Novel 755-nm diode laser vs. conventional 755-nm scanned alexandrite laser: Side-by-side comparison pilot study for thorax and axillary hair removal.

BACKGROUND: Alexandrite (755 nm) and diode lasers (800-810 nm) are commonly used for hair removal. The alexandrite laser technology is somewhat cumbersome whereas new diode lasers are more robust. Recently, alexandrite-like 755 nm wavelength diodes became available. OBJECTIVES: To compare the efficacy, tolerability, and subject satisfaction of a 755 nm diode laser operated in conventional (HR) and non-conventional in-motion (SHR) modes with a conventional scanned alexandrite 755 nm laser for chest and axillary hair removal. MATERIALS AND METHODS: A prospective, single-center, proof of principle study was designed to evaluate the safety, efficacy and handling of a 755 nm diode laser system in comparison to a standard alexandrite 755 nm scanning hair removal laser. RESULTS: The new 755 nm diode is suitable to be used in SHR and HR mode and has been tested for its safety, efficacy and handling in a volunteer with success. Overall, both systems showed a high efficacy in hair reduction (88.8% 755 nm diode laser vs. 77.7% 755 nm alexandrite laser). Also, during the study period, no severe adverse effects were reported. CONCLUSION: The new 755 nm diode laser is as effective and safe as the traditional 755 nm alexandrite laser. Additionally, treatment with the 755 nm diode laser with HR and SHR modes was found to be less painful.

Fractional CO2 laser is as effective as Q-switched ruby laser for the initial treatment of a traumatic tattoo.

BACKGROUND AND OBJECTIVE: Q-switched laser treatments are considered the standard method for removing both regular and traumatic tattoos. Recently, the removal of tattoo ink using ablative fractional lasers has been reported. Ablative fractional CO2 laser and q-switched ruby laser treatments were used in a split-face mode to compare the safety and efficacy of the two types of laser in removing a traumatic tattoo caused by the explosion of a firework. STUDY DESIGN/PATIENTS AND METHODS: A male patient suffering from a traumatic tattoo due to explosive deposits in his entire face was subjected to therapy. A series of eleven treatments were performed. The right side of the face was always treated using an ablative fractional CO2 laser, whereas the left side was treated only using a q-switched ruby laser. RESULTS: After a series of eleven treatments, the patient demonstrated a significant lightening on both sides of his traumatic tattoo, with no clinical difference. After the first six treatments, the patient displayed greater lightening on the right side of his face, whereas after another five treatments, the left side of the patient's face appeared lighter. No side effects were reported. CONCLUSIONS: In the initial stage of removing the traumatic tattoo, the ablative fractional laser treatment appeared to be as effective as the standard ruby laser therapy. However, from the 6th treatment onward, the ruby laser therapy was more effective. Although ablative fractional CO2 lasers have the potential to remove traumatic tattoos, they remain a second-line treatment option.

Heat profiles of laser-irradiated nails.

Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.

Therapy of pathological scars.

The various clinical manifestations of scarring are an important topic for physicians in many disciplines. The prevention of excessive scarring is more successful than the treatment afterwards. Multiple options exist for prevention, wound repair modulation, and treatment of scars. This publication includes an overview of the pathogenesis, clinical classification, documentation, prevention, and invasive and non-invasive therapy options.

Outcomes of wound closure with the reading man flap technique.

BACKGROUND: In dermatologic surgery, numerous flap types have been described for wound closure after skin cancer surgery. The reading man flap was first published in 2008 for the closure of skin defects of the face, trunk, and extremities. Technically, this flap is based on an asymmetrical Z-plasty. OBJECTIVE: To investigate the feasibility, clinical outcomes, and postoperative complications for wound closure with the reading man flap technique. METHODS: We treated seven patients (facial and extremity defects) after microscopically controlled surgery using the reading man flap technique. The median defect size was 491.71 mm2. All of the patients were treated under tumescent local anesthesia. RESULTS: A tension-free defect closure was created in all patients. One minor complication, a wound infection on one leg, was observed. CONCLUSION: The described technique is an easy and safe dermatologic surgery procedure that can be performed under local anesthesia.

Efficacy and safety of laser shields to prevent radiant transmission onto pigmented nevi during laser epilation: an ex vivo histology study.

PURPOSE: The demand for epilation of large body areas involves using large laser spots. The emitted light causes the desired effect in follicular melanin, but it may also produce collateral effects on pigmented melanocytic nevi. To shield melanocytic lesions, several materials were tested for their capabilities to prevent transmission of alexandrite and diode laser light. MATERIALS AND METHODS: Delivered fluence of the diode laser (808 nm, 30 J/cm(2), 12 ms) and the alexandrite laser (755 nm, 30 J/cm(2), 40 ms) and transmission rates were measured for glass slides only and additional sunscreen, polyurethane (PU) foam, zinc paste, white kajal, and a wooden spatula. For each method, ten repeated measurements were conducted. An ex vivo human skin explant model was used for histological validation. RESULTS: Using zinc as an absorber reduced transmission to 8.77% (diode) and 7.99% (alexandrite laser). Respectively transmissions were measured as following: PU foam 19.25% versus 20.78%, sunscreen 19.85% versus 16.91%, white kajal 76.43% versus 71.03% and wooden spatula 8.05% versus 3.62%. Histologically, a single application of therapeutic fluences (755 nm) in uncovered congenital nevi leads to immediate formation of atypical nucleoli, a ballooning degeneration of melanocytes, and subepidermal clefting within the treated area. In the sites of the lesions that were covered by zinc paste, PU foam, sunscreen and wooden spatula, no immediate histological changes were visible. CONCLUSION: Applying a sufficient amount of zinc paste (approximately 1 g/cm(2)) onto melanocytic lesions allows complete coverage during laser epilation.

Circular directed suction technique for ablative laser treatments.

BACKGROUND: The use of ablative laser treatments is steadily increasing. A side-effect is plume, which can potentially transmit infectious material. Insufficient plume removal may lead to transmission of infectious diseases. OBJECTIVE: To introduce a newly developed circular suction technique for ablative interventions. MATERIALS AND METHODS: The new plume removal system consists of a circular master tube and four smaller suction tubes. This design guarantees plume removal around the whole treatment area. This system can be connected in principle to any common aspiration device. The suction system worked effectively with perfect satisfaction in daily routine. Its effect on skin surface temperature was evaluated using thermography and surface temperature measurements. RESULTS: The circular system removed the laser-associated plume much better than ordinary single-point plume-removal systems. Split-face investigations confirm additional benefits in terms of better skin surface cooling. CONCLUSION: The combination of providing a cool air flow during laser treatment and circular suction is a new approach for directed cooling air streams and streamed plume evacuation without obstructing the physician because of its architecture.

Facial pyoderma gangrenosum in senescence.

Clinically, pyoderma gangrenosum (PG) is characterized by a rapidly progressive, painful cutaneous ulcer with an irregular, violaceous and undermined border. PG occurs most frequently on the lower extremities and the trunk of middle-aged individuals. The face is only very rarely affected. We present an 89- and a 90-year-old patient, who developed a facial ulcer consistent with PG.