Nonablative 1450-nm Diode Laser in the Treatment of Facial Atrophic Acne Scars in Type IV to V Asian Skin: A Prospective Clinical Study

Chua, Sze Hon; P, Ang; Khoo, Lawrence; Goh, C. J.

doi:10.1111/j.1524-4725.2004.30402.x

Cited by 62 publications

(59 citation statements)

References 14 publications

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“…Hyperpigmentation has been observed infrequently by the author in tanned individuals or those with Fitzpatrick skin types III-IV. In one study investigating the efficacy of the laser used in the current study for improving acne scarring in Asians with Fitzpatrick type IV and V skin, hyperpigmentation was seen in 39% of treated subjects [27]. Perhaps no hyperpigmentation was noted in the current study because no subject had darker than type III skin, using the Fitzpatrick scale.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to visible wavelengths of light, radiofrequency has also been used to treat acne [22]. Recently, the most commonly used laser modalities for treating acne with electromagnetic radiation are the infrared lasers [23][24][25][26][27][28][29]. These devices were originally developed for dermal remodeling and applied to treatment of rhytides and acne scarring.…”

Section: Introductionmentioning

confidence: 99%

“…One of the most widely used wavelengths for this purpose is the relatively recently developed 1,450 nm diode laser incorporating cryogen spray cooling (Smoothbeam, Candela Corporation, Wayland, MA). Initial studies treating acne scarring with the 1,450 nm diode laser revealed the potential to treat acne, and subsequent studies proved it to be effective at reducing acne [25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

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A pilot investigation comparing low‐energy, double pass 1,450 nm laser treatment of acne to conventional single‐pass, high‐energy treatment

Bernstein

2006

Lasers Surg Med

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Background and Objectives: Laser treatment using a 1,450 nm diode laser has been shown to improve acne and acne scarring. Its widespread adoption in younger populations has been significantly limited by discomfort. Study Design/Materials and Methods: Six subjects with active papular acne were treated in a pilot study to determine parameters for a split-face, double-pass, lowenergy protocol of 1,450 nm laser treatment. Sides of the face were randomized to receive single-pass, high-energy treatment (13-14 J/cm 2 ), or double-pass, low energy treatment (8-11 J/cm 2 ), for a total of four treatments delivered at monthly intervals. Acne counts and standardized, digital photograph were performed 2 months following the final treatment, and compared to pre-treatment counts and photographs. Results: Improvement was evaluated comparing pre-and post-treatment photos and averaged 2.5 for the highenergy, single-pass side and 2.3 for the low-energy, double-pass side, using a 0 (worse) to 4 (max improvement) scale. Acne counts were reduced 78% on the high-energy, single-pass side and 67% on the low-energy, double-pass side. Pain ratings on a 1 (min) to 10 (max) scale averaged 5.6 (range 1-9) for the high-energy, single-pass side and 1.3 (range 1-2) for the low-energy, double-pass side. Conclusions: Low-energy, double-pass 1,450 nm laser treatment effectively reduces acne counts 2 months posttreatment, and dramatically reduces the pain associated with treatment. The treatment parameters used in this study have eliminated the need for anesthetic cream in daily practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A pilot investigation comparing low‐energy, double pass 1,450 nm laser treatment of acne to conventional single‐pass, high‐energy treatment

Bernstein

2006

Lasers Surg Med

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“…Downtime is minimal and is restricted to temporary erythema, edema, and hyperpigmentation after treatments. 30 This laser achieves mild to moderate improvement of acne scarring in Asian patients without producing permanent pigmentary change even in darker skin types IV and V. 31,32 Nonablative Fractionated Lasers…”

Section: -Nm Diode Laser (Candela Smoothbeam)mentioning

confidence: 99%

Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface

Preissig

Hamilton

Markus

2012

Seminars in Plastic Surgery

137

134

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).Laser resurfacing technologies represent an exciting development in the cosmetic surgeon's repertoire to improve the tone, texture, and pigmentation of the skin. Although laser resurfacing is not a substitute for a facelift or blepharoplasty, the appropriate laser not only tightens the skin somewhat but also improves the appearance of lentigines, rhytides, skin texture, and a wide variety of scars.There are ablative and nonablative lasers as well as fractionated and nonfractionated lasers. Nonfractionated lasers act on the entire projected surface area of the treated skin, whereas fractionated lasers target an equally distributed portion of the projected area. An easy way to understand the difference is in looking at the pixels that compose a TV image. Nonfractionated devices treat every single pixel whereas fractionated devices treat only a percentage of the pixels in the treatment area.Ablative lasers vaporize tissue and therefore are more aggressive compared with the gentler nonablative lasers that leave the skin intact. Although ablative lasers result in far more down time and a more difficult recovery process, they remain the lasers that produce the most dramatic outcomes. For more severe facial wrinkles, dyspigmentation, and textural skin challenges, the ablative laser is often the treatment of choice.For patients seeking more moderate improvement-without the possible side effects of ablative lasers-nonablative lasers are often ideal. These lasers leave the epidermis intact while producing rejuvenating skin effects. Depending on the technology, nonablative laser treatments may minimize the appearances of finer wrinkles, ameliorate the texture and tone of the skin, and treat dyspigmentation. By comparison, the treatments are gentler and require little to no downtime, but produce a more moderate response.Ultimately, a patient's needs dictate the selection of the ideal laser. In this review, we seek to demystify the differences between the many available lasers and thereby facilitate the identification of the most appropriate laser for the patient. Ablative Nonfractionated LasersAblative skin resurfacing removes the epidermal layer, producing the most dramatic laser-treated results for skin resurfacing. The lasers quickly superheat water molecules in the skin tissue. When the water turns into gas, the skin cells are vaporized in a precise skin-peeling effect. This effect promotes collagen formation and retraction of the dermis and AbstractNumerous laser platforms exist that rejuvenate the skin by resurfacing its upper layers. In varying degrees, these lasers improve the appearance of lentigines and rhytides, eliminate photoaging, soften scarring due to acne and other causes, and treat dyspigmentation. Five major classes of dermatologic lasers are currently in common use: ablative and nonablative lasers in both fractionated and unfractionated forms as well as radiofrequency technologies. The gentler nonablative lasers allow for quicker healing, whereas harsher ablative lasers tend to be more effective. Fract...

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“…The laser spot diameter was 6 mm. Three clinically relevant MCS-LPS patterns [5][6][7][19][20][21][22] were applied on the skin specimens. As illustrated in Figure 2, MCS-LPS-1 involved the longest total cryogen spray time (t CSC 1 ¼ 38 milliseconds).…”

Section: Laser Devicementioning

confidence: 99%

Thermal responses of ex vivo human skin during multiple cryogen spurts and 1,450 nm laser pulses

et al. 2006

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Background and Objective: Although cryogen spray cooling (CSC) is used to minimize the risk of epidermal damage during laser dermatologic surgery, concern has been expressed that CSC may induce cryo-injury. The objective of this study is to measure temperature variations at the epidermal-dermal junction in ex vivo human skin during three clinically relevant multiple cryogen spurt-laser pulse sequences (MCS-LPS). Study Design/Materials and Methods: The epidermis of ex vivo human skin was separated from the dermis and a thin-foil thermocouple (13 mm thickness) was inserted between the two layers. Thermocouple depth and epidermal thickness were measured using optical coherence tomography (OCT). Skin specimens were preheated to 308C before the MCS-LPS were initiated. Three MCS-LPS patterns, with total cryogen spray times of 38, 30, and 25 milliseconds respectively, were applied to the specimens in combination with laser fluences of 10 and 14 J/cm 2 , while the thermocouple recorded the temperature changes at the epidermal-dermal junction. Results: The thermocouple effectively recorded fast temperature changes during three MCS-LPS patterns. The lowest temperatures measured corresponded to the sequences with longer pre-cooling cryogen spurts. No subzero temperatures were measured for any of the MCS-LPS patterns under study. Conclusions: The three clinically relevant MCS-LPS patterns evaluated in this study do not cause sub-zero temperatures in ex vivo human skin at the epidermal-dermal junction and, therefore, are unlikely to cause significant cryogen induced epidermal injury.

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Nonablative 1450-nm Diode Laser in the Treatment of Facial Atrophic Acne Scars in Type IV to V Asian Skin: A Prospective Clinical Study

Abstract: The nonablative 1450 nm diode laser may be effective in achieving mild to moderate gradual clinical improvement in the treatment of facial atrophic acne scars. The procedure is associated with minimal downtime and is safe for use in darker skin types IV and V.

Cited by 62 publications

References 14 publications

A pilot investigation comparing low‐energy, double pass 1,450 nm laser treatment of acne to conventional single‐pass, high‐energy treatment

A pilot investigation comparing low‐energy, double pass 1,450 nm laser treatment of acne to conventional single‐pass, high‐energy treatment

Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface

Thermal responses of ex vivo human skin during multiple cryogen spurts and 1,450 nm laser pulses

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