Journal of Cosmetic and Laser Therapy最新文献

Melasma is a persistent and recurrent condition that remains difficult to manage effectively. Both fractional 1064 nm picosecond Nd:YAG (PSNY) and low-fluence Q-switched Nd:YAG (QSNY) lasers have been applied in treatment, yet there is currently insufficient data to compare their efficacy and safety. This retrospective study evaluated 99 female patients with melasma, including 54 treated with PSNY laser and 45 with QSNY laser. Each patient received two to five laser sessions at 2-4-week intervals. Clinical efficacy was evaluated by the modified Melasma Area and Severity Index (mMASI) at baseline, as well as four weeks following the second and fifth treatment sessions, with adverse events carefully documented. The PSNY laser produced a mean mMASI reduction of 23.7% and 40.7% after two and five sessions, respectively, while QSNY treatment achieved reductions of 9.8% and 29.5%. Although both modalities were safe and effective, PSNY laser demonstrated faster clinical improvement and required lower energy fluence. Post-inflammatory hyperpigmentation occurred in 7.4% of PSNY-treated patients and 13.3% of QSNY-treated patients, with no significant difference between groups. In conclusion, fractional PSNY laser therapy provides a rapid, safe, and effective alternative to QSNY laser for managing melasma.

The use of high-power lasers for facial rejuvenation has been growing every year. In particular, the Thulium laser in non-ablative mode has gained prominence due to its safety, postoperative comfort, and wide clinical indication. This report details the first documented case of a varicella-zoster virus expression following the use of a non-ablative fractional 1927 nm Thulium laser for facial skin aging and pigmentated lesions. The treatment proposed involved a combination of phototherapies as an adjunctive local strategy, alongside systemic acyclovir therapy. In nine days, herpetic lesions and skin areas with altered sensory function were no longer present. Varicella-zoster virus expression should be considered following aesthetic skin treatments with fractional Thulium laser, and the need for prophylaxis with antiviral agents may be appropriate for certain cases. Moreover, the combination of phototherapies proposed herein seemed to be beneficial for accelerating the resolution of such a condition.

Scars from skin cancer surgery impact patients' quality of life. In recent years, fractional CO₂ (fCO₂) laser has been used for scar improvement. A single-center retrospective study (n = 22) was conducted to evaluate the safety and efficacy of the fCO₂ laser in improving the aesthetic outcome of post-surgical skin cancer scars, using the validated Vancouver Scar Scale (VSS). We obtained a mean VSS reduction of 44.5% and an absolute decrease of 2.77 points (p < .001). Statistically significant improvements were observed in all VSS parameters except for pigmentation. No significant correlation was found between time since surgery and reduction in VSS. Fractional CO₂ laser is a safe and effective approach for improving surgical scars following skin cancer treatment. Its efficacy is not limited to early scars.

Background: Nevus of Ota (NO) "oculodermal melanocytosis" is prevalent in Asians. Bilateral nevus of Ota (BNO) is a rare condition and comprises 5% of the cases seen. Picosecond laser (PS) is useful in treating various cutaneous benign pigmentary disorders including NO. We analyzed the clinical data on BNO in Vietnamese patients and evaluated the efficacy of treatment of the 1064 nm Nd:YAG picosecond laser (PSNY).

Subjects and methods: Twenty-nine Vietnamese patients (ages 2-67 years, mean 23.36 ± 17.5) with BNO received at least 3 treatment sessions with 1064-nm PSNY (4-5 mm spot size; 1.5-2.4J/cm², 4-week intervals). Improvement was documented through serial photographs that were taken at baseline (T0), after 4 weeks of the 3^rd session (T1), 6^th session (T2), 9^th session (T3), and more than 10 sessions (T4). Response to the treatment was graded based on a 5-point grading scale.

Results: The participants were predominantly female (23 females, 6 males). Sclera, nasal mucosa, and pharyngeal NO lesions were observed in 24 patients (51.7%, 69%, and 6.9%, respectively). Two cases (6.89%) had lesions combined with Port-Wine-Stains. In the majority of cases, more than two branches of the trigeminal nerve were involved (89.66%). Onset of the lesions at <10 years old was 69% and involvement of more than two branches of the trigeminal nerve in these patients was 89.66%. Overall, 100% of patients demonstrated an improvement of the BNO lesions following treatment. A total of 88.9% of patients demonstrated a score compatible with good improvement to complete clearance after 9 treatment sessions on the treatment scoring scale. No severe adverse events or complications were observed. The 1064-nm PSNY laser has the potential to achieve faster clearance for treating dermal pigmentary disorders in Asians. To our knowledge, this is the largest reported series of BNO treated with a laser.

Conclusion: Our results suggest that 1064-nm PSNY laser treatment is efficacious and an appropriate therapeutic modality for the treatment of BNO with minimal downtime and minimal adverse side effects.

Colloid milium (CM) is a rare degenerative deposition skin disorder known by multiple small, domed, flesh-colored papules that may coalesce into large plaques or highly disfiguring nodules. CM frequently involves sun-exposed body areas, such as the face and dorsal hands. Currently, there is no single effective treatment for CM. Herein, we present a case of adult colloid milium (ACM) with lesions around his nasolabial fold and perioral region who was successfully treated with long-pulsed Erbium: YAG laser with no scarring, textural changes, pigment alterations, or evidence of clinical recurrence at the 3 years follow-up. A systematic search was conducted in PubMed and Scopus until 25 Jan 2025, evaluating all studies with treatment procedure comprehension for ACM. CO2 laser effectively ablated the lesions, while increasing the risk of thermal damage and scarring. Dermabrasion showed favorable efficacy; however, the authors did not specify whether textural changes or pigmentation disorders occurred. Non-Ablative fractional laser has minimal side effects, while multiple sessions are required for satisfactory results. The long-pulsed Er: YAG laser offers high precision and minimal invasiveness, however, its shallow penetration may require multiple sessions for deeper lesions. Long-pulsed Er: YAG laser should be considered an effective treatment for facial CM lesions. Future studies should compare laser types, optimize parameters, and explore adjunct therapies to improve outcomes.

This study aims to investigate the underlying mechanisms and triggers of delayed-onset inflammatory responses DIRs after hyaluronic acid (HA) fillers injections. The literature review included articles on DIRs following HA filler treatments and identified immunological triggers, bacterial contamination, and filler degradation as key factors contributing to DIRs. Additionally, patient data were analyzed from patients treated for DIRs and showed possible immune activation events prior to DIRs included flu-like symptoms. This study underscores the complexity of DIRs following HA filler treatments and the need for transparency from manufacturers. Comprehensive ingredient data are crucial to better understand DIRs and ensure patient safety.

Energy-based devices, especially lasers and ultrasound (HIFU/MFU-V), have transformed esthetic medicine, yet evidence remains scattered. This hybrid review couples systematic retrieval of quantitative studies with expert synthesis to define areas of strength and caution. Searches of MEDLINE, Embase, Scopus, and Cochrane captured RCTs, observational series, and meta-analyses on laser- and ultrasound-guided interventions. Efficacy, downtime, satisfaction, and complications were extracted and tabulated, focusing on Fitzpatrick IV-VI skin, BMI sub-groups, and emerging AI-guided planning.

Laser resurfacing and chemical peels have emerged as options for the field treatment of actinic keratoses (AKs). We aimed to evaluate the efficacy of lasers and chemical peels for field treatment of AKs and prevention of non-melanoma skin cancer (NMSC). A PubMed search of all relevant literature describing the use of laser resurfacing and chemical peels as field treatment in AK management or NMSC prevention was performed. Articles published through February 15, 2025, were included. Fifty-three unique studies evaluating laser and chemical resurfacing alone, or in combination with other treatments, for the treatment of AKs were identified; 45 focused on laser resurfacing and nine on chemical peels. Fifteen studies evaluated either recurrence of AKs or progression to NMSC. Combination therapies using ablative lasers with photodynamic therapy had the greatest clearance of AKs, and ablative lasers alone were more effective than non-ablative lasers. Chemical peels exhibited a more tolerable side effect profile but were less effective in treating AKs. Further studies are needed to optimize procedural protocols and evaluate long-term outcomes, including recurrence of AKs and progression to NMSC, following these field treatments.

This systematic review evaluates treatment options for postoperative scars using evidence from randomized controlled trials. A total of 214 studies encompassing 11,132 treated scars and 49 unique interventions were identified. Multiple treatments demonstrated efficacy, including topical agents (e.g. silicone), injectables (e.g. botulinum toxin, PRP, corticosteroids, 5-FU), mechanical interventions (e.g. dermabrasion, tension offloading devices), vascular lasers (e.g. PDL, KTP), non-ablative lasers (e.g. NAFL, Nd:YAG), and ablative lasers (e.g. CO₂, Er:YAG). Wide variability in treatment protocols, follow-up duration, and outcome measures limits direct comparisons across studies. Current evidence supports a tailored, multimodal approach to postoperative scar management, guided by individual scar characteristics.