Nitrogen plasma skin regeneration for the treatment of mild‐to‐moderate periorbital wrinkles: A prospective, randomized, controlled evaluator‐blinded trial

Theppornpitak, Naphatsanan; Udompataikul, Montree; Chalermchai, Thep; Ophaswongse, Suwirakorn; Limtanyakul, Piyakan

doi:10.1111/jocd.12767

Cited by 16 publications

(8 citation statements)

References 17 publications

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“…Skin healing after nitrogen PSR treatment involves a process of natural skin regeneration, wherein the upper/ outer layers of skin that are desiccated during treatment remain intact as a natural biological dressing during the early phase of healing; as the "old" skin desquamates, the newly regenerated and smoother pink skin appears [13]. Clinical benefits of nitrogen PSR treatment include a range of treatment protocols for diverse skin types and conditions, effective reversal of photodamage and dyschromia, preservation of natural skin tone, and modest reduction of acne scarring and rhytidosis [10,[12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study Evaluating the Use of Helium Plasma for Dermal Resurfacing

Holcomb¹,

Kelly²,

Hamilton

et al. 2020

Lasers Surg Med

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Background and Objectives: A novel helium plasma device was evaluated for efficacy and safety for dermal resurfacing (ClinicalTrials.gov Identifier: NCT03286283). The helium plasma device delivers energy in a controlled, bimodal fashion that when compared with the nitrogen plasma predicate device in a porcine animal model demonstrated a more limited depth of thermal effect but a greater skin tissue contraction. Study Design/Materials and Methods: Fifty-five eligible subjects seeking improvement in facial rhytids were enrolled for study at one of three investigational sites. Most subjects underwent full-face treatment. Power levels were limited to 20% at peri-oral and peri-orbital areas-a level that correlates to an energy density 40% lower than the highest setting on the predicate device. Three-month posttreatment Fitzpatrick Wrinkle and Elastosis Scale (FWS) scores were compared with baseline scores as determined by blinded independent photographic reviewers (IPRs) and study investigators. Results: Blinded IPRs observed a ≥1-point FWS improvement in 63.64% of subjects whereas study investigators noted a ≥1-point FWS improvement in 54 of 55 subjects (98.18%) of subjects. 90.9% of subjects indicated "improvement" in appearance utilizing the modified Global Aesthetic Improvement Scale. Subgroup analysis showed 1-point (±0.05) FWS improvement by IPRs and study investigators for Fitzpatrick Skin Types II and III, age≥62, two of three study sites, and post-treatment oral steroid use. Eighty Non-Serious Adverse Events in 39 subjects were reported, most of which resolved within 14 days or less. There were no Serious Adverse Events or Unanticipated Device Effects reported. Conclusion: At the modest power level studied, a significant improvement from a single pass helium plasma dermal resurfacing treatment was observable in most subjects by IPRs and investigators, and no serious adverse events were reported. The discrepancy between IPR and study investigator FWS improvement may be explained in part by the limitations of assessing two-dimensional photographs versus live in-person evaluation of subjects. Studies evaluating higher energy levels and/or multiple treatment passes are ongoing. Lasers Surg. Med.

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Section: Introductionmentioning

confidence: 99%

A Prospective Study Evaluating the Use of Helium Plasma for Dermal Resurfacing

Holcomb¹,

Kelly²,

Hamilton

et al. 2020

Lasers Surg Med

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“…Nitrogen PSR histological studies (porcine, human) showed significant neo‐collagenesis and a corresponding reduction in elastosis in the upper dermis . Clinical evaluation of nitrogen PSR treatment effectiveness demonstrated benefits in the appearance of treated skin with improvements in dyschromia, photodamage and skin texture including reduction of acne scarring and rhytidosis . Complications resulting from nitrogen PSR treatment include focally delayed healing, post‐inflammatory hyperpigmentation, and rare hypertrophic scarring events .…”

Section: Introductionmentioning

confidence: 99%

Helium Plasma Skin Regeneration: Evaluation of Skin Tissue Effects in a Porcine Model and Comparison to Nitrogen Plasma Skin Regeneration

Holcomb¹,

Schucker²

2019

Lasers Surg Med

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Background and Objectives Helium plasma skin regeneration (PSR) is a novel skin rejuvenation technology with significant differences compared with nitrogen PSR technology but that may exert similar skin tissue effects. Study objectives included a comparison of acute and chronic skin tissue changes among the two plasmas in a porcine animal model. Study Design/Materials and Methods In this study, both helium and nitrogen gas plasmas were used to treat the dorsal skin of Yorkshire cross mini pigs with 20% (8.6 J/cm2) and 40% (17.8 J/cm2) power helium plasma single pass treatment (4 liter gas flow, continuous energy delivery, and linear non‐overlapping passes) compared with high energy nitrogen plasma double pass treatment (PSR3 @ 14.1 J/cm2: 4.0 J, 2.5 Hz pulse rate, overlapping horizontal, and vertical passes). Acute and chronic skin contraction, maximum acute depth of injury and chronic reparative healing depth were assessed along with representative histopathology in each treatment paradigm. Results High‐energy nitrogen plasma treatment exhibited greatest mean depth of acute tissue injury 4 hours post‐treatment whereas helium plasma treatment exhibited greater acute skin tissue contraction. Then, 20% and 40% power helium plasma treatment results were each very similar among animals as a percentage of nitrogen plasma treatment results for both depths of acute tissue injury and acute skin tissue contraction. Mean depths of reparative tissue healing were similar among treatment paradigms 30 days after treatment with significant intra‐ and inter‐animal variability observed within each treatment paradigm. Thirty‐day mean skin tissue contraction was greater for helium plasma treatment; however, the data varied significantly between animals in all paradigms. Histopathologic tissue evaluation after 30 days showed similar findings among the treatment paradigms with epidermal hyperplasia, flattening of rete ridges and with regenerative granulation tissue expanding the superficial and papillary dermis. Conclusions This study demonstrates modestly reduced depth of the thermal effect, greater skin tissue contraction and similarity of acute and chronic histopathological findings for helium plasma when compared with nitrogen plasma in a porcine animal model. © 2019 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.

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“…Multiple treatments of PSR have been proven to be clinically effective for traumatic scars, mesh skin-grafted scars, and wrinkles at an interval of 3 weeks to 1 month. 9,16 In this study, we reported single-dose PSR treatment combined with radiotherapy as an effective management for keloids. The endpoint of PSR therapy was when the lesions were almost as flat as the surrounding normal skin although red in color.…”

Section: Discussionmentioning

confidence: 94%

Treatment of Keloids Using Plasma Skin Regeneration Combined with Radiation Therapy Under the Evaluation of Patient and Observer Scar Assessment Scale

Ting¹,

Chong²,

Xu³

et al. 2021

CCID

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Keloids are caused by uncontrolled excessive proliferation of fibrous tissue. Multiple treatment strategies including steroid injection, surgical excision, laser therapy and radiation therapy have been reported. Few studies have evaluated the performance of plasma skin regeneration (PSR) in the treatment of keloid. This study aimed to evaluate the effectiveness of PSR combined with radiation therapy for keloids on different body parts. Patients and Methods: A total of 71 patients with 98 keloids were enrolled in this study. Keloids <4 mm thick underwent single-dose PSR, while keloids ≥4 mm thick were administered compound betamethasone injection beforehand. Radiation therapy was administered after 24 hours and again 7 days later after PSR. The outcome was evaluated using the patient and observer scar assessment scale at 12 months post-treatment. Results: Patient-reported average scores for all keloids significantly decreased from 35.05 ±9.94 to 21.84±7.04 (p < 0.05). Keloids on face and neck, chest, and back responded better than those on shoulders and limbs. The recurrence rate was observed to be 15.3% (15 out of 98). Adverse effects were mild. Conclusion: PSR combined with radiation therapy is an effective and safe strategy to treat keloids. Location could be a factor that affects curative effects.

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Nitrogen plasma skin regeneration for the treatment of mild‐to‐moderate periorbital wrinkles: A prospective, randomized, controlled evaluator‐blinded trial

Abstract: Nitrogen plasma skin regeneration is effective and safe for the treatment of mild-to-moderate periorbital wrinkles and darkening.

Cited by 16 publications

References 17 publications

A Prospective Study Evaluating the Use of Helium Plasma for Dermal Resurfacing

A Prospective Study Evaluating the Use of Helium Plasma for Dermal Resurfacing

Helium Plasma Skin Regeneration: Evaluation of Skin Tissue Effects in a Porcine Model and Comparison to Nitrogen Plasma Skin Regeneration

Treatment of Keloids Using Plasma Skin Regeneration Combined with Radiation Therapy Under the Evaluation of Patient and Observer Scar Assessment Scale

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