Cellular senescence contributes to skin aging. Lasers and energy-based devices (EBDs) are used to treat age-related skin changes. Given the clinical improvement seen with these devices, we sought to systematically review whether current evidence supports an impact on cellular senescence.
Methods
A systematic literature review was conducted according to PRISMA guidelines. PubMed, EBSCO, and Web of Science databases were searched for relevant articles examining the effects of lasers and EBDs on cellular senescence. Devices included lasers, radiofrequency, ultrasound, photobiomodulation, photodynamic therapy, and intense pulsed light.
Results
A total of 23 articles presented original work, relevant to dermatology, evaluating the impact of these treatments at a cellular level. These comprised laser (n = 6), light-based (n = 11), and other EBDs (n = 6). Overall, these technologies demonstrated a positive effect on cellular senescence and clinically minimized neocarcinogenesis and improved age-related skin changes.
Conclusions
Literature evaluating the impact of lasers and EBDs on cellular senescence is scarce. This review suggests that these modalities may reduce cellular senescence, thereby restoring cellular signaling and rejuvenating the skin. We propose that these effects represent a converging fundamental mechanism of hormesis promoting skin anti-fragility and longevity.
目的：细胞衰老导致皮肤老化。激光和基于能量的设备（ebd）被用于治疗与年龄相关的皮肤变化。鉴于这些设备的临床改善，我们试图系统地回顾当前的证据是否支持对细胞衰老的影响。方法：根据PRISMA指南进行系统的文献回顾。在PubMed、EBSCO和Web of Science数据库中搜索了有关激光和EBDs对细胞衰老影响的相关文章。设备包括激光、射频、超声、光生物调节、光动力疗法和强脉冲光。结果：共有23篇文章发表了与皮肤病学相关的原创作品，在细胞水平上评估了这些治疗的影响。这些包括激光（n = 6），光基（n = 11）和其他ebd （n = 6）。总的来说，这些技术对细胞衰老和临床最小化新癌的发生以及改善与年龄相关的皮肤变化显示出积极的作用。结论：评价激光和EBDs对细胞衰老影响的文献很少。这篇综述表明，这些方式可以减少细胞衰老，从而恢复细胞信号，使皮肤恢复活力。我们认为，这些效应代表了一种趋同的激效机制，促进皮肤抗脆弱性和长寿。
{"title":"The Impact of Lasers and Energy-Based Devices on Cellular Senescence: A Systematic Review","authors":"Ryan C. Kelm, Morgan B. Murphrey","doi":"10.1002/lsm.70079","DOIUrl":"10.1002/lsm.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cellular senescence contributes to skin aging. Lasers and energy-based devices (EBDs) are used to treat age-related skin changes. Given the clinical improvement seen with these devices, we sought to systematically review whether current evidence supports an impact on cellular senescence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature review was conducted according to PRISMA guidelines. PubMed, EBSCO, and Web of Science databases were searched for relevant articles examining the effects of lasers and EBDs on cellular senescence. Devices included lasers, radiofrequency, ultrasound, photobiomodulation, photodynamic therapy, and intense pulsed light.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 23 articles presented original work, relevant to dermatology, evaluating the impact of these treatments at a cellular level. These comprised laser (<i>n</i> = 6), light-based (<i>n</i> = 11), and other EBDs (<i>n</i> = 6). Overall, these technologies demonstrated a positive effect on cellular senescence and clinically minimized neocarcinogenesis and improved age-related skin changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Literature evaluating the impact of lasers and EBDs on cellular senescence is scarce. This review suggests that these modalities may reduce cellular senescence, thereby restoring cellular signaling and rejuvenating the skin. We propose that these effects represent a converging fundamental mechanism of hormesis promoting skin anti-fragility and longevity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"58 1","pages":"5-20"},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nathan M. Weir, A. J. Burns, Tatiana Kononov, Alisar S. Zahr
<div> <section> <h3> Objectives</h3> <p>A neurocosmetic post-procedure cream (NPPC) was developed as a semi-breathable topical to provide relief and recovery following energy-based device treatments. The NPPC was investigated following hybrid fractional and fractional ablative laser resurfacing to assess tolerability, safety, and patient compliance and retention, as well as compare against a conventional post-procedure topical routine.</p> </section> <section> <h3> Methods</h3> <p>Two randomized, double-blinded, split-face, controlled, procedure-pairing studies were conducted with healthy females aged 35–65 years with Fitzpatrick Skin Types I–III and moderate to severe photodamage. Subjects were randomized to apply the NPPC and a comparator moisturizer (CM) or comparator anhydrous formulation (CAF) three times daily for 7 days post-hybrid fractional laser (HFL) or 14 days post-fractional ablative CO<sub>2</sub> laser (FACL), respectively. Tolerability evaluations, questionnaires, and clinical photography were conducted at baseline and post-baseline timepoints.</p> </section> <section> <h3> Results</h3> <p>Sixteen and twenty-two healthy female subjects completed the HFL and FACL studies, respectively. The NPPC was effective at improving erythema, edema, dryness, burning, itching, stinging, and discomfort as evidenced by tolerability evaluations, clinical photography, and questionnaires. There were no significant adverse events. Day 1 post-FACL treatment, 91% of subjects favorably agreed “the product calmed my skin.” Patient relief and recovery were achieved with the NPPC. Across the two studies, the NPPC performed similarly or better than the conventional postprocedure topical routine investigated. The studies are limited to a small sample size, and the lack of a vehicle-only or untreated control arm is unethical.</p> </section> <section> <h3> Conclusions</h3> <p>An NPPC developed to soothe skin following energy-based device procedures demonstrated patient tolerability, safety, and improved healing time following hybrid and fractional ablative laser treatments. Patients indicated favorable responses to the treatments, and there was high agreement that they would return for a second treatment, denoting patient retention. The NPPC achieved comparable outcomes versus the conventional postprocedure topical routine in both HFL and FACL studies.</p> </section> <section> <h3> Clinical Trial Registration</h3> <div> <ul>
目的：一种神经美容术后乳膏（NPPC）被开发为半透气外用，在能量装置治疗后提供缓解和恢复。我们在分式和分式烧蚀激光表面置换后对NPPC进行了研究，以评估耐受性、安全性、患者依从性和保留性，并与传统的手术后局部常规进行比较。方法：两项随机、双盲、裂面、对照、程序配对研究，研究对象为年龄在35-65岁、菲茨帕特里克皮肤I-III型、中度至重度光损伤的健康女性。受试者在混合分数激光（HFL）后7天或分数烧蚀CO2激光（FACL）后14天，每天三次分别使用NPPC和比较剂保湿剂（CM）或比较剂无水制剂（CAF）。在基线和基线后时间点进行耐受性评估、问卷调查和临床摄影。结果：健康女性受试者分别有16名和22名完成了HFL和FACL研究。耐受性评估、临床摄影和问卷调查证明，NPPC在改善红斑、水肿、干燥、灼烧、瘙痒、刺痛和不适方面是有效的。没有明显的不良事件。facl治疗后的第一天，91%的受试者赞同“该产品使我的皮肤平静”。NPPC使患者得到缓解和恢复。在这两项研究中，NPPC的表现与传统的手术后局部常规相似或更好。这些研究仅限于小样本量，并且缺乏仅使用载体或未经治疗的对照组是不道德的。结论：一种用于舒缓皮肤的NPPC在能量装置程序后显示出患者耐受性，安全性，并且在混合和部分烧蚀激光治疗后改善了愈合时间。患者表示对治疗有良好的反应，并且他们将返回第二次治疗的一致性很高，这表明患者保留。在HFL和FACL研究中，NPPC与传统的术后局部常规相比取得了相当的结果。临床试验注册：HFL研究：ClinicalTrials.gov ID: NCT06436261 https://clinicaltrials.gov/study/NCT06436261?term=NCT06436261&rank=1FACL研究：ClinicalTrials.gov ID: NCT06366503 https://www.Clinicaltrials: gov/ Study /NCT06366503？ClinicalTrials.gov注册在研究结束后完成，用于期刊发表。
{"title":"A Novel Neurocosmetic Postprocedure Cream for Optimal Recovery and Tolerability From Energy-Based Devices","authors":"Nathan M. Weir, A. J. Burns, Tatiana Kononov, Alisar S. Zahr","doi":"10.1002/lsm.70078","DOIUrl":"10.1002/lsm.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A neurocosmetic post-procedure cream (NPPC) was developed as a semi-breathable topical to provide relief and recovery following energy-based device treatments. The NPPC was investigated following hybrid fractional and fractional ablative laser resurfacing to assess tolerability, safety, and patient compliance and retention, as well as compare against a conventional post-procedure topical routine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two randomized, double-blinded, split-face, controlled, procedure-pairing studies were conducted with healthy females aged 35–65 years with Fitzpatrick Skin Types I–III and moderate to severe photodamage. Subjects were randomized to apply the NPPC and a comparator moisturizer (CM) or comparator anhydrous formulation (CAF) three times daily for 7 days post-hybrid fractional laser (HFL) or 14 days post-fractional ablative CO<sub>2</sub> laser (FACL), respectively. Tolerability evaluations, questionnaires, and clinical photography were conducted at baseline and post-baseline timepoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen and twenty-two healthy female subjects completed the HFL and FACL studies, respectively. The NPPC was effective at improving erythema, edema, dryness, burning, itching, stinging, and discomfort as evidenced by tolerability evaluations, clinical photography, and questionnaires. There were no significant adverse events. Day 1 post-FACL treatment, 91% of subjects favorably agreed “the product calmed my skin.” Patient relief and recovery were achieved with the NPPC. Across the two studies, the NPPC performed similarly or better than the conventional postprocedure topical routine investigated. The studies are limited to a small sample size, and the lack of a vehicle-only or untreated control arm is unethical.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An NPPC developed to soothe skin following energy-based device procedures demonstrated patient tolerability, safety, and improved healing time following hybrid and fractional ablative laser treatments. Patients indicated favorable responses to the treatments, and there was high agreement that they would return for a second treatment, denoting patient retention. The NPPC achieved comparable outcomes versus the conventional postprocedure topical routine in both HFL and FACL studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"788-798"},"PeriodicalIF":1.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Picosecond lasers (PSL) are increasingly used for treating melasma, with fewer adverse effects reported compared to Q-switched lasers (QSL). However, the incidence of hypopigmentation following PSL treatment remains unexplored in detail. This case series aims to explore outcomes of hypopigmentation following PSL therapy in patients with melasma, and explore potential contributing factors.
Methods
A retrospective chart review identified four patients with hypopigmentation following PSL treatment for melasma, including one referral from another clinic. Across the cohort, 796 patients underwent 3096 sessions between 2021 and 2025. Treatments used 755 and/or 1064-nm wavelengths at low fluences, with intervals of 4–12 weeks.
Results
Three in-clinic patients (0.38%, 95% CI 0.13%–1.10%) and one referral developed hypopigmentation. Changes occurred across both wavelengths and beam profiles. Histology demonstrated preserved melanocyte density with reduced melanin pigment and melanosome content. None of the cases showed meaningful re-pigmentation at 6-month follow-up. No cases of post-inflammatory hyperpigmentation (PIH) were observed.
Conclusion
While hypopigmentation is rare with PSL treatment, it can occur even with conservative low-fluence settings and adequate intervals between sessions. One possible mechanism is thermal beam- stacking, where slow hand movement during treatment may lead to repeated pulses on the same area. This can result in localised thermal accumulation, potentially causing subcellular disruption of melanosomes without overt melanocyte loss. These findings suggest the need for clinician vigilance in monitoring for hypopigmentation, as re-pigmentation may not be achievable. Larger, controlled studies are needed to clarify risk factors and guide safer practice.
目的：皮秒激光（PSL）越来越多地用于治疗黄褐斑，与调q激光（QSL）相比，报告的不良反应较少。然而，PSL治疗后色素沉着降低的发生率仍未详细探讨。本病例系列旨在探讨黄褐斑患者在PSL治疗后色素沉着降低的结果，并探讨潜在的影响因素。方法：回顾性分析了4例PSL治疗黄褐斑后出现色素沉着的患者，其中1例来自其他诊所。在整个队列中，796名患者在2021年至2025年期间接受了3096次治疗。在低影响下使用755和/或1064纳米波长，间隔4-12周。结果：3例临床患者（0.38%,95% CI 0.13% ~ 1.10%）和1例转诊患者出现色素沉着。波长和光束轮廓都发生了变化。组织学显示黑素细胞密度保留，黑色素和黑素小体含量减少。在6个月的随访中，所有病例均未出现有意义的色素沉着。无炎症后色素沉着（PIH）病例。结论：虽然PSL治疗的低色素沉着很少见，但即使在保守的低通量环境和适当的治疗间隔下也可能发生。一种可能的机制是热束叠加，在治疗过程中缓慢的手部运动可能导致同一区域的重复脉冲。这可能导致局部热积累，潜在地引起黑素小体的亚细胞破坏，而没有明显的黑素细胞损失。这些发现提示临床医生在监测色素沉着不足时需要保持警惕，因为再色素沉着可能无法实现。需要更大规模的对照研究来澄清风险因素并指导更安全的实践。
{"title":"Hypopigmentation Following Picosecond Laser Treatment for Melasma: A Case Series","authors":"Xiaozhun Hang, Davin Sui Lim","doi":"10.1002/lsm.70077","DOIUrl":"10.1002/lsm.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Picosecond lasers (PSL) are increasingly used for treating melasma, with fewer adverse effects reported compared to Q-switched lasers (QSL). However, the incidence of hypopigmentation following PSL treatment remains unexplored in detail. This case series aims to explore outcomes of hypopigmentation following PSL therapy in patients with melasma, and explore potential contributing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective chart review identified four patients with hypopigmentation following PSL treatment for melasma, including one referral from another clinic. Across the cohort, 796 patients underwent 3096 sessions between 2021 and 2025. Treatments used 755 and/or 1064-nm wavelengths at low fluences, with intervals of 4–12 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three in-clinic patients (0.38%, 95% CI 0.13%–1.10%) and one referral developed hypopigmentation. Changes occurred across both wavelengths and beam profiles. Histology demonstrated preserved melanocyte density with reduced melanin pigment and melanosome content. None of the cases showed meaningful re-pigmentation at 6-month follow-up. No cases of post-inflammatory hyperpigmentation (PIH) were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While hypopigmentation is rare with PSL treatment, it can occur even with conservative low-fluence settings and adequate intervals between sessions. One possible mechanism is thermal beam- stacking, where slow hand movement during treatment may lead to repeated pulses on the same area. This can result in localised thermal accumulation, potentially causing subcellular disruption of melanosomes without overt melanocyte loss. These findings suggest the need for clinician vigilance in monitoring for hypopigmentation, as re-pigmentation may not be achievable. Larger, controlled studies are needed to clarify risk factors and guide safer practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"777-787"},"PeriodicalIF":1.9,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Photobiomodulation in Sjögren's Syndrome: Reflections on Emerging Nonpharmacological Strategies","authors":"Gianluca Pagnoni, Aurora Vicenzi, Francesca Coppi","doi":"10.1002/lsm.70076","DOIUrl":"10.1002/lsm.70076","url":null,"abstract":"","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"758-759"},"PeriodicalIF":1.9,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soraya de Mattos Camargo Grossmann, Laura Cascão Lopes, Luiza Grossmann de Almeida, Mariana Silveira Souza, Laura Maria de Almeida Araújo, Helenice de Andrade Marigo Grandinetti, Rinaldo Borges de Almeida
{"title":"Formal Response to the Letter to the Editor Entitled “Photobiomodulation in Sjögren's Syndrome: Reflections on Emerging Nonpharmacological Strategies”","authors":"Soraya de Mattos Camargo Grossmann, Laura Cascão Lopes, Luiza Grossmann de Almeida, Mariana Silveira Souza, Laura Maria de Almeida Araújo, Helenice de Andrade Marigo Grandinetti, Rinaldo Borges de Almeida","doi":"10.1002/lsm.70075","DOIUrl":"10.1002/lsm.70075","url":null,"abstract":"","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kallan Richards, Katya Hanessian, Ali Albaghli, Gabriel Martin, Daniel Jhang, Adel Battikha, Joshua Ghoulian, Zham Okhunov, D. Duane Baldwin
Objectives
Although the thulium fiber laser (TFL, 1940 nm) efficiently fragments stones, concerns have been raised regarding heat production. Recently, a TFL with a modified duty cycle (MDC) was designed to reduce heat generation. The purpose of this study was to compare heat generation between the MDC and conventional TFL.
Methods
Ten millimeter BegoStone phantoms were placed in the proximal ureter of a kidney and ureter model. The model was submerged in a 35°C saline bath, with continuous saline irrigation (22°C) maintained at 15 mL/min through a ureteroscope. Temperature was measured using a needle thermocouple. Five trials of 60 s continuous laser activation were performed for each power setting: 3 W (0.3 J/10 Hz), 10 W (1 J/10 Hz), 20 W (1 J/20 Hz) and 30 W (0.6 J/50 Hz). Thermal dose was calculated as cumulative equivalent minutes at 43°C (CEM₄₃; injury threshold> 20). Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis with p < 0.05 being significant.
Results
Both lasers produced maximum temperatures (Tmax) of 27°C at 3 W. The MDC TFL generated a significantly lower Tmax than the conventional TFL at 10 W (36.9°C vs 42.1°C, p < 0.001), 20 W (38.1°C vs 44.6°C, p < 0.001), and 30 W (52.5°C vs 63.6°C, p < 0.05). CEM₄₃ for the MDC and conventional TFL at 20 W were (0.00 vs 0.90, respectively), and at 30 W (425 vs 275,919, respectively).
Conclusions
The MDC TFL generated lower temperatures at 10, 20, and 30 W. Future studies are necessary to evaluate stone fragmentation efficiency of the MDC TFL.
目的：虽然铥光纤激光器（TFL, 1940 nm）能有效地粉碎石头，但人们对其产生的热量提出了担忧。最近，设计了一种具有改进占空比（MDC）的TFL来减少热量的产生。本研究的目的是比较MDC和传统TFL之间的热量产生。方法：将10毫米BegoStone模型放置于肾脏输尿管近端及输尿管模型。将模型浸泡在35°C生理盐水浴中，通过输尿管镜持续冲洗22°C生理盐水，维持15 mL/min。温度测量使用针热电偶。每种功率设置分别为3 W （0.3 J/10 Hz）、10 W （1 J/10 Hz）、20 W （1 J/20 Hz）和30 W (0.6 J/50 Hz)，进行了5次60 s连续激光激活试验。热剂量计算为43°C下的累积等效分钟（CEM₄₃；损伤阈值bbb20）。使用Kruskal-Wallis和Mann-Whitney U检验进行p的统计分析。结果：两种激光器在3w下产生的最高温度（Tmax）均为27°C。与传统TFL相比，MDC TFL在10 W（36.9°C vs 42.1°C）下产生的Tmax显著低于传统TFL。未来有必要进一步研究MDC TFL的碎石破碎效率。
{"title":"Does Duty Cycle Modification Affect Temperature During Thulium Fiber Laser Lithotripsy?","authors":"Kallan Richards, Katya Hanessian, Ali Albaghli, Gabriel Martin, Daniel Jhang, Adel Battikha, Joshua Ghoulian, Zham Okhunov, D. Duane Baldwin","doi":"10.1002/lsm.70067","DOIUrl":"10.1002/lsm.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although the thulium fiber laser (TFL, 1940 nm) efficiently fragments stones, concerns have been raised regarding heat production. Recently, a TFL with a modified duty cycle (MDC) was designed to reduce heat generation. The purpose of this study was to compare heat generation between the MDC and conventional TFL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten millimeter BegoStone phantoms were placed in the proximal ureter of a kidney and ureter model. The model was submerged in a 35°C saline bath, with continuous saline irrigation (22°C) maintained at 15 mL/min through a ureteroscope. Temperature was measured using a needle thermocouple. Five trials of 60 s continuous laser activation were performed for each power setting: 3 W (0.3 J/10 Hz), 10 W (1 J/10 Hz), 20 W (1 J/20 Hz) and 30 W (0.6 J/50 Hz). Thermal dose was calculated as cumulative equivalent minutes at 43°C (CEM₄₃; injury threshold> 20). Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis with <i>p</i> < 0.05 being significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both lasers produced maximum temperatures (<i>T</i><sub>max</sub>) of 27°C at 3 W. The MDC TFL generated a significantly lower Tmax than the conventional TFL at 10 W (36.9°C vs 42.1°C, <i>p</i> < 0.001), 20 W (38.1°C vs 44.6°C, <i>p</i> < 0.001), and 30 W (52.5°C vs 63.6°C, <i>p</i> < 0.05). CEM₄₃ for the MDC and conventional TFL at 20 W were (0.00 vs 0.90, respectively), and at 30 W (425 vs 275,919, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MDC TFL generated lower temperatures at 10, 20, and 30 W. Future studies are necessary to evaluate stone fragmentation efficiency of the MDC TFL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"821-826"},"PeriodicalIF":1.9,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Shi, Yu-xin Zhang, Dan Ye, Xi Zhao, Hong-mei Zhou, Meng-yao Yang, Jia-hua Guo, Wei-Hui Zeng
Objectives
Rosacea is a chronic inflammatory skin condition with a complex pathogenesis involving immune dysregulation and angiogenesis. Q-switched 1064 nm neodymium:yttrium-aluminum-garnet (QSNY) laser has been demonstrated as an effective treatment for rosacea; however, studies investigating histological changes following QSNY treatment are limited. This study aims to evaluate the therapeutic effects of QSNY and explore its underlying mechanisms.
Materials and Methods
A rosacea-like mouse model was established by intradermal injection of LL37 into BALB/c mice. Hematoxylin and eosin (H&E) staining, along with immunohistochemical staining for myeloperoxidase (MPO) and CD31, were performed to assess inflammation and angiogenesis. mRNA expression levels of rosacea-associated markers were analyzed using real-time quantitative PCR (RT-qPCR) on RNA extracted from skin lesions.
Results
QSNY treatment significantly reduced skin erythema and inflammatory cell infiltration in a rosacea-like mouse model. The number of CD31- and MPO-positive cells were notably decreased following QSNY treatment. Additionally, the mRNA expression levels of rosacea-associated genes, including Toll-like receptor 2 (TLR2), kallikrein 5 (KLK5), cyclic adenosine monophosphate (cAMP), elevated interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF)-1, and VEGF-2 were downregulated.
Conclusion
QSNY effectively mitigates the rosacea phenotype by suppressing inflammation and angiogenesis, highlighting its potential as a therapeutic strategy for rosacea.
{"title":"Therapeutic Effects of Q-Switched 1064 nm Nd:YAG Laser on Rosacea in a Mouse Model: Inflammation and Angiogenesis Modulation","authors":"Jing Shi, Yu-xin Zhang, Dan Ye, Xi Zhao, Hong-mei Zhou, Meng-yao Yang, Jia-hua Guo, Wei-Hui Zeng","doi":"10.1002/lsm.70074","DOIUrl":"10.1002/lsm.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Rosacea is a chronic inflammatory skin condition with a complex pathogenesis involving immune dysregulation and angiogenesis. Q-switched 1064 nm neodymium:yttrium-aluminum-garnet (QSNY) laser has been demonstrated as an effective treatment for rosacea; however, studies investigating histological changes following QSNY treatment are limited. This study aims to evaluate the therapeutic effects of QSNY and explore its underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A rosacea-like mouse model was established by intradermal injection of LL37 into BALB/c mice. Hematoxylin and eosin (H&E) staining, along with immunohistochemical staining for myeloperoxidase (MPO) and CD31, were performed to assess inflammation and angiogenesis. mRNA expression levels of rosacea-associated markers were analyzed using real-time quantitative PCR (RT-qPCR) on RNA extracted from skin lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>QSNY treatment significantly reduced skin erythema and inflammatory cell infiltration in a rosacea-like mouse model. The number of CD31- and MPO-positive cells were notably decreased following QSNY treatment. Additionally, the mRNA expression levels of rosacea-associated genes, including Toll-like receptor 2 (TLR2), kallikrein 5 (KLK5), cyclic adenosine monophosphate (cAMP), elevated interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF)-1, and VEGF-2 were downregulated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>QSNY effectively mitigates the rosacea phenotype by suppressing inflammation and angiogenesis, highlighting its potential as a therapeutic strategy for rosacea.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"837-844"},"PeriodicalIF":1.9,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study systematically reviews randomized controlled trials (RCTs) evaluating laser therapy for vulvar lichen sclerosus (VLS) to assess its efficacy and safety, aiming to inform clinical management and guideline development.
Methods
RCTs on laser treatment for VLS were retrieved from PubMed, Embase, Web of Science, and Cochrane databases up to January 2025, limited to English literature. References from included studies were also screened. Data on study characteristics, laser parameters, outcome measures, measurement tools, and assessment time points were extracted and analyzed.
Results
Seven RCTs (332 patients) reported 19 outcomes and 19 measurement tools, each used a total of 28 times. Symptoms and signs were most frequently reported and commonly measured using the Visual Analog Scale (VAS). Most trials indicated improvements in symptoms, signs, quality of life (QoL), and histology after laser therapy. Three studies reported greater symptom/sign improvement than topical corticosteroids (p < 0.05), and three found higher patient satisfaction (p < 0.05). Two studies showed good tolerability via VAS. Adverse events occurred in five studies (147 patients), including five mild cases (local irritation, blisters, urinary tract infection, itching, and pain). Due to heterogeneity and low study quality, a meta-analysis was not performed.
Conclusions
Laser therapy improves symptoms/signs, QoL, and histological outcomes in VLS, with good safety and tolerability. However, the evidence supporting its use as a monotherapy is limited, and benefits for anti-inflammatory, anti-fibrotic, scar-preventive, or anticarcinogenic effects remain unproven. Large-scale, long-term, and high-quality trials are needed, and future research should establish standardized Core Outcome and Measurement Sets to optimize VLS management.
目的：本研究系统回顾了评价激光治疗外阴硬化苔藓（VLS）的随机对照试验（rct），以评估其有效性和安全性，旨在为临床管理和指南制定提供信息。方法：从PubMed、Embase、Web of Science和Cochrane数据库中检索截至2025年1月的激光治疗VLS的随机对照试验，仅限于英文文献。纳入研究的参考文献也被筛选。提取和分析研究特征、激光参数、结果测量、测量工具和评估时间点的数据。结果：7项随机对照试验（332例患者）报告了19种结局和19种测量工具，每种工具共使用28次。症状和体征是最常报告的，通常使用视觉模拟量表（VAS）进行测量。大多数试验显示激光治疗后症状、体征、生活质量（QoL）和组织学改善。三个研究报告了比局部皮质类固醇更大的症状/体征改善(p结论：激光治疗改善了VLS的症状/体征、生活质量和组织学结果，具有良好的安全性和耐受性。然而，支持其作为单一疗法使用的证据是有限的，并且在抗炎、抗纤维化、疤痕预防或抗癌作用方面的益处仍未得到证实。需要大规模、长期和高质量的试验，未来的研究应建立标准化的核心结果和测量集，以优化VLS管理。
{"title":"Efficacy and Safety of Laser Treatment in Vulvar Lichen Sclerosus: A Systematic Review","authors":"Dongmei Wei, Jian Meng, Qiao Li, Yajing Wang, Yueyue Chen, Xiaoyu Niu","doi":"10.1002/lsm.70062","DOIUrl":"10.1002/lsm.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study systematically reviews randomized controlled trials (RCTs) evaluating laser therapy for vulvar lichen sclerosus (VLS) to assess its efficacy and safety, aiming to inform clinical management and guideline development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RCTs on laser treatment for VLS were retrieved from PubMed, Embase, Web of Science, and Cochrane databases up to January 2025, limited to English literature. References from included studies were also screened. Data on study characteristics, laser parameters, outcome measures, measurement tools, and assessment time points were extracted and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven RCTs (332 patients) reported 19 outcomes and 19 measurement tools, each used a total of 28 times. Symptoms and signs were most frequently reported and commonly measured using the Visual Analog Scale (VAS). Most trials indicated improvements in symptoms, signs, quality of life (QoL), and histology after laser therapy. Three studies reported greater symptom/sign improvement than topical corticosteroids (<i>p</i> < 0.05), and three found higher patient satisfaction (<i>p</i> < 0.05). Two studies showed good tolerability via VAS. Adverse events occurred in five studies (147 patients), including five mild cases (local irritation, blisters, urinary tract infection, itching, and pain). Due to heterogeneity and low study quality, a meta-analysis was not performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Laser therapy improves symptoms/signs, QoL, and histological outcomes in VLS, with good safety and tolerability. However, the evidence supporting its use as a monotherapy is limited, and benefits for anti-inflammatory, anti-fibrotic, scar-preventive, or anticarcinogenic effects remain unproven. Large-scale, long-term, and high-quality trials are needed, and future research should establish standardized Core Outcome and Measurement Sets to optimize VLS management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"760-770"},"PeriodicalIF":1.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosanna Rodríguez-Betancourt, Pedro A. Martínez-Carpio
Background and Objective
Subdermal application of Nd:YAG lasers at wavelengths of 1064, 1320, and 1444 nm has shown promise as a minimally invasive treatment for mild to moderate brachial ptosis. This study explores the efficacy and safety of our procedure, using the 1064 nm wavelength as a standalone modality.
Study Design/Materials and Methods
This was a single-arm, evaluator-blinded clinical trial. A standardized surgical protocol was implemented using subcutaneous delivery of a pure 1064 nm Nd:YAG laser (SP Dynamis, Fotona, Slovenia). The study included 24 upper limbs from 12 female patients diagnosed with stage 2a or 2b brachial ptosis (El Khatib classification). Standardized anthropometric measurements and photographic documentation were obtained at 35 days, 3 months, and 9 months postprocedure. Safety and efficacy were assessed through clinical evaluations and validated patient-reported outcome measures.
Results
Significant esthetic improvements were observed in all treated limbs (p < 0.0001), including reductions in maximum arm circumference (p = 0.0005) and ptosis grade (p = 0.0016) in both arms. The most pronounced changes occurred by Day 35, with additional minor improvements at 3 months that remained stable through the 9-month follow-up. Patient satisfaction was high, and no significant intraoperative or postoperative complications were reported.
Conclusions
Subdermal 1064 nm Nd:YAG laser shows a favorable efficacy and safety profile and, if validated in larger studies, could become a first-line option for mild to moderate brachial ptosis.
{"title":"Subdermal 1064-nm Nd:YAG Laser for the Aesthetic Management of Brachial Ptosis: Blinded Clinical Evaluation in 24 Upper Limbs","authors":"Rosanna Rodríguez-Betancourt, Pedro A. Martínez-Carpio","doi":"10.1002/lsm.70073","DOIUrl":"10.1002/lsm.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Subdermal application of Nd:YAG lasers at wavelengths of 1064, 1320, and 1444 nm has shown promise as a minimally invasive treatment for mild to moderate brachial ptosis. This study explores the efficacy and safety of our procedure, using the 1064 nm wavelength as a standalone modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design/Materials and Methods</h3>\u0000 \u0000 <p>This was a single-arm, evaluator-blinded clinical trial. A standardized surgical protocol was implemented using subcutaneous delivery of a pure 1064 nm Nd:YAG laser (SP Dynamis, Fotona, Slovenia). The study included 24 upper limbs from 12 female patients diagnosed with stage 2a or 2b brachial ptosis (El Khatib classification). Standardized anthropometric measurements and photographic documentation were obtained at 35 days, 3 months, and 9 months postprocedure. Safety and efficacy were assessed through clinical evaluations and validated patient-reported outcome measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant esthetic improvements were observed in all treated limbs (<i>p</i> < 0.0001), including reductions in maximum arm circumference (<i>p</i> = 0.0005) and ptosis grade (<i>p</i> = 0.0016) in both arms. The most pronounced changes occurred by Day 35, with additional minor improvements at 3 months that remained stable through the 9-month follow-up. Patient satisfaction was high, and no significant intraoperative or postoperative complications were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Subdermal 1064 nm Nd:YAG laser shows a favorable efficacy and safety profile and, if validated in larger studies, could become a first-line option for mild to moderate brachial ptosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"799-808"},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustapha Ouali, Gonzalo P. Martin-Martin, Salih Avdicausevic, Amine Alam, Pavel Istok, Ints Brunenieks, Vladimir Dobricanin, Vincent de Parades, Jiong Wu, Peter C. Ambe
Objectives
Minimally invasive treatment of pilonidal sinus disease (PSD) via sinus tract laser closure (SiLaC) and endoscopic pilonidal sinus treatment (EPSiT) is being increasingly employed to manage PSD. Despite its wide adoption amongst colorectal surgeons in many nations, there still exists a wide heterogeneity in surgical technique. The International Society of Laser Proctology (ISoLP) was created by experts in laser proctology has the goal of improving laser-based interventions in coloproctology with the aim of improving patient care in this specialized area.
Methods
This position paper is based on the limited evidence from available literature and largely on the expert opinion of ISoLP members with extended expertise in SiLaC and EPSiT.
Results
ISoLP experts in SiLaC and EPSiT procedures have suggested 10 statements to aid in homogenizing the SiLaC procedure alone and in combination with EPSiT, with the goal of improving treatment outcomes.
Conclusion
The 10 ISoLP position statements have a potential of shaping and homogenizing laser-assisted management of PSD.
{"title":"International Society of Laser Proctology Position Paper on SiLaC and EPSiT/SiLaC in the Management of Pilonidal Sinus Disease","authors":"Mustapha Ouali, Gonzalo P. Martin-Martin, Salih Avdicausevic, Amine Alam, Pavel Istok, Ints Brunenieks, Vladimir Dobricanin, Vincent de Parades, Jiong Wu, Peter C. Ambe","doi":"10.1002/lsm.70071","DOIUrl":"10.1002/lsm.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Minimally invasive treatment of pilonidal sinus disease (PSD) via sinus tract laser closure (SiLaC) and endoscopic pilonidal sinus treatment (EPSiT) is being increasingly employed to manage PSD. Despite its wide adoption amongst colorectal surgeons in many nations, there still exists a wide heterogeneity in surgical technique. The International Society of Laser Proctology (ISoLP) was created by experts in laser proctology has the goal of improving laser-based interventions in coloproctology with the aim of improving patient care in this specialized area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This position paper is based on the limited evidence from available literature and largely on the expert opinion of ISoLP members with extended expertise in SiLaC and EPSiT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ISoLP experts in SiLaC and EPSiT procedures have suggested 10 statements to aid in homogenizing the SiLaC procedure alone and in combination with EPSiT, with the goal of improving treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 10 ISoLP position statements have a potential of shaping and homogenizing laser-assisted management of PSD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"57 10","pages":"845-850"},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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