Highlights of Thirty-Year Experience of Laser Use at the Florence (Italy) Department of Dermatology

Abstract

The CO2 laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous wave CO2 laser delivery system and the newer “superpulsed” and scanned CO2 systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO2 laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital.

Efficacy and safety evaluation of an innovative CO2 laser/radiofrequency device in dermatology

“…The recovery times were between 3 and 7 days in nearly all patients, and the erythema usually never lasted longer than 7 days, showing a reduction in superficial hyperaemia. The average downtime for the fractional CO 2 laser/bipolar radiofrequency device in group B was 5.4 days, showing a slight reduction compared with previous results using fractional CO 2 laser alone 20–39 . Faster healing allowed patients to return to a normal life in public within the first week after the laser session, as there were no marked side‐effects to hide or tolerate.…”

“…Despite a few predictable side-effects like erythema and oedema, the majority of patients were very satisfied, which suggests that the low downtime and side-effects associated with the laser procedure were well tolerated thanks to the degree of improvement achieved at the end of the treatments. Moreover, our preliminary results with the CO 2 laser ⁄ bipolar radiofrequency device, compared with our previous experience with CO 2 laser, 39 showed that good patient satisfaction was achievable with fewer treatments; the average number of sessions for group A was 1.85 while for group B, it was 3.65.…”

“…The average downtime for the fractional CO 2 laser ⁄ bipolar radiofrequency device in group B was 5.4 days, showing a slight reduction compared with previous results using fractional CO 2 laser alone. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Faster healing allowed patients to return to a normal life in public within the first week after the laser session, as there were no marked side-effects to hide or tolerate. Despite a few predictable side-effects like erythema and oedema, the majority of patients were very satisfied, which suggests that the low downtime and side-effects associated with the laser procedure were well tolerated thanks to the degree of improvement achieved at the end of the treatments.…”

Update on the Management of Rosacea

“…[120][121][122][123][124][125][126][127][128][129][130][131][132][133][134][135][136][137][138][139] All may be cosmetically limited due to excessive intraoperative bleeding obstructing visualization and causing imprecise tissue removal, along with the risk of scarring. Technological enhancements such as scanned and "superpulsed" systems emit shorter pulses with high power, reducing common adverse effects such as scarring and dyspigmentation.…”

“…The efficacy, safety, and cost-effectiveness of both agents are well demonstrated in a number of well controlled randomized studies. 26 A few Brimotidine tartrate gel 0.5% [22][23][24] Azelaic acid 15% Pimecrolimus 1% cream [31][32][33] Pimecrolimus 1% cream [31][32][33] Permethrin 5% cream [34][35][36]38 Permethrin 5% cream [34][35][36]38 Oral Surgical (blade and radio) excision 121,136 Other natural Ingredients (botnicals and anti-inflammatories) 43 KTP laser [113][114][115][116][117] Cryosurgery Nd:YAG laser 125 Dermabrasion OnabotulinumtoxinA 151,152 Abbreviations: BP, benzoyl peroxide; ETR, erythematotelangiectatic rosacea; PPR, papulopustular rosacea; Nd:YAG, neodymium:yttrium-aluminum-garnet laser; Er:YAG, erbium:yttrium-aluminum-garnet; PDL, pulsed dye laser; IPL, intense pulsed light; KTP, potassium titanyl phosphate; FDA, US Food and Drug Administration. …”