Fractional Photothermolysis Research Articles

Nonablative Fractional Photothermolysis for the Treatment of Striae Rubra

Nonablative Fractional Photothermolysis for the Treatment of Striae Rubra

Beneficial effects of spraying low mineral content thermal spring water after fractional photothermolysis in patients with dermal melasma

Melasma is a common dermatological skin disease that can now be treated by fractional photothermolysis (fractional resurfacing). Past studies have shown that thermal spring water (TSW) spray can reduce local inflammatory symptoms after dermatological surgery, laser surgery or chemical peelings. The aim of this study was to evaluate the clinical efficacy and safety of spraying TSW post-fractional resurfacing treatment in patients with dermal melasma. Twenty patients with bilateral dermal melasma were included in this split-face comparative study. Patients were treated by fractional resurfacing laser and then TSW was sprayed generously unilaterally. For the next 48 h, patients were instructed to spray thermal water at least six times a day on one side. Patient's self-assessment conducted 10 min and 2 days after TSW spraying (stinging, pain, skin dryness, swelling, and redness) and investigator's 48-h post-treatment evaluation (purpura, skin dryness, erythema, swelling, scars, hyper- or hypopigmentation) were recorded for the treated and control sides using visual analogue scales. Pain, dryness, and redness were significantly lower 10 min after spraying on the TSW-treated side in comparison with the untreated side, as assessed by the patients (P < 0.05). Two days after fractional resurfacing, dryness and redness were still improved on the TSW-treated side. The investigator's evaluation revealed that erythema, the only perceivable sign following irradiation, was significantly reduced by TSW spraying (P < 0.01). This split-face comparative study conducted in patients with dermal melasma showed that spraying TSW after fractional laser resurfacing significantly reduced short-term adverse effects associated with the procedure.

Micro‐island damage with a nonablative 1540‐nm Er:Glass fractional laser device in human skin

Fractional photothermolysis produces micro-islands of thermal injury to the skin while preserving areas among treated tissue sites in order to promote wound healing. Histological changes associated with single and multiple passes of the 1540-nm Er:Glass fractional laser were examined using in vivo human skin. Panni of five abdominoplasty patients were treated intraoperatively with a Fractional Lux1540 erbium glass laser system at various laser parameters, with single and multiple passes. Biopsies were removed and examined using standard histological stains. Deep coagulated columns of collagen separated by regions of unaffected tissue were observed at variable fluence parameters. A direct correlation between the depth of penetration of the coagulated microcolumns and increasing energies was observed. Micro-islands of coagulation were approximately 250 microm in diameter and separated by approximately 800 microm of unaffected tissue. With multiple passes, significantly more disruption of the dermal-epidermal junction (DEJ) occurred at higher fluences. In contrast to the controlled fractional columns observed with single-pass treatments, nonuniform coagulated columns were distributed randomly throughout the tissue when instituting multiple passes over the same treatment region. Micro-islands of thermal damage were observed at variable energy parameters. Pathological changes within the skin were clearly dependent on amount of energy and number of passes of the laser treatment. Significantly more superficial damage, accompanied by disruption of the DEJ was observed with multiple passes when compared with single pass at similar fluences. However, with multiple passes, depth of thermal injury did not increase with increasing energies but did disrupt the micro-island array observed with single-pass fractional treatments.

Treatment of Striae Distensae with Fractional Photothermolysis

Striae distensae are dermal scars characterized by flattening and atrophy of the epidermis. Although many treatment modalities have been tried with variable results, most have been disappointing. To determine whether striae distensae might respond to fractional photothermolysis. Twenty-two women with striae distensae were treated with two sessions each of fractional photothermolysis at a pulse energy of 30 mJ, a density level of 6, and eight passes at intervals of 4 weeks. Response to treatment was assessed by comparing pre- and post-treatment clinical photography and skin biopsy samples. Six of the 22 patients (27%) showed good to excellent clinical improvement from baseline, whereas the other 16 (63%) showed various degrees of improvement. Most of the lesions with excellent results were white in color and of long duration. Skin biopsy revealed that average epidermal thickness and dermal thickness were greater than at baseline. The immunoreactivity of procollagen type 1 increased after treatment. There were no significant side effects except erythema and mild pigmentation. Fractional photothermolysis may be effective in treating striae distensae, without significant side effects. Treatment outcomes were better in patients with white rather than red striae.

Fraktionierte Photothermolyse

Postinflammatory hyperpigmentation (PIH) is a benign but cosmetically disturbing skin lesion, which is notoriously difficult to treat. Standard treatments include topical application of bleaching creams and gels. In this case report, we show that fractional photothermolysis might be a new successful option in the treatment of PIH. Its efficacy must be confirmed by further studies and balanced against possible side effects, but the initial results are promising.

The use of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin: a pilot study

Various modalities have been used to treat acne scars, but limited efficacy and considerable side effects have restricted their proper use. Recently, a new-generation fractional photothermolysis modality has been introduced that has deeper penetrating ability; however, a 1540 nm fractional photothermolysis study has not yet been performed. To evaluate the efficacy and safety of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin. Sixteen volunteers (Fitzpatrick skin types III-IV) with mild to moderate acne scars were enrolled. Acne scar lesions were treated with 1540-nm fractional photothermolysis (Starlux 1540). Three treatment sessions were performed for each patient 4 weeks apart. Outcome assessments included the following four methods: (1) clinical evaluation of the photographs that were taken before and after the treatment; (2) comparison of the quality of life (QOL) of the patients before and after the treatment; (3) patients' satisfaction with the treatment; and (4) comparison of the quantity of collagen and elastic fibers in the skin biopsies before and 12 weeks after the last treatment. A mild to moderate clinical improvement was observed in most of the patients. Moreover, the QOL of all the patients improved, and all of them were satisfied with the results of the treatment. Significant collagen and elastic-fiber increases were also observed after the treatment, and side effects were limited to transient erythema and edema, which occurred in 50% of the patients. No severe side effect was observed. 1540 nm fractional photothermolysis is an effective and safe method for improving acne scar, even in Asian skin.

Fractional Resurfacing for the Treatment of Atrophic Facial Acne Scars in Asian Skin

Atrophic facial acne scars is one of the most common problems in patients with inflammatory acne. Ablative laser resurfacing has unpleasant complications and a long recovery period. Nonablative therapies yield less improvement and satisfaction. The introduction of fractional photothermolysis (FP) is an alternative treatment for atrophic acne scars. To evaluate the effectiveness and safety of a nonablative 1,550-nm erbium-doped fiber laser in the FP of atrophic facial acne scars in one treatment session. Forty-five patients (skin type III-IV, mean age 29) with atrophic facial acne scars were enrolled in the study. Each patient received one treatment of FP. Comparative photographs were taken using specific complexion analysis to identify and quantify depressed scars and texture. Physician evaluations and patient satisfaction were graded on a 4-point scale. Side effects were recorded at each follow-up visit. The improvement in atrophic scars and texture after a FP treatment were significant. Twenty-seven (60%) of the patients had good to excellent results after 1 month. The FP of atrophic facial acne scars resulted in significant improvement even in a single treatment, with good satisfaction and unremarkable side effects.

Fractional Photothermolysis for the Treatment of Hypertrophic Scars

Hypertrophic scars are common problems and represent a challenging condition to treat. Fractional photothermolysis has been effective at resurfacing photodamaged skin, acne scars, and atrophic scars, but there are few reports on its use for hypertrophic scars. To evaluate the safety and efficacy of 1,550-nm erbium-doped fiber laser treatment of hypertrophic scars in eight patients. Eight patients (skin phototypes II-IV) with hypertrophic scars received monthly treatments with a 1,550-nm erbium-doped fiber laser. Energy settings ranged from 35 to 50 mJ, and eight to 10 passes were applied with treatment levels 6 to 8. An independent physician evaluator assessed the treatment response by comparing pre- and posttreatment clinical photographs using a quartile grading scale (grade 1, < or =25%=minimal to no improvement; grade 2, 26-50%=moderate improvement; grade 3, 51-75%=marked improvement; grade 4, >75%=near total improvement. At four weeks after the last treatment session, a mean grade of 2.4 was achieved based on an independent physician's clinical assessment. Improvement in pigmentation occurred in all hyperpigmented scars. Hypertrophic scars can be effectively and safely improved with 1,550-nm erbium-doped fiber laser treatment.

Eruptive Keratoacanthomas on the Legs After Fractional Photothermolysis: Report of Two Cases

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Ahead-of-PrintSpecial Issues Collections Advancement FlapCartilage GraphCompsite GraphEar ReconstructionEyelid ReconstructionFull Thickness Skin GraphInterpolation FlapLip ReconstructionNasal ALANasal ReconstructionNasal Tip - SidewallPull Through FlapRotation FlapSkin Cancer AwarenessSoft TriangleTransposistion Flap VideosPodcastFor Authors Submit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalEditorial BoardAbout the societyAdvertisingSubscription ServicesReprintsOpen AccessRights and PermissionsNZSCM Member Info All Articles Images Videos Podcasts Blogs Advanced Search

Treatment of melasma with nonablative fractional selective photothermolysis—Erbium glass 1540 nm: A new hope

Treatment of melasma with nonablative fractional selective photothermolysis—Erbium glass 1540 nm: A new hope

The use of 1540-nm fractional photothermolysis for the treatment of atrophic facial acne scars

The use of 1540-nm fractional photothermolysis for the treatment of atrophic facial acne scars

Surgical and acne scars: New approach wich fractional photothermolysis

Surgical and acne scars: New approach wich fractional photothermolysis

Fractional Photothermolysis for the Treatment of Postinflammatory Hyperpigmentation after Carbon Dioxide Laser Resurfacing

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Ahead-of-PrintSpecial Issues Collections Advancement FlapCartilage GraphCompsite GraphEar ReconstructionEyelid ReconstructionFull Thickness Skin GraphInterpolation FlapLip ReconstructionNasal ALANasal ReconstructionNasal Tip - SidewallPull Through FlapRotation FlapSkin Cancer AwarenessSoft TriangleTransposistion Flap VideosPodcastFor Authors Submit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalEditorial BoardAbout the societyAdvertisingSubscription ServicesReprintsOpen AccessRights and PermissionsNZSCM Member Info All Articles Images Videos Podcasts Blogs Advanced Search March 2009 - Volume 35 - Issue 3 Previous Abstract Next Abstract Full Text Access for Subscribers: Individual Subscribers Log in for access Institutional Users Access through Ovid® Not a Subscriber? Buy Subscribe Request Permissions You can read the full text of this article if you: Select an option Log In Buy Article Subscribe Content & Permissions Access through Ovid Log In Access through Ovid Article as EPUB Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Dermatologic Surgery. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection COMMUNICATIONS AND BRIEF REPORTSFractional Photothermolysis for the Treatment of Postinflammatory Hyperpigmentation after Carbon Dioxide Laser ResurfacingRokhsar, Cameron K. MD*; Ciocon, David H. MD* Author Information *Division of Dermatology, Albert Einstein College of Medicine, Montefiore and Jacobi Medical Centers, Bronx, New York Address correspondence and reprint requests to: Cameron K. Rokhsar, MD, FAAD, FAACS, 260 East 66th Street, New York, NY 10021-9196, or e-mail: [email protected] Dermatologic Surgery: March 2009 - Volume 35 - Issue 3 - p 535-537 doi: 10.1111/j.1524-4725.2009.01090.x Buy Metrics Abstract Dr. Rokhsar has served in a consulting and advisory capacity to Reliant Technologies. © 2009 by the American Society for Dermatologic Surgery, Inc. Source Fractional Photothermolysis for the Treatment of Postinflammatory Hyperpigmentation after Carbon Dioxide Laser Resurfacing Dermatologic Surgery35(3):535-537, March 2009. Full-Size Email + Favorites Export View in Gallery Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Dermatologic Surgery. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Related Articles Article as EPUB Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Dermatologic Surgery. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Article Level Metrics Related Links Articles in PubMed by Cameron K. Rokhsar, MD Articles in Google Scholar by Cameron K. Rokhsar, MD Other articles in this journal by Cameron K. Rokhsar, MD Related Videos Data is temporarily unavailable. Please try again soon. Back to Top Never Miss an Issue Get new journal Tables of Contents sent right to your email inbox Get New Issue Alerts Browse Journal Content Most Popular For Authors About the Journal Past Issues Current Issue Register on the website Subscribe Get eTOC Alerts For Journal Authors Submit an article How to publish with us Customer Service Live Chat Chat Offline Activate your journal subscription Activate Journal Subscription Browse the help center Help Contact us at: EMAIL: [email protected] TEL: (USA): TEL: (Int’l): 800-638-3030 (within USA) 301-223-2300 (international) Privacy Policy (Updated June 1, 2020) Legal Disclaimer Terms of Use Open Access Policy Feedback LWW Journals Copyright © 2022 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Evaluation of a novel fractional resurfacing device for treatment of acne scarring

Pulsed carbon dioxide (CO(2)) laser devices are considered highly effective treatment options for skin resurfacing. However, the high risk for significant treatment complications following CO(2) resurfacing has warranted the development of new treatment modalities. The concept of fractional photothermolysis was developed to address the shortcomings of ablative and non-ablative device modalities. This report evaluates a fractional approach to CO(2) laser resurfacing for the treatment of moderate to severe acne scarring. The primary endpoint of the study was the overall improvement in the appearance of acne scarring. Thirty subjects, with moderate to severe acne scarring, underwent up to three treatments with an FDA IDE and IRB approved 10,600 nm fractional CO(2) laser system. All subjects were Fitzpatrick skin types I-V and 18-75 years of age. Treatment parameters ranged from 20 to 100 mJ with total densities of 600-1,600 MTZ/cm(2). Improvement of acne scarring was evaluated at 1 and 3 months post-treatment. Twenty-three out of 25 subjects sustained clinical improvement in the appearance of acne scarring at the 3-month follow-up visits according to study investigator quartile improvement scoring. Subjects also had improvement in their overall appearance, including pigmentation and rhytides. Serosanguinous oozing resolved within 24-48 hours following treatment. All subjects had transient erythema, which resolved in the majority of subjects within 1-3 months. Post-operative downtime was significantly decreased compared to traditional ablative resurfacing. No serious complications were reported. Fractional deep dermal ablation improves moderate to severe acne scarring. The added benefit is a considerable reduction both in downtime and risk of complications when compared to traditional CO(2) ablative resurfacing techniques.

Fractional Laser Photothermolysis for Treatment of Facial Wrinkles in Asians

PurposeTo evaluate the safety and efficacy of fractional photothermolysis (FP) in the treatment of facial wrinkles in Asians.MethodsA total of 27 Korean patients (Fitzpatrick type III or IV) received 2-3 FP treatment sessions (Sellas; Dinona Inc., Seoul, Korea) spaced two weeks apart. Treatments were performed at settings of 7 to 9 mJ/microthermal treatment zone (MTZ) and a density of 1000 MTZ/cm2. Standardized digital photographs were obtained before each treatment and three months after the final treatment. The evaluations of clinical photographs were performed by three physicians blinded to the study subjects using a five-point grading scale. In addition, the patients' perceived degree of improvement was assessed three months after the final treatment using a five-point grading scale. Side effects were monitored at each follow-up visit.ResultsThe physicians' assessed degrees of improvement were excellent in three patients (12%), significant in ten (40%), and moderate in seven (28%). The patients' self-assessed degrees of improvement were excellent in five patients (20%), significant in 11 (44%), and moderate in six (24%). Adverse events were limited to transient pain, erythema and edema, except in one case of transient postinflammatory hyperpigmentation.ConclusionsFP is an effective treatment modality for reducing facial wrinkles with minimal side effects in Asian patients.

Immunohistochemical investigation of wound healing in response to fractional photothermolysis

Despite growing clinical evidence of ablative fractional photothermolysis (AFP), little is known about the spatiotemporal molecular changes within the targeted compartments. Six subjects received three different single AFP treatments using a scanned 250 mum CO(2)-laser beam. Spatiotemporal changes of skin regeneration were estimated by immunohistochemical investigation (HSP70, HSP72, HSP47, TGFbeta, procollagen III, CD3, CD20, and CD68) in skin samples 1 h, 3 days, and 14 days postintervention. The remodeling was uniformly started by regrowth of the epidermal compartment followed by partial to complete replacement of the microscopic ablation zones (MAZ) by newly synthesized condensed procollagen III. From day 3 to 14, the number of macrophages as well as giant cells surrounding the MAZ increased. TGFbeta expression was highest 1 h to 3 days following AFP. HSP70 and HSP72 expressions were highest 3-14 days postintervention in the spinocellular layer leading to an upregulation of HSP47. AFP performed by a scanned CO(2)-laser results in an early epidermal remodeling, which is followed by a dermal remodeling leading to a replacement of the MAZ with newly synthesized (pro)-collagen. During this, an inflammatory infiltrate with CD3(+) and CD20(+) cells surrounds the MAZ. The count of macrophages and giant cells involved in the replacement of the necrotic zones seems to be crucial for wound healing.

Treatment of scars with flexion contracture using carbon dioxide laser and fractional photothermolysis

Scars with flexion contracture of various origins are challenging problems which may cause not only cosmetic concerns, but also severe functional restriction. In this report, we describe a case presenting scars with flexion contracture: a 23-year-old Korean female with surgical scars on both axillae, which were treated by laser-cision (incision using carbon dioxide laser) with second intention wound healing followed by a non-ablative fractional photothermolysis system.

Efficacy of the Fractional Photothermolysis System with Dynamic Operating Mode on Acne Scars and Enlarged Facial Pores

Efficacy of the Fractional Photothermolysis System with Dynamic Operating Mode on Acne Scars and Enlarged Facial Pores

Efficacy of the Fractional Photothermolysis System with Dynamic Operating Mode on Acne Scars and Enlarged Facial Pores

Current treatments for acne scars and enlarged facial pores have shown limited efficacy. To evaluate the efficacy and safety of the fractional photothermolysis system (FPS) with dynamic operating mode on acne scars and enlarged pores. Twelve patients with mild to moderate atrophic acne scars and enlarged pores were included in this study. Three sessions of FPS treatment were performed for acne scars and facial pores monthly. Two blinded dermatologists who compared before and after photos based on a quartile grading scale conducted objective clinical assessments of acne scar- and facial pore-treated areas. We took a biopsy immediately after one treatment with the laser from one of the authors to assess the histologic effects of the laser on facial pores. Follow-up results at 4 months after the last treatment revealed that, of the 12 patients, for acne scars, five demonstrated clinical improvements of 51% to 75% and three demonstrated improvements of 76% to 100%, and for facial pores, five demonstrated moderate clinical improvements of 26% to 50% and three demonstrated improvements of 76% to 100%. Side effects, including pain, post-treatment erythema, and edema, were resolved within 1 week. We suggest that the FPS may provide a new treatment algorithm in some cases with acne scars and enlarged pores. Considering the lack of placebo-controlled, split-face design of our study, optimized, prospective studies should be conducted to fully assess the efficacy of FPS with dynamic operating mode.

TUNEL Assay for Histopathologic Evaluation of Irreversible Chromosomal Damage following Nonablative Fractional Photothermolysis

Fractional photothermolysis is extremely popular in skin rejuvenation and remodeling procedures. However, the extent of thermal cellular injury beyond the borders of the coagulated microcolumns produced with fractional phototherapy is undefined. Six abdominoplasty patients were pretreated with the Lux1540 Fractional Erbium device (Palomar, Inc., Burlington, Mass.) at various clinical laser settings. After tissue excision, the panni were immediately biopsied. Biopsy specimens were fixed in formalin, embedded in paraffin, sectioned, and evaluated with the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) procedure for cellular necrosis/apoptosis. Tissue was sectioned horizontally and longitudinally to help define the depth and distribution of the microcolumns of injury in a three-dimensional plane. The extent of cellular necrosis/apoptosis at variable depths within the epidermis and dermis was demonstrated successfully with the TUNEL technique. After the Lux1540 treatment, TUNEL-positive nuclei were identified in a vertically oriented fashion that extended from the epidermis into the papillary and reticular dermis, highlighting the areas of injury. The TUNEL-positive nuclei defined lesions that were approximately 175 to 225 microm in diameter and penetrated to variable depths (200 to 900 microm), depending on the fluence used for treatment (18 to 100 mJ). TUNEL immunofluorescent labeling provided an accurate assessment of cellular damage within and surrounding the microthermal zones of coagulated collagen with respect to column depth and width. Because of its specificity, the TUNEL assay can be a useful adjunct to other histologic stains used to characterize cellular damage and matrix denaturation in skin treated with any fractional ablative or nonablative laser device.