Fractional Laser Resurfacing for Acne Scars: Our Experience at Tertiary Care Hospital of North India.

Background: Acne is very common among adolescents, which may sometimes persist into adulthood, and acne scars continue to have a profoundly negative impact on quality of life. Of all the various modalities available, fractional lasers have shown effective results. Aims and Objectives: The aim of this study was to assess the efficacy and safety of fractional carbon dioxide (CO2) laser resurfacing in atrophic facial acne scars. Materials and Methods: The study included 104 subjects aged ≥18 years with atrophic acne scars on face of more than 6 months of duration recruited over a period of 1 year. All the patients were treated with fractional CO2 laser (600 W power and wavelength 10,600 nm). Four sessions of fractional CO2 laser resurfacing were done at 6-week intervals in each patient. We compared the improvement rate of scars after every session at 6-week interval, 2 weeks after the last session, and finally 6 months after the last laser session. Results: The difference between the mean baseline score (3.43) and mean final score (1.83) using Goodman and Baron's qualitative scar scale was found to be statistically significant (P = 0.001). Mean improvement increased from first treatment session to the end of the treatment course from 0.56 to 1.62 indicating the role of the number of sessions in the overall improvement of acne scars. With regard to overall satisfaction, maximum number of patients were either very satisfied (55.8%) or satisfied (25%) as compared to those who were only slightly satisfied (11.5%) or completely unsatisfied (7.7%). Conclusion: Fractional ablative laser gives excellent results in the management of acne scars and has emerged as an appealing non-invasive option for this indication. Being a safe and effective option for atrophic acne scar treatment, it can be recommended wherever available.

Efficacy of Fractional CO2 Laser for Improvement of Limited Mouth Opening in Systemic Sclerosis.

Background: Systemic sclerosis is a multisystem auto-inflammatory disease-causing fibrosis in the skin and internal organs. A frequent complication of systemic sclerosis is the limited mouth opening (LMO), a difficult-to-treat condition with only a few treatment options available. Aims and Objectives: The aim of this study was to evaluate the response of fractional carbon dioxide (CO2) laser resurfacing in LMO associated with systemic sclerosis. Materials and Methods: This was a hospital-based prospective study in which diagnosed cases of systemic sclerosis were taken. Patients who had significant LMO and who gave informed consent were included in the study. Fractional CO2 laser treatment was performed in the perioral area. Patients were assessed at baseline, after three and six sessions, and 3 months after the last session. Assessment was done by measurement of the interincisor distance (IID) using a ruler and calculation of the mouth handicap in systemic sclerosis (MHISS) scale. Results: Improvement in IID occurred 3 months after the first session with a mean gain of +5 mm (range 2-7). At 6 months, a mean gain of +8.5 mm (range 7-10) in IID was observed (P < 0.001). The MHISS score decreased by a mean of 14 (range 11-17) (P < 0.001). All patients showed improvement of mouth opening, which allowed the patients to have better phonation and the patients were able to have proper dental care posttreatment in the form of brushing of teeth and other dental procedures. The adverse effects noted in these patients included erythema that resolved spontaneously or after icing posttreatment. Other adverse effects noted were stinging and burning sensations that were mild and transient. Conclusion: Fractional CO2 laser forms a safe, effective, and well-tolerated treatment modality for improvement of LMO in systemic sclerosis. Limitations: The limitations of this study were less number of patients and no long-term follow-up.

Comparative study of the clinico-trichoscopic response to treatment of hirsutism with long pulsed (1064 nm) Nd:YAG laser in idiopathic hirsutism and polycystic ovarian syndrome patients.

Treatment of hirsutism is usually resistant, and from medical management to laser hair reduction, the treatment of hirsutism and its assessment are the most challenging. The aim of the study was to compare the response to treatment by laser hair reduction with long pulsed (1064 nm) Nd:YAG laser in patients of idiopathic hirsutism and polycystic ovarian syndrome (PCOS) by clinical and trichoscopic assessment. A hospital-based comparative, observational prospective study was carried out on female patients with hirsutism over a period of 18 months with two groups of participants: fifty women with idiopathic hirsutism (group A) and fifty with PCOS (group B). Laser hair reduction was done with long pulsed (1064 nm) Nd:YAG laser in both groups up to six sessions, 4 weeks apart and followed for 3 months post last laser session. After the sixth session of laser hair reduction, excellent response (> 75% reduction) from baseline was seen in 70% of patients in group A and in 54% of patients in group B. After 3 months of follow-up of the last laser session, it was found that the results persisted in patients with idiopathic cause than in those due to PCOS, seen both clinically and trichoscopically with decrease in hair shaft thickness, hair shaft colour, terminal vs. vellus hair ratio and hair density per cm2. Hirsutism due to idiopathic cause responds better to laser hair reduction with long pulsed (1064 nm) Nd:YAG laser than that due to PCOS, due to underlying hormonal imbalance in the latter group. Follow-up of only up to 3 months after last laser session was done and tricoscan was not done.

Laser Treatment in Hirsutism: An Update.

Unwanted hair growth, which is a common aesthetic problem, has traditionally been treated using various techniques such as shaving, waxing, and epilation, but most of these provide only a temporary solution. Laser and light-based technology for hair removal has become one of the fastest growing procedures in modern cosmetic dermatology in the last decade. Clinical experience suggests that in the ideal subject with fair skin and dark hair, laser treatment can reduce hair growth significantly. This article reviews the various laser and light-based devices used for hair removal along with the various laser and patient parameters that affect the outcome of laser treatment for hair removal. Photoepilation, when properly used, offers clear advantages when compared with older, traditional techniques.

Clinicoepidemiological and Patch Test Profile of Patients Attending the Contact Dermatitis Clinic of a Tertiary Care Hospital in North India: A 7-Year Retrospective Study.

INTRODUCTION: Allergic contact dermatitis (ACD) is a growing concern due to increased use of cosmetics and topical medications routinely and exposure to a large number of allergens on day-to-day basis. Patch testing is a reliable method for detecting the causative antigens in suspected cases. AIMS AND OBJECTIVES: To assess the demographic profile, pattern of ACD, and patch test profile of suspected cases of ACD attending contact dermatitis clinic of our department. MATERIALS AND METHODS: It was a retrospective study in which all the data enrolled in the contact dermatitis clinic of our department over a 7-year period were analyzed. Patch testing was done using the Indian Standard Series of 20 antigens primarily, and other batteries were used depending on patient requirement and availability. RESULTS: A total of 582 patients were enrolled in the contact dermatitis clinic over a period of 7 years. Hand eczema was the most common pattern seen in 268 cases followed by feet eczema, hand and foot eczema, facial eczema, forearm and leg eczema and photoallergic contact eczema. A total of 177 patients (30.4%) gave positive patch test results, with nickel sulfate being the most common allergen identified followed by potassium dichromate, cobalt sulfate, paraphenylenediamine, neomycin sulfate, and fragrance mix. CONCLUSION: Common allergens identified in our study were more or less similar to studies from other parts of India. However, due to the unique climate of the valley, the profile of parthenium sensitivity was low in our study when compared to the rest of the country.