Fractional Photothermolysis Laser Research Articles

Assessment of the immune status of women after ablative fractional laser photothermolysis procedure for the correct of involutional facial skin changes

Introduction. Ablative fractional laser photothermolysis (A-FLPh), used for rejuvenation of aging skin, is based on its controlled damage. Factors of the immune system are involved in the reparative regeneration processes triggered, which, in turn, is also subject to age-related remodeling or immunostaining. The aim of the work was to evaluate in dynamics the response of the immune system to the A-FLPh procedure performed for correction of age-associated facial skin changes. Materials and methods. The study included 25 women aged 42 to 55 years who underwent A-FLPh treatment of facial skin with an Erbium laser. The number of leukocytes, monocytes, neutrophils, lymphocytes, T-lymphocytes, T-helpers, cytotoxic T-cells, regulatory T-cells, NKT-lymphocytes, NK-lymphocytes were counted in the peripheral blood before, on the 8th and 24th after the procedure. We studied phagocytic function of neutrophils and monocytes, NBT-reducing and lysosomal activity of neutrophils; determined the amount of IgA, IgM, IgG, IL-4, IL-6, IL-8, IL-10, circulating immune complexes (CIC). Results. On the 8th day after A-FLPh, the number of neutrophils, neutrophils and monocytes phagocytosis, the number of lymphocytes, regulatory T-cells, IL-6 and IL-8 levels significantly increased; in parallel, the number of CD11b+ NK-lymphocytes, CD11b+ NKT-lymphocytes, IgA, IgG, IL-10 concentrations decreased. On the 24th day, quantitative functional indices of neutrophils, total number of lymphocytes, concentrations of IgA and IgG had no reliable difference from pre-procedure values, phagocytic parameters of monocytes, number of regulatory T-cells, IL-6 and IL-8 levels remained significantly higher, while the number of CD11b+ NK-lymphocytes, CD11b+ NKT-lymphocytes and IL-10, on the contrary, significantly lower than the initial level. Discussion. The revealed changes of systemic immunity indices after A-FLPh testify to both direct and regulatory-modulatory influence of immune factors on skin repair and remodeling after laser damage. Conclusion. The A-FLPh procedure induces a response from both cellular and humoral factors of the immune system, predominantly innate immunity.

Clinical Factors Affecting the Effectiveness of 1550-nm Erbium-Doped Fractional Photothermolysis Laser for Individual Atrophic Acne Scar Types.

Although non-ablative fractional resurfacing is frequently used for atrophic acne scars, few studies have examined clinical factors affecting the effectiveness of non-ablative fractional laser in individual atrophic acne scar types (icepick, rolling, and boxcar scars). Herein, we evaluated the clinical factors affecting the effect of non-ablative fractional laser for individual atrophic acne scar types using objective assessment tools. Thirty-one patients who had been treated by 1550-nm erbium-doped fractional laser for atrophic acne scars were retrospectively reviewed. Icepick, rolling, and boxcar scars were counted using photographs, and acne scar reduction efficiency (ASRE%; the percentage reduction of post-acne scar count from baseline counts) was calculated. The median count of each scar type was significantly reduced at the end of the final session. Boxcar scars responded better (median ASRE 59.2%) than rolling (ASRE 40.6%, p = 0.017) and icepick scars (ASRE 19.1%, p = 0.010). Concomitant isotretinoin use resulted in a greater ASRE and a significantly greater improvement in icepick scars. Patients aged 25years or younger showed a higher ASRE, with a greater improvement in boxcar scars. 1550-nm fractional laser treatment for atrophic acne scars was more effective in patients who were younger and taking isotretinoin concurrently.

ЛАЗЕРНЫЕ И РАДИОВОЛНОВЫЕ ТЕХНОЛОГИИ В ДЕРМАТОВЕНЕРОЛОГИИ И КОСМЕТОЛОГИИ

The article presents current data on the use of laser and radio-wave techniques in dermatology and cosmetology. Types of lasers, reactions of interaction of laser light with skin are characterized, the detailed characteristic of low-intensity and high-intensity laser radiation and opportunities of their application in dermatology and cosmetology is given. Ablative and non-ablative methods of skin exposure, the principle of fractional laser photothermolysis are described. The method of radiowave influence on tissues and its modes is presented. The principles of radiowave surgery and the possibility of using radiowave techniques in the treatment of skin tumors and aesthetic cosmetology are discussed. The data on the use of Plasma RFL regime for plasma skin rejuvenation are described.

Mechanisms of remodeling oral soft tissues (literature review)

Based on the analysis of modern literature, a systematization of information of the soft tissues of the oral cavity remodeling mechanisms after surgical interventions was carried out. Priority area in modern medical practice is the development and use of such methods and drugs that combine maximum safety and high biological activity in relation to body tissues. A number of scientists have proposed and introduced into practical medicine the technology of programmed scar remodeling. According to this technique, injections of antihomotoxic substances directly around the surgical wound are required, which reduce the duration of edema in the tissues. A number of authors have studied the use of a minimally invasive microsurgical method based on fractional laser photothermolysis to initiate the regeneration of gums and oral mucosa. As a result of the study, it was found that microscopic thermal wounds in the form of damage islands surrounded by normal viable tissue contribute to stimulation of regeneration, which leads to complete restoration of the tissue without scar formation. Recently, methods of using directed tissue regeneration have been widely introduced into practice. In this technique, cellular structures are used that increase the activity of regenerative processes - fibroblasts, platelet plasma. Great importance in the processes of regeneration of the oral mucosa has the epidermal growth factor EGF. It is a globular protein, acts like a strong mitogen on cells of endodermal, ectodermal and mesodermal origin. The epidermal factor stimulates cell proliferation and, in combination with other cytokines, is a factor that accelerates wound healing and angiogenesis. For the treatment of patients with periodontal tissue damage, a number of scientists have proposed a method for using an adhesive protective wound cover created with biotechnological high molecular weight hyaluronic acid. Thus, the analysis of literary sources and the systematization of the available information proves the relevance of further studying the features of the mechanisms of remodeling of soft tissues of the oral cavity. Needs of modern maxillofacial surgery requires morphological study for improvement of existing and development of new treatments for patients.

The efficacy of fractional CO2 laser resurfacing in the treatment of facial acne scars

Background: Acne is a common condition with prevalence as high as 80% among adolescents and often it causes atrophic scars. Laser resurfacing is an effective treatment for acne scars. However, post-treatment adverse effects are often induced. Fractional laser photothermolysis has been designed to create microscopic thermal wounds to achieve skin rejuvenation without significant side effects. Objectives: The aim of this study is to assess the efficacy and safety level of fractional CO2 laser in atrophic acne scars treatment. Materials and Methods: Forty patients between 18 and 40 years of both sexes with atrophic acne scars seen in the Department of Dermatology at Najran University Hospital in Najran, Saudi Arabia, were treated with 4–6 sessions of fractional CO2 laser resurfacing. The result was evaluated objectively at each follow-up visit and 3 months after the last laser session using a quartile grading scale. Patient improvements were classified as excellent when the improvement was >50% in scar outcome and appearance of skin, good if 25–50% response, and poor when the response

Fractional Laser Photothermolysis in the Treatment of Skin Defects: Possibilities and Effectiveness (Review)

Fractional Laser Photothermolysis in the Treatment of Skin Defects: Possibilities and Effectiveness (Review)

Alopecia areata treated with fractional photothermolysis laser: A case report

Alopecia areata treated with fractional photothermolysis laser: A case report

Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars.

Background:While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between.Aim:The aim of the present study is to assess the efficacy and safety of fractional CO2 laser resurfacing in atrophic facial acne scars.Materials and Methods:Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ‘excellent’ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ‘good’ and ‘poor’ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted.Results:Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3%) while 15 (25%) and 19 patients (31.7%) demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks.Conclusions:Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar scars with minimal adverse effects.

Adverse events of non-ablative fractional laser photothermolysis: a retrospective study of 856 treatments in 362 patients

Background: Non-ablative fractional laser photothermolysis (NAFP) has been used effectively in the treatment of photodamaged skin and scars, with short post-operative recovery times; but, studies evaluating its adverse events and complication rates in Asian population have been limited. Objective: To determine the frequency and range of adverse events associated with NAFP treatment in Korean patients. Materials and methods: We retrospectively evaluated the outcomes of 754 1550-nm erbium-doped and 102 1927-nm thulium fiber fractional laser treatments in patients with skin phototypes III–IV treated at a single center. Adverse events were identified and tabulated, as were patient demographics and laser parameters. Results: From 856 treatments, there were 43 adverse events (5.0%), the most frequent being prolonged erythema (1.8%), post-inflammatory hyperpigmentation (1.1%) and aggravation of melasma (0.9%). Less frequently observed adverse events included herpes simplex outbreak (0.6%) and acneiform eruption (0.2%). There were no reports of long-term adverse events. Conclusion: Non-ablative fractional laser skin treatment has a relatively low complication rate. The adverse events found were temporary and did not result in long-term or severe sequelae such as hypertrophic scarring, atrophic scarring or permanent pigmentary alteration.

Adverse events of nonablative fractional laser photothermolysis: A retrospective study of 856 treatments in 362 patients

Adverse events of nonablative fractional laser photothermolysis: A retrospective study of 856 treatments in 362 patients

The efficacy in melasma treatment using a 1410 nm fractional photothermolysis laser

Melasma treatment modalities including topical and procedural therapy have been employed with variable results and high recurrence rate. To quantitatively assess improvement in melasma and side effects after 1410nm fractional photothermolysis laser treatments and to determine efficacy at 1-, 2- and 3-month follow-up after treatment. Thirty volunteers with melasma were treated with 1410nm fractional photothermolysis for four passes on full face and additional four passes on melasma area. They were randomly treated on one side of their face with 20mJ at 5% coverage and the other side of their face with 20mJ at 20% coverage. All subjects were treated monthly for five times. Melanin index, Visual analogue scale and Melasma Area and Severity Index score were measured at baseline and 1-, 2- and 3-month follow-up after complete treatment protocol. There was statistically significant improvement of Melanin index at 2- and 3-month follow-up visits, but not at 1-month follow-up visit. Visual analogue scale and Melasma Area and Severity Index score improved significantly on both sides at 1-, 2- and 3-month follow-ups. The overall patients' satisfaction was significantly higher on the side treated with 20mJ, 5% coverage. Adverse reactions included erythema, dryness and post-inflammatory hyperpigmentation on melasma area. Those side effects were significantly more intense on the side treated with 20mJ, 20% coverage. 1410nm fractional photothermolysis laser treatment is a safe and temporary effective procedure for melasma; however, long-term follow-up is still needed. Only 5% coverage should be used to minimize risks of adverse effects.

Fractional Photothermolysis 치료 후 피부회복 촉진에 미치는 경구용 저분자 콜라겐 펩타이드의 효과

최근에는 콜라겐 펩타이드가 항상화효과를 통해 피부의 재생을 촉진시키는 효과를 한다는 연구가 보고되고 있다. 본 구는 저분자 경구 콜라겐 펩타이드가 1550 nm fractional photothermolysis 레이저 치료 후 피부재생에 미치는 영향을 알아보고자 한다. 본 실험에 참여한 환자는 총 10명으로 실험군과 대조군 각 5명씩 무작위배정되었다. 대조군과 실험군 모두 동일하게 fractional photothermolysis 레이저를 시술받았다. 실험군에서는 경구 콜라겐 펩타이드를 하루에 1,000 mg씩 총 8주간 복용하였다. 치료 전후 모든 환자에서 피부의 탄성도, 경표피수분손실도, 홍반지수를 측정하였다. 피부탄성도는 실험군에서 대조군에 비해 통계적으로 유의하게 피부의 탄력성이 증가하였음을 확인하였다(p < 0.05). 경표피수분손실도는 두군간에 유의한 차이가 없었고, 홍반지수는 실험군에서 더 빨리 감소하는 결과를 보였다. 환자의 주관적 만족도평가에서 시술 4주 후 환자의 만족도는 실험군에서 평균 2.0점, 대조군에서 1.2점으로 나타났다. 저분자 콜라겐 펩타이드는 1550 nm fractional photothermolysis 레이저 치료 후 피부회복 촉진에 도움이 된다. Recent studies have revealed that collagen peptide plays a protective role on skin by improving the activity of antioxidants and acts as an inducer of skin regeneration. To evaluate the efficacy of low molecular weight collagen peptide for skin recovery after non-ablative 1550 nm fractional photothermolysis laser. 10 volunteers were randomly divided into two groups. Both control and experimental groups received fractional photothermolysis treatment. In the experimental group, 5 subjects received oral collagen peptide 1,000 mg/day for 8 weeks. Before and after the treatment, we measured elastic recovery of skin, transepidermal water loss (TEWL) and erythema index (EI) for each patients. The evaluation of clinical results showed that elastic recovery of skin is higher in the experimental group than the control group (p < 0.05). TEWL have no significancy between two groups and erythema rapidly disappeared in the experimental group. On the quartile grading scale, the mean patient satisfaction 4 weeks after the fractional photothermolysis treatment was 2.0 in experimental group and 1.2 in control group. The low molecular weight collagen peptide appears to be an effective conservative therapy for skin recovery after non-ablative 1550 nm fractional photothermolysis treatment.

Fractional laser resurfacing for acne scars: a review

This review investigates the effectiveness of ablative and nonablative fractional photothermolysis (FP) lasers for treating facial acne scars. Twenty-six studies (13 ablative FP, 13 nonablative FP) published between 2003 and January 2011 were reviewed. Quantitative and qualitative data from each article were examined and analysed. Four studies were split-face randomized controlled studies. While the data analysed were all clinically relevant and significant, there were some methodological differences between the studies. Outcomes included subjective and objective assessment of scar appearance, pre- and postoperative treatment, side-effects and pain scores. A small number of studies used three-dimensional optical imaging profiling and histology for objective assessment. Even allowing for methodological variability, ablative FP had an improvement range of 26-83% whereas nonablative FP had an improvement range of 26-50%. Patients who underwent treatment with an ablative FP laser experienced erythema for 3-14 days which resolved by 12 weeks, whereas patients who opted for the nonablative FP laser experienced erythema for between 1 and 3 days and this resolved within a week. A higher proportion of patients (up to 92·3%) who underwent ablative FP experienced postinflammatory hyperpigmentation (PIH) than those who had nonablative FP (up to 13%). The maximum duration of PIH in ablative FP was up to 6 months whereas in nonablative FP it lasted for up to 1 week. The procedure with ablative FP was relatively uncomfortable compared with nonablative FP. The pain score with ablative FP ranged from 5·90 to 8·10 (scale 1-10) and with nonablative FP from 3·90 to 5·66 (scale 1-10).

A systematic review of laser resurfacing for acne scars

A systematic review of laser resurfacing for acne scars

Split-face comparative study of 1550 nm fractional photothermolysis and trichloroacetic acid 15% chemical peeling for facial melasma in Asian skin

Fractional photothermolysis (FP) therapy and chemical peels have been reported to be effective in patients with recalcitrant melasma. However, there is little information to compare the efficacy of single treatment session in Asian women. The aim of this study was to examine the efficacy, long-lasting outcomes and safety of a single session of 1550-nm erbium-doped FP in Asian patients, compared with trichloroacetic acid (TCA) peel with a medium depth. Eighteen Korean women (Fitzpatrick skin type III or IV) with moderate-to-severe bilateral melasma were randomly treated with a single session of 1550-nm FP on one cheek, and with a 15% TCA peel on the other cheek. Outcome measures included an objective melasma area severity index and subjective patient-rated overall improvement at 4 and 12 weeks after treatment. Melasma lesions were significantly improved 4 weeks after either treatment, but melasma recurred at 12 weeks. Post-inflammatory hyperpigmentation developed in 28% of patients at 4 weeks but resolved in all but one patient by 12 weeks. There was no difference between FP treatment and TCA peeling with respect to any outcome measure. FP laser and TCA peel treatments were equally effective and safe when used to treat moderate-to-severe melasma, but neither treatment was long-lasting. We suggest that multiple or periodic maintenance treatments and/or supplemental procedures may be required for the successful treatment of melasma in Asian women.

Successful Gingival Depigmentation With Laser‐Patterned Microcoagulation: A Case Report

Introduction: Current methods for gingival depigmentation, including mechanical surgery, cryosurgery, laser treatments, and radiosurgery, create significant patient discomfort and risk of complications, thereby reducing attractiveness of the depigmentation procedure for many patients. To our knowledge, this case report presents a first‐time application of a new technology, laser‐patterned microcoagulation (LPM) based on the concept of fractional laser photothermolysis that was successfully applied in dermatology and ophthalmology.Case Presentation: One patient was treated for local hyperpigmentation of the labial attached gingiva in the maxillary anterior area. A diode laser with wavelength 980 nm and power 20 W was used to create microcoagulation columns with a 30% area filling factor. Two treatments were performed, 2 weeks apart, without anesthesia. The patient was followed for 5 months. The discomfort during the procedure was tolerable without anesthesia. Healing was uneventful and visually completed with significant reduction of pigmentation at 2 weeks after treatment. Complete visual depigmentation was observed at both 2 weeks and 2 months after the second treatment.Conclusions: To our knowledge, this is the first clinical case of hyperpigmentation treatment using LPM, demonstrating feasibility of a new, minimally invasive and effective method of localized gingival hyperpigmentation removal. The patient discomfort is significantly less than that reported for other methods for depigmentation.

Acute Effects of Fractional Laser on Photo-Aged Skin

Nonablative fractional photothermolysis (FP) laser treatment has shown clinical efficacy on photo-aged skin. Few studies have examined the molecular responses to FP. To characterize the dynamic alterations involved in dermal matrix remodeling after FP laser treatment. A single multipass FP treatment was performed. Baseline, day 1, and day 7 biopsies were obtained. Biopsies were sectioned and stained for histology and immunofluorescence confocal microscopic. Heat shock protein-70 (HSP-70) and matrix metalloproteinase-1 (MMP-1) expression and extracellular matrix (ECM) autofluorescence were examined. Quantitative real-time polymerase chain reaction (qRT-PCR) experiments were performed probing for collagen 1A1 (COL1A1) and COL3A1. All three patients were Caucasian women aged 49, 62, and 64 with Fitzpatrick skin types II, III, and IV. Transient neutrophilic infiltration found on day 1. Protein expression of HSP-70 and MMP-1 were up-regulated on day 1, reverting to baseline by day 7. ECM autofluorescence decreased from baseline to day 7. qRT-PCR showed a minor decrease in COL1A1 and COL3A1 messenger RNA 1day after treatment. Variable results between patients receiving equal treatment were evident.

Immunohistological Evaluation of Skin Responses After Treatment Using a Fractional Ultrapulse Carbon Dioxide Laser on Back Skin

Fractional photothermolysis (FP) lasers have been widely used in treating photo-aged skin, acne scars, and other skin conditions. Although plenty of clinical data have demonstrated the efficacy of the FP laser, only limited histologic studies have been available to observe serial short- to long-term skin responses. Seven healthy Chinese women received one pass of fractional carbon dioxide laser treatment on the left upper back. Biopsies were taken at the baseline and 4 hours, 1 day, 5 days, 1 month, 3 months, 6 months, and 1 year after the procedure for hematoxylin and eosin stains, immunohistochemical evaluation (for heat shock proteins and elastin), and Verhoeff-iron-hematoxylin stains (for collagen and elastic fiber). Remarkably greater expression of heat shock protein (HSP)70 could be observed 4 hours after the procedure, which diminished significantly by 3 months, 6 months, and 1 year after the procedure. HSP47 reached its peak expression 1 month after the procedure, especially around microscopic thermal zones, and maintained its high level of expression 3 and 6 months after the procedure. Distinct new formation and remodeling of collagen and elastic fibers could be observed 3 and 6 months after procedure. FP-induced HSP expression and new formation of collagen and elastic fibers lasted as long as 6 months, longer than the previously acknowledged 3 months.

Fractional Photothermolysis Laser Treatment of Male Pattern Hair Loss

Various trials have been conducted on the management of male pattern hair loss (MPHL). A variety of laser and light sources have been used for the treatment of MPHL. To understand the effects of a 1,550-nm fractional erbium-glass laser on the hair cycle in an alopecia mouse model and to study the clinical effects of the same laser used as treatment for MPHL. Irradiation was applied to the shaved skin of C3H/HeN mice using various energy and density settings and varied irradiation intervals. In a clinical pilot study involving human subjects, 20 participants were treated over five sessions at 2-week intervals. A fractional photothermolysis laser was used at the energy of 5 mJ and a total density of 300 spots/cm(2). In the animal study, the hair stimulation effects were dependent upon the energy level, density, and irradiation interval. The anagen conversion of hair and the increase in Wnt 5a, β-catenin signals were observed. In the human pilot study, incremental improvements in hair density and growth rate were observed. This pilot study showed that a 1,550-nm fractional erbium-glass laser might induce hair growth, but more intensive studies are required to clarify the clinical applications of this treatment.

Skin rejuvenation with the use of fractional photothermolysis(MultiPlex technology) in a combination with the CAP system

A new method of skin rejuvenation with the use of fractional laser photothermolysis (MultiPlex technology) in a combination with the CAP system is based on the sequential skin exposure to low-intensity radiation with different wavelengths (1,440 nm and 1,320 nm). This method produces much more evident esthetic results than radiation of greater intensity but with one wavelength only.