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1.
Lasers Med Sci ; 39(1): 146, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38822948

RESUMO

Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500-600 nm), IPL with M22 590 (590-1200 nm), or IPL with M22 vascular filter (530-650 nm and 900-1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251.


Assuntos
Terapia de Luz Pulsada Intensa , Lasers de Corante , Rosácea , Humanos , Lasers de Corante/uso terapêutico , Lasers de Corante/efeitos adversos , Feminino , Rosácea/radioterapia , Rosácea/terapia , Adulto , Masculino , Pessoa de Meia-Idade , Terapia de Luz Pulsada Intensa/métodos , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/efeitos adversos , Resultado do Tratamento , Terapia com Luz de Baixa Intensidade/métodos , Terapia com Luz de Baixa Intensidade/instrumentação , Terapia com Luz de Baixa Intensidade/efeitos adversos
2.
Am J Clin Dermatol ; 22(6): 785-800, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34287769

RESUMO

Acne vulgaris is a disease of the pilosebaceous unit and the most common inflammatory dermatosis worldwide. It is also associated with significant economic burden. Limitations of conventional topical and systemic treatments include long treatment course, intolerable adverse effects, antibiotic resistance, and patient compliance. Therefore, laser and light-based interventions present as alternative options over the past decade and have been used in combination with conventional pharmacological therapies and other physical modalities. An updated overview on the use of lasers and light-based devices in acne management is presented to help clinicians understand the safety and efficacy of these treatment options. The effectiveness of neodymium:yttrium aluminum garnet (Nd:YAG) for treating acne is supported by more high-level studies compared with other laser devices. There is limited evidence to support the use of CO2 lasers, potassium titanyl phosphate lasers, and 1565-nm non-ablative fractional lasers for treating acne. Among light devices, photodynamic therapy is the most studied, showing higher efficacies than some of the conventional topical and oral acne therapies. Intense-pulsed light and blue light therapies also show favorable outcomes. A limitation is that most studies are non-randomized and lack a control group, and report on a variety of device settings, treatment regimens, and outcome measures, making it challenging to summarize and generalize findings. Although the use of laser and light devices to treat acne is promising, further work with randomized controlled study designs and larger sample sizes will provide improved guidance on the application of these modalities.


Assuntos
Acne Vulgar/terapia , Terapia de Luz Pulsada Intensa/instrumentação , Terapia com Luz de Baixa Intensidade/instrumentação , Fotoquimioterapia/instrumentação , Acne Vulgar/diagnóstico , Ensaios Clínicos como Assunto , Humanos , Lasers de Gás/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
3.
J. optom. (Internet) ; 14(2): 103-113, April-June 2021. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-208521

RESUMO

Purpose: This study aims to estimate the efficacy and safety of a new intense pulsed light (IPL) Thermaeye Plus for dry eye disease (DED) secondary to meibomian gland dysfunction (MGD).Patients and methods: This is a prospective, longitudinal study of patients with moderate to severe MGD. Treatment consisted of 4 consecutive IPL sessions, 12 flashes with the same energy 8J/cm2 on the periocular area at days 1, 14, 28, and 49. All patients were evaluated before each IPL sessions and 1 and 4 months after the last session. Measuring: Symptoms score and OSDI questionnaire, Non-invasive tear meniscus height (NITMH), Non-invasive break up (NITBUT), Tear osmolarity (TO), Corneal fluorescein staining (CFS) and Eyelid margin and Meibomian gland assessment. The adverse effects on the eye, periocular area, and systemic complications were evaluated. All types of skin pigmentation (Fitzpatrick scale I to VI) were included. Results: The study included 44 consecutive patients (88 eyes), 40 males and 48 females, with a mean age of 52.5±13.6 years, ranging from 22 to 78 years. Significant improvements were observed in single and total signs and symptoms. The most significant changes were observed in dryness, foreign body sensation (p<0.001), and pain (p<0.005). The OSDI questionnaire showed a significant decrease in total symptoms (p<0.003). The percentage of patients with a normal index <13, improved from 23.8% (10 patients) at baseline to 80.9% (34 patients) at last visit, after 23 weeks. Clinical sings also improved, more than 90%, stand out telangiectasia and blepharitis (p<0.002, and p<0.0005, respectively). No statistical differences between age (<40y, 40–60y, and >60y) and gender were observed. The clinical improvement began after the second and third week after the first IPL session, until the end of the IPL treatment (D49). After that, the results maintained stable until the last visit, after 11 weeks. ... (AU)


Assuntos
Humanos , Xeroftalmia/terapia , Glândulas Tarsais/anormalidades , Glândulas Tarsais/lesões , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Oftalmopatias/patologia , Oftalmopatias/terapia , Estudos Prospectivos , Estudos Longitudinais
4.
J Drugs Dermatol ; 20(2): 203-207, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33538557

RESUMO

BACKGROUND: Intense Pulsed Light (IPL) is a non-coherent polychromatic broadband filtered flashlamp that emits light in the spectrum of approximately 400–1200 nm. Its effects on photorejuvenation are well documented. The goal of this study is to help practitioners better conceptualize and fine tune IPL device settings in order to produce the most effective and safest clinical outcome. MATERIALS/METHODS: This was a prospective study testing several filters (515 nm; 560 nm; 590 nm and 530–650; 900–1200 nm vascular filter), fluences, pulse durations, and pulse numbers (ie, multiple sequence pulsing or MSP) with a new IPL system. RESULTS: Post-procedure erythema response was more pronounced with increasing fluence, decreasing wavelength, fewer pulses and shorter pulse duration. The exception was the 515 nm filter with regard to pulse duration, which was observed to have a more pronounced response with longer pulse durations. The overall clinical outcome at the 4-week follow-up visit demonstrated greatest improvement in erythema and pigmentation using the 515 nm filter on a Fitzpatrick Skin Type III individual. CONCLUSION: Greatest clinical endpoint response at 4-week follow-up was observed with more robust initial responses. This was most apparent at higher fluence levels and fewer pulse counts. However, when the IPL is pushed to aggressive parameters, there is risk of hypopigmentation and hair loss as seen in this case study. Skin type is an important consideration when using IPL and MSP adds to its safety profile. J Drugs Dermatol. 2021;20(2):203-207. doi:10.36849/JDD.5638.


Assuntos
Alopecia/prevenção & controle , Técnicas Cosméticas/efeitos adversos , Eritema/prevenção & controle , Hipopigmentação/prevenção & controle , Terapia de Luz Pulsada Intensa/efeitos adversos , Idoso , Alopecia/diagnóstico , Alopecia/etiologia , Dorso , Técnicas Cosméticas/instrumentação , Eritema/diagnóstico , Eritema/etiologia , Seguimentos , Humanos , Hipopigmentação/diagnóstico , Hipopigmentação/etiologia , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Masculino , Fotografação , Estudos Prospectivos , Rejuvenescimento , Estudos de Caso Único como Assunto , Pele/diagnóstico por imagem , Pele/efeitos da radiação , Pigmentação da Pele/efeitos da radiação , Resultado do Tratamento
5.
Dermatol Surg ; 46(11): 1397-1402, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32804891

RESUMO

BACKGROUND: Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease. Topical treatments often yield ineffective and temporary results. OBJECTIVE: The objective of this article is to review and assess all the studies that used light and laser devices to treat KP and its variants. MATERIAL AND METHODS: On January 15, 2017, an online search of the MEDLINE, Embase, and Cochrane databases was performed using the following combination of keywords: "keratosis pilaris" and "treatment." RESULTS: Seventeen studies related to light and laser treatments were retained for analysis. The total number of treated patients was 175. Of which, 22 patients had KP atrophicans faciei, 17 patients had KP rubra, and 136 patients had KP. CONCLUSION: Light and laser devices have been emerging as promising therapeutic options for a disfiguring disease that still lacks, until today, an effective long-term treatment.


Assuntos
Anormalidades Múltiplas/terapia , Doença de Darier/terapia , Sobrancelhas/anormalidades , Terapia de Luz Pulsada Intensa/métodos , Terapia com Luz de Baixa Intensidade/métodos , Anormalidades Múltiplas/diagnóstico , Ensaios Clínicos como Assunto , Doença de Darier/diagnóstico , Humanos , Terapia de Luz Pulsada Intensa/instrumentação , Lasers de Corante/uso terapêutico , Lasers de Gás/uso terapêutico , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/instrumentação , Índice de Gravidade de Doença , Resultado do Tratamento
7.
J Cosmet Dermatol ; 19(1): 88-92, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31638320

RESUMO

BACKGROUND: Facial telangiectasia is one of the common skin vascular lesions characterized by dilated cutaneous vasculatures. The variety of diameters and difference in depths of lesional blood vessels are the major challenges for effective treatments for Facial telangiectasia. AIMS: To compare the efficacy and safety profiles of pulsed dye laser (PDL, 595 nm) with intense pulsed light (IPL) configured by three different wavelength bands in the treatment for facial telangiectasia in Asian populations. PATIENTS/METHODS: A retrospective analysis of hospital records and review on photographs were performed for those subjects with facial telangiectasia (n = 160) who were treated in our department from January 2017 to January 2019. Patients were received two sessions of one of the four following laser treatments: PDL (595 nm, n = 38), IPL with M22 vascular filter (530-650 nm and 900-1200 nm, n = 39), M22 560 (560-1200 nm, n = 42), and M22 590 (590-1200 nm, n = 41). RESULTS: The patients in all the four groups showed an overall and significant improvement of indexes of lesional severity and subjective discomfort as well as improvement score of facial telangiectasia after treatment as compared to baseline. In addition, PDL (595 nm) and IPL with vascular filter (530-650 nm and 900-1200 nm) treatments showed significantly better indexes of lesional severity, subjective discomfort, and improvement score of facial telangiectasia as compared with other two treatments. CONCLUSION: Light devices with various wavelength ranges showed different efficacies of treatment for facial telangiectasia, among which PDL (595 nm) and IPL with M22 vascular filter (530-650 nm and 900-1200 nm) had similar and the best clinical efficacy as compared to IPL with other wavelength bands.


Assuntos
Terapia de Luz Pulsada Intensa/métodos , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade/instrumentação , Telangiectasia/terapia , Adolescente , Adulto , Face , Feminino , Humanos , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia de Luz Pulsada Intensa/instrumentação , Terapia com Luz de Baixa Intensidade/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
J Cosmet Dermatol ; 19(1): 102-104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31782594

RESUMO

BACKGROUND: Idiopathic calcinosis cutis is an uncommon form of calcinosis cutis. It may present as tumoral calcinosis, subepidermal calcified nodules or scrotal calcinosis. Subepidermal calcified nodules may also present as milia-like lesions commonly seen in children with Down's syndrome in the absence of tissue damage or metabolic disorders, it has been seldom reported in adults. The treatment of choice is surgical excision. However, a surgical approach may not always be beneficial to the patient given the cosmetic outcomes. Here, we describe the successful use of a CO2 laser in the treatment of milia-like calcinosis cutis of the forehead in an adult without Down's syndrome. AIMS: To describe the treatment of Milia-like idiopathic calcinosis cutis of the forehead in an adult without Down's syndrome successfully treated with a CO2 laser. METHODS: We report a case of a 48-year-old man who presented with skin-colored hard asymptomatic papules on the forehead that started about 9 years ago, a biopsy was performed and a diagnosis of milialike calcinosis cutis was made. Surgical excision was discarded regarding the location and the number of lesions, instead, a CO2 laser was used to treat this condition. RESULTS: Successful laser excision of the lesions with appealing cosmetic results. CONCLUSIONS: CO2 laser seems to be a valuable tool to treat milia-like calcinosis cutis lesions.


Assuntos
Calcinose/terapia , Terapia de Luz Pulsada Intensa/instrumentação , Ceratose/terapia , Lasers de Gás/uso terapêutico , Idoso , Biópsia , Calcinose/diagnóstico , Calcinose/patologia , Testa , Humanos , Ceratose/diagnóstico , Ceratose/patologia , Masculino , Pele/patologia , Resultado do Tratamento
9.
Dermatol Surg ; 45(11): 1401-1405, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31658188

RESUMO

BACKGROUND: Current treatment options for rosacea include topical agents, oral therapies, phototherapy using lasers, or intense pulsed light (IPL). Combination therapy for rosacea often yields better results than monotherapy. The safety of laser/light treatments in combination with systemic doxycycline has been questioned because of the theoretical risk of photosensitivity. OBJECTIVE: The purpose of this study was to assess the incidence of phototoxicity or photosensitivity in rosacea patients receiving concomitant laser or light treatments and systemic doxycycline. METHODS: Treatment records of 36 patients receiving laser/light treatments while also being treated with standard dose or anti-inflammatory dose of doxycycline were retrospectively reviewed. RESULTS: No adverse reactions related to doxycycline combined with laser/light therapy were reported. Specifically, no photosensitivity or sensitivity to wavelengths in the pulsed dye laser (PDL), or IPL range was observed in this cohort. All patients achieved some degree of clearance. CONCLUSION: The results of this retrospective study demonstrate that doxycycline used in conjunction with laser or nonlaser light therapy is a valid combination therapy for improving signs and symptoms of rosacea. No photosensitivity reactions were observed to commonly used IPL or PDL devices.


Assuntos
Antibacterianos/efeitos adversos , Doxiciclina/efeitos adversos , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Rosácea/terapia , Administração Cutânea , Adolescente , Adulto , Idoso , Antibacterianos/administração & dosagem , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/efeitos adversos , Doxiciclina/administração & dosagem , Feminino , Humanos , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Lasers de Corante/efeitos adversos , Terapia com Luz de Baixa Intensidade/métodos , Masculino , Pessoa de Meia-Idade , Transtornos de Fotossensibilidade/diagnóstico , Transtornos de Fotossensibilidade/etiologia , Estudos Retrospectivos , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Resultado do Tratamento , Adulto Jovem
10.
Photobiomodul Photomed Laser Surg ; 37(9): 527-531, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31335299

RESUMO

Objective: To investigate the safety of and change from baseline of tear breakup time and visual analog pain scales in dry eye disease subjects with upper lid Meibomian gland dysfunction after intense pulsed light (IPL) treatment assessing global ocular pain severity, ocular pain frequency, and ocular pain in the previous 24 h. This is a prospective single-site study. Methods: All patients received active treatment consisting of four treatments spaced no fewer than 2 weeks apart and no longer than 4 weeks apart. The IPL therapy was performed with a Lumenis M22 (Lumenis Ltd., Yokneam, Israel) xenon-based micropulsed IPL utilizing a 590 nm filter with a 6 mm clear SapphireCool cylindrical lightguide for the upper lids with a fluence of 10 J/cm2 across the upper eyelids, including the tragus for two passes. Patients then received expression of their meibomian glands using two cotton-tipped applicators. Tear breakup data were collected as well as global ocular pain, ocular pain episodes in the past 24 h and frequency of ocular pain episodes. Results: All of the assessments for the treated eyes improved over the course of treatment. Statistically significant physician increases in measured tear breakup times were measured for each eye independently. Statistically significant decreases in global eye dryness scale, eye dryness in the preceding 24 h, and frequency of ocular pain episodes between treatments were observed. There were no serious or nonserious adverse events in the trial. Conclusions: This pilot study suggests that a new specialized 6 mm cylindrical handpiece for the M22 Lumenis IPL machine is safe and effective in increasing physician-measured tear breakup time as well as several scales of the symptoms of ocular dryness, including global symptoms, frequency of symptoms, and ocular dryness occurring within the previous 24 h before the study visit.


Assuntos
Síndromes do Olho Seco/terapia , Terapia de Luz Pulsada Intensa/métodos , Glândulas Tarsais/fisiopatologia , Adulto , Idoso , Síndromes do Olho Seco/fisiopatologia , Desenho de Equipamento , Feminino , Humanos , Terapia de Luz Pulsada Intensa/instrumentação , Masculino , Pessoa de Meia-Idade , Medição da Dor , Projetos Piloto , Estudos Prospectivos , Lágrimas/metabolismo
11.
Lasers Surg Med ; 51(6): 500-508, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30681160

RESUMO

BACKGROUND: Optical energy-based devices, including intense pulsed light (IPL) and potassium titanyl phosphate (KTP) lasers achieve reduction of pigmented and vascular lesions in a relatively similar number of treatments. This study aimed to evaluate the efficacy and safety of an IPL with a "KTP-like" filter emitting a wavelength of 525-585 nm for the treatment of solar lentigines on the hands and face. METHODS: This was a single center, prospective, open-label clinical trial including 16 healthy Caucasian subjects (15 females, mean age, 55 years; skin types II and III) with hand and facial solar lentigines. Subjects were treated with three IPL treatment sessions with a KTP-like filter conducted at monthly intervals. Follow-up evaluations were performed 1, 3, and 6 months after the last treatment session. Overall pigmentation improvement, pigmentation clearance per lesion, adverse events, and subject tolerability to treatment were evaluated. RESULTS: Significant improvements in facial and hand pigmentation were noted at all follow-up visits (P < 0.0001). One month after the last treatment session, good to excellent outcomes were noted in 74.6% of treated facial areas and 90% of treated hand regions. Although the effect of treatment gradually declined in both treatment regions over the 6-month follow-up period, over 60% of subjects demonstrated good to excellent results at the study end. Clinical effectiveness was further confirmed by the reduction in Melanin Index (MI) following each treatment as compared to baseline. Downtime and complications were minimal. CONCLUSIONS: IPL treatment with a KTP-like filter is a well-tolerated and effective method for reducing facial and hand pigmentation. Lasers Surg. Med. 51:500-508, 2019. © 2019 Wiley Periodicals, Inc.


Assuntos
Terapia de Luz Pulsada Intensa/instrumentação , Lasers de Estado Sólido/uso terapêutico , Lentigo/terapia , Envelhecimento da Pele , Adulto , Idoso , Feminino , Seguimentos , Humanos , Lentigo/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
12.
J Drugs Dermatol ; 17(11): 1184 -1185, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30500137

RESUMO

Bruising after dermal filler and neuromodulator injections is a common side effect and can have durations of 1 to 2 weeks. While it ultimately resolves, faster resolution can produce better outcomes for patients and also make patients more likely to return for future treatments. We report the successful reduction in bruising following injections of fillers with an intense pulsed light source. We also documented the onset of action of bruising resolution with serial photographs. Resolution started within the first hour of treatment and continued rapidly over 48 hours. This is the first-time reported study of resolution of bruising from injectables with intense pulsed light. Patient satisfaction is improved when such adverse events are minimized.


Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Equimose/terapia , Terapia de Luz Pulsada Intensa/métodos , Rejuvenescimento , Preenchedores Dérmicos/administração & dosagem , Equimose/diagnóstico por imagem , Equimose/etiologia , Humanos , Injeções Subcutâneas/efeitos adversos , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia de Luz Pulsada Intensa/instrumentação , Lasers de Corante/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/instrumentação , Terapia com Luz de Baixa Intensidade/métodos , Satisfação do Paciente , Fotografação , Envelhecimento da Pele , Resultado do Tratamento
13.
Semin Cutan Med Surg ; 36(4): 138-147, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29224030

RESUMO

The development of fractional photothermolysis has revolutionized the treatment of skin scarring, rejuvenation, and tightening. By creating targeted microthermal zones and leaving surrounding tissue intact, this concept has provided the field with efficacious results, with less downtime and a better safety profile. This has started to change the paradigm of what is considered first-line treatment for scarring and rejuvenation. While originally applied to nonablative lasers, fractionation has now been employed in ablative, quality-switched, picosecond, and novel hybrid fractional lasers. Furthermore, other energy-based technologies, such as radiofrequency, have adopted the concept of fractionation in an attempt to optimize the balance of efficacy, downtime, and side effects. Herein, we describe how the ever-expanding repertoire of fractional devices is applied to the treatment of scarring, skin rejuvenation, and tightening. In addition, newer applications, such as transdermal drug delivery, are being developed by using fractional devices. Growing experience with these devices has broadened their relevance to more skin types and body sites than ever. Ultimately, the knowledge of appropriate treatment parameters is paramount and allows for the safe and effective treatment of a variety of patients with numerous devices.


Assuntos
Cicatriz/tratamento farmacológico , Cicatriz/terapia , Fototerapia/métodos , Rejuvenescimento , Envelhecimento da Pele , Administração Cutânea , Cicatriz Hipertrófica/terapia , Técnicas Cosméticas , Sistemas de Liberação de Medicamentos/instrumentação , Humanos , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Queloide/terapia , Lasers , Fototerapia/instrumentação , Terapia por Radiofrequência , Envelhecimento da Pele/efeitos dos fármacos , Envelhecimento da Pele/efeitos da radiação
14.
J Drugs Dermatol ; 16(6): s104-s107, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29028863

RESUMO

Non-invasive rejuvenation of the skin is performed regularly in many cosmetic offices. Using evidence-based medicine, we will review the various technologies being used for non-invasive rejuvenation. This includes the use of intense pulsed light (IPL), which has been thoroughly studied and shown to be quite useful for this type of rejuvenation in removing the red and brown pigments, as well as affecting collagen. Fractional lasers, both non-ablative and ablative in nature, also can show dramatic improvements in the skin and associated clinical studies are reviewed here. Also described are radiofrequency (RF) fractional pin devices and RF microneedles used for non-invasive rejuvenation. Picosecond lasers are showing very positive results in the non-invasive rejuvenation market. Finally, absorbable sutures are being used to lift the skin and add volume in the skin over a duration of time. They are quickly becoming more popular.

J Drugs Dermatol. 2017;16(6 Suppl):s104-107.

.


Assuntos
Técnicas Cosméticas/instrumentação , Terapia de Luz Pulsada Intensa/instrumentação , Rejuvenescimento , Envelhecimento da Pele , Humanos
15.
J Cosmet Dermatol ; 16(4): 438-443, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28741866

RESUMO

BACKGROUND: Home optical devices are becoming an increasingly popular treatment modality sought out by patients for dermatologic pathologies such as acne, hair removal and anti-aging, as these devices are a low-cost and convenient therapy choice. METHODS: An Internet search using PubMed.gov was completed with search terms, "home device dermatology," "home device acne," "home device hair" or "hair removal," and "home device aging." RESULTS: Currently, there are multiple home optical devices available on the market. These devices have been approved for the treatment of acne, scars, hair removal, and wrinkles using intense pulsed light, light-emitting diode, heat, infrared, low-level light therapy, and laser. Although studies on home devices are limited, current dermatologic literature shows that these devices are promising with significant post-treatment results as well as a high level of safety. CONCLUSIONS: Home optical devices are mostly used without medical practitioner supervision. As home devices usually deliver less energy per session than with professional treatments, it is important that consumers are given realistic expectations of post-treatment outcomes. Patients may use home devices without disclosure to their physician and it is important as healthcare professionals to be aware of the existence of these devices, how to use the devices properly (including what diseases can be treated and which skin types are considered safe for use), as well as any adverse effects that may occur. New research endeavors are being completed to explore the used of home devices for the treatment of chronic inflammatory diseases such as psoriasis.


Assuntos
Acne Vulgar/terapia , Remoção de Cabelo/instrumentação , Terapia de Luz Pulsada Intensa/instrumentação , Terapia a Laser/instrumentação , Fototerapia/instrumentação , Autocuidado/instrumentação , Envelhecimento da Pele/efeitos da radiação , Humanos
16.
Rev. bras. queimaduras ; 15(4): 274-277, out. - dez. 2016. ilus
Artigo em Português | LILACS | ID: biblio-915189

RESUMO

Cicatrizes decorrentes de queimadura acarretam grandes danos físicos e emocionais aos pacientes. Seu tratamento permanece um desafio na prática clínica. O uso atual de tecnologias a laser e luz, como o laser ablativo fracionado e a luz intensa pulsada (LIP), tem se mostrado eficaz na recuperação estética e funcional da pele acometida. Este trabalho tem por objetivo a demonstração do resultado do tratamento de cicatriz de queimadura extensa com LIP e laser ablativo fracionado Erbium: YAG a partir do relato de caso de uma paciente de 38 anos vítima de queimadura por chama direta aos 6 anos de idade. A paciente apresentou melhora clínica significativa no aspecto estético e funcional da lesão. O uso desses métodos combinados apresenta resultados favoráveis para o tratamento desses casos.


Scars resulting from burning causes great physical and emotional damage to patients. Its treatment remains a challenge in clinical practice. Current use of laser and light technologies, such as fractional ablative laser and intense pulsed light (ILP), have been shown to be effective in aesthetic and functional recovery of affected skin. This work aims to demonstrate the results of the treatment of extensive burn scarring with ILP and fractional ablative laser Erbium:YAG relating the case report of a 38-year-old female victim of direct flame burn at 6-years-old. The patient presented significant clinical improvement in the aesthetic and functional aspect of the lesion. The use of these combined methods presents favorable results for the treatment of these cases.


Las cicatrices resultantes de quemaduras causan grandes daños físicos y emocionales a los pacientes. El tratamiento sigue siendo un reto en la práctica clínica. El uso actual de tecnologías láser y de luz, tales como el láser ablativo fraccionado y la luz pulsada intensa (LPI) han demostrado ser herramientas eficaces para la recuperación estética y funcional de la piel afectada. Este trabajo tiene como objetivo mostrar el resultado del tratamiento de una cicatriz extensa por quemadura usando LPI y láser ablativo fraccional Erbio:YAG a partir del caso clínico de una paciente de 38 años de edad víctima de quemaduras por fuego directo (llama) a los 6 años de edad. La paciente mostró una mejoría clínica significativa en el aspecto estético y funcional de la lesión. El uso de estos métodos combinados mostró resultados favorables para el tratamiento de este tipo de casos.


Assuntos
Humanos , Feminino , Adulto , Queimaduras/terapia , Tratamento Terciário , Cicatriz/terapia , Terapia a Laser/instrumentação , Terapia de Luz Pulsada Intensa/instrumentação
17.
J Drugs Dermatol ; 15(4): 421-32, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27050697

RESUMO

UNLABELLED: A melanin meter has been created to assess real time skin pigmentation to optimize settings for visible light aesthetic applications. METHODS: A handheld meter was applied to non sun-damaged skin on the back of volunteers to measure skin pigmentation prior to treatment with IPL light sources over a range of pulse widths and ascending fluences. Curves for maximum epidermal tolerances as a function of pigmentation were determined. These curves were then tabulated for each pulse width in device software to provide guidance in the selection of fluences. Based on these findings, the device was applied in over 300 patients at a comprehensive laser and cosmetic dermatology center. RESULTS: A pigment meter evaluation led to treatment parameter guidance in intense pulsed light applications. These suggested ranges for settings based on the melanin index score proved useful, accurate, and safe in applications over a broad range of skin colors and across various anatomic units of the skin. CONCLUSION: A pigment meter can be used to identify appropriate settings with IPL treatments in order to enhance safety and efficacy when treating epidermal pigmented lesions, vessels, general photodamage and excessive hair (where the principles of selective photothermolysis are applied).


Assuntos
Técnicas Cosméticas/instrumentação , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Melaninas/análise , Transtornos da Pigmentação/diagnóstico , Transtornos da Pigmentação/terapia , Humanos , Planejamento da Radioterapia Assistida por Computador/instrumentação , Planejamento da Radioterapia Assistida por Computador/métodos , Envelhecimento da Pele/patologia , Resultado do Tratamento
18.
Actas dermo-sifiliogr. (Ed. impr.) ; 107(3): 215-223, abr. 2016. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-150831

RESUMO

BACKGROUND: Among the different approaches for improving the effectiveness in the treatment of Capillary Malformations type Port Wine Stain (CM type PWS) are the intense pulsed light sources. There are few clinical studies prove useful in the treatment of CM. Furthermore, no studies have been published yet demonstrating the histological effects of IPL in CM. OBJECTIVES: To assess the histological effects of pulsed light in capillary malformations type port wine stain. We wanted to compare epidermal, dermal and vessel wall damage after treatment with different combinations of IPL parameters. MATERIAL AND METHODS: Fifty-five post-treatment biopsies were performed in 15 consenting patients with CM and stained with nitroblue-tetrazolium chloride (NBTC). Patients had not been treated previously. RESULTS: Fifteen patients with CM, with a median age of 39 years-old were enrolled in this study. In this series, the patients with the most severe epidermal damage were those with a darker phototype. Pink CM were especially resistant to treatment, even using high fluences, short pulse durations and stacking pulses. Longer intra- and interpulse delays were effective in purple CM, achieving adequate vessel destruction. CONCLUSIONS: IPL devices provide a vast amount of treatment possibilities and further studies are necessary to optimize therapeutic approaches to CM. In this study we have observed the histological effects of different pulses on the MC type PWS


ANTECEDENTES: Entre las distintas estrategias para intentar mejorar la eficacia en el tratamiento de las malformaciones capilares tipo mancha en vino de Oporto (MC tipo MVO) están las fuentes de luz pulsada intensa. Existen hasta la fecha pocos estudios clínicos que avalen su utilidad en el tratamiento de las MC. Además, no disponemos de estudios histológicos que objetiven los efectos de la luz pulsada en la coagulación de estos vasos anómalos. OBJETIVOS: Evaluar los efectos histológicos de la luz pulsada en las MC tipo MVO. Intentamos comparar el daño epidérmico, dérmico y de la pared de los vasos después del tratamiento con distintos parámetros de IPL. MATERIAL Y MÉTODOS: Fueron realizadas 55 biopsias postratamiento en las MC de 15 pacientes. Las muestras fueron teñidas con cloruro de nitroblue tetrazolium. RESULTADOS: Quince pacientes (edad media: 39 años) fueron inscritos en este estudio. En esta serie los pacientes con mayor daño epidérmico fueron aquellos con un fototipo más alto (>IV). Las malformaciones de color rosa pálido eran especialmente resistentes al tratamiento, incluso con altas fluencias, duraciones de pulso corto y pulsos repetidos. Los pulsos de una mayor duración fueron especialmente eficaces en malformaciones capilares violáceas. CONCLUSIONES: Los equipos de IPL ofrecen una gran cantidad de opciones de tratamiento en las MC, sin embargo necesitamos conocer mejor sus efectos para realizar abordajes más eficaces y seguros. En este estudio hemos podido observar los efectos histológicos de los distintos pulsos sobre las MC tipo MVO


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças do Cabelo/diagnóstico , Doenças do Cabelo/prevenção & controle , Doenças do Cabelo/terapia , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia de Luz Pulsada Intensa , Terapia de Luz Pulsada Intensa/instrumentação , Nitroazul de Tetrazólio/farmacologia , Nitroazul de Tetrazólio/uso terapêutico , Radiação Solar/efeitos adversos , Inativação Luminosa Assistida por Cromóforo/instrumentação , Inativação Luminosa Assistida por Cromóforo/métodos , Inativação Luminosa Assistida por Cromóforo
19.
Microvasc Res ; 105: 47-53, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26776941

RESUMO

Intense pulsed light (IPL) with low energy insufficient to completely destroy a vasculature was applied to rabbit ears to investigate vasculature alteration. Glycerol was combined with IPL to enhance the transfer efficacy of IPL energy. Both trans-illumination and laser speckle contrast images were obtained and analyzed after treatment. The application of IPL and glycerol combination induced vasodilation and improvement in blood flow. Moreover, such phenomenon was maintained over time. IPL may be applied to treat blood circulatory diseases by inducing vasodilation and to improve blood flow.


Assuntos
Orelha/irrigação sanguínea , Terapia de Luz Pulsada Intensa , Imagem Óptica/métodos , Imagem de Perfusão/métodos , Vasodilatação , Animais , Velocidade do Fluxo Sanguíneo , Feminino , Glicerol/administração & dosagem , Terapia de Luz Pulsada Intensa/instrumentação , Lasers de Corante , Modelos Animais , Coelhos , Fluxo Sanguíneo Regional , Fatores de Tempo
20.
J Cosmet Laser Ther ; 18(1): 2-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26073119

RESUMO

OBJECTIVE: The objective of this study was to evaluate the safety and efficacy of combination facial treatment by 3 technologies. MATERIALS AND METHODS: Eleven patients completed the clinical trial that consisted of alternate treatments of intense pulsed light (IPL) in 3 sessions and continuous + fractional bipolar radiofrequency (RF) in 3 alternating sessions, 3 weeks apart. Follow-up visits were made at 6 and 12 weeks following the last treatment. Lesions were evaluated by photographs taken at baseline and at follow-up time points according to predetermined scales. RESULTS: Results showed statistically significant improvement in wrinkling (24% after 6 weeks and 33% after 12 weeks), pigmentation (38% after 6 weeks and 62% after 12 weeks), vascular lesions (29% after 6 weeks and 67% after 12 weeks), and laxity (37% after 6 weeks and 40% after 12 weeks). CONCLUSIONS: Combination facial treatment by IPL, and continuous and fractional RF is safe and enables the treatment of a variety of facial lesions, taking advantage of accessible applicators for different clinical indications on the same device. Thus, comprehensive facial skin rejuvenation has become feasible.


Assuntos
Terapia de Luz Pulsada Intensa , Terapia por Radiofrequência , Rejuvenescimento , Envelhecimento da Pele , Pigmentação da Pele , Adulto , Idoso , Terapia Combinada/instrumentação , Face , Feminino , Seguimentos , Humanos , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia de Luz Pulsada Intensa/instrumentação , Pessoa de Meia-Idade , Fotografação , Estudos Prospectivos , Ondas de Rádio/efeitos adversos , Método Simples-Cego
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