Histologic analysis of a 2,940 nm fractional device.

BACKGROUND AND OBJECTIVES: An evaluation of the histological effects of a 2,940 nm fractional erbium:YAG (Er:YAG) laser device with adjustable depth and coagulation settings in a human abdominoplasty model. The goal of this study was to use light and confocal microscopy to determine the dimensions of the microthermal zones (MTZs) created by this device in the epidermal and dermal layers. STUDY DESIGN/MATERIALS AND METHODS: Three subjects were consented and treated after being randomly assigned to a laser depth of either 250 µm, 500 µm, or 1,000 µm. Four coagulation levels were tested in each subject. Two biopsies were taken immediately, 1 and 2 weeks post-treatment from each zone and viewed by light and confocal microscopy. Two blinded observers examined the sections for changes in collagen and measured depth and width of the MTZs. Coagulation was assessed and recorded as the depth and width of denaturation; measured as the depth and width of ablation plus surrounding thickness of thermal necrosis from dissipated heat. RESULTS: Light microscopy findings in all treated samples showed a perforated epidermis and dermis immediately after treatment. The depths of ablation produced did not accurately reflect the three different laser settings. Depths of denaturation also did not increase with increased coagulation level settings as expected. The width of ablation in the MTZs, a non-adjustable setting, was the most accurate and reproducible in all subjects. Confocal microscopy samples revealed the presence of collagen remodeling in the dermis, which increased significantly at 1 and 2 weeks post-treatment. CONCLUSIONS: Treatment with the 2,940 nm Er:YAG device led to significant changes of the dermis at light microscopy levels. The adjustable laser depth and coagulation settings did not produce predictable depths of ablation or denaturation, possibly as a result of the variation of tissue hydration properties among individuals. Increased collagen remodeling was seen in the dermis in all subjects at 1 and 2 weeks post-treatment.

Efficacy of a multiple diode laser system for body contouring.

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) has been shown to induce cellular reactions in nonphotosynthetic cells however skepticism remains regarding efficacy at the clinical level. The purpose of this study was to evaluate the efficacy of LLLT independent of liposuction. Additionally, a weight loss supplement (Curva™, Santa Barbra Medical Innovations, Santa Barbra, CA) was evaluated. This clinical trial evaluates the effectiveness of the Erchonia EML Laser (Zerona™ System, Santa Barbra Medical Innovations) for non-invasive fat reduction and body contouring in a split-body clinical evaluation. MATERIALS AND METHODS: Five subjects were enrolled and completed the study. Subjects had a body mass index (BMI) of less than or equal to 29 kg/m(2) and satisfied the set inclusion criteria. Participants were randomly assigned to receive low-level laser treatments on one side of the body three times per week for 2 weeks. One group took the weight loss supplement and was also treated with the laser. Subject satisfaction questionnaires, physician blinded photo evaluation, circumference measurements and ultrasound measurements were utilized to evaluate efficacy. RESULTS: Circumference measurements revealed no statistically significant reduction at either 7 days or 1 month post-treatment. One month following treatment the greatest circumference reduction overall was 0.5 ± 0.3 inches. Ultrasound measurements also did not reveal statistically significant reduction in fat layer thickness (P > 0.5). Evaluation by three blinded dermatologists resulted in average correct photo identification of 51.1%. Results reflect little clinical difference between post-treatment and baseline images. Three subjects recording a "dissatisfied" rating on satisfaction questionnaires and all subjects reported the effects of the treatment were less than expected. Subjects who took the weight loss supplement had no greater circumference reduction or identifiable clinical outcome. CONCLUSIONS: This small study demonstrates to the authors that there needs to be more evidence to show clinical circumferential reduction before LLLT can be recommended as an effective therapeutic option.

Clinical study to determine the safety and efficacy of a low-energy, pulsed light device for home use hair removal.

BACKGROUND AND OBJECTIVES: The principle of selective photo-thermolysis has been studied extensively for hair removal applications in a medical setting. A new, portable, hand-held device featuring two filtered Xenon lamps that utilizes pulsed light in low optical fluencies for hair removal has been developed for consumer use. The purpose of this clinical study was to determine the efficacy and safety of this low-energy, pulsed-intense light device intended for home use hair removal. STUDY DESIGN/ MATERIALS AND METHODS: The treatment group consisted of 10 adults with skin types I-IV who possessed unwanted dark hair in the non-facial region. The subjects received between 4 and 6 treatments on a bi-weekly basis with the device by a trained member of the clinical staff. The clinical responses were evaluated by performing manual hair counts using magnified vision and photographs which were obtained prior to treatment and at each subsequent visit. RESULTS: Mean hair reduction was 36% 4 weeks after the final treatment and 10% 12 weeks after the final treatment. This resulted in a mean hair count reduction of 23% over the two follow-up appointments. There was no definitive correlation between customer satisfaction and hair count reduction. Adverse reactions were limited to transient, localized, post-treatment erythema. No complications were encountered. CONCLUSIONS: This low-energy, pulsed-light device is a quick, safe, and relatively effective at-home hair reduction treatment option in patients with various skin phototypes.