Helium plasma dermal resurfacing: Consensus guidelines

Abstract

Introduction: Nine experienced physician users of a novel helium plasma dermal resurfacing device for heating the skin at a controlled depth to achieve collagen coagulation, tissue contraction, and neocollagenesis convened to discuss their experiences and keys to success with their off-label use of this device with collectively more than 800 cases performed for facial skin renewal procedures. Methods: A round table discussion format was used to address a variety of topics including pretreatment considerations, optimum treatment parameters, posttreatment healing regimen, and avoidance and management of side effects and complications. All panelists consented to data collection, analysis, compilation, and publication. Results: Ideal candidates for the procedure were identified along with optimum treatment parameters and posttreatment care. Strategies for avoidance and management of complications and side effects were discussed. Conclusions: Consensus guidelines were developed for patient selection, pretreatment considerations, treatment parameters, posttreatment healing regimen, and avoidance and management of complications and side effects.

Helium plasma dermal resurfacing: VISIA CR assessment of facial spots, pores, and wrinkles—Preliminary findings

“…Improvement of facial skin appearance is among the most common reasons patients seek treatment from cosmetic dermatologists and aesthetic surgeons. While options for energy‐based skin rejuvenation are numerous those that lead to renewal of the upper skin layers through immediate (eg, CO2 laser 2 ; eg, erbium YAG laser 3 ; eg, helium PDR [2 or more passes with debridement of desiccated tissue after first pass] 4 ; eg, ablative fractional [laser] resurfacing 5 ) or delayed ablation (eg, nitrogen plasma skin regeneration 6 ; eg, helium PDR [single pass leaving desiccated tissue in place] 4 ; eg, non‐ablative fractional (laser) resurfacing 7 ) are considered to be the most effective.…”

“…| 1669 HOLCOMB layers through immediate (eg, CO2 laser 2 ; eg, erbium YAG laser 3 ; eg, helium PDR [2 or more passes with debridement of desiccated tissue after first pass] 4 ; eg, ablative fractional [laser] resurfacing 5 ) or delayed ablation (eg, nitrogen plasma skin regeneration 6 ; eg, helium PDR [single pass leaving desiccated tissue in place] 4 ; eg, non-ablative fractional (laser) resurfacing 7 ) are considered to be the most effective.…”

High energy, double pass helium plasma dermal resurfacing: A prospective, multicenter, single‐arm clinical study

“…Hypertrophic and even cicatricial scarring has been observed with other full field (e.g., CO 2 laser; erbiumYAG laser) and fractional (e.g., CO 2 laser) ablative skin resurfacing treatments as well as the predicate nitrogen plasma skin regeneration technology (personal observation, JDH)possible contributing factors include excessive depth of treatment, excessive density of microscopic ablation zones (CO 2 ablative fractional resurfacing), excessive energy density with extensive residual thermal damage, secondary wounding of treated skin tissue, posttreatment infection of treated skin tissue, over-treatment of thinner and/or less vascular skin and delayed wound healing. 5,[10][11][12][13][14] Moderate severity hypertrophic scarring in the left temple and jawline/mandibular border areas was diagnosed in one subject at the 90-day visit. These areas experienced secondary trauma from taping of an NG tube…”

“…As helium plasma energy is delivered to the tissue and tissue coagulation occurs, the electrical impedance of treated tissue increases causing RF energy to disperse peripherally to untreated tissue with lower electrical impedance-this phenomenon limits the depth of effect and potential for reduction of deeper rhytids from single-pass HPDR treatment. 5 Although greater depth of effect may be achieved by increasing helium plasma device power even greater depth of effect may be achieved by additional energy delivery with a second pass over the tissue. 5,6 The superficially coagulated/ desiccated tissue may be left in place to serve as a biological dressing if only single-pass treatment is desired, however, it must be gently removed before a second pass is performed to reduce tissue impedance and thereby ensure adequate energy delivery.…”

“…5 Although greater depth of effect may be achieved by increasing helium plasma device power even greater depth of effect may be achieved by additional energy delivery with a second pass over the tissue. 5,6 The superficially coagulated/ desiccated tissue may be left in place to serve as a biological dressing if only single-pass treatment is desired, however, it must be gently removed before a second pass is performed to reduce tissue impedance and thereby ensure adequate energy delivery. 5,6 The purpose of this multi-center clinical study (ClinicalTrials.gov Identifier: NCT04185909) is to demonstrate the effectiveness and safety of high energy (40% power), double pass HPDR treatment of facial skin.…”