Picosecond Alexandrite Laser Research Articles

Efficacy and safety of picosecond 755-nm alexandrite laser with diffractive lens array for non-ablative rejuvenation in Chinese skin.

The picosecond alexandrite laser with diffractive lens array (DLA) offers the dual advantages of a picosecond pulse duration and the fractionated delivery of laser energy. This study explores the efficacy and safety of the DLA for treatment of multiple aesthetic concerns associated with photoaging of the face including skin texture irregularities, dyspigmentation, enlarged pore size, rhytides, and skin laxity. This prospective, evaluator-blinded trial enrolled Fitzpatrick skin type III-IV patients with mild to moderate signs of facial photoaging. Patients received six full face treatments at 4 week intervals for a total of 107 treatments. Standardized photography was obtained at baseline and at 1, 2, and 3 month follow-up visits. Two independent blinded evaluators rated each of the five signs of photoaging on a 10-point visual analog scale (VAS) at each follow-up visit compared to baseline. A global aesthetic improvement score was also assigned at each follow-up visit. Secondary outcomes included patient-rated pain and heat sensation on a 10-point VAS, and overall satisfaction. Adverse events were noted after each treatment and at each follow-up visit. A total of 18 Chinese patients age 35-59 completed the study. A statistically significant improvement in skin texture and dyspigmentation scores was noted at the 1 month follow-up that was sustained at 3 months. No significant improvements wer--e observed in pore size, rhytides, or skin laxity. The mean pain score was 5.1 ± 2 and mean heat sensation was 3.6 ± 2.1. Expected transient erythema and edema occurred in 95.3% (102/107) and 1.9% (2/108) of treatments, respectively, and resolved in hours. No incidences of post-inflammatory hyperpigmentation (PIH) were noted at the 1, 2, and 3 month visits. The 755-nm picosecond laser with DLA is a safe and effective non-ablative modality for targeting facial skin texture irregularities and dyspigmentation in Chinese skin. Patients tolerated the treatment well with adverse effects limited to transient erythema and edema. Lasers Surg. Med. 51:8-13, 2019. © 2018 Wiley Periodicals, Inc.

Comparison of the efficacy and safety of a picosecond alexandrite laser and a Q-switched alexandrite laser for the treatment of freckles in Chinese patients

Comparison of the efficacy and safety of a picosecond alexandrite laser and a Q-switched alexandrite laser for the treatment of freckles in Chinese patients

Benefits and Risks of Low-Fluence Picosecond Alexandrite Laser Treatment

近年相次いで上市されたピコ秒レーザーをダウンタイムのない程度の低フルエンスで照射した場合の効果と問題点について解明する目的で，筆者の施設で同治療を施行した217名の患者の全数調査を行った．ピコ秒アレキサンドライトレーザーPicoSure®を用いて同一術者が同じ規準で照射した．治療前に毎回撮影している写真を評価した．その結果本治療は，雀卵斑には著効，老人斑には有効，肝斑には無効であるだけでなく5%以上に増悪が認められ，危険であることが判明した．

Treatment of flat and elevated pigmented disorders with a 755-nm alexandrite picosecond laser: clinical and histological evaluation.

The novel picosecond lasers, initially developed for faster tattoo removal, have also shown great efficacy in endogenous pigmentary disorders. To describe the efficacy and safety profile of an alexandrite (755-nm) picosecond laser in a wide range of pigmented flat and elevated cutaneous lesions. A retrospective study was performed in which we collected all the clinical images of patients treated with the 755-nm alexandrite picosecond laser for 12months (November 2016-November 2017). Clinical features were obtained from their medical charts. Patients treated for tattoo removal were excluded. All the images were analyzed by three blind physicians attending to a visual analogue scale (VAS) from 0 to 5 (0, no change; 1, 1-24% clearance; 2, 25-49% clearance; 3, 50-74% clearance; 4, 75-99% clearance; 5, complete clearance). Patient satisfaction was obtained from a subjective survey including four items: very satisfied, satisfied, non-satisfied, and totally dissatisfied. Thirty-seven patients were included (12 males; 25 females). The mean age of the study was 42.35years. Twenty-five patients (68%) were treated for different pigmented flat disorders such as solar and mucosal lentigines (5), stasis dermatitis (4), or nevus of Ota (4), among other diagnoses. Twelve patients (32%) were treated for epidermal elevated lesions such as warts (5), epidermal nevi (2), and seborrheic keratosis (3), among other elevated lesions. Mean number of laser treatment was 3.02 sessions while mean follow-up after last laser treatment was 4.02months. Mean VAS score of the three observers was 3.44 (61% of clearance) for pigmentary flat disorders and 3.60 (67%) for elevated lesions. Adverse effects reported were mild blistering in the first 2-5days following laser treatment in some of the patients. Overall satisfaction among the patients included was high. The novel 755-nm picosecond alexandrite laser is effective not only for the resolution of pigmented flat lesions of different nature but also for the treatment of the more difficult elevated pigmented lesions.

A split-face, single-blinded, randomized controlled comparison of alexandrite 755-nm picosecond laser versus alexandrite 755-nm nanosecond laser in the treatment of acquired bilateral nevus of Ota–like macules

Q-switched alexandrite lasers (QSALs) have been used for the treatment of acquired bilateral nevus of Ota-like macules (ABNOMs). Currently, picosecond alexandrite laser (PSAL) pulses have become available for pigmentary disorders. However, no studies have compared PSAL and QSAL in the treatment of ABNOM. We sought to compare the efficacy and safety of PSAL and QSAL in the treatment of ABNOM. Each patient (n=30) received 3 treatments at 6-month intervals. Matching areas were delimitated on the face of each patient (left/right comparison); 1 side was treated with PSAL and the other side was treated with QSAL. The safety and efficacy of the 2 lasers were determined by visual assessment and self-report from patients 6months after the final treatment. The PSAL-treated area achieved significantly better clearance (3.73 vs 2.4) with less severe pain (4.47 vs 5.16). The incidence rate of postinflammatory hyperpigmentation was 27.77% and 54.44% for the PSAL and QSAL treatments, respectively, and the duration of postinflammatory hyperpigmentation was 1.32 and 1.74months, respectively (P<.001). The limitations of our study include the small sample size and the lack of objective evaluation. Compared with QSAL, PSAL therapy afforded significantly better clinical outcomes andfewerside effects in the treatment of ABNOM.

Successful Treatment of Argyria Using the Picosecond Alexandrite Laser

Successful Treatment of Argyria Using the Picosecond Alexandrite Laser

Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q‐switched ruby, and Q‐switched Nd:YAG nanosecond lasers: A retrospective photographic review

Laser procedures in skin of color (SOC) patients are challenging due to the increased risk of dyspigmentation and scarring. A novel 755 nm alexandrite picosecond laser has demonstrated effectiveness for tattoo removal and treatment of acne scars. No studies to date have evaluated its applications in pigmentary disorders. The purpose of this retrospective study was to evaluate the safety profile and efficacy of the picosecond alexandrite laser compared to the current standard treatment, Q-switched ruby and neodynium (Nd):YAG nanosecond lasers, for pigmentary disorders in SOC patients. A retrospective photographic and chart evaluation of seventy 755 nm alexandrite picosecond, ninety-two Q-switched frequency doubled 532 nm and 1,064 nm Nd:YAG nanosecond, and forty-seven Q-switched 694 nm ruby nanosecond laser treatments, in forty-two subjects of Fitzpatrick skin types III-VI was conducted in a single laser specialty center. The picosecond laser was a research prototype device. Treatment efficacy was assessed by two blinded physician evaluators, using a visual analog scale for percentage of pigmentary clearance in standard photographs. Subject assessment of efficacy, satisfaction, and adverse events was performed using a questionnaire survey. The most common pigmentary disorder treated was Nevus of Ota (38.1%), followed by solar lentigines (23.8%). Other pigmentary disorders included post-inflammatory hyperpigmentation, congenital nevus, café au lait macule, dermal melanocytosis, Nevus of Ito, and Becker's nevus. Clinical efficacy of the Q-switched nanosecond lasers and picosecond laser treatments were comparable for lesions treated on the face with a mean visual analog score of 2.57 and 2.44, respectively, corresponding to approximately 50% pigmentary clearance. Subject questionnaires were completed in 58.8% of the picosecond subjects and 52.0% of the Q-switched subjects. Eighty four percent of subjects receiving Q-switched nanosecond laser treatments and 50% of the subjects receiving alexandrite 755 nm picosecond laser treatments felt satisfied to completely satisfied. Side effects observed in subjects treated with the alexandrite 755 nm picosecond laser were similar to those commonly observed and reported with the nanosecond Q-switched technology. All side effects were temporary, resolving within one month, and no long-term complications were noted. All patients who were very satisfied with their picosecond laser treatment for Nevus of Ota noted a delayed improvement only after 3 months. The 755 nm alexandrite picosecond, 694 nm ruby, 532 nm, and 1064 nm neodynium:YAG nanosecond lasers appear to be safe and effective modalities for removal of pigmentary disorders in skin of color patients with no long-term complications if used appropriately. This study demonstrates the potential of the 755 nm alexandrite picosecond laser in further clinical applications beyond tattoo removal. While the Q-switched lasers were effective, promising results were also observed using an early version of the novel picosecond laser for the removal of pigmentary lesions in SOC patients. As we continue to improve our understanding of the 755 nm picosecond laser, this device may prove to be a safe and effective alternative to the Q-switched lasers for the treatment of facial pigmented lesions in patients with skin of color.

Analysis of incidence of bulla formation after tattoo treatment using the combination of the picosecond Alexandrite laser and fractionated CO2 ablation.

The picosecond Alexandrite laser has shown increased efficacy in tattoo removal in comparison to Q-switched lasers. However, bulla formation is a well-known and expected side effect of this novel treatment and causes patient discomfort. To analyze the incidence of bulla formation after tattoo treatment using the combination of the picosecond Alexandrite laser and fractionated CO2 ablation. This is a retrospective chart review to determine the incidence of bulla formation after laser tattoo removal in 95 patients who were treated with either with the picosecond Alexandrite laser alone or in combination with fractional CO2 ablation. Twenty-six patients (32%) treated with the picosecond laser alone experienced blistering, whereas none of the patients treated with the combination of the picosecond laser and fractionated CO2 ablation experienced blistering. The difference in incidence of bulla formation between the 2 groups was found to be statistically significant (p < .05). This study shows a significant decrease in bulla formation associated with tattoo treatment when fractionated CO2 ablation is added to the picosecond Alexandrite laser, which is consistent with observations from a previous case series. This is important because decreasing extensive blistering likely results in increased patient satisfaction and willingness to return for future treatments.

Treatment of Tattoos With a Picosecond Alexandrite Laser

OBJECTIVE To study a picosecond 755-nm alexandrite laser for the removal of tattoos to confirm the efficacy of this therapy, focusing on the effect of therapy on the target lesion as well as the surrounding tissues and quantifying the number of necessary treatments. DESIGN Fifteen patients with tattoos were enrolled. Treatments were scheduled approximately 6±2 weeks apart. Standard photographs using 2-dimensional imaging were taken at baseline, before each treatment, and 1 month and 3 months after the last treatment. SETTING Dermatology clinic at SkinCare Physicians in Chestnut Hill, Massachusetts. PATIENTS Fifteen patients with darkly pigmented tattoos. MAIN OUTCOME MEASURES Treatment efficacy was assessed by the level of tattoo clearance in standard photographs. These photographs were assessed by a blinded physician evaluator and based on a 4-point scale. Efficacy was also assessed based on physician and patient satisfaction measured on a 4-point scale. RESULTS Twelve of 15 patients with tattoos (80%) completed the study. All 12 patients obtained greater than 75% clearance. Nine patients (75%) obtained greater than 75% clearance after having 2 to 4 treatments. The average number of treatment sessions needed to obtain this level of clearance was 4.25. All 12 patients (100%) were satisfied or extremely satisfied with the treatment. Adverse effects included pain, swelling, and blistering. Pain resolved immediately after therapy, while the swelling and blistering resolved within 1 week. Hypopigmentation and hyperpigmentation were reported at the 3-month follow-up. CONCLUSION The picosecond 755-nm alexandrite laser is a safe and very effective procedure for removing tattoo pigment.