Background Postacne erythema (PAE) is a common sequela of inflammatory acne vulgaris, treatment of which has been challenging due to limited options available and the variability of results for each modality. Recently, a 577‐nm high‐power optically pumped semiconductor laser (HOPSL) initially developed for vascular lesions has shown promising results for the treatment of PAE. Aims To evaluate the efficacy and safety of 577‐nm HOPSL in the treatment of postacne erythema. Methods This was a split‐face, randomized controlled trial pilot study. Twenty‐one patients with PAE on both sides of their face were enrolled. Each subject's face sides were randomly assigned to either receive 577‐nm HOPSL treatment (QuadroStar PRO™, Asclepion Laser Technologies) using the scanner handpiece, 1mm spot size, 80% coverage, 12‐15 J/cm2, 30 ms, 2 passes for 3 sessions at 1‐month intervals, or no treatment at all. Outcome measures such as overall improvement, the Erythema Index (EI), and Melanin Index (MI) from 3 different areas on both treatment and control sides were assessed at baseline, and 1‐month follow‐up after each treatment session. Side effects including pain, erythema, swelling, and crusting were also recorded. Results Upon completion of the treatment period, the mean EI was significantly decreased in both treated and nontreated sides of the face (P < .001 and P = .001, respectively). The laser‐treated sides already demonstrated significant reduction in the mean EI compared with nontreated sides at 1 month after the 2nd treatment (P = .007). The mean MI of both sides, however, did not show any statistically significant differences from baseline, and likewise when comparing between sides. Patients reported more improvement on laser‐treated sides compared with nontreated sides. Reported side effects were limited to mild discomfort during treatment and transient facial erythema lasting approximately 30 minutes. Conclusion Patients who received treatment with the 577‐nm HOPSL had better outcomes with minimal side effects at 1 month after 2 treatments as compared to those who did not receive any treatment. Therefore, the 577‐nm HOPSL may be considered as an effective adjuvant treatment for PAE and early erythematous atrophic scars.
BackgroundStudies of the laser treatment of nondermatophyte mold (NDM) onychomycosis are limited. Long‐pulsed neodymium:yttrium‐aluminum‐garnet (Nd:YAG) 1064‐nm laser has been introduced as an adjuvant dermatophyte onychomycosis treatment.AimsTo investigate the efficacy and safety of long‐pulsed Nd:YAG 1064‐nm laser for NDM onychomycosis treatment, compared with topical amorolfine nail lacquer alone and a combination treatment.Patients/MethodsThis randomized controlled trial was conducted at the Nail Clinic, Siriraj Hospital. Patients diagnosed with NDM were included and randomly assigned to three treatment groups: laser at 1 month interval (1064‐nm Nd:YAG at a fluence of 35 J/cm2, pulse width 30 ms, and pulse rate 1.0 Hz); topical amorolfine nail lacquer alone; and a combination treatment.ResultsSixty patients completed the study. The patients treated with the laser, amorolfine, and the combination achieved mycological cure rates of 35%, 60%, and 65%, respectively (P = .05), while 10%, 30%, and 30% of the patients in the respective groups were clinically cured. The mean durations to the mycological cures in the patients treated with laser, amorolfine, and the combination were 5.9, 4.8, and 5.2 months, respectively. By comparison, the corresponding mean durations to the clinical cures were 6.9, 6.5, and 5.9 months. Both the times to the mycological cures and the clinical cures did not differ significantly between the groups (P = .290 and P = .309, respectively). There were no serious complications with the laser treatment.ConclusionsLaser alone achieved only a 30% mycological cure rate for NDM onychomycosis. The combination treatment yielded similar outcomes to the topical treatment alone.
Background Reapplication of sunscreen every 2 hours is recommended, especially after swimming, sweating, or working outdoors. However, the sustainability of sunscreen during the workday among outdoor workers is still unclear. Objective To evaluate the course of facial sunscreen coverage and sustainability over an 8‐hour workday among outdoor workers. Materials and Methods This open‐label trial included 20 healthy subjects who spend at least 80% of their workday outdoors. All volunteers applied 2 mg/cm 2 of provided broad‐spectrum sunscreen mixed with the invisible blue fluorescent agent to all parts of their face in the morning. A VISIA‐CR camera was used to capture facial fluorescence intensity every 2 hours, and digital image analysis software was used to quantify fluorescence intensity at six areas of the face at each time point for 8 hours. Results Sunscreen coverage declined most rapidly during the first 2 hours with a mean reduction of 18.31%. By the end of the 8‐hour study workday, the mean decrease in sunscreen coverage was 31.63% (range: 17.39%‐45.29%). Conclusion Reapplication of sunscreen is essential among outdoor workers. After 4 hours, the amount of sunscreen remaining on the face may not be sufficient for protecting the skin from harmful ultraviolet radiation.
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