Nonablative skin remodeling: Selective dermal heating with a mid-infrared laser and contact cooling combination

Ross, E. Victor; Sajben, Francis P.; Hsia, J.; Barnette, David J.; Miller, Charles H.; McKinlay, Joseph R.

doi:10.1002/(sici)1096-9101(2000)26:2<186::aid-lsm9>3.0.co;2-i

Cited by 151 publications

(109 citation statements)

References 29 publications

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“…Biopsy specimens demonstrated some collagen thickening in the papillary dermis, but histological changes did not extend deeper into the dermis. Ross et al [17] recently treated human patients with an Er:glass laser (1.54 mm) in combination with a contact cooling device. They were able to achieve epidermal preservation with slight tinctoral change in dermal collagen to depths of 400±1,300 mm.…”

Section: Introductionmentioning

confidence: 99%

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: I. Histological study*

et al. 2001

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Background and Objective: To evaluate histologically the characteristics of repetitive Er:YAG laser exposure of skin in combination with cryogen spray cooling (CSC), and its potential as a method of laser skin resurfacing. Study Design/Materials and Methods: Rat skin was irradiated in vivo with sequences of 10 Er:YAG laser pulses (repetition rate 20 Hz, pulse duration 150 or 550 ms, single-pulse¯uence 1.3±5.2 J/cm 2 ). In some examples, CSC was applied to reduce epidermal injury. Histologic evaluation was performed 1 hour, 1 day, 5 days, and 4 weeks post-irradiation. Results: A sequence of ten 550-ms pulses with¯uences around 2 J/cm 2 resulted in acute dermal collagen coagulation to a depth of approximately 250 mm, without complete epidermal ablation. CSC improved epidermal preservation, but also diminished the coagulation depth. Four weeks after irradiation, neo-collagen formation was observed to depths in excess of 100 mm. Conclusion: Dermal collagen coagulation and neo-collagen formation to depths similar to those observed after CO 2 laser resurfacing can be achieved without complete ablation of the epidermis by rapidly stacking long Er:YAG laser pulses. Application of CSC does not offer signi®cant epidermal protection for a given dermal coagulation depth.

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Section: Introductionmentioning

confidence: 99%

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: I. Histological study*

et al. 2001

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“…The irradiation sources included a 1.32 mm Nd:YAG laser [8,9], Er:glass laser (1.54 mm) [10], or non-coherent pulsed light source [11], applied in combination with either CSC or a contact cooling device. All these modalities utilize relatively weakly absorbed radiation, which enables heat deposition deep into the dermis, and active cooling of the skin surface.…”

Section: Introductionmentioning

confidence: 99%

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: II. Theoretical analysis

et al. 2001

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Background and Objective: To analyze the effects of laser pulse duration and cryogen spray cooling (CSC) on epidermal damage and depth of collagen coagulation in skin resurfacing with repetitive Er:YAG laser irradiation. Study Design/Materials and Methods: Evolution of temperature ®eld in skin is calculated using a simple onedimensional model of sub-ablative pulsed laser exposure and CSC. The model is solved numerically for laser pulse durations of 150 and 600 msec, and 6 msec cryogen spurts delivered just prior to (``pre-cooling''), or during and after (``post-cooling'') the 600 msec laser pulse. Results: The model indicates a minimal in¯uence of pulse duration on the extent of thermal effect in dermis, but less epidermal damage with 600 msec pulses as compared to 150 msec at the same pulse¯uence. Application of pre-or post-cooling reduces the peak surface temperature after laser exposure and accelerates its relaxation toward the base temperature to a different degree. However, the temperature pro®le in skin after 50 msec is in either example very similar to that after a lower-energy laser pulse without CSC. Conclusion: When applied in combination with repetitive Er:YAG laser exposure, CSC strongly affects the amount of heat available for dermal coagulation. As a result, CSC may not provide spatially selective epidermal protection in Er:YAG laser skin resurfacing.

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“…To further improve the side effects and the downtime after laser treatments, nonablative fractional lasers (NAFLs) or ablative fractional lasers (AFLs) can be used. Fractional lasers produce arrays of minimal thermal wounds known as microthermal zones (MTZs) in the tissue while sparing the tissue surrounding each wound [3,4]. Typically, the diameter of the MTZ ranges from 125 μm to 250 μm with a zone of intact skin between the MTZs.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of wound healing process of human skin after fractional laser treatments with optical coherence tomography

Tsai¹,

Yang²,

Shen³

et al. 2013

Biomed. Opt. Express

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Abstract:Fractional photothermolysis induced by non-ablative fractional lasers (NAFLs) or ablative fractional lasers (AFLs) can remodel the skin, regenerate collagen, and remove tumor tissue. However, fractional laser treatments may result in severe side effects, and multiple treatments are required to achieve the expected outcome. Thus, the treatment outcome and downtime after fractional laser treatments are key issues to determine the following treatment strategy. In this study, an optical coherence tomography (OCT) system was implemented for in vivo studies of wound healing after NAFL and AFL treatments. According to the OCT scanning results, the laser-induced photothermolysis including volatilization and coagulation could be morphologically identified. To continue monitoring the wound healing process, the treated regions were scanned with OCT at different time points, and the en-face images at various tissue depths were extracted from three-dimensional OCT images. Furthermore, to quantitatively evaluate the morphological changes at different tissue depths during wound healing, an algorithm was developed to distinguish the backscattering properties of untreated and treated tissues. The results showed that the coagulation damage induced by the NAFLs could be rapidly healed in 6 days. In contrast, the tissue volatilization induced by AFLs required a longer recovery time of 14 days. In conclusion, this study establishes the feasibility of this methodology as a means of clinically monitoring treatment outcomes and wound healing after fractional laser treatments. References and links 1. T. S. Alster and S. Garg, "Treatment of facial rhytides with a high-energy pulsed carbon dioxide laser," Plast. ©2013 Optical Society of AmericaReconstr. Surg. 98(5), 791-794 (1996). 2. C. B. Zachary, "Modulating the Er:YAG laser," Lasers Surg. Med. 26(2), 223-226 (2000).

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Nonablative skin remodeling: Selective dermal heating with a mid-infrared laser and contact cooling combination

Cited by 151 publications

References 29 publications

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: I. Histological study*

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: I. Histological study*

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: II. Theoretical analysis

Monitoring of wound healing process of human skin after fractional laser treatments with optical coherence tomography

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