Ablative Resurfacing Laser Research Articles

Treatment protocols and efficacy of combined laser with medical treatment modalities in vitiligo.

Nowadays, lasers are used for treatment of vitiligo in difficult-to-treat areas and refractory lesions. Combination of lasers with other medical modalities can provide higher efficacy, faster response rate, and higher compliance of patients to treatment. In this article, we reviewed articles regarding safety, efficacy, and treatment protocols of combined laser with other medical modalities. We searched articles with relevant key words in Google scholar and PubMed. Inclusion criteria were articles in English language since January 2000 until March 2021that evaluate combination of laser with other topical or systemic medical treatments. A total of 42 articles evaluated efficacy of lasers [excimer, carbon dioxide (CO2 ), erbium-doped yttrium-aluminum-garnet (Er:YAG), and non-ablative resurfacing laser] combined with topical or systemic medical treatment modalities. Effective response rate (more than 50% improvement) varied between 7.7% and 92%. Initial repigmentation observed between 4 and 13weeks after beginning of treatment. Combination of laser with medical modalities leads to more rapid repigmentation, superior efficacy, and better compliance of patients with localized non-segmental type of vitiligo compared to monotherapy. Combination of excimer laser with topical therapy might be suggested for recalcitrant vitiligo lesions in face and neck. Combination of fractional ablative resurfacing lasers with topical therapy, especially 5-flurouracil, can be recommended particularly in recalcitrant acral and bony prominent areas. Further studies are required to achieve conclusive evidence in order to define the best stage of vitiligo for laser therapy and most effective combined treatment regimen.

Complications in the Cosmetic Dermatology Patient

Over recent decades, the options available to patients for cosmetic rejuvenation have expanded dramatically. The range of options commonly available to patients now includes neuromodulators, fillers, sclerotherapy, chemical peels, lasers, lights and other energy devices, and liposculpture and continues to grow. Like all therapeutic interventions, these cosmetic dermatologic procedures are not without risk. Timely recognition of complications and intervention are paramount for optimal patient outcomes. Part 1 of this review focused on the common complications that may result from injectable cosmetic procedures. The second part will discuss the complications of chemical peels, lasers, light and energy devices, and fat removal/sculpture procedures. A MEDLINE search was performed on cosmetic dermatology complications from 1989 to 2015, and results are summarized. Practical considerations of these complications are also provided. Reports of complications after neuromodulator, injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, polymethylmethacrylate, sclerotherapy, fat transfer, liposuction, cryolipolysis, chemical peels, lasers, and light sources, such as Q-switched laser, intense pulsed light, and nonablative and ablative resurfacing lasers, were found. Review of the literature revealed multiple management options for potential complications of the multitude of cosmetic dermatology procedures now available to patients.

Complications in the Cosmetic Dermatology Patient: A Review and Our Experience (Part 1).

Over recent decades, the options available to patients for cosmetic rejuvenation have expanded dramatically. The range of options commonly available to patients now includes neuromodulators, fillers, sclerotherapy, chemical peels, liposculpture, lasers, and lights and other energy devices and continues to grow. As with all therapeutic interventions, these cosmetic dermatologic procedures are not without risk. Timely recognition of complications and intervention are paramount for optimal patient outcomes. Part 1 of this review will focus on the common complications of injectable cosmetic procedures, such as neuromodulators, fillers, and sclerotherapy. The second part will discuss the complications of chemical peels, lasers, light and energy devices, and fat removal procedures. A MEDLINE search was performed on cosmetic dermatology complications from 1989 to 2015, and results are summarized. Practical considerations of these complications are also provided. Reports of complications after neuromodulator, injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, polymethylmethacrylate, sclerotherapy, fat transfer, liposuction, cryolipolysis, chemical peels, lasers, and light sources, such as Q-switched laser, intense pulsed light, nonablative and ablative resurfacing lasers, were found. Review of the literature revealed multiple management options for potential complications of the multitude of cosmetic dermatology procedures now available to patients.

Facelift combined with simultaneous fractional laser resurfacing: Outcomes and complications

The combination of simultaneous surgical rhytidectomy with ablative resurfacing has been a controversial procedure due to the concern of postoperative wound healing. Traditional ablative resurfacing lasers are believed to have higher rates of complications, leading to delayed healing and skin flap loss when combined with face rhytidectomy surgeries. With the development of fractionated ablative laser therapy, there has been increased interest in combining these two procedures. The objective of this study is to evaluate the clinical outcomes of patients undergoing simultaneous full-face rhytidectomy in combination with fractionated ablative skin resurfacing. A retrospective chart analysis was performed for all patients who had a combined procedure of facelift and ablative fractional laser resurfacing from 2008 to 2013 by the senior author (SKS). Postoperative recovery and complications were recorded. The surgical technique used for performing the facelift was an extended supraplatysmal dissection with SMAS plication. Fraxel Re:Pair 10,600-nm fractional carbon dioxide laser was used to perform an ablative resurfacing including the elevated skin flaps. A total of 86 patients were included. Average age was 60.01 years (range of 45-78 years). Longest follow up was five years. The average size of the elevated skin flaps was 100cm(2). Average skin type was a Fitzpatrick type 2. All patients had complete re-epithelialization by one week after their procedure. Four patients (4.6%) experienced acne outbreaks. Four patients (4.6%) had facial erythema that persisted greater than two weeks. Of these four patients, all resolved by five weeks postoperatively. There was no delayed wound healing or skin flap loss observed. Our results indicate that simultaneous rhytidectomy with fractionated ablative laser resurfacing does not cause an increase in wound healing or skin loss. Due to improved patient outcomes with combining these procedures, we believe that this can be increasingly offered as a safe combination.

Histologic Effects of Resurfacing Lasers

By utilizing resurfacing lasers, physicians can significantly improve the appearance of sun-damaged skin, scars, and more. The carbon dioxide and erbium:yttrium-aluminum-garnet lasers were the first ablative resurfacing lasers to offer impressive results although these earlier treatments were associated with significant downtime. Later, nonablative resurfacing lasers such as the neodymium:yttrium-aluminum-garnet laser proved effective, after a series of treatments with less downtime, but with more modest results. The theory of fractional photothermolysis has revolutionized resurfacing laser technology by increasing the safety profile of the devices while delivering clinical efficacy. A review of the histologic and molecular consequences of the resurfacing laser-tissue interaction allows for a better understanding of the devices and their clinical effects.

New application of the long‐pulsed Nd‐YAG laser as an ablative resurfacing tool for skin rejuvenation: a 7‐year study

Carbon dioxide (CO2 ) and erbium-yttrium aluminum garnet (Er-YAG) lasers are the gold standards in ablative skin resurfacing. Neodymium-doped yttrium aluminum garnet (Nd-YAG) laser is considered a nonablative skin resurfacing laser whose usage is limited due to its high cost. To assess the efficacy and safety of Nd-YAG as an ablative resurfacing laser and to compare the results with those previously published for CO2 and Erbium-YAG lasers. A total of 296 patients (251 female and 45 male) with Fitzpatrick skin types III-IV and dermatological conditions amenable to ablative skin resurfacing participated in this study. Nd-YAG laser parameters assessed were wavelength (1064nm), pulse duration (5ms), fluence (10J/cm(2) ), and spot size (8-10mm). Efficacy of Nd-YAG laser was assessed by comparing pre- and posttreatment photographs. An improvement of 30-80% was observed in treated patients. The degree of improvement correlated positively with the number of laser sessions. The most common side effect was hyperpigmentation. Other side effects were less common and mild in intensity compared with published results for gold standard ablative lasers. Not only was the Nd-YAG laser found to be as effective as Er-YAG and CO2 lasers, but treated patients also had shorter recovery and treatment times, and at lower cost.

The Evolution of Melasma Therapy: Targeting Melanosomes Using Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminium Garnet Lasers

Melasma is an acquired disorder of pigmentation that commonly affects women with phototypes III-V, and it has a negative impact on the quality of life in affected individuals. It presents clinically as symmetric tan or brown patches on the face, most often involving the forehead, cheeks, perioral region, and periorbital region. On histologic examination, there is increased melanin in the epidermis and/or an increased number of melanosomes in the dermis, with a normal number of highly melanized and dendritic melanocytes. The mainstay of treatment is the use of sunscreen along with topical medications that suppress melanogenesis. Clearance is usually incomplete and recurrences or exacerbations are frequent, probably because of the poor efficacy in clearing dermal melanosomes. Treatment with high-energy pigment-specific lasers, ablative resurfacing lasers, and fractional lasers results in an unacceptably high rate of postinflammatory hyper- and hypopigmentation and rebound melasma. Recently, promising results have been achieved with low-fluence Q-switched neodymium-doped yttrium aluminium garnet laser treatment, which can selectively target dermal melanosomes without producing inflammation or epidermal damage, in all skin phototypes. This article reviews the current treatment modalities for melasma, the rationale for using and the clinical results of combination therapy with low-fluence Q-switched neodymium-doped yttrium aluminium garnet lasers.

Hand Rejuvenation: A Review and Our Experience

The aged hand is characterized by cutaneous and dermal atrophy, with deep intermetacarpal spaces, prominent bones and tendons, and bulging reticular veins. Epidermal changes include solar lentigines, seborrheic keratoses, actinic keratoses, skin laxity, rhytides, tactile roughness, and telangiectasia. A Medline search was performed on hand rejuvenation from 1989 to 2011, and results are summarized. Practical applications of these procedures are also discussed. Reports of injectable hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, autologous fat transfer, vein treatment, and chemical peels, along with lasers and light sources such as Q-switched laser, intense pulsed light, photodynamic therapy, nonablative resurfacing lasers, and ablative resurfacing lasers, in the rejuvenation of hands were found. Review of the literature revealed options for minimally invasive treatment for rejuvenation of the skin and volume restoration of the dorsal hand. These treatments include injectables and fat transfer for volume restoration; sclerotherapy or vein ablation for dorsal hand vein treatment; and chemical peels, lasers, light, and energies for the treatment of epidermal and dermal changes.

Nonablative Fractional Laser Resurfacing

The desire to achieve cosmetic rejuvenation and reduce effects of aging and photodamage urged scientists to develop effectual techniques which have minimal side effects and impressive long-term efficacy. Traditional ablative resurfacing laser therapy has been used for several years;however, it has harmful side effects on the patient’s skin such as dyspigmentation, persistent erythema, infections, acneiform eruptions and scarring. It also prolongs downtime, so it puts a significant burden on society. Nonablative resurfacing laser therapy declines side effects of traditional therapies, although it has lower effectiveness in comparison with ablative one.Nonablative fractional resurfacing laser therapy commenced a modern technique which diminished side effects, while maintains the efficacy of traditional methods. The aim of of this current review is to sum up nonablative fractional laser therapies used for skin photorejuvenation at the past and present time and to evaluate the indications,advantages and classification of it and non-fractional resurfacing laser therapy

The use of lasers for dermatological conditions

There have been significant advances in the use of lasers for skin disorders. New generation pulsed dye lasers and dual wavelength lasers have optimized the treatment of vascular lesions such as port wine stains. The improved safety of lasers for hair removal has enabled children with pathologically excessive hair to be treated safely, and for treatment to be carried out on dark-skinned individuals. Exogenous melanin and radiofrequency devices have made epilation of light-coloured hair possible. The pulsed dye laser and intense pulsed light devices may improve active inflammatory acne, and can be used as optical sources for photodynamic therapy in the treatment of cutaneous dysplasias including actinic keratoses. Fractional resurfacing technology has bridged the gap between ablative resurfacing lasers and non-ablative lasers. Pneumatic suction devices may improve comfort and efficacy of treatment and are available as an attachment for existing lasers or integrated into handpieces. There have been significant advances in the use of lasers for skin disorders. New generation pulsed dye lasers and dual wavelength lasers have optimized the treatment of vascular lesions such as port wine stains. The improved safety of lasers for hair removal has enabled children with pathologically excessive hair to be treated safely, and for treatment to be carried out on dark-skinned individuals. Exogenous melanin and radiofrequency devices have made epilation of light-coloured hair possible. The pulsed dye laser and intense pulsed light devices may improve active inflammatory acne, and can be used as optical sources for photodynamic therapy in the treatment of cutaneous dysplasias including actinic keratoses. Fractional resurfacing technology has bridged the gap between ablative resurfacing lasers and non-ablative lasers. Pneumatic suction devices may improve comfort and efficacy of treatment and are available as an attachment for existing lasers or integrated into handpieces.

Lasers in dermatology

Abstract In recent years, there have been many significant advances in the use of lasers for skin disorders. New generation pulsed dye lasers with dynamic cooling have optimized the treatment of vascular lesions such as port-wine stains. Improved safety of lasers for hair removal has enabled treatment to be carried out on dark-skinned individuals. Exogenous melanin and radiofrequency devices have made epilation of light-coloured hair possible. Fractional resurfacing technology has bridged the gap between ablative resurfacing lasers and non-ablative lasers. Pneumatic suction devices may improve comfort and efficacy of treatment.