effective treatments.

Afro-Americanos , Terapia com Luz de Baixa Intensidade/métodos , Dermatopatias/etnologia , Dermatopatias/radioterapia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Incidência , Terapia com Luz de Baixa Intensidade/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Dermatopatias/diagnóstico , Pigmentação da Pele/fisiologia , Resultado do Tratamento , Estados Unidos/epidemiologia