Treatment of leg veins with combined pulsed dye and Nd:YAG lasers: 60 patients assessed at 6 months.

INTRODUCTION: Leg telangiectasias have been reported to have been treated with a variety of lasers. This study was designed to measure response to treatment of leg telangiectasias with a unique coupled 585 nm and 1064 nm pulse. METHODS: Sixty female patients (24-62 y.o., skin types II-IV) with leg vein varicosities were treated with pulses of a combined 585 nm long pulsed dye (LPDL) and 1064 nm Nd:YAG lasers, which were delivered sequentially using a novel dual laser device. Pulses were placed along the entire length of the targeted veins. A beam diameter of 7 mm with pulses of 10 ms and 9 J/cm² of fluence for LPDL, and pulses of 30 ms and 80 J/cm² for the 106 nm Nd:YAG were utilized and these remained uniform. Time delays between sequential LPDL and Nd:YAG pulses were 125 ms, 250 ms and 500 ms depending on vein diameter of 4, 3 and 2 mm respectively. One or two treatments were given at 2 month intervals, with post-treatment assessments at 6 months following the final treatment. Patients subjectively assessed the treatment and their results were used to draw up a satisfaction index (SI). Objective assessment was based on clinical photography and computer-generated data using a vein clearance detection computer program. RESULTS: The overall patient satisfaction rate was 47 of 60 patients and the objective assessments, based on blinded evaluation of clinical photography as well as computer assessment, demonstrated good to very good improvement in 47 by photograph evaluation and 49 of 60 patients by computer edge detection data. CONCLUSIONS: The combination of LPDL and Nd:YAG laser pulses offered efficient treatment of leg veins irrespective of skin type. Results were better on blue and vessels larger than 1 mm. Side effects were minimal and transient.

The treatment of melasma with topical creams alone, CO2 fractional ablative resurfacing alone, or a combination of the two: a comparative study.

BACKGROUND: Melasma is a difficult entity to treat. Topical creams or chemical peels offer some success, and the newer fractional lasers have also been proposed to be useful. This three-armed study compares topical creams, CO2 ablative fractional resurfacing and the combination of both modalities. PATIENTS AND METHODS: Thirty females with melasma, mean age of 38 years, skin types II-IV, were allocated to three groups: group A received treatment with Kligman's formula maintenance topical cream program; group B, CO2 fractional resurfacing using high power, fixed pulse width and low frequency; and group C, both laser and maintenance topical cream treatment. Subjective patient and clinician assessments based on melasma area severity index (MASI) scores were made at baseline, one, two, six and 12 months, and the satisfaction index (SI) and overall efficacy calculated. RESULTS: All patients completed the study. The SI and overall efficacy in groups A, B and C were 100% at one month in all groups but progressively decreased in further assessments except for group C in which better scores were maintained throughout. MASI scores for group C were statistically significantly improved compared to A and B at six and 12 months (P < 0.001 for both). CONCLUSION: The fractional CO2 laser and topical cream regimen produced good, well-maintained results in melasma treatment compared with the monotherapy groups.

FTIR characterization and release of bovine serum albumin from bioactive glasses.

BACKGROUND: Bioactive glass has attracted substantial interest in orthopedics, but it has been less explored as a drug carrier. This study investigated the bovine serum albumin (BSA) release from bioactive 13-93B0 and 13-93B3 glasses. METHODS: Glass disks (13-93B0 and 13-93B3; n = 5) were loaded with 4 mg of BSA and coated under different chitosan-coating conditions. The amount of BSA released in phosphate-buffered saline (PBS) was evaluated, and a degradation study was performed to find out the weight loss and pH of PBS. Secondary structures of BSA on 13-93B0 were characterized by Fourier transform infrared (FTIR) spectroscopy. RESULTS: One hundred percent protein release occurred by 24 hours for all 13-93B3 groups. However, chitosan coating delayed 100% release up to 72 hours in 13-93B0 groups. The 13-93B3 glass showed higher degradation rates than 13-93B0 regardless of chitosan-coating status. Multilayer and sandwich chitosan coatings further delayed BSA release from 13-93B0. FTIR analysis revealed that α-helical structure was the highest among all groups and significantly higher in the 2% sandwich chitosan coating group (32.0% ± 2.1%), compared with uncoated and 4% chitosan groups. CONCLUSIONS: Chitosan coating can delay the burst release of BSA from 13-93B0 glass and be a potential coating on bioactive glass for drug delivery purposes.

The 800-nm diode laser in the treatment of leg veins: assessment at 6 months.

BACKGROUND: The efficacy of the 800-nm diode laser system in clearing leg veins was analyzed subjectively and objectively in a variety of leg veins. METHODS: A total of 10 women (age 25-55 years, skin types II-IV) with a variety of leg vein types were treated with an 800-nm diode laser. A sequence of pulses (5-8 stacked pulses, pulse duration 50 milliseconds, delay 50 milliseconds) was applied on a 3-mm spot (210-336 J/cm2 fluence, depending on vessel size). Treatment on the same vein was performed at intervals of 2 months until complete clearance was achieved (maximum: 3 treatments). The results were assessed at 6 months from the last treatment. Patients evaluated their subjective improvement by means of a questionnaire to elicit the satisfaction index. In an independent objective assessment, the clearance index was based on the pretreatment and posttreatment clinical photography, also analyzed by a computer program. RESULTS: All patients completed the trial with mild but transient side effects. The patient 6-month assessments for very good, good, fair, poor, and worse were 1, 5, 3, 1, and 0, respectively. For the clinician-assessed clearance index, the numbers for the same grades were 2, 6, 2, 0, and 0, and for the computer assessment they were 1, 6, 2, 1, and 0. No patient scored worse in any assessment. The overall satisfaction index and clinician and computer clearance indexes were 60%, 80%, and 70%, respectively. LIMITATIONS: No control group could be obtained in this study. CONCLUSIONS: The 800-nm diode laser as used in the study may well offer an effective treatment method for leg veins that is comparatively pain and side-effect free. Best results were obtained in vessels of 3 to 4 mm in diameter located on the thigh, and in patients with phototype III skin. No correlation was seen between results and patient age.

1064-nm Nd: YAG laser-assisted cartilage reshaping for treating ear protrusions.

BACKGROUND: Correction of prominent ears is a common plastic surgical procedure. The laser-assisted cartilage reshaping (LACR) technique for protruding ears was developed at the French National Institute of Health and Medical Research in Lille, France, using both the 1064- and 1540-nm wavelengths, with a view to simplifying the surgical procedure. Herein we report our results with the 1064-nm wavelength. METHODS: Between 2008 and 2010, twenty-six 1064-nm LACR procedures in 14 patients were performed. Twelve patients received treatment to both ears, and 2 patients received treatment to one ear. Each procedure consisted of a single treatment session. The treatment consisted of laser irradiation of both sides of the helix with single pulses of 70 J/cm2. The beam diameter was 6 mm. Early and late complications were defined and reviewed for all patients. Satisfaction was assessed by patients using a visual analogue scale from 0 (unsatisfied) to 20 (highly satisfied). The superior and middle cephaloauricular distances were prospectively evaluated at 6 months after treatment. RESULTS: Complications included eight cases of localized skin burns and one case of dermatitis. The mean right/left superior and middle cephaloauricular distances were 10.5±1.5 mm/10.7±1.0 mm and 16.3±2.2 mm/16.3±2.8 mm, respectively, as compared to 17.5±2.9 mm/18.6±2.5 mm (P<0.01) and 24.5±2.6 mm/24.7±1.7 mm (P<0.01) before the operation. Mean patient satisfaction was 16.8/20±3.3. CONCLUSION: Despite promising results for cartilage reshaping, the 1064-nm LACR procedure often leads to skin burns and inflammatory tissue reaction after treatment. Moreover, LACR with the 1064-nm wavelength is painful and necessitates local anaesthesia. LEVEL OF EVIDENCE: 4.

Pulsed and scanned carbon dioxide laser resurfacing 2 years after treatment: comparison by means of scanning electron microscopy.

Studies have reported short-term and long-term (1-year) findings for laser skin resurfacing. Two of the most popular systems used for this procedure, the continuous-wave Sharplan 40C SilkTouch system and the pulsed Coherent 5000C UltraPulse system with a computer pattern generator, were previously compared for a range of follow-up times up to 1 year, using light microscopy and transmission electron microscopy. This study analyzed the 2-year morphological differences using scanning electron microscopy. Tissue samples were obtained from 10 patients (age range, 50 to 72 years; skin types II and III) who had undergone laser resurfacing 2 years previously. One half of the face of each patient had been treated with the continuous-wave system and the other half with the pulsed system. The samples were subjected to scanning electron microscopy. On the continuous-wave-treated side, significantly better dermal collagen organization was observed at 2 years, with plump-appearing fibers that were closely knit to form a compact structure. On the side treated with the pulsed system, the collagen fibers in the papillary dermis were more loosely arranged and appeared drier. In both the continuous-wave-treated and pulsed-treated areas, the epidermis appeared healthy and exhibited some signs of age-related deterioration, with slightly flatter plaques and somewhat more flaking keratin on the pulsed-treated side. Probably because of the greater degree of residual thermal damage associated with the continuous-wave system, at 2 years after treatment there was more prolific synthesis and better orientation of collagen fibers, which were maintained for longer times, compared with the pulsed-treated specimens.

The effects of 3D bioactive glass scaffolds and BMP-2 on bone formation in rat femoral critical size defects and adjacent bones.

Reconstruction of critical size defects in the load-bearing area has long been a challenge in orthopaedics. In the past, we have demonstrated the feasibility of using a biodegradable load-sharing scaffold fabricated from poly(propylene fumarate)/tricalcium phosphate (PPF/TCP) loaded with bone morphogenetic protein-2 (BMP-2) to successfully induce healing in those defects. However, there is limited osteoconduction observed with the PPF/TCP scaffold itself. For this reason, 13-93 bioactive glass scaffolds with local BMP-2 delivery were investigated in this study for inducing segmental defect repairs in a load-bearing region. Furthermore, a recent review on BMP-2 revealed greater risks in radiculitis, ectopic bone formation, osteolysis and poor global outcome in association with the use of BMP-2 for spinal fusion. We also evaluated the potential side effects of locally delivered BMP-2 on the structures of adjacent bones. Therefore, cylindrical 13-93 glass scaffolds were fabricated by indirect selective laser sintering with side holes on the cylinder filled with dicalcium phosphate dehydrate as a BMP-2 carrier. The scaffolds were implanted into critical size defects created in rat femurs with and without 10 µg of BMP-2. The x-ray and micro-CT results showed that a bridging callus was found as soon as three weeks and progressed gradually in the BMP group while minimal bone formation was observed in the control group. Degradation of the scaffolds was noted in both groups. Stiffness, peak load and energy to break of the BMP group were all higher than the control group. There was no statistical difference in bone mineral density, bone area and bone mineral content in the tibiae and contralateral femurs of the control and BMP groups. In conclusion, a 13-93 bioactive glass scaffold with local BMP-2 delivery has been demonstrated for its potential application in treating large bone defects.

Valoración clínica e histológica de resultados de una tecnología innovadora de láser Erbio: YAG para rejuvenecimiento facial / Clinical and histological results evaluation of an innovative Erbium: YAG laser technology for facial rejuvenation

Introducción y Objetivo: En los últimos años existe un creciente interés en el empleo de tecnología láser parcialmente ablativa en el rejuvenecimiento facial. Entre los láseres desarrollados con esta finalidad, el de Erbio:YAG acoplado a un sistema de ablación espacial modulada (RecoSMA(R), Linline, Minsk, Bielorrusia) merece atención porque cambia el tradicional depósito térmico del láser por un fenómeno de empuje mecánico. Nuestro objetivo fue determinar la eficacia y seguridad de un nuevo método de rejuvenecimiento facial que emplea un láser de Erbio:YAG acoplado al sistema RecoSMA®. Material y Método: Estudiamos 26 mujeres, con fototipos II a V y signos de envejecimiento facial entre moderados y severos en relación con su edad cronológica. Todas se sometieron a 2 sesiones de tratamiento separadas por 3 semanas. En cada sesión tratamos la totalidad de la cara. Tomamos fotografías y biopsias antes del primer tratamiento y 3 y 6 meses después del segundo. Evaluamos la eficacia clínica, tolerancia, efectos adversos, complicaciones y cambios clínicos e histológicos. Resultados: Las líneas finas, arrugas y las características del envejecimiento facial global mejoraron de forma significativa (p< 0.0001). La media de mejoría de líneas finas y arugas en ambos grupos fue de 66,4 ± 9,4 (r= 4585). La media de mejoría del envejecimiento global en ambos grupos (A+B) fue de 76.2% ± 6.2 (r = 60 - 85%) a los 3 meses, y de 59.4% ± 9.6 (r= 40 -75%) a los 6 meses. Mostramos a todas las pacientes fotografías comparativas de antes y después del tratamiento, y el 85% manifestaron estar satisfechas o muy satisfechas con los resultados. Vimos también que los resultados obtenidos a los 3 meses disminuían en la evaluación a los 6 meses, con un 62% de pacientes satisfechos. Conclusiones: El perfil eficacia-seguridad fue muy satisfactorio con ventajas adicionales respecto a otros láseres empleados para el rejuvenecimiento facial. Hay que tener en cuenta la disminución de resultados a los 6 meses para indicar sesiones adicionales, aunque debe advertirse previamente a los pacientes

Introduction and Objective: In recent years there has been a growing interest in the use of partially ablative laser technology in facial rejuvenation. Among the lasers developed for this purpose, the Erbium: YAG laser coupled to a modulated space ablation system (RecoSMA®, Linline, Minsk, Belarus) deserves attention because it changes the traditional thermal deposit of the laser due to a push mechanic phenomenon. Our aim was to determine the effectiveness and safety of a new method of facial rejuvenation using an Er:YAG laser together with a system of spatially modulated ablation. Methods: Twenty six women, phototypes II to V, with signs of moderate to severe facial aging were studied in relation to their chronological age. All patients received 2 treatments 3 weeks apart. At each session the entire face was treated. Photographs and biopsies were taken before the 1st treatment and 3 and 6 months after the 2nd treatment. Clinical effectiveness, tolerance, adverse effects, complications, clinical and histological changes were evaluated. Results: Fine lines, wrinkles, and overall characteristics of skin ageing improved significantly (p < 0.0001). The mean of improvement in fine lines and wrinkles in both groups (A+B) was by 66.4 ± 9.4 (r= 45-85). Several signs of facial ageing improved an average by 76.2% ± 6.2 (r = 60 - 85%) at 3 months, and by 59.4% ± 9.6 (r= 40 - 75%) at 6 months.The patients were shown the before and after photographs and 85% were satisfied or very satisfied. It was observed that the results obtained decrease slightly in the evaluation at 6 months (62% satisfied patients) making additional treatment sessions necessary. Conclusions: Compared to other lasers used for facial rejuvenation, results of this study showed to have additional benefits and an excellent effectivenesssafety ratio. We must take into account the decrease of positive results at 6 months, so additional sessions are required although patients must be warned previously

Effect of material, process parameters, and simulated body fluids on mechanical properties of 13-93 bioactive glass porous constructs made by selective laser sintering.

The effect of particle size distribution, binder content, processing parameters, and sintering schedule on the microstructure and mechanical properties of porous constructs was investigated. The porous constructs were produced by indirect selective laser sintering (SLS) of 13-93 bioactive glass using stearic acid as a polymeric binder. The binder content and d(50) particle size in the feedstock powders were simultaneously reduced from 22 to 12 wt% and from 20 to 11 µm, respectively, to identify the minimum binder content required for the SLS fabrication. An average particle size of ∼16 µm with a binder content of 15 wt% significantly reduced post-processing time and improved mechanical properties. Increasing the laser power and scan speed at the energy density of 1 cal/cm² maintained the feature sharpness of the parts during the fabrication of green parts and could almost double the mechanical properties of the sintered parts. Changes in the heating rates, ranging from 0.1 to 2 °C/min, during the post-processing of the fabricated "green" scaffolds showed that the heating rate significantly affects the densification and mechanical properties of the sintered scaffolds. The compressive strength of the scaffolds manufactured with the optimized parameters varied from 41 MPa, for a scaffold with a porosity of ∼50%, to 157 MPa, for a dense part. The bioactive scaffolds soaked in simulated body fluids for durations up to 6 weeks were used to evaluate the change in mechanical properties in vitro.

Estimation of properties of a photoinitiated silorane-based composite with potential for orthopaedic applications.

We have synthesized a filler-reinforced silorane composite that has potential applications in orthopaedic surgery, such as for a bone stabilizer. The purpose of the present work was to develop a method for estimating four properties of this material; namely, maximum exotherm temperature, flexural strength, flexural modulus, and fracture toughness. The method involved the use of mixture design-of-experiments and regression analysis of results obtained using 23 formulations of the composite. We validated the estimation method by showing that, for each of four composite formulations that were not included in the method development, the value of each of the aforementioned properties was not significantly different from that obtained experimentally. Our estimation method has the potential for use in the development of a wide range of orthopaedic materials.

Fabrication of 13-93 bioactive glass scaffolds for bone tissue engineering using indirect selective laser sintering.

Bioactive glasses are promising materials for bone scaffolds due to their ability to assist in tissue regeneration. When implanted in vivo, bioactive glasses can convert into hydroxyapatite, the main mineral constituent of human bone, and form a strong bond with the surrounding tissues, thus providing an advantage over polymer scaffold materials. Bone scaffold fabrication using additive manufacturing techniques can provide control over pore interconnectivity during fabrication of the scaffold, which helps in mimicking human trabecular bone. 13-93 glass, a third-generation bioactive material designed to accelerate the body's natural ability to heal itself, was used in the research described herein to fabricate bone scaffolds using the selective laser sintering (SLS) process. 13-93 glass mixed with stearic acid (as the polymer binder) by ball milling was used as the powder feedstock for the SLS machine. The fabricated green scaffolds underwent binder burnout to remove the stearic acid binder and were then sintered at temperatures between 675 °C and 695 °C. The sintered scaffolds had pore sizes ranging from 300 to 800 µm with 50% apparent porosity and an average compressive strength of 20.4 MPa, which is excellent for non-load bearing applications and among the highest reported for an interconnected porous scaffold fabricated with bioactive glasses using the SLS process. The MTT labeling experiment and measurements of MTT formazan formation are evidence that the rough surface of SLS scaffolds provides a cell-friendly surface capable of supporting robust cell growth.

Dermoscopic and reflectance confocal microscopic features of exogenous ochronosis.

BACKGROUND: Exogenous ochronosis presents as an acquired asymptomatic hyperpigmentation on photoexposed areas, predominantly over bony prominences, and is caused by the topical application of several skin-lightening agents. OBSERVATIONS: We describe a 63-year-old Hispanic woman who developed exogenous ochronosis lesions on her face after using topical bleaching creams containing hydroquinone, 2% to 3%, and oxybenzone, 2%, for several years. Dermoscopy revealed irregular brown-gray globular, annular, and arciform structures that corresponded to focal deposition of ochronotic pigment on the dermis. These deposits correlated with multiple banana-shaped nonrefractile structures seen using reflectance confocal microscopy. Histopathologic sections revealed the deposition of a banana-shaped, yellow to brown material in the papillary and middle dermis. Ultrastructural examination revealed an amorphous electron-dense material mostly located in the core of elastic fibers and also in smaller amounts in the interstitium with prominent degenerative changes in the elastic fibers. A good correlation was observed between the results of both noninvasive techniques and the diagnostic histologic features of this condition. CONCLUSIONS: We characterized by means of dermoscopy, reflectance confocal microscopy, and electronic microscopy a case of exogenous ochronosis. To our knowledge, this is the first description of reflectance confocal microscopic findings in this condition. Dermoscopy and reflectance confocal microscopy are proved to be useful noninvasive techniques for the diagnosis of this pigmentary disorder.

Results of fractional ablative facial skin resurfacing with the erbium:yttrium-aluminium-garnet laser 1 week and 2 months after one single treatment in 30 patients.

The erbium:yttrium-aluminium-garnet (Er:YAG) laser has recently been used in the fractional resurfacing of photo-aged skin. Our study evaluated the results after one single session of fractional resurfacing with Er:YAG. Thirty women participated in the study, with an average age of 46 years, skin types from II to IV, and wrinkle grades I to III. The 2,940 nm Er:YAG system used (Pixel, Alma Laser, Israel) had variable pulse durations (1 ms to 2 ms) and energy densities (800 mJ/cm(2) to 1,400 mJ/cm(2)) which, together with the number of passes (four to eight), were selected as a function of wrinkle severity. All patients received only one treatment. Postoperative side effects were evaluated. The number of wrinkles was documented with clinical photography and was scored. Histological assessment was carried out on two patients before and 2 months after treatment. All patients completed the study. Of the patients, 93% reported good or very good improvement of the degree of their wrinkles, with a satisfaction index of 83%. Pain was not a problem during treatment, and there were no side effects except for in one phototype IV patient, who had hyperpigmentation. Histology 2 months after the single treatment demonstrated younger morphology of both the epidermis and dermis, with improvement of the pretreatment typical elastotic appearance. At the parameters used in our study, only one treatment session of Er:YAG laser could achieve effective skin rejuvenation, with effects recognized in both the dermis and, more importantly, the epidermis. This regimen offers an interesting alternative to the conventional approach of multi-session fractional resurfacing.

Correlation of histological findings of single session Er:YAG skin fractional resurfacing with various passes and energies and the possible clinical implications.

BACKGROUND AND OBJECTIVES: Ablative fractional resurfacing shows promise for skin resurfacing and tightening and also to improve treatment of epidermal and dermal pigmentary disorders. This study aimed at determining any correlation between epidermal ablation and effects on the dermis when using an Er:YAG laser in ablative fractional resurfacing mode. MATERIALS AND METHODS: Ten female subjects participated in the study, mean age 52 years, Skin phototypes: 1 Fitzpatrick type II; 8 type III and 1 type IV. The degree of wrinkles (Glogau scale II or III) was similar in all cases. The laser used was the Pixel Er:YAG system (Alma Lasertrade mark, Israel) which delivers the laser beam via a hand-piece equipped with a beam splitter to divide the 2,940 nm beam into various microbeams of 850 microm in diameter in an 11 mmx11 mm treatment area. Using a constant energy of 1,400 mJ/cm(2), on a test area of 4 cmx2 cm. Two, 4, 6, and 8 passes on the preauricular area of the face were evaluated immediately after treatment. In all cases, the handpiece was kept in the same position, and rotated slightly around its perpendicular axis between passes, then moved on to the next spot. Biopsies were performed and tissue samples were routinely processed and stained with hematoxylin and eosin (H&E). RESULTS: No patient reported any noticeable discomfort, even at 8 passes. The histological findings revealed that, independent of the degree of the wrinkles, more laser passes produced more ablative removal of the epidermis. Residual thermal damage (RTD) with 2 laser passes was not observed but with 4 and 6 passes increased thermal effects and vacuole formation in the epidermal cells were noticed. With 8 laser passes, total epidermal removal was seen together with frank RTD-related changes in the upper part of the papillary dermis. CONCLUSION: In this study, we have demonstrated that high density fractional Er:YAG laser energy in a single session with multiple passes targeted not only the skin surface with elimination of the epidermis, but could also achieve heat deposition in the upper dermis. When performing ablative fractional resurfacing with an Er:YAG laser, treatment of varying degrees of damage could be achieved by varying the number of passes.

Nd:YAG laser combined with IPL treatment improves clinical results in non-ablative photorejuvenation.

BACKGROUND: Intense pulsed light (IPL) sources have been reported in non-ablative photorejuvenation, but the excellent histological findings do not always coincide with the clinical results and patient satisfaction index (SI). METHODS: Ten female patients (two forehead, four periocular and four perioral), ages ranging from 28 to 46 years, skin types II-IV, wrinkle types I-III, participated in the study. The IPL system was applied with the yellow (570 nm) cut-off filter, 30 J/cm(2), single pulse, followed by the Nd:YAG at 120 J/cm(2), double pulse (7 ms per shot with 20 ms between pulses) on the wrinkled areas only. Three sessions were given at monthly intervals, and an assessment was made 1 and 6 months after the third session. Biopsies were taken from four consenting patients as a cross-section before the first treatment and then 1 and 6 months after the third session. For clinical control and contrast of tissue results, a group of 10 patients (two forehead, four periocular and four perioral; ages ranging from 27 to 47 years, skin types II-IV, wrinkle types I-III) was treated only with IPL, using the same parameters and sessions. Histologies were taken from four consenting patients. RESULTS: The histology showed thickening of the epidermis with good dermal collagen organization in both groups. However, the combined treatment showed more dramatic changes in histological tissue condition, and ectatic blood vessels were seen in the deeper dermis. The patient SI values, related to the results, were lower when IPL was used alone. All patients completed the study. In the combined treatment group, overall SIs of 8 (80%) and 8 (80%) were obtained at the control points of 1 and 6 months, respectively, after session 3, compared with SIs of 6 (60%) and 4 (40%) scored by patients in the IPL group at the same points. Discomfort and side effects were minimal in both groups. CONCLUSIONS: The addition of the Nd:YAG laser to the IPL regimen in non-ablative skin rejuvenation gave very good histological results, which were echoed by stronger patient satisfaction than in the control group treated only with IPL. Visible improvement in the skin condition of both groups was achieved, but was better in the combined treatment group.

Hair removal evaluated with a filterless flashlamp-based system: a preliminary study in 10 patients.

BACKGROUND: A relatively inexpensive, portable epilation system based on unfiltered flashlamp technology (Spa Touch, Epilast, Paris, France)was macroscopically and histologically evaluated for efficacy and duration of hair removal. PATIENTS AND METHODS: Ten patients participated (eight female, two male, aged 22-62 years, skin types I-V). The system delivers a 35 ms pulse of 6-7.5 J/cm2 of broadband infrared visible light through a large treatment window in the handpiece, held in light contact with the target skin,without skin cooling or anaesthesia. The skin was shaved before the first treatment, and the subsequent frequency of application over a further four sessions was done every month. RESULTS: Histology revealed the destruction of most of the hair shaft, with regrowth of finer and lighter hair approximately 4 weeks after the final treatment, depending on the area treated. Patients were satisfied with results if epilation was maintained on a monthly basis. A delay in treatment allows hair to grow back. An interesting observation was recorded on white and vellous hair. Nine of the 10 patients noted better skin condition in the treated area. CONCLUSIONS: This system retards hair regrowth and acts as a 'light razor' that can be implemented for speedy epilation at a reasonable cost.