Efficacy and safety of pulsed dye laser for the treatment of surgical scars: a systematic review and meta-analysis

Cai, Yujia; Zeng, Xiaofang; Ying, Jieya; Zhu, Yuan; Qiu, Yu; Xiang, Wenzhong

doi:10.1007/s10103-021-03385-z

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…For both indications, clinical studies demonstrate the efficacy of PDL‐based therapy via (1) selective targeting of lesion vessels and (2) nonselective thermal injury/remodeling produced by high pulse energies and multiple passes. 28 , 29 , 30 Our study introduces a third potential rationale for a PDL‐based approach: reduced drug clearance when combined with AFL‐assisted topical treatments such as 5‐FU.…”

Section: Discussionmentioning

confidence: 99%

Local vasoregulative interventions impact drug concentrations in the skin after topical laser‐assisted delivery

et al. 2022

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Introduction The ability of ablative fractional lasers (AFL) to enhance topical drug uptake is well established. After AFL delivery, however, drug clearance by local vasculature is poorly understood. Modifications in vascular clearance may enhance AFL‐assisted drug concentrations and prolong drug dwell time in the skin. Aiming to assess the role and modifiability of vascular clearance after AFL‐assisted delivery, this study examined the impact of vasoregulative interventions on AFL‐assisted 5‐fluorouracil (5‐FU) concentrations in in vivo skin. Methods 5‐FU uptake was assessed in intact and AFL‐exposed skin in a live pig model. After fractional CO2 laser exposure (15 mJ/microbeam, 5% density), vasoregulative intervention using topical brimonidine cream, epinephrine solution, or pulsed dye laser (PDL) was performed in designated treatment areas, followed by a single 5% 5‐FU cream application. At 0, 1, 4, 48, and 72 h, 5‐FU concentrations were measured in 500 and 1500 μm skin layers by mass spectrometry (n = 6). A supplemental assessment of blood flow following AFL ± vasoregulation was performed using optical coherence tomography (OCT) in a human volunteer. Results Compared to intact skin, AFL facilitated a prompt peak in 5‐FU delivery that remained elevated up to 4 hours (1500 μm: 1.5 vs. 31.8 ng/ml [1 hour, p = 0.002]; 5.3 vs. 14.5 ng/ml [4 hours, p = 0.039]). However, AFL's impact was transient, with 5‐FU concentrations comparable to intact skin at later time points. Overall, vasoregulative intervention with brimonidine or PDL led to significantly higher peak 5‐FU concentrations, prolonging the drug's dwell time in the skin versus AFL delivery alone. As such, brimonidine and PDL led to twofold higher 5‐FU concentrations than AFL alone in both skin layers by 1 hour (e.g., 500 μm: 107 ng/ml [brimonidine]; 96.9 ng/ml [PDL], 46.6 ng/ml [AFL alone], p ≤ 0.024), and remained significantly elevated at 4 hours (p ≤ 0.024). A similar pattern was observed for epinephrine, although trends remained nonsignificant (p ≥ 0.09). Prolonged 5‐FU delivery was provided by PDL, resulting in sustained drug deposition compared to AFL alone at both 48 and 72 hours in the superficial skin layer (p ≤ 0.024). Supporting drug delivery findings, OCT revealed that increases in local blood flow after AFL were mitigated in test areas also exposed to PDL, brimonidine, or epinephrine, with PDL providing the greatest, sustained reduction in flow over 48 hours. Conclusion Vasoregulative intervention in conjunction with AFL‐assisted delivery enhances and prolongs 5‐FU deposition in in vivo skin.

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Section: Discussionmentioning

confidence: 99%

Local vasoregulative interventions impact drug concentrations in the skin after topical laser‐assisted delivery

et al. 2022

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“…The most common treatment for port-wine stains is pulse dye laser (PDL). A meta-analysis in China summarized cutaneous reactions of PDL including pooled purpura (98.3%), edema (97.6%), crusting (21.5%), blistering (8.7%), hyperpigmentation (12.8%) and hypopigmentation (0.9%), and scarring (0.2%), overall showing high level of safety and low chance of causing long-term complications [56]. Unfortunately, some port-wine stains are insufficiently treated with PDL.…”

Section: Port-wine Stainmentioning

confidence: 99%

Neonatal skin health and associated dermatological conditions

Rezaei,

Linggonegoro,

Admani

2024

Current Opinion in Pediatrics

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Purpose of review This review describes recent developments in neonatal skincare management and situates these findings within the preexisting literature on neonatal dermatology. Recent findings The studies included in this review expand research methods evaluating skincare management to different contexts across the world. Several studies explore the roles of emollient therapy, disinfection, and skin-to-skin contact on improving neonates’ long-term health outcomes. Recent findings also assess the impact of neonatal interventions on atopic dermatitis risk later in life as well as epidemiological and microbiome variables that may predict this risk. Additionally, updates on various dermatological conditions unique to neonates are discussed in further detail. Summary Neonatal skincare management differs in notable ways from that of other age groups. The presentation of dermatologic diseases as well as the rare conditions that affect neonates make their clinical management unique. The recent literature on neonatal dermatology can help inform clinicians regarding important considerations in treating their neonatal population.

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“… 25 A meta-analysis also suggested that PDL may be a secure and efficient way to repair surgical scars, because PDL substantially reduced the VSS scores in height, vascularity, pliability, and pigmentation, with no overtly harmful impacts on the majority of persons. 26 To treat hypertrophic burn scars in Chinese children with Fitzpatrick skin types III and IV, a retrospective research was conducted to determine the best PDL therapy settings and indicated that early intervention, sensible treatment intervals, and modest PDL fluence were ideal. 27 …”

Section: Lasermentioning

confidence: 99%

Advances in Photoelectric Therapy for the Early Intervention and Treatment of Traumatic Scars

Zhang¹,

Wang²,

Huang³

2023

CCID

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Traumatic scar is a disease that affected approximately tens of millions of patients worldwide. According to the histological and morphological properties of scars, the traumatic scar typically includes superficial scar, atrophic scar, hypertrophic scar, and keloid. Its formation is a natural consequence of wound healing, regardless of whether the wound was caused by trauma or surgery. However, the production of scars has considerable impacts on the physical and mental health of patients, even causing substantial aesthetic and functional impairments. Prevention or early treatment of scars is the most suitable therapeutic method, including surgical and non-surgical procedures; nevertheless, the benefits of non-operative therapies for scars are quite limited, and surgical treatments are always hard to achieve satisfying outcomes. Through the application of innovative technologies such as lasers, intense pulsed light, and radiofrequency, significant progress has been made in the treatment of traumatic scars. This review highlights the current advancements of photoelectric therapy for the prevention and treatment of various traumatic scars, which may throw light on innovative therapeutic options for scar therapies.

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Efficacy and safety of pulsed dye laser for the treatment of surgical scars: a systematic review and meta-analysis

Cited by 5 publications

References 26 publications

Local vasoregulative interventions impact drug concentrations in the skin after topical laser‐assisted delivery

Local vasoregulative interventions impact drug concentrations in the skin after topical laser‐assisted delivery

Neonatal skin health and associated dermatological conditions

Advances in Photoelectric Therapy for the Early Intervention and Treatment of Traumatic Scars

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