Fractional Erbium Glass Laser Research Articles

The difference in the curative effects of 5-aminolevulinic acid nano-gold photodynamic therapy and 1550 nm erbium glass fractional laser therapy in severe rosacea

The difference in the curative effects of 5-aminolevulinic acid nano-gold photodynamic therapy and 1550 nm erbium glass fractional laser therapy in severe rosacea

Evaluating the Efficacy of Platelet Rich Plasma and 1550 nm Fractional Laser in Combination and Alone for the Management of Androgenetic Alopecia.

Androgenetic alopecia (AGA) in men and women is the most common cause of hair loss. Affected individuals may experience psychological distress and social withdrawal. Current treatment options for AGA, such as minoxidil and finasteride, vary in efficacy and have side effects. Platelet-rich plasma (PRP) and photobiomodulation are among treatment options that have gained popularity in recent years. While less is known about the effectiveness of fractional lasers for combating hair loss, research suggests that by creating microscopic thermal injury zones, fractional lasers may cause an increase in hair growth from a wound healing process. In this study, we evaluated the efficacy and safety of PRP and 1550 nm fractional erbium-glass laser as monotherapy or combination treatment for AGA in 60 patients. All patients experienced improvement in AGA, but patients treated with the combination therapy had greater improvement in hair density. Overall, PRP and 1550 nm in combination or alone are good treatment choices for AGA, with no side effects. J Drugs Dermatol. 2022;21(11):1166-1169. doi:10.36849/JDD.6750.

The effect of 1540‐nm fractional erbium‐glass laser in the treatment of androgenic alopecia

Androgenic alopecia is common, chronic dermatologic disorder. A variety of lasers and light sources appear to be safe and effective in the treatment of AGA. To evaluate the efficacy and safety of 1540-nm fractional erbium glass laser in the treatment of AGA. This was an interventional therapeutic study for the treatment of patients with AGA. The patients received 10 sessions with 1540-nm fractional erbium glass laser at 2-week intervals. The assessment of the response was done before and at the end of follow-up period, both objectively (the change in the density of terminal hair and the diameter of the hair shaft) and subjectively (patient satisfaction). Any adverse effects were documented during the study. Forty-seven out of 51 patients completed the study. After 5months of laser treatment, the density of hair and hair thickness was significantly increased in both males and females (P value .001). The 1540-nm fractional erbium-glass laser seems to be an effective and safe option for treatment of patients with AGA. The improvement was accomplished in a short period.

Combined Therapeutic Strategies for Keloid Treatment.

Recent advances in keloid management favor the administration of combination therapy over monotherapy. The authors evaluated the safety and efficacy of combination therapy to treat keloids using fractional lasers, cryotherapy, and intralesional corticosteroids. The authors performed a retrospective study involving 35 Korean patients. Each patient underwent treatment using the 1,550 nm nonablative fractional erbium-glass laser, followed by the 10,600 nm ablative fractional carbon dioxide laser. Laser treatment was immediately followed by the administration of superficial cryotherapy and intralesional triamcinolone injection. Therapeutic efficacy was assessed using the Vancouver Scar Scale (VSS) score and the 7-point patient self-assessment score. The mean total and subcategory VSS scores showed statistically significant improvements. The height and pliability scores showed the most significant and quickest responses to the combination therapy. The patients reported remarkable improvement in itching, pain, and limitations of motion after a single combination therapy session. Twenty patients were followed up for 1 year after the discontinuation of the combination treatment, and the recurrence was observed only in one patient. No significant adverse effects were observed throughout the follow-up period. Combination keloid therapy using fractional lasers, superficial cryotherapy, and intralesional triamcinolone injection is safe and more effective than individual monotherapies.

A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia.

Fractional 1550-nm erbium-glass (Er:Glass) laser therapy is effective in inducing hair regrowth. Combining fractional Er:Glass laser therapy with topical minoxidil may yield therapeutic benefits for patients with androgenetic alopecia (AGA). To compare the efficacy and safety of fractional Er:Glass laser used in combination with topical 5% minoxidil versus 5% minoxidil alone for the treatment of male AGA, 30 men with AGA were randomized to 24weeks of split-scalp treatment using fractional Er:Glass laser and 5% minoxidil on one side (combined therapy) or 5% minoxidil alone on the other side (monotherapy). The primary outcome was the difference in hair density and diameter, from baseline, between two treatment sides, at week 24. The secondary outcome was a global photographic assessment, evaluated by two dermatologists and the participants. Adverse events were evaluated. Twenty-nine participants completed the 24-week study period. Combination therapy provided significantly superior results for both the primary and secondary outcomes (all p < 0.05). No serious adverse events were identified for either treatment. In conclusion, combination therapy, consisting of fractional Er:Glass laser and topical minoxidil, is a promising treatment option for AGA. Laser-induced photothermolysis and the formation of effective routes for transdermal drug delivery are possible mechanisms. clinicaltrials.in.th, identifier TCTR20160912001.

Efficacy of erbium glass laser in the treatment of Old World cutaneous leishmaniasis: A case series.

Treatment of cutaneous leishmaniasis remains a challenge; new physical treatment modalities including laser systems are of interest in the treatment of localized lesions. Fourteen patients (10 females) with 20 lesions of Old World cutaneous leishmaniasis underwent weekly treatments of 1540 nm erbium glass fractional laser (Palomar) using 10mm spot size hand piece in four passes of 50-70mJ/cm2 fluence and 10ms pulse duration. Twelve lesions were available for assessment: six (50%) improved at 6weeks and eleven lesions (91.7%) at 12weeks. There were no recurrences at 6- and 12-month follow-ups. Erbium glass fractional laser may be an alternative treatment for localized cases of Old World cutaneous leishmaniasis.

411 The efficacy of 1550-nm erbium-glass fractional laser treatment and its effect on the expression of insulin-like growth factor 1 and Wnt/β-catenin in androgenetic alopecia

411 The efficacy of 1550-nm erbium-glass fractional laser treatment and its effect on the expression of insulin-like growth factor 1 and Wnt/β-catenin in androgenetic alopecia

Ablative Fractional 10 600 nm Carbon Dioxide Laser Versus Non-ablative Fractional 1540 nm Erbium-Glass Laser in Egyptian Post-acne Scar patients.

Introduction: Non-ablative fractional erbium-doped glass 1540 nm and fractional ablative 10600 nm carbon dioxide lasers are regarded as effective modalities for treating acne atrophic scars. In this study, we aimed to compare the effectiveness of fractional CO2 laser and fractional nonablative 1540 nm erbium doped glass laser in treating post acne atrophic scars in Egyptian patients. Methods: Fifty-eight patients complaining of moderate and severe acne atrophic scars were randomly divided into 2 groups of 29 patients each. Both groups were subjected to 4 treatment sessions with 3 weeks interval and were followed up for 3 months. In group A, enrolled patient sreceived C2 laser, while in group B, patients were treated with 1540 nm erbium glass fractional laser. Results: Clinical assessment revealed that the mean grades of progress and improvement were higher with fractional 10600 nm CO2 laser but with non-significant difference between both treatments (P = 0.1). The overall patients' satisfaction with both lasers were not significantly different (P = 0.44). Conclusion: Both fractional ablative CO2 and fractional non-ablative erbium glass lasers are good modalities for treating acne scars with a high efficacy and safety profile and good patient satisfaction. The fractional ablative laser showed higher efficacy while non-ablative laser offered less pain and shorter downtime.

Efficacy of fractional lasers in treating alopecia: a literature review.

Hair loss stemming from different types of alopecia, such as androgenic alopecia and alopecia areata, negatively affects over half the population and, in many circumstances, causes serious psychosocial distress. Current treatment options for alopecia, such as minoxidil, anthralin, and intralesional corticosteroids, vary efficacy and side effect profiles. It is known that low-level laser/light therapies (LLLT), or photobiomodulations, such as the US FDA-cleared HairMax Lasercomb®, He-Ne laser, and excimer laser, are relatively affordable, user-friendly, safe, and effective forms of treatment for hair loss. While less is known about the effectiveness of fractional lasers for combating hair loss, research suggests that by creating microscopic thermal injury zones, fractional lasers may cause an increase in hair growth from a wound healing process, making them potential therapeutic options for alopecia. A literature review was performed to evaluate the effectiveness of fractional lasers on hair regrowth. The specific fractional laser therapies include the 1550-nm nonablative fractional erbium-glass laser, the ablative fractional 2940-nm erbium:YAG laser, and the ablative fractional CO2 fractional laser. Additional randomized controlled trials are necessary to further evaluate the effectiveness of the lasers, as well as to establish appropriate parameters and treatment intervals.

712 Biological effects of non-ablative fractional erbium glass laser treatment and gene regulatory response in human 3D skin models

712 Biological effects of non-ablative fractional erbium glass laser treatment and gene regulatory response in human 3D skin models

Effects of non-ablative fractional erbium glass laser treatment on gene regulation in human three-dimensional skin models.

Clinical experiences with non-ablative fractional erbium glass laser therapy have demonstrated promising results for dermal remodelling and for the indications of striae, surgical scars and acne scars. So far, molecular effects on human skin following treatment with these laser systems have not been elucidated. Our aim was to investigate laser-induced effects on skin morphology and to analyse molecular effects on gene regulation. Therefore, human three-dimensional (3D) organotypic skin models were irradiated with non-ablative fractional erbium glass laser systems enabling qRT-PCR, microarray and histological studies at same and different time points. A decreased mRNA expression of matrix metalloproteinases (MMPs) 3 and 9 was observed 3 days after treatment. MMP3 also remained downregulated on protein level, whereas the expression of other MMPs like MMP9 was recovered or even upregulated 5 days after irradiation. Inflammatory gene regulatory responses measured by the expression of chemokine (C-X-C motif) ligands (CXCL1, 2, 5, 6) and interleukin expression (IL8) were predominantly reduced. Epidermal differentiation markers such as loricrin, filaggrin-1 and filaggrin-2 were upregulated by both tested laser optics, indicating a potential epidermal involvement. These effects were also shown on protein level in the immunofluorescence analysis. This novel standardised laser-treated human 3D skin model proves useful for monitoring time-dependent ex vivo effects of various laser systems on gene expression and human skin morphology. Our study reveals erbium glass laser-induced regulations of MMP and interleukin expression. We speculate that these alterations on gene expression level could play a role for dermal remodelling, anti-inflammatory effects and increased epidermal differentiation. Our finding may have implications for further understanding of the molecular mechanism of erbium glass laser-induced effects on human skin.

Treatment of Facial Laceration Scars with a 1,550-Nm Fractional Erbium-Glass Laser

Treatment of Facial Laceration Scars with a 1,550-Nm Fractional Erbium-Glass Laser

Enhancing hair follicle regeneration by nonablative fractional laser: Assessment of irradiation parameters and tissue response.

Identification of methods to enhance anagen entry can be helpful for alopecia. Recently, nonablative laser has been proposed as a potential treatment for alopecia. However, how the laser parameters affect stem cell activity, hair cycles and the associated side effects have not been well characterized. Here we examine the effects of irradiation parameters of 1,550-nm fractional laser on hair cycles. The dorsal skin of eight-week-old female C57BL/6 mice with hair follicles in synchronized telogen was shaved and irradiated with a 1,550-nm fractional erbium-glass laser (Fraxel RE:STORE (SR1500) Laser System, Solta Medical, U.S.A.) with varied beam energies (5-35 mJ) and beam densities (500-3500 microthermal zones/cm(2) ). The cutaneous changes were evaluated both grossly and histologically. Hair follicle stem cell activity was detected by BrdU incorporation and changes in gene expression were quantified by real-time PCR. Direct thermal injury to hair follicles could be observed early after irradiation, especially at higher beam energy. Anagen induction in the irradiated skin showed an all-or-non change. Anagen induction and ulcer formation were affected by the combination of beam energy and density. The lowest beam energy of 5 mJ failed to promote anagen entry at all beam densities tested. As beam energy increased from 10 mJ to 35 mJ, we found a decreasing trend of beam density that could induce anagen entry within 7-9 days with activation of hair follicle stem cells. Beam density above the pro-regeneration density could lead to ulcers and scarring followed by anagen entry in adjacent skin. Analysis of inflammatory cytokines, including TNF-α, IL-1β, and IL-6, revealed that transient moderate inflammation was associated with anagen induction and intense prolonged inflammation preceded ulcer formation. To avoid side effects of hair follicle injury and scarring, appropriate combination of beam energy and density is required. Parameters outside the therapeutic window can result in either no anagen promotion or ulcer formation.

Randomized split-face controlled study to evaluate 1550-nm fractionated erbium glass laser for treatment of acne vulgaris--an image analysis evaluation.

Novel and promising results in acne treatment with infrared lasers have been reported. The 1,550-nm erbium glass laser is one of the infrared lasers that may be useful in the treatment of acne. The aim of this study was to evaluate the efficacy of an erbium glass laser in treatment of active acne and to study the effect of this type of laser on sebaceous glands. Twenty-four patients with active acne lesions were treated using 1,550-nm (30-40 mJ) fractional erbium glass laser. Every patient received 4 sessions with a 2-week interval. Follow-up was done every 3 months for 1 year. The image analyzer computer system was used to measure the sebaceous gland size. A significant reduction (p < .0001) in the mean count of lesions was observed after treatment and in the follow-up period. A significant reduction in the size of sebaceous glands was also evident after laser treatment. Treatment of active acne with the 1,550-nm erbium glass laser is effective. Papules, pustules, and nodules all respond well to therapy. The sebaceous gland size decreased significantly, which accounts for the long remission period.

Nonablative fractional laser as a tool to facilitate skin penetration of 5-aminolaevulinic acid with minimal skin disruption: a preliminary study

Effective penetration of a photosensitizer is an essential step in photodynamic therapy (PDT). There have been trials of several methods, including laser treatment, to facilitate prompt and sufficiently deep transdermal drug delivery. To evaluate the effects of nonablative fractional laser pretreatment on 5-aminolaevulinic acid (ALA) penetration of the skin. Twelve treatment areas (1 × 1 cm(2)) on the backs of 10 healthy male subjects were mapped. Test areas received laser treatment followed by incubation with ALA. Laser treatment was performed with a 1550 nm fractional erbium glass laser, and the laser energy was set to 20 or 50 mJ with a spot density of 50 cm(-2). ALA incubation time was 30, 60 or 180 min. Porphyrin fluorescence was measured. Sites pretreated with nonablative fractional laser showed significantly increased porphyrin fluorescence compared with nonpretreated areas. Laser energy strength and ALA incubation time were positively correlated with ALA absorption. Nonablative fractional laser treatment effectively enhanced ALA skin penetration. Pretreatment with a nonablative fractional laser can be used for ALA-PDT to achieve higher ALA uptake and shortened ALA incubation times with minimal skin barrier disruption compared with ablative laser.

Comparison of fractional, nonablative, 1550-nm laser and 595-nm pulsed dye laser for the treatment of facial erythema resulting from acne: A split-face, evaluator-blinded, randomized pilot study

Background: Postinflammatory erythema is commonly seen in patients with inflammatory acne. There are no reliable treatment guidelines for acne erythema. Objective: We compared the effect and safety of a nonablative, 1550-nm fractional laser and a 595-nm pulsed dye laser (PDL) for the treatment of acne erythema. Materials and methods: Twelve Korean patients with acne erythema were enrolled. Sides of the face were randomized to receive treatment with a fractional laser or a PDL for a total of three treatments at 4-week intervals. The assessment of effectiveness was mean change in mexameter scores, investigator's and patients’ clinical assessments. Results: Statistically significant improvements in baseline acne erythema were observed through an improved erythema index on both treated sides. But, the improvements from each laser treatment were not significantly different. Mean scores of investigator assessments were 3.42 ± 0.67 in fractional laser-treated sites and 3.33 ± 0.65 in PDL-treated sites. Patients assessed their improvement as good or excellent in 91.7% of fractional laser-treated sites and 75% of PDL-treated sites. Conclusion: Both lasers are effective and safe modalities for the treatment of acne erythema; however, these data suggest better clinical efficacy with the use of a 1550-nm, erbium-glass fractional laser.

Appropriate Timing for Thyroidectomy Scar Treatment Using a 1,550-nm Fractional Erbium-Glass Laser

Surgical scarring is a common cosmetic problem that occurs in various surgical fields, including dermatology. Many trials have been conducted to determine how to prevent this distressing scar formation. A 1,550-nm fractional erbium-glass laser has been used to improve the appearance of surgical scars, but an appropriate treatment time has not been established. To determine the appropriate time to apply 1,550-nm fractional erbium-glass laser treatment for thyroidectomy scars. Korean patients with linear surgical suture lines after thyroidectomy (N=65) were treated using a 1,550-nm fractional erbium-glass laser. Patients were divided into three groups according to postoperative treatment time. Laser treatment was started in 40, 15, and 10 patients 3weeks, 3months, and 6months postoperatively, respectively. Each patient was treated three times at 1-month intervals using the same parameters (14mJ, 100 spots/cm(2) , 2 passes). Mean Vancouver Scar Scale scores were significantly lower after laser treatment (p<.01), with the greatest difference in the group that began treatment 3weeks postoperatively. Global assessment also indicated better cosmetic outcomes in the 3-week postoperative treatment group. Early postoperative 1,550-nm fractional erbium-glass laser treatment of thyroidectomy scars is more effective than later treatment.

A study on fractional erbium glass laser therapy versus chemical peeling for the treatment of melasma in female patients

Introduction:Melasma is a commonly acquired hypermelanosis and a common dermatologic skin disease that occurs on sun-exposed areas of face.Aims:To assess the efficacy and safety of non-ablative 1,550 nm Erbium glass fractional laser therapy and compare results with those obtained with chemical peeling.Materials and Methods:We selected 30 patients of melasma aged between 20 years and 50 years for the study. The patients were divided into two groups of 15 patients each. Group I patients were subjected to four sessions of 1,550 nm Erbium glass non-ablative fractional laser at 3 weeks interval. In group II patients, four sessions of chemical peeling with 70% glycolic acid was performed.Results:After 12 weeks of treatment, percentage reduction in Melasma Area and Severity Index (MASI) score was seen in 62.9% in the laser group and 58.7% in the peels group.Conclusion:It was observed that 1,550 nm fractional laser is as effective as 70% glycolic acid peel in reducing MASI score in patients with melasma.

Analysis of the temporal change in biophysical parameters after fractional laser treatments using reflectance confocal microscopy

Fractional photothermolysis is a popular treatment option for photorejuvenation. Previous literature studies have demonstrated the clinical effectiveness of fractional photothermolysis on cutaneous photoaging; however, the associated changes in biophysical properties of the skin following fractional photothermolysis have not been fully elucidated. This study was conducted to investigate the temporal changes in biophysical parameters after fractional laser treatment on Asian skin. Eleven female subjects underwent a single treatment with an erbium glass fractional laser. Skin roughness, elasticity, transepidermal water loss (TEWL), dermal thickness were evaluated before and immediately after treatment and 3 days, 1 week, 2 weeks, and 4 weeks after treatment. The changes in the dermal papilla were analyzed using a reflectance confocal microscopy (RCM). Skin roughness showed the greatest improvement at the first week and net elasticity was most improved at the second week. TEWL and the percentage of melanized and active dermal papillae (DP) were mostly increased for 3 days. At 4 weeks after treatment, the number of total dermal papillae showed a significant increase compared with pretreatment. This is the first study of the characterization and quantification of dermal papilla reflecting the dermal repair process after fractional photothermolysis through an RCM.

Treatment of actinic keratoses and photodamage with non-contact fractional 1540-nm laser quasi-ablation: an ex vivo and clinical evaluation

The main use of non-ablative fractional photothermolysis today is for the improvement of wrinkles and scars. The purpose of this work was to evaluate the effect of a "classic" non-ablative fractional 1540 nm on facial photodamaged skin and actinic keratoses. Seventeen patients with facial actinic keratoses (AKs) and photodamage underwent two or three laser treatments with fractional 1540-nm erbium glass laser at fluences of 75 mJ, 15 ms pulse duration, and 10-mm spot size in non-contact mode. Two blinded assessors and participants evaluated clinical improvement of treatment areas after 3 months, using a quartile grading scale (no improvement = 0, 1-25% improvement = 1, 26-50% = 2, 51-75% = 3, and 76-100% = 4). Three months after the last treatment, the mean level of improvement was 3.4 ± 0.72 for AK and 3.3 ± 0.54 for skin appearance. Adverse events observed after each treatment were moderate erythema, mild edema, erosions (two cases), and mild desquamation. No scarring or post-inflammatory pigmentary changes were observed. The clinical results were supported by histological changes observed in Yucatan pig studies in vivo and ex vivo. The 1540-nm fractional erbium glass laser in the non-contact mode is a safe and effective treatment for facial photodamage and AKs.