Q-switched Ruby Laser Research Articles

Platelet-Rich Plasma Injection Combined With Q-Switched Ruby Laser in the Treatment of Periorbital Hyperpigmentation.

Periorbital hyperpigmentation is a prevalent skin condition that represents a large quantity of cases seen in cosmetic dermatology. Patients tend to be left with pigmentation after Q-switched ruby laser treatment, especially the perioribital area. The study is conducted to compare the effect of PRP injection combined with laser therapy versus laser alone for periorbital hyperpigmentation treatment. In this single-center, case-control study, 30 patients with periorbital hyperpigmentation were allocated to receive PRP injection injection after Q-switched ruby laser or Q-switched ruby laser only, followed by a 12-week and 24-week follow-up visit. Visual analogue scale, Sadick tear trough rating scale, and patients' self-evaluation were used to evaluate the therapeutic effect. The combined group achieved a better improvement in long-term effect and had effect on facial rejuvenation. Patient satisfaction was higher in the combined group. Erythema and mild pain were the most common adverse reactions of both groups. Combining with PRP injection can improve the therapeutic effect of Q-switched ruby laser in treating periorbital hyperpigmentation and lessen the risk of post-inflammatory hyperpigmentation, indicating a new option for POH treatment.

Drug-Induced Pigmentation: A Review.

Drug-induced pigmentation (DIP) is estimated to account for 20% of all cases of acquired hyperpigmentation. Over 50 agents have been implicated, including antibiotics, antimalarials, antiretrovirals, antipsychotics, prostaglandin analogs, heavy metals, and chemotherapeutic agents. The skin, mucosal surfaces, nails, and hair can all be affected, with the color, distribution, onset, and duration of pigmentation varying between offending agents. Both a thorough physical examination and medication history are necessary to determine the offending agent. In terms of mechanism, DIP occurs most frequently through the accumulation of melanin within the dermis but also by drug accumulation, pigment synthesis, and iron deposition. Photoprotection, including applying a broad-spectrum sunscreen, wearing photoprotective clothing, and seeking shade, plays an important role in the prevention of exacerbation of DIP. Multiple lasers, including the picosecond alexandrite, Q-switched Nd:YAG, Q-switched alexandrite, and Q-switched ruby lasers, have been successful in obtaining clearance of DIP. In this review, we examine the unique characteristics of each of the inciting agents in terms of incidence, clinical presentation, time to onset and resolution, and pathogenesis.

Early Treatment of Nevus of Ota in Children is More Effective and Beneficial to Mental Health: Observation on the Efficacy of Q-Switched Ruby Laser in Treating 159 Cases of Nevus of Ota in Children.

Nevus of Ota (NO), also known as "brownish-blue nevus of the palate of the eye", is a benign dermal pigmentation that increases skin disease. The Q-switched ruby laser is a classic treatment for nevus of Ota in children, but the optimal age for treatment is still controversial. The aim of this study was to investigate the treatment effect of Q-switched ruby laser in children with nevus of Ota at different ages and the effect on psychological health status. Children with nevus of Ota treated with Q-switched ruby laser in the Department of Dermatology of the Second Affiliated Hospital of Wenzhou Medical University from June 2015 to June 2019 were retrospectively analysed. And the mental health status was assessed using the CDI scale. In the preschool children group (0-7 year age), the significant efficacy rates was 93.1%, the average number of treatments was 3.6, and the overall incidence of adverse reactions was 4.7%. The significant efficacy rates in the school-age children group (7-14 year age) was 90.3%, the average number of treatments was 5.1, and the overall incidence of adverse reactions was 13.7%. The mean post-treatment CDI score in the preschool children group was 10.8, and 9.7% of children exceeding 19 points. The mean pre-treatment CDI score in the school-age children group was 17.3, and 24.6% of children exceeding 19 points. The mean post-treatment CDI score was 13.6 and 15.1% of children exceeded 19 points. The chi-square test for the significant efficacy rate of the two groups showed P>0.05, which was not statistically significant. The significant efficacy rate of the preschool group and that of the school-age children group. The t-test for the number of treatments in the two groups showed P<0.05, which was statistically significant. Adverse reactions in the two groups showed a statistically significant P<0.05. The mean CDI scores and the percentage of depressed individuals in the school-age children group were significantly lower after treatment than before treatment (p<0.05). Q-switched ruby laser is safe and effective in treating nevus of Ota in children. Early treatment can reduce the number of treatments and the incidence of adverse reactions. In addition, early treatment can reduce children's depression, which is beneficial to mental health.

Transvascular delivery of talaporfin sodium to subcutaneous tumors in mice by nanosecond pulsed laser-induced photomechanical waves

BackgroundWe previously developed a site-specific transvascular drug delivery system (DDS) based on photomechanical waves (PMWs) or laser-induced stress/shock waves (LISWs). In this study, we investigated the validity of this method to deliver a clinical photosensitizer, talaporfin sodium (TS), to subcutaneous tumors in mice and to enhance the efficacy of photodynamic therapy (PDT). MethodsTS solution (2.5 mg/kg) was intravenously injected into mice. Immediately thereafter, PMWs were applied to the tumor by irradiating a laser target with a Q-switched ruby laser pulse (0.8 J/cm2). Five hours after TS administration, some tumors were excised to evaluate the depth distribution of the delivered TS under a fluorescence microscope. Other tumors were subjected to PDT by irradiating the tissues with a 665 nm continuous-wave laser diode (75 mW/cm2, 667 s) at this timepoint. The effects of PDT were evaluated on the basis of the two primary therapeutic mechanisms of TS-mediated PDT: i) damage to tumor cells and ii) damage to endothelial cells of tumor vessels, i.e., the vascular shutdown effect on tumors. ResultsPMW application significantly increased the accumulation of TS in the tumor parenchyma but not in the tumor vessel walls; the endothelial cell junctions of tumor vessels should be the route of TS delivery enhanced by PMWs. Thus, as a result of PMW application followed by PDT, while the vascular shutdown effect on the tumors was not enhanced, direct damage to the tumor cells was increased, resulting in significant tumor growth retardation without body weight loss for 7 days after treatment.

Q-switched ruby laser is safe and effective in treating primary gingival hyperpigmentation.

Physiologic gingival hyperpigmentation (PGH) is a benign condition that results from increased melanin production and is prevalent among darker skin individuals. Although the use of lasers for PGH has gained popularity in recent years, the lasers being used are mostly ablative, and act through a non-selective tissue damage mechanism. The objective of this study was to evaluate the use of a non-ablative 694-nm Q-switched ruby laser (QSRL) for the depigmentation of PGH. A retrospective single-center study of patients diagnosed with PGH and treated with a QSRL Between March 2019 and November 2020. Four patients were treated with QSRL for 1-3 sessions, until complete depigmentation was achieved. The average follow-up was 11 months (range 7-18 months) with no patient exhibiting re-pigmentation. Adverse events included mild local tenderness and transient erosions in two patients. The 694-nm QSRL is a novel and promising safe and effective method for treating PGH with the advantages of being a non-ablative modality that minimizes tissue damage and optimizes the outcome.

Comparison of a single treatment with a Q-switched ruby laser and a Q-switched Nd:YAG neodymium laser for blue and black tattoo removal

BACKGROUND: Black and blue tattoo pigment are the most commonly used colors and can be injected at different depths. The effectiveness of tattoo removal is related to the selected wavelength, type of laser, energy parameters, number of procedures performed. Q-switched (QS) ruby and neodymium (Nd:YAG) lasers are most effective in removing blue and black tattoos due to their high peak power and ability to break the pigment into small particles that are absorbed by the macrophage system. In the literature available to us, it was not possible to find data on comparative efficacy and adverse events in their application.&#x0D; AIM: comparison of single treatment of blue and black tattoos with QS ruby laser (wavelength 694 nm) and neodymium Nd:YAG laser (wavelength 1064 nm).&#x0D; MATERIALS AND METHODS: 35 patients with blue and black tattoos were included in our study. The tattoos were divided into two parts or two adjacent tattoos were used on the same part of the body with the same density and color of the tattoo pigment; one side was treated with a ruby laser and the other with a neodymium laser. The comparison took into account the instantaneous reaction, the result of processing and side effects. Statistical significance was set at a power level 0.05.&#x0D; RESULTS: Edema and erythema were more common immediately after ruby laser treatment (power 0.05). The neodymium QS laser lightened tattoos better than the ruby QS laser after a single treatment (0.05 power). There was no difference in side effects between the two types of lasers.&#x0D; CONCLUSIONS: Neodymium Nd:YAG QS laser shows more efficiency and fewer procedures when removing blue and black tattoos. The instantaneous reaction after treatment with this type of laser is less pronounced than after the ruby laser.

Treatment of melasma using a combination of CO2 laser and Q-switched ruby laser

Treatment of melasma using a combination of CO₂ laser and Q-switched ruby laser

Iron oxide nanoparticles coated with polydopamine as a potential nano-photothermal agent for treatment of melanoma cancer: an in vivo study.

Melanoma is a metastatic cancer resistant to a wide range of therapies, including standard chemotherapy and radiation therapy, and cannot be treated with existing treatments owing to its intrinsic drug resistance. In terms of convenience and cheap cost of fabrication, one of the novel treatments is using polydopamine-coated iron oxide nanoparticles (IONs@PDA). Iron oxide nanoparticles (IONs) were synthesized (7.36nm) and coated with polydopamine (15-20nm). To examine the effect of photothermal ablation in melanoma cells (B16-F10), a Q-switched ruby laser (λ = 694nm, spot size = 4mm, output power = 5J/s) was used. The prepared nanoprobe was applied to mice, and their survival after treatment was evaluated. Then histopathological studies were done on the livers and skins of the treated mice. The nanoparticles absorb the laser, raising the temperature and initiating photothermal treatment, with significant apoptosis (74%) after the 4th time of treatment. Photothermal therapy (PTT) by using IONs@PDA proved to be effective in the treatment of melanoma cells (tumor size of < 2mm) without side effects. The lifespan of mice was significantly increased in a group of mice post-administered IONs@PDA and laser ablation. The fabricated nanoprobe (IONs@PDA) enhanced the melanoma cell apoptosis in the mice model, and it has promise for the treatment of melanoma (B16-F10) cells using photothermal therapy.

Successful Treatment of Pigmented Fungiform Papillae of the Tongue With Q-switched Ruby Laser.

Successful Treatment of Pigmented Fungiform Papillae of the Tongue With Q-switched Ruby Laser.

In vivo harmonic generation microscopy for monitoring the height of basal keratinocytes in solar lentigines after laser depigmentation treatment.

The development of solar lentigines (SLs) is related to chronic ultraviolet exposure-induced cell senescence. We have previously demonstrated that basal keratinocyte enlargement is a morphological hallmark of skin senescence correlated to the process of skin aging, while clinical studies on the long-term monitoring of the cellular morphological changes in SLs after laser treatment are lacking. In this study, we have developed the harmonic generation microscopy (HGM) for in vivo monitoring the height of basal keratinocytes (HBK) and had administered Q-switched ruby laser or picosecond 532-nm Nd:YAG laser treatment on each side of the face of 25 Asian patients with facial SLs, respectively. In vivo HGM imaging was conducted to longitudinally analyze HBK and the horizontal cell size (HCS). Before treatment, the HBK was significantly higher in the SLs lesional area than that in the adjacent normal region, whereas there was no significant difference in the HCS. After treatment, the lesional HBK remained significantly higher than normal skin regardless of the laser treatment used. Our study indicates that the basal keratinocytes remain abnormal after laser treatment and demonstrates the capability of in vivo HGM for longitudinal, quantitative monitoring of cell senescence and therapeutic effect in SLs.

Q-switched Ruby laser alone or in combination with topical flutamide for the treatment of Becker nevus syndrome; a randomized clinical trial

Background: Becker’s nevus syndrome (BNS) is a benign hamartoma that is aesthetically bothersome and usually appears during puberty. Various modalities of laser therapy alone or in combination with other medications can be used for the treatment of BNS, but no unified approach with an acceptable response is yet available. The current study aimed to compare the outcomes of Q-switched ruby 694 nm laser (QSRL) alone and in combination with 4% topical flutamide for the management of BNS. Methods: The current randomized clinical trial was conducted on twenty-two BNS patients between 2016-2018. The patients were randomly allocated to treatment with QSRL 694 nm alone (group A) versus in combination with 4% topical flutamide (group B). The QSRL was administered twice with four-week intervals for both groups, while group B was also administered topical flutamide 4% twice a day for eight weeks. The treatment outcomes were assessed and compared at baseline and then within 4 and 8 weeks of commencing the interventions. Results: The evaluation of the two groups in terms of lesion size alterations, response to treatment, and patients' satisfaction showed insignificant differences between the two groups (P>0.05). In addition, neither approach A (P=0.33) nor approach B (P=0.46) led to remarkable changes in lesion color. Conclusion: Based on the findings of the current study, the use of QSRL alone or even in combination with topical 4% flutamide was not suitable for the management of BNS lesions.

Comparing the efficacy and safety of Q-switched and picosecond lasers in the treatment of nevus of Ota: a systematic review and meta-analysis.

Nevus of Ota is cosmetically burdensome and often prompts patients to seek treatment. Lasers are commonly used in removing these lesions; however, no systemic analysis has been conducted to support a gold standard laser. To conduct a meta-analysis of the efficacy and safety of Q-switched Nd:YAG lasers (QSNL), Q-switched ruby lasers (QSRL), Q-switched alexandrite lasers (QSAL), and picosecond alexandrite lasers (PSAL) in removing nevus of Ota. Inclusion criteria were nevus of Ota patients treated with QSNL, QSRL, QSAL, or PSAL and documentation of percent clearance and the rate of at least one adverse event. Articles in English, Chinese, or Japanese were included. The prespecified outcome measures were efficacy (percent clearance) and safety (rates of hyperpigmentation, hypopigmentation, scarring, and recurrence). The review included 57 studies and 13,417 patients. The pooled success rate was 64% for QSNL (95% CI 52-76%), 54% for QSRL (95% CI 39-69%), 58% for QSAL (95% CI 44-72%), and 100% for PSAL (95% CI 98-102%). The pooled adverse event rate was 5% for QSNL (95% CI 4-6%), 14% for QSRL (95% CI 9-19%), 9% for QSAL (95% CI 6-12%), and 44% (95% CI 31-57%) for PSAL. QSNL has the most evidence for effectively and safely treating nevus of Ota. PSAL potentially has a superior efficacy; however, further studies are needed to elucidate its side effect profile when treating nevus of Ota.

Management of periorbital hyperpigmentation: An overview of nature-based agents and alternative approaches.

Periorbital hyperpigmentation (POH) is a common dermatological condition that presents as dark periorbital area beneath the lower eyelids, and it is commonly found in females belonging to the age group of 16 to 45 years. The data presented in this review include studies conducted on patients with a clinical/histological diagnosis of POH or melasma. Many diverse topical depigmenting agents comprising an array of naturally obtained actives such as arabinoxylans, α-arbutin, asiaticoside, azelaic acid, beta-carotene, boswellic acid, caffeine, chrysin, curcumin, cyanidin-3-glucoside, d-glucoronic acid, dihydrochalcone, dipalmitoyl-hydroxyprolene, fucoxanthin, genistein, glabridin, b-glucogallin, hyaluronic acid, lactic acid, lycopene, niacinamide, pycnogenol, retinol, salidroside, and xymenynic acid demonstrated significant benefits in the management of POH. An exhaustive literature search revealed that other techniques such as blepharoplasty, carboxytherapy, calcium hydroxylapatite fillers, tear trough implant, Q-switched ruby laser, medicated tattoo, fat transfer, micro-needling, chemical peels, nitrogen plasma skin regeneration, intense pulsed light, and radiofrequency have been evaluated and reported to be beneficial in the treatment of POH. The use of topical depigmenting agents is the most widely reported method in the clinical management of POH. Of these, α-arbutin, caffeine, cyanidin-3-glucoside, and dihydrochalcone are reported to exhibit significant benefits. Combination products containing a blend of actives are reported to be better than single active containing products. This review aims to provide a comprehensive perspective on the role of several topical actives in the modulation of melanin and tyrosinase biosynthesis pathway involved in the complex pathophysiology of POH. It also presents the advantages of combination products and other alternative therapies used in the management of POH.

Becker’s Nevus in a 24-Year-Old Female Patient with Rheumatoid Arthritis: A Case Report of a Laser Therapy Without Recurrence

Introduction: Becker’s nevus is a type of cutaneous hamartoma that occurs as a brown hyperpigmented patch with irregular borders. The exact pathogenesis of Becker’s nevus is not clear, but hormonal disturbances might play a triggering role. Q-switched lasers have demonstrated favorable effects on improving hyperpigmentation lesions; however, following using a Q-switched laser, the nevus usually reoccurs. Case Presentation: In this study, we described a 24-year-old female patient with Becker’s nevus treated with Q-switched ruby laser (694 nm) whose lesion recovered without any complications or recurrence. The patient had rheumatoid arthritis and has been taking oral methotrexate, hydroxychloroquine, and prednisolone for ten years. Conclusions: Although hyperpigmentation has reported following laser therapy, our patient did not develop any pigmentation, and the lesion did not recur, which can be due to her concurrent drugs, suggesting the role of the immune system in recurrence of Backer’s nevus.

The outcome of using different surgical modalities and laser therapy in the treatment of small‐ and medium‐sized congenital melanocytic nevi: a systematic review

The purpose of this study is to review the published articles regarding different surgical modalities including laser therapy in the treatment of congenital melanocytic nevi (CMN). A systematic review was done using several databases including PubMed, Ovid Medline, Google Scholar, and Medline to search for articles related to surgical excisions and different treatment modalities of CMN. Fourteen studies were included according to the inclusion and exclusion criteria. The results have shown that the Q-switched ruby laser therapy was the most commonly used laser therapy to treat CMN. Overall, using laser therapy had positive outcomes in CMN treatment. However, limited knowledge was available regarding patient satisfaction with the outcomes of laser therapy. We concluded that the most acceptable surgical choice was using excision with tissue expanders. Laser-intense pulsed light (IPL) alone and in combination with Erbium:yttrium-aluminum-garnet (Er:YAG) has a risk of recurrence. Combination of types of the laser is more effective than a single one.

A retrospective study of FQSRL and IPL in the treatment of Café-au-lait macule

Background The application of fractional Q-switched ruby laser (FQSRL) or intense pulsed light (IPL) on Café-au-lait macule (CALM) is rational and the data are lacking. Objective To evaluate the efficacy and safety of FQSRL and IPL in CALM. Methods The patients with CALM who were treated with FQSRL or IPL were retrospectively observed from April 2016 to April 2019. The laser/light treatments were conducted at an interval of 3–4 weeks. Results For FQSRL (N = 67), 88.23%, 95.46%, 100% patients achieved >50% improvement by three sessions, four sessions, and more than four sessions of treatment, respectively. A better and better efficacy was shown with the increasing number of sessions (χ 2 = 89.51, p < .01). For IPL (N = 54), 45% and 87.5% achieved >50% improvement by three sessions and more than four sessions of treatments, respectively. More than four sessions achieved better efficacy than less sessions (p < .01). Under various time-points, FQSRL presented more favorable responses than IPL (p < .05). All the adverse effects were tolerable and acceptable. Conclusions FQSRL or IPL would be an alternative and safe modality for CAML in Chinese patients.

Light and Laser Modalities in the Treatment of Cutaneous Sarcoidosis: A Systematic Review.

Sarcoidosis is a systemic non-caseating granulomatous disease of unknown aetiology. Cutaneous manifestations are present in approximately 10-30% of the patients with the systemic form. Therapy is indicated in case of disabling symptoms, organ dysfunction or cosmetically distressing manifestation. Despite different therapeutic possibilities, cutaneous sarcoidosis remains exceptionally difficult to treat. Light and laser therapy may be a promising alternative. In this systematic review, we summarised the available treatments according to the literature concerning light and laser therapy for cutaneous sarcoidosis. Publications written in English and German, published between January 1990 and July 2016 in the database PubMed, MEDLINE, Embase, and Scopus were analysed. Light therapy with intense pulsed light, photodynamic therapy, and ultraviolet A light therapy, as well as laser therapy with pulsed dye laser, YAG laser, and Q-switched ruby laser were described. The results are based on individual case reports and small case series. Randomised controlled studies are lacking.

Light and laser treatment modalities for disseminated superficial actinic porokeratosis: a systematic review.

Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser and light modalities in the treatment of DSAP. A systematic review of light and laser treatment modalities was conducted to include 26 cases of patients with DSAP. Systematic review resulted in 14 articles to be included. Photodynamic therapy (PDT) overall was the least successful treatment modality, with clinical improvement seen in a minority of patients (MAL-PDT: N = 9 patients, 33.3% showed improvement; ALA-PDT: N = 3 patients, 0% improvement; hypericin-PDT: N = 2 patients, 0% improvement) after numerous post-procedural side effects of hyperpigmentation, inflammation, erythema, and discomfort. Overall, in the available reports, PDT demonstrates poor outcomes with greater incidence of side effects. The response rates of DSAP lesions treated with lasers were as follows: (Q-switched ruby lasers: N = 2, 100%; CO2 laser: N = 1, 100%; PDT and CO2 combination therapy: N = 2, 0-50%; erbium and neodymium YAG lasers: N = 2, 100%; fractional 1927-nm thulium fiber lasers: N = 2, 100%; Grenz rays: N = 1, 100%; and fractional photothermolysis: N = 2, 100%). The side effects of laser therapy were minimal and included mild erythema, slight hyperpigmentation, and moderate edema. Laser therapy is a promising treatment option for DSAP with an excellent side effect profile. However, higher power studies are required to determine optimal guidelines for laser treatment of DSAP.

Thermal distribution and response in Q-switched ruby laser treatment for oculodermal melanosis (Nevus of Ota)

Aim: A clinically useful treatment laser must generate stable and precise energy of low diffusivity. This study assessed the photothermal response of a Q-switched ruby laser (QSRL) in the treatment of oculodermal melanosis (Nevus of Ota).

The Treatment of Pigmented Lesions in Taiwan

Combined dyspigmentation such as lentigines intermingled with freckles, or melasma with acquired bilateral nevus of Ota-like macules, are common among women in Taiwan. There are various lasers available, including Qswitched Nd-YAG laser, Q-switched alexandrite laser, Q-switched ruby laser, and pico laser. We conducted a literature review to understand the current practice of treatment for pigmented lesions in Taiwan.