Glass Fractional Laser Research Articles

The efficacy of enoxolone in reducing erythema and pain after laser treatment: A randomized split-face pilot study.

Enoxolone, derived from licorice, possesses potent anti-inflammatory, and antioxidant properties. However, its effectiveness in alleviating post-laser reactions has not been extensively studied. This randomized split-face pilot study aimed to evaluate the effects of enoxolone on skin following laser treatment. Ten healthy subjects underwent non-ablative 1550 nm Er:Glass fractional laser treatment and then randomly applied a moisturizer without enoxolone on one side of the face and a dermo-cosmetic formular containing 2% enoxolone mixed with the same moisturizer on the other side. The erythema index (EI), clinician's erythema assessment (CEA), and pain scores were recorded at 30 min, 60 min, and 24 h posttreatment. The group treated with enoxolone showed significantly lower EI and CEA compared to the control group at 24 h posttreatment. Additionally, pain scores were notably reduced in the enoxolone-treated group 30 min after treatment. This study suggests that dermo-cosmetic formular containing 2% enoxolone is effective in reducing erythema and pain following laser treatment.

Treatment of striae albae with 1,550 nm Er: Glass vs. CO2 fractional laser: A self-controlled study.

The objective of this study was to compare the efficacy and safety of fractional CO2 laser and 1,550 nm Er: glass laser in the treatment for the patients with striae albae. The female adults with striae albae in the abdomen for at least 12 months were recruited. After informed consent obtained, the patient received three treatments at 2-month intervals. The lesions on the left abdomen were treated with 10,600 nm CO2 fractional laser and right side treated with 1,550 nm Er: glass fractional laser. The pictures were taken before each visit and 3 months after the final treatment. The criteria for the evaluations using a quartile grading scale were excellent (76-100%), good (51-75%), fair (26-50%), poor (1-25%), and no improvement (0%). The safety and efficacy of the two lasers were independently evaluated using before and after photographs by two dermatologists. In addition, the self-reports to investigate the pain and satisfaction from patients were also recorded. Totally, 27 cases were recruited, and 25 patients completed the treatments and follow-up. The excellent and good results (improvement of 51-100%) were achieved on the right abdomen in 84% of the patients, while 48% on the left site (p < 0.05). Hyper-pigmentation was seen in 20% of the patients assessed on the left abdomen and only in 8% on the right abdomen. During the treatments, average score of the pain on the right abdomen was 5.41 ± 2.13, which was higher than that on the left (4.19 ± 2.12) (p < 0.001). No permanent hyper-pigmentation was found on the both sides. Considering the whole treatments, the patients favored the modality used on the right side (80 vs. 68%, p < 0.05). Compared with CO2 fractional laser, 1,550 nm Er: glass fractional laser therapy provides the significantly better clinical outcomes and fewer side effects in the treatment of striae albae. The sample size and follow-up time were limited.

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

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.

优化强脉冲光联合1 565 nm非剥脱点阵激光改善面部光老化随机半脸对照研究

Objective To evaluate the safety and efficacy of the combined treatment with an optimized intense pulsed light (IPL) and a non-ablative fractional laser (NAFL) for facial rejuvenation. Methods A prospective, split-face, randomized, controlled study was conducted. A total of 22 testees with facial photoaging, who aged from 35 to 55 years, were enrolled into this study from the Department of Dermatology of Peking University First Hospital between March and June in 2017. By a random number table, the two sides of each testee′s face were randomized to receive combined treatment with optimized IPL immediately followed by non-ablative 1 565 nm Erbium:Glass fractional laser (combined treatment group) or non-ablative 1 565 nm Erbium:Glass fractional laser alone (NAFL group) once every month for 3 sessions. Before the treatment, 60 and 90 days after the treatment (1 month after the second and third treatment respectively) , photos of the treatment regions were taken, skin physiology parameters (including skin melanin, erythema indices, water content of the stratum corneum, transepidermal water loss[TEWL],skin flexibility and glossiness) were measured, and subjective and objective clinical evaluation was carried out. After each treatment, adverse reactions were assessed by two dermatologists independently, including facial erythema, swelling and crusting, desquamation, pigmentation and pains. Results During the treatment course, 1 testee dropped out due to pains, another 1 testee dropped out for personal reasons, and 20 testees completed the treatment and follow-up. The combined treatment group showed significantly decreased melanin indices on days 60 and 90 (152.9 ± 36.9 and 155.0 ± 38.1, respectively) compared with that before the treatment (168.4 ± 41.3, F= 5.321, P 0.05) . No significant difference was observed between the pre-and post-treatment erythema indices in either of the two groups (both P > 0.05) . The water content of the stratum corneum on days 60 and 90 significantly increased compared with that before the treatment in both the combined treatment group (F= 21.795, P 0.05) . On days 60 and 90, the combined treatment group and NAFL group both showed significantly increased skin flexibility (P<0.05, 0.001, respectively) and glossiness (both P<0.001) compared with those before the treatment. On day 90, the skin glossiness in the combined treatment group was higher than that in the NAFL group (P<0.05) . The short-term adverse reactions included transient pain, erythema and swelling which lasted 2-3 days, and slight desquamation. The main adverse reaction was mild local pigmentation, which lasted 2-3 months and then subsided gradually. Conclusion The 3 sessions of treatment with an optimized IPL immediately followed by a 1 565 nm NAFL is clinically superior to those with the NAFL alone for improving the facial pigmentation and skin glossiness, and the adverse reactions are usually transient and mild. Key words: Skin aging; Laser therapy; Treatment outcome; Non-ablative fractional laser; Intense pulsed light; Combination therapy

Efficacy of nonablative fractional laser in the treatment of striae gravidarum: a clinical observation

Objective To assess the efficacy and safety of nonablative 1 565-nm Er:Glass fractional laser in the treatment of striae gravidarum. Methods The left and right sides of the abdomens of 30 subjects with striae gravidarum were divided into 2 groups by simple randomization: treatment group treated with nonablative 1 565-nm Er:Glass fractional laser every 4 weeks for 3 sessions, and control group receiving no treatment. These subjects were followed up at the baseline, 4th, 8th and 12th week. At the same time, photos were taken, the skin flexibility was evaluated, and the width of striae was measured. Four weeks after the final treatment, clinical improvement was evaluated by 2 doctors, who were blind to the therapeutic protocol, according to clinical photos and three-dimensional (3D) images, and satisfaction scores were also evaluated. Skin biopsies were taken from the left and right sides of the abdomens of 3 subjects, and subjected to histopathological examination. Four months after the final treatment, all the subjects were telephoned for evaluation of adverse reactions and recurrence. Results A total of 27 subjects completed the whole trial. Four weeks after the final treatment, 25 (92.6%) of the 27 subjects were considered to achieve an improvement by doctors. However, 21 (77.8%) of the 27 subjects considered themselves to achieve an improvement. After 3 sessions of treatment, the treatment group showed a significant decrease in the largest width of striae from 4.852 mm to 3.296 mm (P < 0.001) and a significant increase in skin flexibility from 0.803 to 0.878 (P < 0.001) . Histopathologically, the control group showed obviously atrophic epidermis and decreased collagen and elastin in the dermis, while the treatment group showed thickened epidermis and dermis, extended rete ridges, and increased collagen and elastic fibers which arranged more regularly. Immediate adverse reactions during the treatment included erythema and edema, and other adverse reactions included mild crust, itching and post-inflammatory hyperpigmentation (PIH) . PIH was improved at 4 months after the final treatment compared with that at 4 weeks after the final treatment. Conclusion The nonablative 1 565-nm Er:Glass fractional laser can markedly improve the width and appearance of striae gravidarum, and increase skin flexibility in the treatment region. Key words: Laser therapy; Treatment outcome; Safety; Striae gravidarum; 1565 nm Er:Glass fractional laser

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.

Lasers in the treatment of acne.

Acne is a chronic disease of the pilosebaceous units, presenting as inflammatory or noninflammatory lesions, affecting primarily the face but also the back and chest. The mainstay of treatment remains topical retinoids, benzoyl peroxide, azelaic acid, antibiotics, and isotretinoin, many of which result in poor compliance, lack of durable remission, and incur adverse effects. The use of lasers to treat acne is continuously increasing because of their minimal complications, limited number of office-based treatments required, potential benefits of simultaneously treating acne scarring, and the rapid onset of results. The 1450 nm diode laser, 585- and 595-nm pulsed dye lasers (PDLs), near infrared diode lasers, 1320 nm Nd:YAG laser, 532 nm potassium titanyl phosphate laser, 1064 nm long-pulsed Nd:YAG laser, 1540 nm Erbium (Er):Glass Laser, and the 1550 nm Er:Glass fractional laser are among the most common lasers used to treat acne and acne scarring. These lasers target the underlying causes of acne including the colonization of Priopionibacterium acnes, high levels of sebum production, altered keratinization, inflammation, and bacterial colonization of hair follicles on the face, neck, and back. We review the efficacy and side effect profiles of various lasers used to treat acne.

The long-term effect of 1550 nm erbium:glass fractional laser in acne vulgaris.

We evaluated the short-term and long-term effects of the 1550 nm erbium:glass (Er:glass) fractional laser in the treatment of facial acne vulgaris. Forty-five (9 male and 36 female) acne patients were treated 4 times at 4-week intervals with the following parameters: 169 spot density and 15-30 mJ/cm(2) fluence. There was no control group. The laser spots were adjustable (maximum overlap: 20%) according to the treatment area, and delivered in rows in order to cover all the face. Clinical photographs were taken. The IGA scores and lesion counts were performed for each treatment. Their current state was obtained by phone call follow-up to determine the long-term effect and photographs were offered by themselves or taken in hospital. After four treatments, all patients had an obvious reduction of lesion counts and IGA score and the peak lesion counts decreased to 67.7% after the initial four treatment sessions. For long-term effect, 8 patients lost follow-up, hence 37 patients were followed-up. 8 patients were 2-year follow up, 27 at the 1-year follow-up, and all patients at the half-year follow-up. The mean percent reduction was 72% at the half-year follow-up, 79 at the 1-year follow-up and 75% at the 2-year follow-up. Side effects and complications were limited to transient erythema and edema, and few patients suffered from transient acne flare-ups and sensitivity. All patients responded that their skin was less prone to oiliness. In conclusion, acne can be successfully treated by 1550 nm Er:glass fractional laser, with few side effects and prolonged acne clearing.

Treatment of cosmetic tattoos with nonablative fractional laser in an animal model: A novel method with histopathologic evidence

Cosmetic tattoos are difficult to treat using Q-switched lasers. We introduce a novel method for the treatment of cosmetic tattoos using a nonablative fractional laser and investigate the underlying pathophysiological mechanisms in an animal model. Ten rats were tattooed on their backs with white and flesh-colored pigments. One-half of each tattoo was treated with a 1,550-nm, erbium:glass fractional laser system with energy settings of 17 mJ and 169 MTZ/cm(2) × 2 passes for five sessions at 1-month intervals. The untreated half of each tattoo served as the control. An independent physician reviewed the photographs and scored the clinical response. Serial skin samples were obtained at baseline and at various times after laser treatment. These tissue sections were stained with hematoxylin and eosin, and immunostained for types I, III, and IV collagen; laminin; fibronectin; and α-smooth muscle actin. White tattoos showed excellent responses in two rats and good responses in eight rats, whereas flesh-colored tattoos showed excellent responses in four rats and good responses in six rats (P = 0.001 in both cases compared with baseline). Both tattoos exhibited a similar clearance rate (P > 0.05) and histological reactions. Microscopic epidermal necrotic debris (MEND) containing tattoo pigments and collagen fibrils appeared on day 1, increased on day 2, and was exfoliated after 5 days. The dermal-epidermal junction lost integrity 30 minutes after treatment, but recovered completely on day 3. The expression of fibronectin and collagen-III, which play key roles in wound healing, increased around the microscopic treatment zone on days 1-5 and 4-7, respectively. A few myofibroblasts appeared on days 4-7. Nonablative fractional lasers (NAFLs) successfully remove cosmetic tattoos by transepidermal elimination of tattoo pigments through the disrupted dermal-epidermal junction. This action is facilitated by the wound healing process.

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.

Comparison of a 1,550 nm Erbium:Glass fractional laser and a chemical reconstruction of skin scars (CROSS) method in the treatment of acne scars: A simultaneous split‐face trial

Acne scarring is a common complication of acne but no effective single treatment modality has been developed. To compare the efficacy of 1,550 nm Er:Glass fractional laser and chemical reconstruction of skin scar (CROSS) method in the treatment of acne scars. A split-face trial was conducted in 20 patients (10 rolling, 10 icepick types) with acne scars. One side was treated with the 1,550 nm Er:Glass fractional laser three times with a 6-week interval. And the other side was treated with CROSS method two times every 12 weeks. Significant improvement was observed in both sides of the face. In rolling type, the objective and subjective improvement rates were significantly higher in the sides treated with laser than CROSS method. However, in icepick type, there were no statistically significant differences between the two treatment sides. In the laser sides, grades of pain were significantly higher than that of treated with CROSS method. However, downtimes and lasting days of erythema were significantly longer in the sides treated with CROSS method. A 1,550 nm Er:Glass fractional laser and CROSS method are both well-tolerated and effective treatment options in the acne scars. However, there was a relatively small difference between the two treatment modalities. Therefore, dermatologists should consider the acne scar type to select the treatment options. Lasers Surg. Med. 41:545-549, 2009. (c) 2009 Wiley-Liss, Inc.

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.

The effect of Er: glass fractional laser and chemical reconstruction of skin scar (CROSS) method in treatment of acne scars: A simultaneous split-face comparison study

The effect of Er: glass fractional laser and chemical reconstruction of skin scar (CROSS) method in treatment of acne scars: A simultaneous split-face comparison study