Laser Treatment Of Skin Research Articles

Laser–tissue interaction simulation considering skin-specific data to predict photothermal damage lesions during laser irradiation

Abstract This study aimed to develop a simulation model that accounts for skin-specific properties in order to predict photothermal damage during skin laser treatment. To construct a computational model, surface geometry information was obtained from an optical coherence tomography image, and the absorption coefficient of the skin was determined through spectrophotometry. The distribution of the internal light dose inside the skin medium was calculated using the light propagation model based on the Monte Carlo method. The photothermal response due to the absorption of laser light was modeled by a finite difference time domain model to solve the bio-heat transfer equation. The predicted depth and area of the damaged lesions from the simulation model were compared to those measured in ex vivo porcine skin. The present simulation model gave acceptable predictions with differences of approximately ∼10% in both depth and area.

Effect of the COVID-19 Pandemic on Nonsurgical Cosmetic Procedure Interest

The COVID-19 pandemic caused many shifts in the national economy, job market, and healthcare sector, especially elective procedures such as in cosmetic plastic surgery. While there has been research in the changes in cosmetic plastic surgery since the start of the COVID-19 pandemic, there have been no study to date determining the changes in distinct sectors, such as nonsurgical plastic surgery procedures and the popular trends that may be more sensitive to changes to general public interest. The Google Trends tool was used to determine these changes in interest. Nonsurgical procedures were retrieved from the American Society of Plastic Surgery (ASPS) website, grouped into categories, such as neurotoxin, chemical peel, filler, hair removal, dermaplaning, skin laser treatment, skin tightening, and thread lift, and used as Google Trends search terms. Search term weekly data were collected from March 2018 to March 2020 and March 2020 to March 2022, divided by the start of the COVID-19 lockdown, and compared. After the start of the COVID-19 pandemic, the majority of nonsurgical procedures showed an increase in interest, with the most significant changes including neurotoxin procedures especially lip Botox, filler in the chin, cheek, jawline, tear trough, lip, and nose, skin-improving treatments, non-invasive forms of body contouring, and thread lift. Brands like Dysport, Radiesse, Restylane, Sculptra, Versa, Emsculpt, and Morpheus8 showed increased interest. Most nonsurgical procedures increased in interest after the COVID-19 lockdown, with facial and skin-improving procedures showing the most increase in interest.

Evaluation of the effectiveness of laser treatment capillary malformation in children (systematic review)

Background. Capillary angiodysplasia is a common vascular malformation represented by an increase in the number of dilated capillaries of the skin. Being located in the face area, this defect contributes to the development of an inferiority complex in a child. Various methods are used for treatment, but all of them are not effective enough. Currently, the most effective and promising method is laser photodestruction.Aim. To study the efficacy and safety of laser treatment of skin сapillary angiodysplasia in children with various laser devices (PDL 585 nm, Nd:YAG 1064 nm, Nd:YAG/KTP 532 nm), based on a systematic review of modern literature for the period from 2000 to 2020.Materials and methods. A systematic review was conducted in foreign and Russian databases for the period from 2000 to 2020. Keywords were used for the search: capillary angiodysplasia, capillary malformation, wine stain, vascular malformation, laser treatment. Out of 1543 literature sources, 9 full-text articles are included in the review.Results. Comparing the results of treatment using different types of lasers, it was noted that a very good result was achieved in 33.8% of cases, good in 33.7%, average in 20.4%, no effect in 1.2%. The total number of complications was 62 cases (9.5%): hyperpigmentation in 32 patients, scars in 15 cases, hypopigmentation in 12, skin atrophy in three.Discussion. The conducted systematic review indicates the effectiveness and disadvantages of using various laser radiation for the treatment of capillary angiodysplasia of the skin. The articles lack information on the relationship between the effectiveness of treatment from morphological and hemodynamic features of vascular formations and the selectivity of laser radiation to skin chromophores.Conclusion. It is necessary to conduct research to select the optimal laser radiation, taking into account the morphological and hemodynamic features of capillary angiodysplasia, which will ensure minimal skin damage and improve treatment results.

Safety and Effectiveness of Penles<sup>®</sup> Tape 18 mg (Lidocaine) for Pain Relief in Skin Laser Treatment (Drug Use-results Survey)

Safety and Effectiveness of Penles<sup>®</sup> Tape 18 mg (Lidocaine) for Pain Relief in Skin Laser Treatment (Drug Use-results Survey)

Non-Ablative Fractional Laser to Facilitate Transdermal Delivery

The advances in laser technology have led to its rapidly expanding applications in dermatology. This study aims at the novel use of a non-ablative fractional laser to enhance transdermal permeation of diclofenac sodium and sumatriptan succinate. The effects of the laser on skin were characterized visually with dye binding, scanning electron microscopy, pore permeability index, and histology. In vitro transdermal permeation of drugs through laser treated and untreated human dermatomed skin was analyzed over 24 h and quantified by HPLC. Drug transport through untreated skin resulted in transdermal delivery of 72.61 μg/cm2 ± 50.35 and 22.80 ± 0.64 μg/cm2 of diclofenac sodium and sumatriptan succinate, respectively. Laser treatment of skin significantly increased (p < 0.005) delivery of diclofenac sodium to 575.66 ± 207.18 μg/cm2 and sumatriptan succinate to 498.32 ± 97.54 μg/cm2. This is a first of its kind study that demonstrates the use of 1410 nm non-ablative fractional laser to enhance transdermal permeation of 2 small molecular weight drugs.

Gene Profiling Analysis of the Early Effects of Ablative Fractional Carbon Dioxide Laser Treatment on Human Skin

The use of carbon dioxide (CO2) laser-mediated ablative fractional resurfacing (AFR) is currently under extensive clinical investigation, but the molecular mechanisms underlying this process are unclear. To determine the early expressed genes that are upregulated in human skin after treatment using a CO2 fractional laser. Whole human skin was irradiated using an AFR CO2 laser, and changes in gene expression after 2 and 24 hours were analyzed using microarray analysis. The results were validated using reverse transcriptase polymerase chain reaction (RT-PCR). Laser scanning confocal microscopy (LSCM) was used to investigate the expression of the validated proteins after AFR CO2 laser treatment of skin that had been biopsied from seven Korean patients. Gene expression profiling showed that the most significantly upregulated genes in these skin samples were those encoding Wnt5a, cysteine-rich angiogenic inducer 61 (CYR61), and heat shock protein (HSP) 90. These results were confirmed using real-time RT-PCR and LSCM. Irradiation using an AFR laser may induce the expression of Wnt5a, CYR61, and HSP90 in human skin during the early remodeling phases, suggesting that the induction of proteins may be the preceding event that is associated with the clinical effects of laser treatment.

Perioperative effects of oral midazolam premedication in children undergoing skin laser treatment: a double-blinded randomized placebo-controlled trial

To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital. Ninety children, candidates for skin laser treatment were randomly assigned to 1 of 3 groups of 30 each: the placebo group received 0.1 ml/kg orange flavored juice, group 2 and 3 receiving 0.5 and 1 mg/kg of injectable midazolam mixed with an equal volume of orange juice, respectively. The main outcome measures included the mask acceptance, patients' behavioral scales and postoperative events. There were no significant differences in heart rate, respiratory rate, and systolic blood pressure among the three groups. However, arterial oxygen saturation was significantly reduced in those given 1 mg.kg(-1) midazolam. The median scores of anxiety, separation from parent, preparing an intravenous line, acceptance of the oxygen mask, good sedation, crying reduction and consciousness level were better in midazolam group. Postoperative agitation and re-crying were also more frequent in placebo receivers. Those given 1 mg.kg(-1) midazolam were significantly more optimal for sedation, crying, consciousness, preparing an intravenous line, and postoperative re-crying compared with 0.5 mg.kg(-1) midazolam receivers. As a preanaesthetic medication, the 1 mg.kg(-1) dose of orally given midazolam especially in a volume of orange juice and can optimize the children's behavior during skin laser treatment with no serious adverse effects, enhancing their parents' satisfactions about the sedative protocol.

Calcitonin Transport through Skin Using Iontophoresis

The objective of this work is to study transdermal delivery of calcitonin using iontophoresis and to evaluate various factors which affect the transdermal transport. We have studied the effect of polarity, current density, drug concentration, penetration enhancers (isopropyl myristate [IPM] and ethanol) and laser treatment on transdermal flux and the results were compared. We also investigated the iontophoretic flux from microemulsions containing calcitonin together with oleic acid (OA) or IPM. In vitro flux study was performed at 33oC, using side-by-side diffusion cell and full thickness hairless mouse skin. Anodal delivery at pH 3.0 was much larger than cathodal and passive delivery, due to the positive charge of calcitonin. Cumulative amount delivered (CUM) by cathodal or passive delivery was close to zero for 10 hours. The pretreatment of skin by neat IPM markedly increased the CUM anodically. CUM increased as the current density, drug concentration or the duration of IPM treatment increased. Microemulsion containing IPM or oleic acid was prepared and the phase diagram was constructed. CUM also increased when IPM was incorporated into a microemulsion. OA microemulsion showed similar enhancing effect to IPM microemulsion. The delivery of calcitonin from 70% (v/v) ethanol aqueous solution showed a large increase in flux. Laser treatment of skin before flux experiment exhibited about 2 fold increase in total calcitonin amount transported for 12 hours, when compared to that delivered by IPM microemulsion. Based on these results, we have evaluated the possibility of delivering enough amount of calcitonin to reach the therapeutic level. The data suggest that it is highly possible to deliver clinically effective amount of calcitonin using iontophoresis patch with small area (<10 cm2).

Connective tissue response to fractionated thermo‐ablative Erbium: YAG skin laser treatment

Indications for and prevalence of laser therapies with a fractionated laser beam have risen significantly. However, as of yet, little is known about the underlying molecular changes, especially with respect to dermal extracellular-matrix remodelling, wound healing and inflammation. This study aimed at the investigation of the connective tissue response of sun-damaged skin following fractionated laser treatment. Seven patients received a laser therapy on the lateral side of the neck of wrinkles grade III-IV (Glogau scale) using a fractionated thermo-ablative erbium yttrium aluminium garnet (Er:YAG) laser (2940 nm, BURANE XL; Quantel Derma, Erlangen, Germany). Skin biopsies were taken at baseline from untreated skin, 1 and 6 weeks after laser intervention to investigate hyaluronan (HA), collagen-I (Coll-I) and collagen-III (Coll-III) remodelling as well as alteration of matrix metalloproteinase 1 expression (MMP-1). To address this issue, HA synthesizing (HA synthetases, HAS) and degrading (hyaluronidases, HYAL) enzymes were measured at mRNA-level using a real-time PCR. Furthermore, immunohistochemical staining for HA was performed by using the HA binding protein (HAbP) and for Coll-I, Coll-III and MMP-1 by using monoclonal antibodies. The degree of inflammation was correlated descriptively. Our findings were that at the two examined read out points, HAS and HYAL showed a slight response alluding to HA synthesis under minimal signs of inflammatory reaction. Concordantly, although to a varying degree, an increase in the HA content of the skin after laser treatment could be detected by immunhistochemistry. During remodelling, Coll-I, Coll-III and MMP-1 showed a cyclic course with a peak after 1 week. Conclusively, our results indicate a light alteration of the HA metabolism towards synthesis and a transient collagen neogenesis caused by a single fractionated thermo-ablative laser skin intervention. Clinical improvement might be attributed to synergistic effects between collagen neogenesis and the water binding capacities of HA and its influence on skin contraction and remodelling.

Port-wine vascular malformations and glaucoma risk in Sturge-Weber syndrome

Treatment of the capillary vascular malformation (port-wine stain) in Sturge-Weber syndrome with the use of a laser is helpful cosmetically. However, concerns have been raised that laser obliteration of port-wine stains may result in ocular hypertension. The aim of this study was to review clinical features and management of ocular complications of SWS and assess the effects of dermatological laser treatment on the incidence of glaucoma or ocular hypertension. This retrospective cohort study was conducted in an institutional setting. All patients had involvement of the face. Patients who underwent skin laser to the port-wine vascular malformation were analyzed further. Ocular involvement, glaucoma, and skin laser treatment and the relationship to ocular hypertension/glaucoma were observed. Forty-one Sturge-Weber syndrome patients with port-wine vascular malformation were analyzed. Glaucoma was observed in 24 patients (58.5%) at mean age of 2.9 years (range, 0.0-16.5). Of these, 18 (75.0%) were treated with medical therapy, and 10 (41.7%) required trabeculectomy, with 2 of these requiring Seton implant. Of the 41 patients, 28 (68.3%) underwent laser to face/forehead. Mean age of laser commencement was 5 years (range, 0.4-16.5). Thirteen did not undergo laser treatment. Fourteen of the 28 and 10 of the 13 developed ocular hypertension/glaucoma. This retrospective review did not find evidence to suggest that laser treatment of port-wine vascular malformations causes glaucoma or that it can worsen a preexisting ocular hypertension or glaucoma. Statistical analysis was inconclusive.

Audit cycle of documentation in laser hair removal

Lasercare clinics are one of the largest providers of skin laser treatment in the United Kingdom, in both private sector and National Health Service. Laser hair removal is performed by trained nurses following written protocols. Choice of laser and fluence is tailored to Fitzpatrick skin type. We audited and re-audited documentation of six criteria in patients receiving laser hair removal (signed consent, Fitzpatrick skin type, use of appropriate laser, appropriate fluence, patient satisfaction and objective assessment) across 13 clinics at different points in time. Data were obtained on 772 treatments. Overall findings revealed excellent documentation of consent, use of appropriate laser and fluence (median 100%), good documentation of skin type (median 90%) and poor documentation of patient satisfaction and objective assessment (median 67% and 53%, respectively). Comparison between baseline and repeat audit at 6-8 months (nine clinics) showed significant improvement across clinics in these latter two criteria [patient satisfaction: odds ratio (OR) 0.38, 95% confidence interval (CI) 0.15-0.78, P=0.01; objective assessment: OR 0.23, 95% CI 0.07-0.50, P=0.0003 (Mantel-Haenszel weighted odds ratios)]. We conclude that quality of documentation was generally and consistently high in multiple clinics and that re-auditing led to significant improvement in poor scores. This simple measure could easily be implemented more widely across many disciplines.

Scatter‐limited phototherapy: A model for laser treatment of skin

To effectively deliver laser light into the skin for non-ablative resurfacing, hair removal, and other applications, one must account for scatter, absorption, and thermal diffusion. A novel method to control the penetration of laser light into tissue is proposed. This method uses the incident beam diameter, the pulse duration, and the intrinsic light scattering of tissues such as skin to limit the laser light penetration and thermal damage. We term this innovative laser delivery concept 'scatter-limited phototherapy'. This study demonstrates how the delivery mechanism simplifies the non-ablative treatment of sun-damaged skin. Calculations are based upon Gaussian scatter of light and isotropic thermal diffusion. Calculations of light distribution and profiles of temperature increase are created. Using an optical fiber delivery system with the appropriate diameter, coupled with skin surface protection, one can create thermal damage at a given depth with preservation of the epidermis. Scatter-limited phototherapy is a predictive model, allowing one to design better laser delivery systems. Scatter-limited phototherapy should also be applicable to other fields of dermatologic surgery, such as hair removal and the treatment of vascular lesions. Additionally, other medical specialties will be able to use the concept of scatter-limited phototherapy to predict and better understand laser-tissue interactions.