Laser Treatment of Dark Skin

Shah, Sona; Alster, Tina S.

doi:10.2165/11538940-000000000-00000

Cited by 76 publications

(44 citation statements)

References 104 publications

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“…Table 1 Main laser and light sources used for vascular surgery 1,2,9,11,28 Laser type with darker skin types can be treated, but more care has to be taken in selecting an appropriate energy level and in choosing proper treatment intervals. The overlying melanin is a competing chromophore for the yellow laser light; 30,38 it can shield the underlying vascular lesion and reduce the amount of effective light reaching the lesion. There is a higher risk of postoperative hyperpigmentation or hypopigmentation.…”

Section: Medical History and Clinical Examinationmentioning

confidence: 99%

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Adamič¹,

Pavlović

Rubin

et al. 2015

Acad Dermatol Venereol

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Aim Lasers and non-coherent intense pulse light sources (IPLS) are based on the principle of selective photothermolysis and can be used for the treatment of many vascular skin lesions. A variety of lasers has been developed for the treatment of congenital and acquired vascular lesions which incorporate these concepts into their design. Although laser and light sources are very popular due to their non-invasive nature, caution should be considered by practitioners and patients to avoid permanent side-effects. The aim of these guidelines is to give evidence-based recommendations for the use of lasers and IPLS in the treatment of vascular lesions. Results Lasers and IPLS are very useful and sometimes the only available method to treat various vascular lesions. It is of a paramount importance that the type of laser or IPLS and their specific parameters are adapted to the indication but also that the treating physician is familiar with the device to be used. The crucial issue in treating vascular lesions is to recognize the immediate end-point after laser treatment. This is the single most important factor to ensure both the efficacy of the treatment and avoidance of serious side-effects. Methods Conflicts of interestNone declared. Funding sourceNone.Since the publication of previous European Society of Laser Dermatology (ESLD) guidelines in 2007, there have been significant advances in the field of laser treatment of common vascular lesions.1 These guidelines have been updated by the Consensus Panel under the auspices of the ESLD. Methodology, search strategy and recommendation formulation are described in Appendix II. A brief overview of vascular lasersStandard vascular lasers include pulsed dye lasers (585 and 595 nm), and KTP-lasers (532 nm), followed by longer wavelength lasers such as alexandrite lasers (755 nm), diode lasers (800-900 nm) and millisecond Nd:YAG lasers (1064 nm). New developments include a non-uniform pulse sequence or a dual-wavelength modality (combined dual wavelength 595 and 1064 nm-pulsed dye and Nd:YAG laser) and microsecond Nd: YAG lasers. [2][3][4][5][6] Even fractional photothermolysis has begun to be used for selected vascular lesions. Lasers' and intense pulse light sources (IPLS) effects are based on the principle of selective photothermolysis. In general, they deliver a precisely graded aliquot of energy to a defined area of the skin in a reproducible, standardized manner that almost always involves addition or evacuation of heat. The greatestThe first two authors have contributed equally to the manuscript.

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Section: Medical History and Clinical Examinationmentioning

confidence: 99%

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Adamič¹,

Pavlović

Rubin

et al. 2015

Acad Dermatol Venereol

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“…The skin type is important in laser therapy, as melanin in the basal layer of the epidermis can intensify thermal injury from laser and lead to an increased incidence of side effects such as scarring, atrophy and pigmentary changes . Currently, there is a general consensus that long‐pulsed lasers such as Nd:YAG are safe to reduce complications in darker skin types as they reduce the absorption of laser from melanin within the skin . However, a ‘safe range’ of laser energy parameters is not well established in the literature, and this discrepancy highlights the need for formal laser parameter guidelines.…”

Section: Laser Parameters Used For Our Patientmentioning

confidence: 99%

“…3 Currently, there is a general consensus that long-pulsed lasers such as Nd:YAG are safe to reduce complications in darker skin types as they reduce the absorption of laser from melanin within the skin. 4 However, a 'safe range' of laser energy parameters is not well established in the literature, and this discrepancy highlights the need for formal laser parameter guidelines.…”

mentioning

confidence: 99%

Keloid scar as a complication of triple therapy laser treatment of a recalcitrant facial port wine stain

Rinaldi

Syed

2019

Clin Exp Dermatol

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“…11 Although postoperative topical "bleaching agents" may be used to treat transient postinflammatory hyperpigmentation, pre-operative prophylaxis with skin lightening agents has not been shown to decrease the incidence of hyperpigmentation. Furthermore, complications can and do occur, and these are often technique dependent.…”

Section: Adverse Eventsmentioning

confidence: 99%

Erbium

Farshidi

Hovenic²,

Zachary³

2014

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.A blative laser resurfacing is an effective treatment modality for rejuvenation and skin tightening. In the 1980s, the high-energy short-pulsed carbon dioxide (CO 2 ) laser was the first laser used for ablative resurfacing; however, its extensive collateral thermal damage was associated by a relatively high risk for adverse events and downtime. 1,2 The advent of the 2,940-nm erbium:yttrium aluminum garnet (Er:YAG) laser introduced an alternative device for ablative laser resurfacing with the ability to improve the appearance of skin with faster healing, less persistent erythema, and less delayed-onset permanent hypopigmentation.Like its CO 2 predecessor, the Er:YAG laser targets both intracellular and extracellular water as its chromophore. With a wavelength more closely corresponding to the absorptive peak of water (3,000 nm), its energy more efficiently vaporizes water-containing tissue, minimizing collateral thermal damage. 2,3 Superficial epidermal vaporization induces expression of keratin 16 (KRT16), a maker for epidermal injury, and also a rapid transient increase in keratinocyte proliferation, as indicated by staining for Ki67. However, with this simple superficial injury, the epidermal basal layer remains unaffected, and immunostaining for laminin gamma-2 confirms this integrity.Of interest, intra-epidermal injury alone can drive dermal extracellular matrix changes and remodeling. 4 This wound-healing response is evidenced by a marked increase in the inflammatory cytokines interleukin (IL)-1 beta and IL-8, a potent chemoattractant for polymorphonuclear leukocytes. The subsequent neutrophil infiltration extends from the dermis into the epidermis.The inflammatory phase is followed by remodeling of the dermal extracellular matrix and is driven by the activator protein 1 transcription factor complex, which regulates transcription of several important cytokines and metalloproteinases (MMPs). Metalloproteinase-1 initiates cleavage of collagen fibrils; MMP-3 and MMP-9 further degrade cleaved collagen. These factors are substantially elevated in both the epidermis and dermis.Fibroblasts throughout the mid to upper dermis increase production of Type I and Type III collagens. 4 It has been hypothesized that relatively low and controlled concentrations of reactive oxygen species stimulate signal transduction processes for transcription factor activation, gene expression, muscle contraction, and fibroblast growth, thus playing a role in collagen and extracellular matrix formation. 5 Nevertheless, Er:YAG laser resurfacing involves a highly organized cascade of molecular events that stimulate wound healing and dermal matrix remodeling. *All the authors are affiliated with the

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Laser Treatment of Dark Skin

Cited by 76 publications

References 104 publications

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Keloid scar as a complication of triple therapy laser treatment of a recalcitrant facial port wine stain

Erbium

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