A split-face study: comparison of picosecond alexandrite laser and Q-switched Nd:YAG laser in the treatment of melasma in Asians

Lee, Mei‐Ching; Lin, Ying-Fang; Hu, Sindy; Huang, Yau‐Li; Chang, Shyue‐Luen; Cheng, Chun‐Yu; Chang, Chen-Nen

doi:10.1007/s10103-018-2529-2

Cited by 49 publications

(44 citation statements)

References 24 publications

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“…In a recent prior study, PS lasers were shown to be superior to QS lasers in direct comparison for the treatment of melasma on the face . In our centers, melasma treatment with the PS laser showed moderate improvement (Figure = B&A pic) and minimal side effects, consistent with prior studies having similar success while others had mixed success . With that being said, the main issue of melasma is its high recurrence rate, which is independent of the technology used.…”

Section: Discussionsupporting

confidence: 87%

“…The nature of the disease—partial remission and high recurrence rate—still rendered laser toning imperfect for the treatment of melasma in one study . In a recent prior study, PS lasers were shown to be superior to QS lasers in direct comparison for the treatment of melasma on the face . In our centers, melasma treatment with the PS laser showed moderate improvement (Figure = B&A pic) and minimal side effects, consistent with prior studies having similar success while others had mixed success .…”

Section: Discussionsupporting

confidence: 82%

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Retrospective photographic review of nontattoo indications treated by picosecond laser

Mehrabi

Friedman

Al‐Niaimi

et al. 2020

J of Cosmetic Dermatology

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Dermatology is a rapidly advancing field with many technologies added to the expanding armamentarium of the physician, particularly in the cosmetic sector of the specialty. Patients of all age groups and backgrounds seek treatment for skin conditions; these range from young adults with acne and acne scarring to the elderly requiring skin rejuvenation. energy-based devices (EBDs) are increasingly frequently used for the treatment of different aesthetic dermatological problems. Every technology offers a different mechanism of action, recovery timescale, and adverse effects. New technologies are becoming costlier, and this may have implications on the ratio of service to cost-effectiveness. A well-tolerated EBD procedure that can effectively treat different skin types and multiple skin conditions with minimal adverse effects and shortened downtime might be more economically attractive due to its versatility and favorability among patients and treating physicians alike.Picosecond (PS) lasers were approved by the US FDA in 2012 for the removal of tattoos. 1 The iconic feature of the PS laser is that its pulse duration is less than a nanosecond, achieving a photoacoustic effect and limiting the amount of thermal damage delivered to surrounding tissue. 2,3 Aside from tattoo removal, PS Abstract Background: Picosecond (PS) lasers were approved by the US FDA in 2012 after being shown to remove tattoos with more success and fewer treatments compared with traditional methods. PS lasers were shown to be versatile, indicated for the treatment of lentigines, café-au-lait macules (CALMs), and acne scars and skin rejuvenation. Objective:We report our experience treating our patients for different indications using a PS laser. Methods:We performed a retrospective chart and photographic review of all patients seen between 2016 and 2018 that were treated in our centers with a PS laser for nontattoo indications. Clinical outcomes were evaluated using side-by-side comparisons of the clinical photographs by two blinded, independent physicians using a visual analog scale consisting of six levels of treatment response. Results: A total of 233 patients were studied. Most sought treatment for solar lentigo (27%) and skin rejuvenation (14%). Epidermal nevi exhibited the greatest improvement with treatment, while acne scarring demonstrated the least. Only 24% of patients experienced noteworthy, transient adverse effects. Conclusion: Picosecond lasers were efficacious and safe for a variety of indications. They were effective in treating epidermal nevi and pigmented lesions, such as Lentigines and CALMs. K E Y W O R D S aesthetic improvement, epidermal nevus, laser treatment, picosecond laser, solar lentigines | 613 MEHRABI Et Al.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 82%

Retrospective photographic review of nontattoo indications treated by picosecond laser

Mehrabi

Friedman

Al‐Niaimi

et al. 2020

J of Cosmetic Dermatology

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“…3 Treatment with a picoseconds laser was successful in one setting with no recurrence after 12 months.The picoseconds lasers generate ultrashort pulses in a trillionth of a second leading to a predominance of a photoacoustic effect rather than a photothermal one. While the efficacy of picoseconds lasers in tattoos is beyond doubt, superiority in the treatment of benign pigmented conditions compared to Q-switched nanosecond lasers was reported in split-face studies 4,5. Reports of conditions unresponsive to the Q-switched nanosecond lasers, which subsequently cleared with the picoseconds laser-as is the case in our patient-further proves the superior efficacy of the picoseconds lasers 6.…”

supporting

confidence: 72%

Localized argyria from silver nasal piercing unresponsive to Q‐switched laser successfully treated with a 1064 picoseconds laser

Al‐Niaimi

2019

J of Cosmetic Dermatology

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A 23-year-old woman with a 1-year history of a grayish silvery macule on the right nasal ala, following a silver jewelry nose piercing, presented to the laser clinic for consideration of, at her request, ablative laser treatment for removal of what she described as a discoloration that is having a profound effect on her psychological well-being. The macule was asymptomatic and had been unsuccessfully treated prior to her presentation with a 1064 nm Q-switched laser though the exact parameters were not available as this was performed in a different city. Treatment was performed with the 1064 nm wavelength of a picoseconds laser (Picoway; Candela) using the nonfractional zoom handpiece with a 4 mm spot, with 1.8 J/cm 2 in 2 passes. There was erythema as an endpoint. The macule gradually disappeared in <2 weeks with no scarring (Figure 1).Localized argyria is a gray-silvery colored macule or a patch that results from cutaneous contact to objects containing silver metal. 1 It is usually asymptomatic and in dermatology is seen mostly following piercings. It has also been seen following silver nitrate applications and acupuncture. 2 Previous reports have shown efficacy of Q-switched 1064 nm Nd:YAG laser in localized argyria; however, this was unsuccessful in our patient. 3 Treatment with a picoseconds laser was successful in one setting with no recurrence after 12 months.The picoseconds lasers generate ultrashort pulses in a trillionth of a second leading to a predominance of a photoacoustic effect rather than a photothermal one. While the efficacy of picoseconds lasers in tattoos is beyond doubt, superiority in the treatment of benign pigmented conditions compared to Q-switched nanosecond lasers was reported in split-face studies. 4,5 Reports of conditions unresponsive to the Q-switched nanosecond lasers, which subsequently cleared with the picoseconds laser-as is the case in our patient-further proves the superior efficacy of the picoseconds lasers. 6

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“…Although previous reports with a variety of fractionated and non-fractionated modalities have shown limited success, the risks of rapid recurrence, rebound hyperpigmentation, and developing mottled hypopigmentation are significant. To date, picosecond laser has been used to treat melasma in one case series; one prospective open-label trial; four prospective, randomized, split-face trials; and one randomized controlled trial involving a cumulative total of 140 patients [56][57][58][59][60][61][62]. Choi et al [57] conducted a randomized single-blind split-face clinical trial involving 39 patients with melasma.…”

Section: Melasmamentioning

confidence: 99%

A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations

et al. 2020

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Background and Objectives The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence‐based recommendations are developed for the use of picosecond laser in dermatology. Study Design/Materials and Methods A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors’ combined clinical experience, clinical recommendations were developed. Results After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I–IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II–III evidence; tattoo removal was associated with level I evidence. Conclusion Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

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A split-face study: comparison of picosecond alexandrite laser and Q-switched Nd:YAG laser in the treatment of melasma in Asians

Cited by 49 publications

References 24 publications

Retrospective photographic review of nontattoo indications treated by picosecond laser

Retrospective photographic review of nontattoo indications treated by picosecond laser

Localized argyria from silver nasal piercing unresponsive to Q‐switched laser successfully treated with a 1064 picoseconds laser

A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations

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