Picosecond Alexandrite Laser Research Articles

Picosecond Alexandrite Laser With Diffractive Lens Array Combined With Long-Pulse Alexandrite Laser for the Treatment of Facial Photoaging in Chinese Women: A Retrospective Study.

Facial photoaging is a type of facial skin aging induced mainly by exogenous factors (ultraviolet radiation) and often manifests itself in the form of hyperpigmentation, telangiectasia, roughness, increase in fine lines/wrinkles, and enlarged pores. Recently, picosecond lasers have become an emerging option for the treatment of facial photoaging, and long-pulse alexandrite lasers (LPAL) have demonstrated promising potential in the treatment of photoaging-related symptoms. This study aimed to evaluate the efficacy and safety of picosecond alexandrite laser (PSAL) with diffractive lens array (DLA) combined with LPAL for facial photoaging. This is a retrospective study of 20 Chinese female patients with facial photoaging who received PSAL with DLA combined with LPAL during a 1-year period. All patients were treated every 4weeks for a total of three treatments. Objective indicators of facial photoaging and patient satisfaction were evaluated before each treatment, and pain scores and adverse effects were recorded after each treatment. Compared with baseline, patients showed significant differences in all facial photoaging indices (p<0.01). After receiving three treatments, there was a 20.1% decrease in the pigmentation index, a 23.9% decrease in the erythema index, a 34.5% decrease in the texture index, a 28.4% decrease in the fine lines index, a 56% decrease in the pore index, a 9.3% elevation and a 17.1% decrease in elasticity R2 and F4, respectively, and a 55% decrease in sebum content. The mean satisfaction score for the three treatments was 4.67 (3.33, 5.00), and the mean visual analogue scale (VAS) pain score was 7.00. No serious adverse effects such as post-inflammatory hyperpigmentation (PIH), hypopigmentation, or blistering were observed at the treatment site during the treatment period. PSAL with DLA combined with LPAL for the treatment of facial photoaging with significant efficacy, high patient satisfaction, and minimal adverse effects.

Evaluation of 755-nm Picosecond Alexandrite Laser With a Focus Lens Array for the Treatment of Enlarged Facial Pores.

This study aims to evaluate the use of 755-nm picosecond alexandrite laser with a focus lens array to treat facial pores. Laser treatment was performed on 129 patients between January 2021 and October 2022. VISIA imaging system was used for photographic assessments, the total average number and pore index was calculated, the physicians' assessment score and patient satisfaction score were collected, and the incidence of disadvantage effects was also documented. The mean patient age was 35.2±6.4 years (21-45y). The total average number of facial pores was 1614.1±412.8, and the total average number decreased to 1262.6±356.2 three months after the last treatment. The pretreatment baseline of pore index was 26.1±4.5, while the pore index was 21.3±3.7 three months after the last treatment. The physicians' assessment score was 2.7 on the 0-to-4 scale, and patient satisfaction score was 3.5 on the 1-to-5 scale. There were no adverse events, such as hyperkeratosis, scarring, and hypo-or hyperpigmentation. 755-nm picosecond alexandrite laser with a focus lens array was safe and effective in the treatment of facial pores with relatively few unanticipated adverse events. Level IV-observational study without controls.

Picosecond alexandrite laser treatment of nevus of Ota in children.

The picosecond alexandrite laser has been safely and effectively used to treat the nevus of Ota in adults. However, limited data are available for children. To investigate the efficacy, safety, and correlative influencing factors of a 755nm picosecond alexandrite laser in the treatment of nevus of Ota in children. We retrospectively analyzed Chinese children with nevus of Ota who received a 755nm picosecond alexandrite laser treatment in a tertiary dermatological hospital. A total of 305 pediatric patients received an average of two treatments achieving an average of 79% pigment clearance. After the first treatment, 22 patients achieved complete clearance (95%-100%), and 72 patients achieved excellent response (75%-94%), with an average initial efficacy of 63% lesion clearance. Treatment at an early age achieved better initial efficacy (0- to 12-month group >1- to 6-year group, 6- to 12-year group). And 0- to 12-month group achieved better final efficacy. More treatment sessions also increased the final efficacy. Both initial efficacy and final efficacy were better when treating a darker lesion. The incidence of complications was 12.1%, with 10.8% being post-inflammatory hyperpigmentation and 1.3% being hypopigmentation. The rate of recurrence was 6.6%. Retrospective study. A 755nm picosecond alexandrite laser is safe and effective in treating nevus of Ota in children. Younger to initiate treatment, darker lesions, and more treatments are positively associated with better pigmentation clearance.

Low-Fluence Q-Switched Nd: YAG Laser (LF-QSNY) May Be a Better Choice for the Treatment of Early Nevus of Ota: A Prospective Self-Controlled Trial of LFQS and Picosecond Alexandrite Laser

Background. Low-fluence Q-switched Nd: YAG laser (LF-QSNY) and picosecond 755 nm alexandrite laser (PSAL) have shown superiority in the treatment of nevus of Ota (NO). Objective. To compare the efficacy and safety of PSAL and LF-QSNY in the treatment of NO. Methods. 15 patients randomly underwent split-lesion treatment of the two lasers within three months. The visual analogue scale (VAS) was used to evaluate the efficacy outcomes. The patient’s preferences, recurrence rate, and adverse events were also documented. Results. Fifteen patients with 34 lesions finished the trial. Lesions, operated with LF-QSNY and PSAL, reached VAS scores of 3.47 ± 0.67 and 3.51 ± 0.87, respectively (P&gt;0.05). Most significant improvement in LF-QSNY was achieved after the first session (VAS = 1.84). One (6.67%) patient experienced a relapse on the PSAL side. Temporary hypopigmentation and hyperpigmentation mainly occurred on the PSAL side. Patients under five years demonstrated superior efficacy (3.81 ± 0.47 vs 3.08 ± 0.66, P=0.046) than those over with the treatment of LF-QSNY. Limitations. Limited sample and lack of objective evaluation. Conclusion. The difference between the LF-QSNY and PSAL in the treatment of NO was statistically insignificant, while LF-QSNY may be a better choice for the treatment of early NO. This trial is registered with ChiCTR1900022690.

The role of 755-nm alexandrite picosecond laser in melasma management.

Melasma is a skin dyspigmentation condition that disproportionately affects women, particularly those of Latino, Black, and Asian ethnicities, significantly impacting their quality of life. Efforts to identify effective treatment options have led to the exploration of picosecond laser technology which utilizes brief pulse durations to break down pigment while minimizing thermal damage to surrounding tissue. The 755-nm alexandrite picosecond laser, currently FDA approved for benign pigmented lesion removal, including melasma, is a promising solution. We aim to assess the efficacy and safety of the 755-nm alexandrite picosecond laser both as a stand-alone treatment for melasma and in combination with topical agents. We conducted a PubMed search using "755-nm picosecond" AND "melasma," "755-nm picosecond" AND "hydroquinone," and "755-nm picosecond" AND "tranexamic acid." English-written studies examining this laser as monotherapy or in combination with the topical agents were included. Those not meeting the criteria or lacking data related to melasma improvement were excluded. Monotherapy with the 755-nm picosecond laser led to a 50-75% improvement in melasma appearance in 40% of participants and a significant reduction in the average Melasma Area and Severity Index (MASI) score (p < 0.001) in all patients of one study. Notably, the use of topical tranexamic acid (TTA) in conjunction with the picosecond laser exhibited the most significant degree of improvement in hemi-MASI scores compared to the laser monotherapy group at one- and three-months post-treatment (p < 0.05). Patient satisfaction was also significantly higher for the combination group (p < 0.05). In contrast, combining hydroquinone (HQ) with the picosecond laser demonstrated no significant difference in outcomes compared to HQ alone, both of which were less effective than TTA with picosecond laser. The combination of the 755-nm picosecond laser with TTA proves promising, outperforming both laser monotherapy and laser with HQ. While monotherapy with the picosecond laser or topical agents is effective, literature favors combination therapy, especially the 755-nm picosecond laser with TTA, for superior benefits and minimal side effects. Ultimately, individualized regimens, considering factors like skin type, should be prioritized, given the heightened risk of postinflammatory hyperpigmentation, especially in skin of color patients.

Comparison of the efficacy and safety of picosecond Nd:YAG laser (1,064 nm), picosecond alexandrite laser (755 nm) and 2% hydroquinone cream in the treatment of melasma: A randomized, controlled, assessor-blinded trial.

Increasing numbers of studies demonstrated that picosecond lasers (Picos) were effective and safe for melasma. However, A limited number of randomized controlled trials (RCTs) regarding Picos contribute to a modest level of evidence. Topical hydroquinone (HQ) remains to be the first-line therapy. To compare the efficacy and safety of non-fractional picosecond Nd:YAG laser (PSNYL), non-fractional picosecond alexandrite laser (PSAL), and 2% HQ cream in the treatment of melasma. Sixty melasma patients with Fitzpatrick skin types (FST) III-IV were randomly assigned to the PSNY, PSAL, and HQ groups at a 1:1:1 ratio. Patients in PSNYL and PSAL groups received 3 laser sessions at 4-week intervals. The 2% HQ cream was applied twice daily for 12 weeks in patients of the HQ group. The primary outcome, the melasma area and severity index (MASI) score, was evaluated at weeks 0, 4, 8, 12, 16, 20, and 24. The patient assessment score by quartile rating scale was rated at weeks 12, 16, 20, and 24. Fifty-nine (98.3%) subjects were included in the analysis. Each group showed significant change from baseline in MASI scores from week 4 to week 24. The MASI score in the PSNYL group showed the greatest reduction compared to the PSAL group (p = 0.016) and HQ group (p = 0.018). The PSAL group demonstrated comparable MASI improvement as the HQ group (p = 0.998). The PSNYL group had the highest patient assessment score, followed by the PSAL group and then the HQ group, although only the differences between PSNYL and HQ groups at weeks 12 and 16 were significant. Four patients (6.8%) experienced recurrence. Other unanticipated events were transient and subsided after 1 week to 6 months. The efficacy of non-fractional PSNYL was superior to that of non-fractional PSAL, which was not inferior to 2% HQ, thus non-fractional Picos providing an alternative for melasma patients with FSTs III-IV. The safety profiles of PSNYL, PSAL, and 2% HQ cream were similar. https://www.chictr.org.cn/showprojen.aspx?proj=130994, ChiCTR2100050089.

A Retrospective Analysis of the Efficacy and Safety of Q‐Switched and Picosecond Lasers for Treating Becker’s Nevus

Background. Becker’s nevus (BN) severely affects a patient’s appearance and can lead to depression, especially when it involves the face or neck. Currently, there is no effective treatment. Laser therapy has become popular, but its efficacy has not been confirmed. We evaluated the efficacy and safety of lasers in treating BN. Methods. This retrospective study involved 49 patients exposed to different laser treatments who completed at least one treatment session and follow‐up. Results. The patients treated with the 755‐nm alexandrite picosecond laser and Q‐switched 694‐nm ruby laser gained relatively good results: 3.07 ± 1.09 and 2.87 ± 1.14 on the five‐point scale and 3.47 ± 0.73 and 3.40 ± 0.85 on the GAIS, respectively. However, the results of the 755‐nm alexandrite picosecond laser with a diffractive focus lens array and the fractionated 1064‐nm neodymium‐doped: yttrium aluminum garnet picosecond laser were poor. Furthermore, there were marked differences between the number of treatment sessions and treatment effects, both for the five‐point grading score for pigment clearance (F = 15.246, p &lt; 0.001) and GAIS (F = 15.469, p &lt; 0.001). Concerning different lasers and efficacy, there were no marked differences between the five‐point grading scale and the GAIS (p &gt; 0.05). Conclusions. Although the efficacy of various lasers for BN is not satisfactory and there are no marked differences between picosecond and Q‐switched lasers, they can help in selecting an appropriate laser for slight‐to ‐moderate pigment removal. The 755‐nm alexandrite picosecond laser is a new option, whereas nonablative fractional picosecond lasers for BN are not recommended. Increasing the number of treatment sessions can improve the curative effect slightly.

Photoaging and Sequential Function Reversal with Cellular-Resolution Optical Coherence Tomography in a Nude Mice Model.

Although nude mice are an ideal photoaging research model, skin biopsies result in inflammation and are rarely performed at baseline. Meanwhile, studies on antiphotoaging antioxidants or rejuvenation techniques often neglect the spontaneous reversal capacity. Full-field optical coherence tomography (FFOCT) can acquire cellular details noninvasively. This study aimed to establish a photoaging and sequential function reversal nude mice model assisted by an in vivo cellular resolution FFOCT system. We investigated whether a picosecond alexandrite laser (PAL) with a diffractive lens array (DLA) accelerated the reversal. In the sequential noninvasive assessment using FFOCT, a spectrophotometer, and DermaLab Combo®, the photodamage percentage recovery plot demonstrated the spontaneous recovery capacity of the affected skin by UVB-induced transepidermal water loss and UVA-induced epidermis thickening. A PAL with DLA not only accelerated skin barrier regeneration with epidermal polarity, but also increased dermal neocollagenesis, whereas the nonlasered group still had >60% collagen intensity loss and 40% erythema from photodamage. Our study demonstrated that FFOCT images accurately resemble the living tissue. The photoaging and sequential function reversal model provides a reference to assess the spontaneous recovery capacity of nude mice from photodamage. This model can be utilized to evaluate the sequential noninvasive photodamage and reversal effects after other interventions.

Efficacy and safety of 755-nm picosecond alexandrite laser with topical tranexamic acid versus laser monotherapy for melasma and facial rejuvenation: a multicenter, randomized, double-blinded, split-face study in Chinese patients.

To compare the efficacy and safety of 755-nm picosecond alexandrite laser and topical tranexamic acid (TTA) combination therapy with laser monotherapy, for the treatment of melasma and facial rejuvenation. This multicenter, randomized, double-blinded, split-face study enrolled 37 patients who presented with melasma and photoaging. Facial halves were randomized to receive either laser and TTA combination therapy or laser monotherapy. Three treatments were delivered at 4-5weeks intervals. Patients were followed up for 1, 3, and 6months post-final treatment and evaluated by blinded investigators for hemi-Melasma Area and Severity Index (hemi-MASI), facial dyschromia, skin texture, laxity, and rhytids. Daily diaries rating healing progress for 7days posttreatment and satisfaction grading were performed by all patients. Adverse events were recorded. Thirty-six patients completed the follow-up. Compared with the baseline, hemi-MASI, dyschromia, and skin texture on both halves improved significantly through the follow-up (p = 0.000). A significant difference in hemi-MASI and dyschromia between combination therapy halves and monotherapy halves was noticed at 1- and 3-month follow-ups (p < 0.05). The laser monotherapy halves displayed significantly less redness and sensitivity during the 7-day posttreatment recovery period (p < 0.05). Patients' satisfaction ratings for the combination therapy halves were higher than the monotherapy halves at 1-month follow-up (p < 0.05). No severe adverse events were observed. The picosecond alexandrite laser and TTA combination therapy demonstrated synergistic efficacy for hemi-MASI and dyschromia improvements over laser monotherapy. The optimization of the picosecond laser and TTA combination regimen needs further investigation.

Evaluation of Picosecond 755-nm Alexandrite Laser With a Diffractive Lens Array on Pore Size Reduction.

Medications, lasers and light therapy have all been shown to transiently minimize pore size. Current research of the 755-nm Alexandrite picosecond laser (Cynosure, MA) on pore size shows differing results regarding the efficacy, with one study of Asian volunteers (Fitzpatrick skin type IV) reporting &ldquo;marked&rdquo; improvement of pores, yet another study reporting no significant improvement in pore size in Chinese patients (Fitzpatrick skin type III&ndash;IV), causing some contention. This study aims to rectify the discordant results through the examination of the 755-nm Alexandrite picosecond laser on pore size reduction in a sample consisting of Fitzpatrick skin type I&ndash;III. Patients who received 755-nm Alexandrite picosecond laser treatment for photorejuvenation, (6 mm lens array) with a fluence of 0.71 J/cm2 of the face or head, with at least two treatments over four-week intervals were included in the study. A precision subject imaging system (Canfield VISIA&reg; Complexion Analysis Generation 7, NJ) was used to assess three parameters of pore size (feature count, score, percentile rank) at each time period at right lateral, left lateral and frontal views. A Wilcoxin signed rank test was performed to compare differences between time periods and a mixed model ANOVA was utilized to account for patients who received less than three treatments. Significance level set to P=&lt;0.05. 32 participants met criteria and underwent at least two picosecond laser treatments for photorejuvenation. There was an overall reduction in pore count in approximately 57% of participant data points from times 1 to 2 and 50% reduction from times 2 to 3. There was a 100% pore count reduction observed from baseline compared with the follow-up visit four weeks after the third treatment, at time 4. Further, there was a significant improvement of pores demonstrated by score from times 1 to 3 (Z= -2.197, P=0.028) as well as percentile rank between times 1 and 2 (Z= -2.070, P=0.038) and times 1 and 3 (Z= -2.201, P=0.028). Future studies should investigate the longterm effect of 755-nm Alexandrite picosecond laser on pore size reduction as continued patient recruitment and data collection is necessary to effectively discern the 755-nm Alexandrite picosecond laser debate. Thus, prolonged follow up post treatment should be evaluated in order to determine if results are maintained. Nonetheless, the 755-nm Alexandrite picosecond laser shows promising results for the improvement of skin pores thus far. J Drugs Dermatol. 2021;20(12):1302-1306. doi:10.36849/JDD.6199.

755-nm Alexandrite Picosecond Laser with a Diffractive Lens Array or Zoom Handpiece for Post-Inflammatory Hyperpigmentation: Two Case Reports with a Three-Year Follow-Up.

ObjectivePost-inflammatory hyperpigmentation (PIH) is a reactive hypermelanosis of various skin types, which occurs as a sequela of cutaneous inflammation or injury. Despite generally a self-limited and temporary condition, PIH is still a frustrating problem that can have significant psychosocial effects on patients, especially those with darker skin types. Laser therapy is one of the effective treatments for PIH, and various wavelength lasers and light devices have been utilized in PIH therapy. Nonetheless, data on the long-term efficacy of the 755-nm alexandrite picosecond laser are limited.MethodsThis study analyzed two cases of PIH treated with a combination of a 755-nm alexandrite picosecond laser and a diffractive lens array or zoom handpiece. Efficacy of the treatment was determined by the images of skin lesions under a fixed light source before and after each treatment, which were independently reviewed by two plastic-surgery specialists blinded to the clinical data. Improvement was classified as complete (>75%), significant (50–75%), mild (25–50%), and inefficient (<25% or no obvious change). Skin imaging analysis was carried out using the VISIA system (Canfield, USA), and dermoscopy was performed at the same time.ResultsAfter two to three courses of treatment, all cases showed significant or complete improvement, and no recurrence was observed during the three years of follow-up.ConclusionA 755-nm alexandrite picosecond laser in combination with a diffractive lens array or zoom handpiece had significant and long-term efficacy for the treatment of PIH caused by trauma. However, attention should be paid to the problem of transient deepening of pigmentation during treatment.

A case of Nevus of Ota treated with laser picosecond Alexandrite 755 nm: A case-report

Background: Nevus of Ota is a well-defined dermal melanocytosis characterized by bilateral multiple small, bluish-brown macules in the area innervated by the first and second branches of the trigeminal nerve. Currently, the therapeutic modalities for this condition are still limited and complete resolution is difficult to achieve.Case Description: A 23-year-old woman complained a brown spot on the right cheek since the patient was born. It looked like the skin but slightly darker than its surroundings. Four years ago the patient had received 6 sessions of QS: Nd-YAG laser therapy, but the spot is still clearly visible. Dermatological status of the orbital, infraorbital, zygomatic, and right buccal regions showed multiple hyperpigmented patches, gray-brown, well-defined, geographically in shape with size 0.2 x 0.3cm – 5 x 7cm. The lesion was unilateral and distributed within the innervation area of the second and third trigeminal nerve. Miravex® skin analysis showed that the average level of melanin was 0.464 with a melanin variation of 45%. Therefore, patient was diagnosed with Nevus of Ota. The proposed treatment was picosecond alexandrite 755nm laser, with a frequency of 2.5 Hz, pulse duration 550-750 ps, spot size 4 mm, and fluence 1.59 J/cm2. A marked improvement was observed after the treatment and after 21 days, a good grade of improvement was reported.Conclusion: Nevus of Ota can effectively treated with 755nm picosecond alexandrite laser therapy and results in a good grade of improvement.

Three-Year Results of Facial Photoaging in Asian Patients After Alexandrite 755 nm Picosecond Laser With Diffractive Lens Array: A Split-Face, Single-Blinded, Randomized Controlled Comparison.

The long-term efficacy of a picosecond alexandrite laser (PSAL) with a diffractive lens array (DLA) for the treatment of photoaging is absent. To observe the long-term efficacy of PSAL for the treatment of photoaging. Each patient (n = 10) received 10 treatments at 2-week intervals. One side of the face was randomly selected for treatment. At 1, 3, 6, and 36 months after the final treatment, two blinded physicians evaluated photographs with four clinical indicators of photoaging (dyschromia, skin texture, skin laxity, and rhytids). A quartile scale was used. At baseline, there were no significant differences in dyschromia, skin texture, facial laxity, or rhytids between the treated and control sides (P > 0.05). Picosecond laser-treated side showed 0.85 and 1.05 (both P < 0.05) better for dyschromia at 3- and 6-month follow-up, and 0.6 (P < 0.05) better for skin texture at 6-month follow-up. At 36-month follow-up, the degree of photoaging is intensified on the control side while the rejuvenation efficacy maintained on the treated side, with 1.4, 0.75, and 0.8 (all P < 0.05) better for dyschromia, skin texture, and rhytids relative to the control side measures. Our results demonstrate the long-term efficacy and safety of PSAL with DLA for the treatment of facial photoaging. Small sample size and the lack of objective evaluation. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

A randomized split-face, investigator-blinded study of a picosecond Alexandrite laser for post-inflammatory erythema and acne scars.

The 755 nm picosecond Alexandrite laser has been demonstrated to be effective and well tolerated in patients with acne scars. In this split-face, investigator-blinded study, 16 patients with post-inflammatory erythema (PIE) and acne scars were randomized to receive laser treatment on half the face, with the other half serving as a control. The treatment side demonstrated a significant improvement in both PIE and scars compared to the baseline and also when compared to the control side. Treatment was well-tolerated, with only transient and mild erythema and edema reported as side-effects. In our study, the picosecond Alexandrite laser was safe and effective in the treatment of PIE and acne scars. Comprehensive treatment outcomes should be taken into consideration when deciding on which device to use.

Treatment of segmental lichen aureus in the pediatric age with a 755nm alexandrite picosecond laser. A new therapeutic approach for pigmented purpuric dermatosis.

JDDG: Journal der Deutschen Dermatologischen GesellschaftVolume 18, Issue 10 p. 1201-1203 Dermatosurgery – Tricks of the Trade Treatment of segmental lichen aureus in the pediatric age with a 755 nm alexandrite picosecond laser. A new therapeutic approach for pigmented purpuric dermatosis Diego Fernandez-Nieto, Corresponding Author fnietodiego@gmail.com Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain Correspondence to Diego Fernandez-Nieto, MD Dermatology Department Ramon y Cajal University Hospital Carretera Colmenar Viejo km 9.100 28034 Madrid, Spain E-mail: fnietodiego@gmail.comSearch for more papers by this authorJuan ­Jimenez-Cauhe, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this author­Daniel ­Ortega-Quijano, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this authorCristina Pindado-­Ortega, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this authorPablo Boixeda, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this author Diego Fernandez-Nieto, Corresponding Author fnietodiego@gmail.com Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain Correspondence to Diego Fernandez-Nieto, MD Dermatology Department Ramon y Cajal University Hospital Carretera Colmenar Viejo km 9.100 28034 Madrid, Spain E-mail: fnietodiego@gmail.comSearch for more papers by this authorJuan ­Jimenez-Cauhe, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this author­Daniel ­Ortega-Quijano, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this authorCristina Pindado-­Ortega, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this authorPablo Boixeda, Dermatology Department, Ramon y Cajal University Hospital, Madrid, SpainSearch for more papers by this author First published: 12 July 2020 https://doi.org/10.1111/ddg.14172Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume18, Issue10October 2020Pages 1201-1203 RelatedInformation

Efficacy and Safety Evaluation of Picosecond Alexandrite Laser with a Diffractive Lens Array for Treatment of Melasma in Asian Patients by VISIA Imaging System.

Objective: To evaluate the efficacy and safety of picosecond (ps) 755-nm alexandrite laser with a diffractive lens array (DLA) generating laser-induced optical breakdown, which may be beneficial for melasma treatment. Background: Melasma is notorious for difficult to treat with any modality setting. Recently, picosecond alexandrite laser with DLA seems promising for dealing with it without intolerable complications. Methods: Twenty (N = 20) Asian female melasma patients with Fitzpatrick skin type IV were recruited for 3 treatment sessions of picosecond 755-nm alexandrite laser with DLA at a 4- to 6-week interval. The pulse duration was 750 ps. An 8-mm spot size and the fluence of 0.4 J/cm2 was used over the target area with 2 passes per treatment area and around 2000-2500 passes in total. The repetition rate was 10 Hz. Melasma Area and Severity Index (MASI) score and VISIA® imaging system analysis were utilized for evaluation before treatment and 4 weeks after the completion of the third treatment session. The clinical improvement and adverse events were assessed by the physicians and patients, respectively. Results: The median age of the patients was 45 years (from 27 to 55 years). In the physicians' evaluation, 40% (n = 8) of patients showed good improvement and 40% (n = 8) of patients showed moderate improvement. The mean MASI score before and after laser therapy showed significant improvement from 9.0 ± 4.8 to 6.5 ± 3.7 (p < 0.001). VISIA analysis of the forehead presented significant improvement in spots (p = 0.007) and porphyrins (p = 0.032). Some patients experienced erythema (25%), pruritus (20%), and scaling (20%) but subsided within few days of using emollients and sunscreen. Only 5% (n = 1) of patients developed mild postinflammatory hyperpigmentation, which also subsided in 3 weeks. Conclusions: Three sessions of picosecond 755-nm alexandrite laser with a DLA were effective for melasma treatment in Asian patients with minimal side effects.

Comparison of a picosecond alexandrite laser versus a Q-switched alexandrite laser for the treatment of nevus of Ota: A randomized, split-lesion, controlled trial

Novel picosecond lasers have been available for various pigmentary disorders. However, there are limited data directly comparing picosecond lasers and Q-switched lasers for treatment of nevus of Ota. To compare the efficacy and safety of a picosecond alexandrite laser (PSAL) with a Q-switched alexandrite laser (QSAL) for the treatment of nevus of Ota. Each lesion of 56 enrolled participants was split into 2 parts and randomly assigned to either the PSAL or QSAL treatment arm. Each lesion was treated in up to 6 sessions in 12-week intervals. Efficacy and safety were determined using blinded visual evaluation and self-report at each follow-up visit. The PSAL arm achieved a significantly better clearance (5-point scale, PSAL 4.53 vs QSAL 4.0) with fewer sessions (PSAL 5.26 vs QSAL 5.87) and less severe pain (Visual Analog Scale, PSAL 5.61 vs QSAL 6.40). Patients were more satisfied with PSAL than QSAL (Likert scale, 4.5 vs 4.0). Occurrences of postinflammatory hyperpigmentation (PSAL 26% vs QSAL 34%) and hypopigmentation (PSAL 21% vs QSAL 47%) were also lower in PSAL than QSAL arm. Lack of objective assessments and outcome measures. PSAL demonstrated better clinical results and fewer adverse events than QSAL for the treatment of nevus of Ota.

Using reflectance confocal microscopy to observe in vivo melanolysis after treatment with the picosecond alexandrite laser and Q-switched Nd:YAG laser in melasma.

Melasma is an acquired type of hyperpigmentation that is characterized by the appearance of scattered light- to dark-brown macules and patches on the face. Recently, several lasers have been proposed as treatment options for melasma. In particular, the picosecond alexandrite laser is an ideal laser for selective photothermal melanolysis. The aim of our study was to compare the effectiveness in melanolysis of a single treatment of the picosecond alexandrite laser with that of the Q-switched Nd:YAG laser using reflectance confocal microscopy imaging of the melasma lesions. We performed a spilt-face study using the picosecond alexandrite laser and Q-switched Nd:YAG laser in eight patients with melasma. Both melasma lesions and surrounding normal skin were examined under reflectance confocal microscopy 1 and 24 hours after treatment. The melanin intensity of each skin layer was investigated. At baseline, melasma has irregular melanin distribution and a higher melanin density than surrounding normal skin under reflectance confocal microscopy. After a single treatment with either the picosecond alexandrite laser or the Q-switched Nd:YAG laser, both melanin-induced reflectance and melanin index decreased. Our findings suggest that it is feasible to assess the distribution of melanin by reflectance confocal microscopy and observe the melanolysis in melasma lesion after laser treatment. Lasers Surg. Med. 51:423-429, 2019. © 2018 Wiley Periodicals, Inc.

Efficacy and safety of picosecond Alexandrite laser in treatment of nevus of Ota

Objective To analyze the efficacy, safety and the correlative influencing factors of picosecond Alexandrite laser in the treatment of nevus of Ota. Methods 49 patients with nevus of Ota receiving picosecond Alexandrite laser in our department from October 2015 to October 2017 were retrospectively analyzed, and grouped according to patient gender, age of onset, age of first treatment, Tanino classification of skin lesions and color grading. Clinical characteristics, treatment effects, adverse reactions, influencing factors and other factors were analyzed. Results 49 patients with nevus of Ota were treated 1-4 times, and 9 cases were cured. After one treatment, the significant effective rate was 28.6%, the effective rate was 53.1%, and the effective rate was 100% after 3 treatments, and the effective rate was 100% after 4 treatments. No significant difference was found in the first treatment efficacy between different genders, age of onset, Tanino classification and color grading (P>0.05). There was a significant difference in the first treatment effect between different first treatment age groups (P<0.05). The inverse relationship between age and efficacy was found. The younger the age, the better the first treatment effect. Pigmentation appeared in 2 patients after treatment and subsided after 6 months. No adverse reactions such as scars and hypopigmentation appeared. Conclusions Picosecond Alexandrite laser is a safe and highly effective therapy for nevus of Ota. Key words: Nevus of Ota; Lasers; Validation studies; Safety; Alexandrite laser

Effects of picosecond laser on the multi-colored tattoo removal using Hartley guinea pig: A preliminary study.

Picosecond lasers have emerged as the leading technology for tattoo removal due to their shorter pulse lengths. To clarify the features of picosecond lasers, we compared picosecond and nanosecond lasers in their ability to remove multi-colored tattoo in an animal model. We first compared a nanosecond quality-switched Nd:YAG laser with picosecond Alexandrite and quality-switched Nd:YAG lasers and then the picosecond quality-switched Nd:YAG laser with the picosecond Alexandrite laser, using a guinea pig model. The colors in the tattoos included red, orange, yellow, green, blue, and black. Guinea pigs were treated for one session with each type of laser. The clearance of pigmentation and local reactions were evaluated based on clinical photographic assessment, quantitative assessment using a colorimeter, histopathology, and electron microscopic examination before laser treatment, immediately after, and at 3 weeks after the treatment. Regardless of pulse duration, a 532-nm laser was the most effective in clearing red, orange, and yellow pigments, although the overall effect and safety was better with the picosecond 532 nm laser. A picosecond 755 nm laser demonstrated excellent efficacy in removing only green and blue pigments. a picosecond 1064 nm laser demonstrated some effects on non-black colored tattoos. In terms of safety, picosecond lasers produced less tissue injury than nanosecond lasers. Conclusively, picosecond lasers are more effective and safer than nanosecond lasers.