-
Actas Dermo-sifiliograficas 2022Burn scars cause high morbidity in the form of contractures, body disfigurement, and itching, and they also have a high emotional impact that adversely affects patient... (Review)
Review
Burn scars cause high morbidity in the form of contractures, body disfigurement, and itching, and they also have a high emotional impact that adversely affects patient quality of life. Laser therapy has proven effective in this setting. It is superior to topical treatments and can be used in conjunction with surgery, helping to reduce morbidity. The use of lasers in hospital dermatology departments, however, is still limited. Carbon dioxide laser resurfacing is the most widely used modality for reducing scar thickness, improving textural abnormalities, and treating contractures. Treatments improve mobility for patients with constrictions. Pulsed dye laser treatments are particularly useful for reducing erythema in recent burn scars and preventing subsequent hypertrophy. Pigment laser treatments with short pulse durations (nanoseconds or picoseconds) can improve hyperpigmentation. In this article, we review the evidence for the use of laser therapy for burn scars and propose a treatment algorithm.
Topics: Humans; Cicatrix; Cicatrix, Hypertrophic; Lasers, Gas; Burns; Quality of Life; Laser Therapy; Contracture; Treatment Outcome
PubMed: 35963335
DOI: 10.1016/j.ad.2022.06.018 -
Lasers in Medical Science Mar 2023Multiple laser modalities have been used for melasma treatment. However, the effectiveness of picosecond laser in treating melasma remains unclear. This meta-analysis... (Meta-Analysis)
Meta-Analysis Review
Multiple laser modalities have been used for melasma treatment. However, the effectiveness of picosecond laser in treating melasma remains unclear. This meta-analysis investigated the effectiveness and safety of picosecond laser for melasma treatment. Randomized controlled trials (RCTs) comparing picosecond laser with conventional treatment for melasma were searched through five databases. The melasma area severity index (MASI)/modified MASI (mMASI) was used to quantify the degree of melasma improvement. Standardized mean differences and 95% confidence intervals were calculated using Review Manager for result standardization. Six RCTs, which used picosecond laser at 1064, 755, 595, and 532 nm wavelengths, were included herein. Picosecond laser significantly reduced the MASI/mMASI, but the results were highly heterogeneous (P = 0.008, I = 70%). In the subgroup analysis of 1064 and 755 nm picosecond lasers, 1064 nm picosecond laser significantly reduced the MASI/mMASI with no significant side effects (P = 0.04). Meanwhile, 755 nm picosecond laser did not significantly improve the MASI/mMASI compared with topical hypopigmentation agents (P = 0.08) and caused post-inflammatory hyperpigmentation. Other laser wavelengths could not be used in the subgroup analysis owing to an insufficient sample size. Picosecond laser at 1064 nm is safe and effective for melasma treatment. Picosecond laser at 755 nm is not superior to topical hypopigmentation agents in treating melasma. The exact efficacy of other wavelengths of picosecond laser for melasma treatment remains to be verified in large-scale RCTs.
Topics: Humans; Lasers, Solid-State; Melanosis; Hyperpigmentation; Combined Modality Therapy; Hypopigmentation; Treatment Outcome
PubMed: 36897459
DOI: 10.1007/s10103-023-03744-y -
Lasers in Surgery and Medicine Jan 2021The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened... (Review)
Review
BACKGROUND AND OBJECTIVES
The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence-based recommendations are developed for the use of picosecond laser in dermatology.
STUDY DESIGN/MATERIALS AND METHODS
A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors' combined clinical experience, clinical recommendations were developed.
RESULTS
After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I-IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II-III evidence; tattoo removal was associated with level I evidence.
CONCLUSION
Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
Topics: Dermatology; Humans; Lasers, Solid-State; Melanosis; Rejuvenation; Tattooing
PubMed: 32282094
DOI: 10.1002/lsm.23244 -
Lasers in Medical Science Jan 2023Picosecond lasers have a very short pulse duration and a high peak power density. When fractional optical delivery systems are attached to picosecond lasers, they... (Review)
Review
Picosecond lasers have a very short pulse duration and a high peak power density. When fractional optical delivery systems are attached to picosecond lasers, they generate an array of concentrated microspots with a high fluence surrounded by areas with a low fluence. This article discusses the histologic characteristics and clinical applications of fractional picosecond laser treatment. Fractional picosecond laser produces laser-induced optical breakdown (LIOB) and laser-induced cavitation (LIC) in the epidermis and dermis respectively, and can encourage skin regeneration and dermal remodeling. It has been shown that fractional picosecond laser has a positive effect on facial photoaging, enlarged facial pores, dyspigmentation, wrinkles, and atrophic scars. Further research is still needed to confirm the benefits of fractional picosecond lasers.
Topics: Humans; Lasers, Solid-State; Skin; Epidermis; Cicatrix; Pigmentation Disorders; Treatment Outcome
PubMed: 36658259
DOI: 10.1007/s10103-022-03704-y -
Facial Plastic Surgery Clinics of North... Feb 2020Picosecond laser technology was cleared by Food and Drug Administration in 2012 and enhanced our ability to clear both benign pigmentation and dermal ink through a... (Review)
Review
Picosecond laser technology was cleared by Food and Drug Administration in 2012 and enhanced our ability to clear both benign pigmentation and dermal ink through a photomechanical impact created in the tissue. This impact created is greater than comparative nanotechnology and can be accomplished with lower fluences and smaller pulse durations. The addition of a diffractive lens array (FOCUS lens) has created a new category in skin rejuvenation by stimulating elastin and collagen through photomechanical and photoacoustic effects and not only through traditional photothermal tissue effects.
Topics: Humans; Laser Therapy; Lasers, Solid-State; Rejuvenation; Skin Aging; Tattooing
PubMed: 31779945
DOI: 10.1016/j.fsc.2019.09.008 -
Dermatologie (Heidelberg, Germany) Jun 2023The picosecond laser is one of the latest laser systems in dermatology and was originally developed to optimize tattoo removal. Advances in this technology has expanded... (Review)
Review
BACKGROUND
The picosecond laser is one of the latest laser systems in dermatology and was originally developed to optimize tattoo removal. Advances in this technology has expanded the use of the picosecond laser to numerous other indications.
OBJECTIVES
This article provides an overview of the technical background as well as the indications of the picosecond laser in dermatological laser medicine and elucidates the possibilities and limits of this laser system.
MATERIALS AND METHODS
The article is based on a review of the current literature as well as experience from clinical practice in a university laser department.
RESULTS
The picosecond laser enables a particularly gentle and effective treatment due to ultra-short pulses and the principle of laser-induced optical breakdown. Compared to Q‑switched lasers, the picosecond laser has fewer side effects and is associated with lower pain intensity and shorter downtime. In addition to the removal of tattoos and pigmentary disorders, it is also used in the treatment of scars and rejuvenation.
CONCLUSIONS
The picosecond laser has a wide range of indications in dermatological laser medicine. The current data indicate that the laser is an effective method with few side effects. Further prospective studies have to be conducted to assess the efficacy, tolerability and patient satisfaction in an evidence-based manner.
Topics: Humans; Prospective Studies; Dermatology; Lasers; Tattooing; Laser Therapy; Drug-Related Side Effects and Adverse Reactions
PubMed: 37099130
DOI: 10.1007/s00105-023-05144-3 -
Optics Letters Jun 2023Piezoelectric stretching of optical fiber is a technique that enables the creation of optical delays of a few picoseconds; this is useful in a variety of applications in...
Piezoelectric stretching of optical fiber is a technique that enables the creation of optical delays of a few picoseconds; this is useful in a variety of applications in interferometry or optical cavities. Most commercial fiber stretchers involve lengths of fiber of a few tens of meters. Using a 120-mm-long optical micro-nanofiber, we can create a compact optical delay line that achieves tunable delays of up to 19 ps at telecommunication wavelengths. The high elasticity of silica and the micron-scale diameter allow this significant optical delay to be achieved with low tensile force while keeping the overall length short. We successfully report both static and dynamic operation of this novel, to the best of our knowledge, device. It could find application in interferometry and laser cavity stabilization, where short optical paths and strong resistance to the environment would be required.
Topics: Nanofibers; Stretchers; Equipment Design; Lasers; Optical Fibers
PubMed: 37319091
DOI: 10.1364/OL.492600 -
Dermatologic Surgery : Official... May 2023The role of lasers in the treatment of melasma and acquired hyperpigmentation disease of the skin has been suggested by clinicians. However, there is no consensus on the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The role of lasers in the treatment of melasma and acquired hyperpigmentation disease of the skin has been suggested by clinicians. However, there is no consensus on the most efficient and safe treatment method.
OBJECTIVE
To systematically evaluate the efficacy and safety of picosecond laser in the treatment of melasma.
METHODS AND MATERIALS
PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese scientific journal database, and Wanfang database were searched. The data for therapeutic efficacy, melasma area and severity score, and incidence rate of adverse reactions were extracted from the included studies.
RESULTS
A total of 20 studies involving 1,182 patients were included in this network meta-analysis. Combined therapy with carbamic acid and 1064-nm picosecond laser was the best measure. Melasma area and severity index score of patients after low-power fractional CO2 laser treatment was higher than that of patients after the treatment with 1064-nm picosecond laser.
CONCLUSION
Aminomethyl cyclic acid combined with 1064-nm picosecond laser may have the highest effective rate after treatment. Low-power fractional CO2 laser provided the lowest melasma area and severity index score after treatment, and the incidence rate of adverse reactions after treatment, was highest when intense pulsed light was used.
Topics: Humans; Network Meta-Analysis; Lasers, Solid-State; Melanosis; Hyperpigmentation; Skin; Treatment Outcome
PubMed: 37116000
DOI: 10.1097/DSS.0000000000003775 -
Archives of Dermatological Research Dec 2023Melasma is a skin dyspigmentation condition that disproportionately affects women, particularly those of Latino, Black, and Asian ethnicities, significantly impacting... (Review)
Review
Melasma is a skin dyspigmentation condition that disproportionately affects women, particularly those of Latino, Black, and Asian ethnicities, significantly impacting their quality of life. Efforts to identify effective treatment options have led to the exploration of picosecond laser technology which utilizes brief pulse durations to break down pigment while minimizing thermal damage to surrounding tissue. The 755-nm alexandrite picosecond laser, currently FDA approved for benign pigmented lesion removal, including melasma, is a promising solution. We aim to assess the efficacy and safety of the 755-nm alexandrite picosecond laser both as a stand-alone treatment for melasma and in combination with topical agents. We conducted a PubMed search using "755-nm picosecond" AND "melasma," "755-nm picosecond" AND "hydroquinone," and "755-nm picosecond" AND "tranexamic acid." English-written studies examining this laser as monotherapy or in combination with the topical agents were included. Those not meeting the criteria or lacking data related to melasma improvement were excluded. Monotherapy with the 755-nm picosecond laser led to a 50-75% improvement in melasma appearance in 40% of participants and a significant reduction in the average Melasma Area and Severity Index (MASI) score (p < 0.001) in all patients of one study. Notably, the use of topical tranexamic acid (TTA) in conjunction with the picosecond laser exhibited the most significant degree of improvement in hemi-MASI scores compared to the laser monotherapy group at one- and three-months post-treatment (p < 0.05). Patient satisfaction was also significantly higher for the combination group (p < 0.05). In contrast, combining hydroquinone (HQ) with the picosecond laser demonstrated no significant difference in outcomes compared to HQ alone, both of which were less effective than TTA with picosecond laser. The combination of the 755-nm picosecond laser with TTA proves promising, outperforming both laser monotherapy and laser with HQ. While monotherapy with the picosecond laser or topical agents is effective, literature favors combination therapy, especially the 755-nm picosecond laser with TTA, for superior benefits and minimal side effects. Ultimately, individualized regimens, considering factors like skin type, should be prioritized, given the heightened risk of postinflammatory hyperpigmentation, especially in skin of color patients.
Topics: Humans; Female; Hydroquinones; Tranexamic Acid; Quality of Life; Melanosis; Hyperpigmentation; Treatment Outcome; Lasers, Solid-State
PubMed: 38151661
DOI: 10.1007/s00403-023-02794-0