A 1064-nm Neodymium-doped Yttrium Aluminum Garnet Picosecond Laser for the Treatment of Hyperpigmented Scars

Koren, Amir; Niv, Roni; Cohen, Shai; Artzi, Ofir

doi:10.1097/dss.0000000000001917

Cited by 12 publications

(12 citation statements)

References 15 publications

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“…Our experience with the PS laser for treatment of hyperpigmented scarring is promising, exhibiting satisfactory results (Figure = B&A pic) with a low side effect and pain profile and minimal downtime, similar to our past experience . Nevertheless, our experience does not seem to have differed much from prior treatments using a fractional nonablative laser .…”

Section: Discussionsupporting

confidence: 79%

Retrospective photographic review of nontattoo indications treated by picosecond laser

Mehrabi

Friedman

Al‐Niaimi

et al. 2020

J of Cosmetic Dermatology

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Dermatology is a rapidly advancing field with many technologies added to the expanding armamentarium of the physician, particularly in the cosmetic sector of the specialty. Patients of all age groups and backgrounds seek treatment for skin conditions; these range from young adults with acne and acne scarring to the elderly requiring skin rejuvenation. energy-based devices (EBDs) are increasingly frequently used for the treatment of different aesthetic dermatological problems. Every technology offers a different mechanism of action, recovery timescale, and adverse effects. New technologies are becoming costlier, and this may have implications on the ratio of service to cost-effectiveness. A well-tolerated EBD procedure that can effectively treat different skin types and multiple skin conditions with minimal adverse effects and shortened downtime might be more economically attractive due to its versatility and favorability among patients and treating physicians alike.Picosecond (PS) lasers were approved by the US FDA in 2012 for the removal of tattoos. 1 The iconic feature of the PS laser is that its pulse duration is less than a nanosecond, achieving a photoacoustic effect and limiting the amount of thermal damage delivered to surrounding tissue. 2,3 Aside from tattoo removal, PS Abstract Background: Picosecond (PS) lasers were approved by the US FDA in 2012 after being shown to remove tattoos with more success and fewer treatments compared with traditional methods. PS lasers were shown to be versatile, indicated for the treatment of lentigines, café-au-lait macules (CALMs), and acne scars and skin rejuvenation. Objective:We report our experience treating our patients for different indications using a PS laser. Methods:We performed a retrospective chart and photographic review of all patients seen between 2016 and 2018 that were treated in our centers with a PS laser for nontattoo indications. Clinical outcomes were evaluated using side-by-side comparisons of the clinical photographs by two blinded, independent physicians using a visual analog scale consisting of six levels of treatment response. Results: A total of 233 patients were studied. Most sought treatment for solar lentigo (27%) and skin rejuvenation (14%). Epidermal nevi exhibited the greatest improvement with treatment, while acne scarring demonstrated the least. Only 24% of patients experienced noteworthy, transient adverse effects. Conclusion: Picosecond lasers were efficacious and safe for a variety of indications. They were effective in treating epidermal nevi and pigmented lesions, such as Lentigines and CALMs. K E Y W O R D S aesthetic improvement, epidermal nevus, laser treatment, picosecond laser, solar lentigines | 613 MEHRABI Et Al.

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Section: Discussionsupporting

confidence: 79%

Retrospective photographic review of nontattoo indications treated by picosecond laser

Mehrabi

Friedman

Al‐Niaimi

et al. 2020

J of Cosmetic Dermatology

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“…Picosecond laser for acne scars has been studied in one case series; four retrospective reviews; five prospective open-label clinical trials; and one randomized, split-face, comparison trial versus fractional 1550 nm erbium fiber laser involving a cumulative total of 194 subjects [8,9,63,65,66,71,72]. Additionally, there has been one case series of 16 patients studying picosecond laser treatment of hyperpigmented scars; one retrospective review of 24 patients with hypertrophic scars; one retrospective review of nine patients with atrophic surgical scars which was subsequently extended by the same group to include an additional eight subjects with atrophic scars and eight subjects with hypertrophic surgical scars; and one randomized, evaluator-blinded, split-body comparison trial of fractionated picosecond Nd:YAG laser versus 1565 nm fractional non-ablative laser for the treatment of striae alba in 20 subjects [64,[67][68][69][70].…”

Section: Scarsmentioning

confidence: 99%

“…Reliable conclusions are therefore more difficult to arrive upon. Fractionated 1064 nm picosecond Nd:YAG laser showed promise for the treatment of hyperpigmented scars resulting from burn injury, road accident, leishmaniasis, and surgical procedure in a small case series of 16 patients [67]. Although the level of evidence is weak, there is likely an effective role for fractionated picosecond laser for the improvement of hyperpigmented scars given its more robust track record for the treatment of hyperpigmentation due to other causes such as benign pigmentary conditions and photodamage.…”

Section: Scarsmentioning

confidence: 99%

A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations

et al. 2020

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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.

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“…PS lasers have a pulse duration less than a nanosecond and achieve a photoacoustic effect that decreases the surrounding tissue thermal damage and epidermal injury to reduce the risk of dyspigmenation 26 . This laser device also targets cutaneous pigmentation by selective photothermolysis 27 . Lasers with a laser‐induced optical breakdown (LIOB) were used by ophthalmology in the early 1980s.…”

Section: Ablative Fractional Lasersmentioning

confidence: 99%

“…According to Koren et al 27 picosecond lasers have been used in clinical practice since 2012 and target cutaneous pigmentation by selective photothermolysis. The device operates at a subnanosecond pulse duration range and can be another effective treatment modality in atrophic acne scars.…”

Section: Ablative Fractional Lasersmentioning

confidence: 99%

Treating acne scars in 2020: Use of lasers

Utley

Gold

2020

Dermatological Reviews

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Background Acne scarring is an unfortunate complication of acne vulgaris. Acne scars occur in nearly 49% of people that suffer from acne and has shown psychosocial effects such as poor self‐esteem, social isolation, low confidence, in addition to a significant depression risk factor and suicide. Multimodal treatment approaches can improve efficacy and treatment considerations should be based on individualized patients. Utilizing lasers in treating acne scars as well as acne scars in ethnic skin are reviewed. Energy‐based devices include fractional (ablative and nonablative) for moderate to severe acne in addition to novel device systems. Methods A literature review of treating acne scars with lasers including pulse dye laser, fractional (ablative and nonablative), picosecond, and novel devices. Results Use of lasers in treating acne scars is an effective approach and multimodal device options for acne scarring are presented in the review. Conclusion Acne‐scarring laser treatment modalities and evidence‐based treatments should be promoted for each individual patient. Updated laser treatments for acne scarring are covered, in addition to ethnic skin, along with a discussion and selection on laser treatment modalities.

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A 1064-nm Neodymium-doped Yttrium Aluminum Garnet Picosecond Laser for the Treatment of Hyperpigmented Scars

Cited by 12 publications

References 15 publications

Retrospective photographic review of nontattoo indications treated by picosecond laser

Retrospective photographic review of nontattoo indications treated by picosecond laser

A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations

Treating acne scars in 2020: Use of lasers

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