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Lasers and New Technologies in Hair Diseases
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Giselle Martins Pinto, Patricia Damasco
The first fractional device approved for clinical use was a erbium glass laser (Fraxel® SR750 laser Reliant Technologies, Mountain View, CA) operating at a wavelength of 1550 nm targeting water as a chromophore and working to a depth of 0.4–2.0 mm causing thermal injury without tissue destruction [28, 33]. Disposable tips are available in 7- and 15-mm sizes. The MTZ density settings range from 125 MTZ/cm2 to 320 MTZ/cm2; however, the density of the new machines can be determined by the doctors. The final treatment density, which correlates with the percentage of surface area treated, is determined by both the MTZ setting and number of laser passes. Microscopic treatment zones of 81 to 180 μm in width, and 300 μm to greater than 1400 μm in depth, are created in the skin depending on the pulse energies used (6 to 70 mJ) [27].
Fractional Photothermolysis in Acne Scars
Published in Antonella Tosti, Maria Pia De Padova, Gabriella Fabbrocini, Kenneth R. Beer, Acne Scars, 2018
Gillian Beer, Patrick M. Zito, Adrianna Gonzalez, Kenneth R. Beer
In order to qualify for the study, subjects needed to have at least five acne scars. Scars had to be symmetric to qualify to be treated. The investigators used a 1550-nm Fraxel laser using different density settings (200 versus 393 microthermal treatment zones [MTZ]) but the same fluence (40 mJ) to treat patients at intervals of 4 weeks. Patients who completed the four treatments noted an improvement in the appearance of the scars for both settings with a minimal difference between the densities used. They concluded that this laser was safe and effective for treating acne scars. However, they noted a high incidence of hyperpigmentation following the procedure. This adverse event was significantly higher at the higher density settings.
Laser: General principles
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Madangopolan Ethunandan, Colin Hopper
Fractional photothermolysis (Fraxel) works by producing thermal damage to microscopic zones of the epidermis and dermis and therefore it is postulated that following fraxel skin resurfacing, the surrounding normal skin will help in faster healing and less ‘down time’ between treatments.
Self-limited acne agminate-like granulomatous reaction to facial laser rejuvenation in a patient with comedonal acne vulgaris
Published in Journal of Cosmetic and Laser Therapy, 2020
Kamran Balighi, Robabeh Abedini, Alireza Ghanadan, Amir Abbas Peymanfar, Marwa Akhdar, Ifa Etesami
In a study on 730 patients to investigate the adverse effects of fractional lasers, complications only occurred in 4%, 3.3%, and 6% of the patients who were treated with the fractional Fraxel 1927-nm laser, Fraxel 1550-nm laser, and Fraxel CO2 laser, respectively. Complications included 13 acne eruptions, 9 dermatitis, 5 herpes simplex breakouts, 4 prolonged erythema, 1 abrasion, 1 bacterial infection, 1 drug eruption, 1 hyperpigmentation, 1 increased swelling, and 1 telangiectasia (4). In a retrospective study on 961 patients who underwent 1,550-nm erbium-doped laser, 73 patients (7.6%) encountered complications among which acneiform eruptions were the most common (1.87%). Other less frequent side effects included post-inflammatory hyperpigmentation and prolonged erythema (5). Moreover, in a review article on all reported complications of fractional laser, the incidence of acneiform lesions fluctuated between 2% and 10% and disruption of follicular units during treatment and aberrant follicular epithelialization during healing were proposed mechanisms to contribute to acne exacerbation after fractional laser (1).
Emerging drugs for the treatment of vitiligo
Published in Expert Opinion on Emerging Drugs, 2020
Priyanka Karagaiah, Yan Valle, Julia Sigova, Nicola Zerbinati, Petar Vojvodic, Davinder Parsad, Robert A. Schwartz, Stephan Grabbe, Mohamad Goldust, Torello Lotti
In another innovative study, a unique combination of Fraxel Herbium laser (Valseriana® Fraxel Herbium Laser), topical latanoprost and UV-A1 laser were used in 27 patients with vitiligo. All patients were first irradiated with the single passage of Fraxel Herbium laser (wavelength of 1540 nm) at 1800 mJ/P followed by topical latanoprost 0.005% (Xalatan®) application (1 drops every 2.5*2.5 cm2 lesion). The day after, the lesions were irradiated with UVA1 laser for 20 min (Laser Alba 355®, the wavelength of 355 nm). The treatment was repeated every 21 days, for 9 months. Excellent repigmentation (>75% repigmentation) was achieved in 27 patients (90%) with a mean value of 88% and 3 patients (10%) achieved marked repigmentation (50–75%). Adverse effects were limited to transient inflammation and erythema [101].
Complications and posttreatment care following invasive laser skin resurfacing: A review
Published in Journal of Cosmetic and Laser Therapy, 2018
Dan Li, Shi-Bin Lin, Biao Cheng
Kim and colleagues evaluated the effects of vitamin C used in patients after Fraxel laser. The results showed that it may reduce damage to the skin’s surface barrier induced by laser and promote the restoration of skin pH, despite its limitations in improving skin lightness and reducing skin redness(76). Vitamin C has various recognized medical effects on the skin, such as inhibiting melanogenesis, promoting collagen biosynthesis, and accelerating wound healing. However, the skin’s natural barrier reduces the absorption of vitamin C. According to a study by Woan-Ruoh, all the laser resurfacing techniques facilitated the topical delivery of vitamin C except for the Er:YAG laser, which removed a part of the epidermal layer, leaving relatively insufficient space for the deposition of vitamin C. This observation contrasts with that of the CO2 laser due to its completely different laser-tissue interactions compared with those of the Er:YAG laser, which mainly depends on tissue heating to achieve its effect(77).