Acne Scars (acne + scar)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Comparison of a Long-Pulse Nd:YAG Laser and a Combined 585/1,064-nm Laser for the Treatment of Acne Scars: A Randomized Split-Face Clinical Study

DERMATOLOGIC SURGERY, Issue 11 2009
SEONG UK MIN MD
BACKGROUND Nonablative laser is gaining popularity because of the low risk of complications, especially in patients with darker skin. OBJECTIVE To compare the efficacy and safety of a long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and a combined 585/1,064-nm laser for the treatment of acne scars. MATERIALS AND METHODS Nineteen patients with mild to moderate atrophic acne scars received four long-pulse Nd:YAG laser or combined 585/1,064-nm laser treatment sessions at fortnightly intervals. Treatments were administered randomly in a split-face manner. RESULTS Acne scars showed mild to moderate improvement, with significant Echelle d'évaluation clinique des cicatrices d'acné (ECCA) score reductions, after both treatments. Although intermodality differences were not significant, combined 585/1,064-nm laser was more effective for deep boxcar scars. In patients with combined 585/1,064-nm laser-treated sides that improved more than long-pulse Nd:YAG laser-treated sides, ECCA scores were significantly lower for combined 585/1,064-nm laser treatment. Histologic evaluations revealed significantly greater collagen deposition, although there was no significant difference between the two modalities. Patient satisfaction scores concurred with physicians' evaluations. CONCLUSION Both lasers ameliorated acne scarring with minimal downtime. In light of this finding, optimal outcomes might be achieved when laser treatment types are chosen after considering individual scar type and response. [source]

Clinical Trial of Dual Treatment with an Ablative Fractional Laser and a Nonablative Laser for the Treatment of Acne Scars in Asian Patients

DERMATOLOGIC SURGERY, Issue 7 2009
SANGEUN KIM MD
BACKGROUND Many methods have been proposed for the treatment of acne scars, with variable cosmetic results. Nonablative skin resurfacing is one method that has been proposed. Because of a need for more noticeable clinical improvements, the ablative fractional laser was recently introduced. OBJECTIVE To reduce complications and improve the results of ablative fractional laser resurfacing by combining this treatment of acne scars with nonablative lasers. METHODS A series of 20 patients (skin phototypes IV,V) with atrophic facial acne scars were randomly divided into two groups that received three successive monthly treatments with an ablative fractional laser using high (group A) and low (group B) energy on one facial half and an ablative fractional laser with low energy plus a nonablative resurfacing laser on the other facial half. Patients were evaluated using digital photography at each treatment visit and at 3 months postoperatively. Clinical assessment scores were determined at each treatment session and follow-up visit. RESULTS Although the use of the ablative fractional laser with high energy resulted in an improvement in patients' acne scars, the combination of ablative fractional laser resurfacing and nonablative laser resurfacing yielded the best results, as assessed in photographs as well as by the overall appearance of the acne scars. With the combination method, fewer complications were observed. [source]

Minimally Ablative Erbium:YAG Laser Resurfacing of Facial Atrophic Acne Scars in Asian Skin: A Pilot Study

DERMATOLOGIC SURGERY, Issue 5 2008
YONG-KWANG TAY MD
BACKGROUND Atrophic scars are dermal depressions caused by collagen damage most commonly occurring after inflammatory acne vulgaris. There are little published data regarding the effectiveness and safety of minimally invasive lasers in the treatment of atrophic acne scars in darker skin types. OBJECTIVE The purpose was to evaluate the efficacy and safety of a low-fluence 2,940-nm erbium:YAG laser in the treatment of atrophic acne scars in Asian patients. MATERIALS AND METHODS Nine patients aged 19 to 45 years with mild to moderate atrophic facial scars and Skin Types IV and V were treated with topical anesthesia and one to two passes with an erbium:YAG laser two times at 1-month intervals. Treatment parameters were 6-mm spot size, fluence of 400 mJ, pulse duration of 300 ,s, and repetition rate of 2 Hz. RESULTS At 2 months after the last treatment, mild to moderate clinical improvement was noted in all patients compared to baseline. Treatment was well tolerated. Side effects consisted of posttreatment erythema, peeling, and crusting, which resolved within 1 to 2 weeks. There was no postinflammatory hyper- or hypopigmentation, blistering, or hypertrophic scarring. CONCLUSION Low-fluence erbium:YAG facial resurfacing was effective and safe in patients with mild to moderately severe atrophic acne scarring. [source]

Histologic Study of Depressed Acne Scars Treated with Serial High-Concentration (95%) Trichloroacetic Acid

DERMATOLOGIC SURGERY, Issue 8 2006
ANTHONY YUG MD
BACKGROUND Acne scarring is a common manifestation that remains a therapeutic challenge to dermatologists, dermatologic surgeons, and plastic surgeons. Although multiple therapeutic modalities exist, treatment often remains inadequate. The use of high-concentration (95%) trichloroacetic acid (TCA) applied focally to atrophic acne scars has been described. OBJECTIVE The current study confirms the utility of focal application of 95% TCA to acne scars in addition to a histologic examination of this technique. METHODS Acne scars in three patients were treated with focal 95% TCA by serial application. Wooden applicators were used to apply TCA focally and repeated at 6-week intervals for a total of six treatments. Punch biopsies were performed at baseline and at 1 year postoperatively. Histologic examination was performed with routine hematoxylin/eosin, Masson trichrome, and Verhoeff-van Gieson staining. RESULTS Clinical examination revealed apparent cosmetic improvement in both depth and appearance of acne scars. Patient satisfaction was high. Histologic examination demonstrated a decrease in the depth of acne scars. In addition, increased collagen fibers and fragmentation of elastic fibers were noted. There were no complications from the procedure. CONCLUSION Focal application of high-concentration TCA to atrophic and "ice-pick" acne scars appears to produce clinical improvement. Histologic changes of this technique are described. [source]

Nonablative 1450-nm Diode Laser in the Treatment of Facial Atrophic Acne Scars in Type IV to V Asian Skin: A Prospective Clinical Study

DERMATOLOGIC SURGERY, Issue 10 2004
Sze-Hon Chua MRCP (UK)
Background. There is presently little published data on the clinical effectiveness of nonablative lasers in the treatment of atrophic acne scars and the safety of their use in patients with darker skin types. Objective. This study aims to determine the clinical effectiveness and safety of the nonablative 1450 nm diode laser with cryogen cooling spray in the treatment of facial atrophic acne scars in Type IV-V Asian skin. Methods. This is a prospective non-comparative open study. 4 to 6 laser treatment sessions were performed on patients with atrophic acne scars. Final clinical assessment was performed 6 months after the last treatment. Results. 57 patients were evaluated. Patient's self-assessment of scar improvement as compared with doctor's assessment was as follows: patients who completed 4 treatments (15.7% vs 6.6%), patients who completed 5 treatments (20% vs 7.9%) and patients those who completed 6 treatments (17.3% vs 5.0%). Main side effects were mild to moderate pain during the procedure, transient erythema, and hyperpigmentation which occurred in 39% of treated patients. Conclusion. The nonablative 1450 nm diode laser may be effective in achieving mild to moderate gradual clinical improvement in the treatment of facial atrophic acne scars. The procedure is associated with minimal downtime and is safe for use in darker skin types IV and V. [source]

Atrophic and a Mixed Pattern of Acne Scars Improved With a 1320-nm Nd:YAG Laser

DERMATOLOGIC SURGERY, Issue 9 2003
Arlene S. Rogachefsky MD
Background. Acne scar correction remains a challenge to the dermatologic surgeon. With nonablative laser resurfacing, this correction is imputed to dermal collagen remodeling and acne scar reorganization. Although atrophic acne scars tend to respond to laser treatment, the deeper ice pick and boxcar scars tend to be laser resistant. Objective. To investigate the treatment of atrophic and a mixed pattern of facial acne scars, we evaluated a 1320-nm Nd:YAG laser. Twelve subjects with atrophic facial acne scars (N=6) or a combination of atrophic and pitted, sclerotic, or boxcar scars (N=6) received three laser treatments. Physician and patient acne scar ratings were performed at baseline and at 6 months after the last treatment. Acne scars were rated with a 10-point severity scale. Results. Mean acne scar improvement was 1.5 points on physician assessments (P=0.002) and 2.2 points on patient assessments (P=0.01). Acne scars were rated more severely by patients than by the physician at all intervals. There were no noted complications at 6 months. Conclusion. The 1320-nm Nd:YAG laser is a safe and effective nonablative modality for the improvement of atrophic and a mixed pattern of facial acne scars. [source]

Resurfacing of Pitted Facial Acne Scars with a Long-Pulsed Er:YAG Laser

DERMATOLOGIC SURGERY, Issue 2 2001
Jeung-Tae Jeong MD
Background. Conventional short-pulsed Er:YAG lasers show less effective hemostasis and weak photothermal damage on papillary dermis. Recently, newer long-pulsed Er:YAG laser systems has been developed. Objective. To evaluate the clinical and histologic effects of long-pulsed Er:YAG laser resurfacing for pitted facial acne scars. Methods. Thirty-five patients with pitted facial acne scars were treated with a long-pulsed Er:YAG laser. All patients had Fitzpatrick skin phototypes III,V. A pulsed Er:YAG laser with a 5 mm handpiece at a setting of 7.0,7.5 J/cm2 with a 10-msec pulse duration was used. The laser was fired at 5 Hz, with four to five passes. In 28 patients, the results of laser treatment were evaluated for the degree of clinical improvement, duration of erythema, pigmentary change, and any adverse events at 2 weeks, 1 month, and 3 months. In seven patients, skin biopsy specimens were obtained at the following intervals: immediately, 1 week, 2 weeks, 4 weeks, and 8 weeks postoperatively for histologic examination. Results. The results of long-pulsed Er:YAG laser resurfacing for pitted facial acne scars were excellent in 10 patients (36%), good in 16 patients (57%), and fair in 2 patients (7%). Erythema occurred in all patients after laser treatment and lasted longer than 3 months in 15 patients (54%). Postinflammatory hyperpigmentation occurred in 8 patients (29%). But the pigmentation faded or disappeared within 3 months. One patient (4%) experienced mild hypopigmentation. Pruritic symptoms that required medical intervention occurred in 16 patients (57%). Mild to moderate postoperative acne flare-up occurred in 8 patients (29%). No other adverse effects such as scarring, bacterial infection, or contact dermatitis were observed. Conclusion. In conclusion, resurfacing with a long-pulsed Er:YAG laser is a safe and very effective treatment modality for pitted facial acne scars. [source]

Comparison of a Long-Pulse Nd:YAG Laser and a Combined 585/1,064-nm Laser for the Treatment of Acne Scars: A Randomized Split-Face Clinical Study

DERMATOLOGIC SURGERY, Issue 11 2009
SEONG UK MIN MD
BACKGROUND Nonablative laser is gaining popularity because of the low risk of complications, especially in patients with darker skin. OBJECTIVE To compare the efficacy and safety of a long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and a combined 585/1,064-nm laser for the treatment of acne scars. MATERIALS AND METHODS Nineteen patients with mild to moderate atrophic acne scars received four long-pulse Nd:YAG laser or combined 585/1,064-nm laser treatment sessions at fortnightly intervals. Treatments were administered randomly in a split-face manner. RESULTS Acne scars showed mild to moderate improvement, with significant Echelle d'évaluation clinique des cicatrices d'acné (ECCA) score reductions, after both treatments. Although intermodality differences were not significant, combined 585/1,064-nm laser was more effective for deep boxcar scars. In patients with combined 585/1,064-nm laser-treated sides that improved more than long-pulse Nd:YAG laser-treated sides, ECCA scores were significantly lower for combined 585/1,064-nm laser treatment. Histologic evaluations revealed significantly greater collagen deposition, although there was no significant difference between the two modalities. Patient satisfaction scores concurred with physicians' evaluations. CONCLUSION Both lasers ameliorated acne scarring with minimal downtime. In light of this finding, optimal outcomes might be achieved when laser treatment types are chosen after considering individual scar type and response. [source]

Histologic Study of Depressed Acne Scars Treated with Serial High-Concentration (95%) Trichloroacetic Acid

DERMATOLOGIC SURGERY, Issue 8 2006
ANTHONY YUG MD
BACKGROUND Acne scarring is a common manifestation that remains a therapeutic challenge to dermatologists, dermatologic surgeons, and plastic surgeons. Although multiple therapeutic modalities exist, treatment often remains inadequate. The use of high-concentration (95%) trichloroacetic acid (TCA) applied focally to atrophic acne scars has been described. OBJECTIVE The current study confirms the utility of focal application of 95% TCA to acne scars in addition to a histologic examination of this technique. METHODS Acne scars in three patients were treated with focal 95% TCA by serial application. Wooden applicators were used to apply TCA focally and repeated at 6-week intervals for a total of six treatments. Punch biopsies were performed at baseline and at 1 year postoperatively. Histologic examination was performed with routine hematoxylin/eosin, Masson trichrome, and Verhoeff-van Gieson staining. RESULTS Clinical examination revealed apparent cosmetic improvement in both depth and appearance of acne scars. Patient satisfaction was high. Histologic examination demonstrated a decrease in the depth of acne scars. In addition, increased collagen fibers and fragmentation of elastic fibers were noted. There were no complications from the procedure. CONCLUSION Focal application of high-concentration TCA to atrophic and "ice-pick" acne scars appears to produce clinical improvement. Histologic changes of this technique are described. [source]

Resurfacing of Different Types of Facial Acne Scar With Short-Pulsed, Variable-Pulsed, and Dual-Mode Er:YAG Laser

DERMATOLOGIC SURGERY, Issue 4 2004
Sang-Hyuk Woo MD
Background. Laser skin resurfacing has become a popular therapeutic modality for the correction of acne scars, but it is not always effective in all types of acne scars. Objective. To evaluate the clinical effects of resurfacing with the short-pulsed Er:YAG laser, the variable-pulsed Er:YAG laser, and the dual-mode Er:YAG laser for each type of facial acne scars. Methods. One hundred fifty-eight patients with facial acne scars were included in this study. Eighty three patients (18 deep boxcar scars, 8 ice-pick scars, 11 rolling scars, and 46 shallow boxcars) were treated with the 350-,s short-pulsed Er:YAG laser at the setting of 12.5 to 15%/cm2. Thirty-five patients (8 deep boxcar scars, 4 ice-pick scars, 12 rolling scars, and 11 shallow boxcars) were treated with the variable-pulsed Er:YAG laser at the setting of 7.0 to 7.5%/cm2 and 7-ms pulse duration. Forty patients (8 deep boxcar scars, 4 ice-pick scars, 17 rolling scars, and 11 shallow boxcars) were treated with the dual-mode Er:YAG laser with 350-, ablation mode at 17.5%/cm2 and 8-ms coagulation mode at 3.15%/cm2. Facial photographs were obtained at baseline and at 2- to 4-week intervals postoperatively. Acne scars were classified into four types, and clinical improvements of facial acne scars were evaluated. Results. Resurfacing with the short-pulsed Er:YAG laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and poor to fair for rolling scars. Resurfacing with the variable-pulsed laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and good for rolling scars. Resurfacing with the dual-mode laser shows good to excellent results for ice-pick, shallow, and rolling scars and produced good results on deep boxcar scars. Conclusion. Shallow boxcar and ice-pick scars can be treated successfully using any types of Er:YAG laser. In cases of rolling and deep boxcar scars, however, Er:YAG laser with a long-pulse duration for a thermal effect is needed for successful treatment. [source]

Atrophic and a Mixed Pattern of Acne Scars Improved With a 1320-nm Nd:YAG Laser

DERMATOLOGIC SURGERY, Issue 9 2003
Arlene S. Rogachefsky MD
Background. Acne scar correction remains a challenge to the dermatologic surgeon. With nonablative laser resurfacing, this correction is imputed to dermal collagen remodeling and acne scar reorganization. Although atrophic acne scars tend to respond to laser treatment, the deeper ice pick and boxcar scars tend to be laser resistant. Objective. To investigate the treatment of atrophic and a mixed pattern of facial acne scars, we evaluated a 1320-nm Nd:YAG laser. Twelve subjects with atrophic facial acne scars (N=6) or a combination of atrophic and pitted, sclerotic, or boxcar scars (N=6) received three laser treatments. Physician and patient acne scar ratings were performed at baseline and at 6 months after the last treatment. Acne scars were rated with a 10-point severity scale. Results. Mean acne scar improvement was 1.5 points on physician assessments (P=0.002) and 2.2 points on patient assessments (P=0.01). Acne scars were rated more severely by patients than by the physician at all intervals. There were no noted complications at 6 months. Conclusion. The 1320-nm Nd:YAG laser is a safe and effective nonablative modality for the improvement of atrophic and a mixed pattern of facial acne scars. [source]

Comparison of a Long-Pulse Nd:YAG Laser and a Combined 585/1,064-nm Laser for the Treatment of Acne Scars: A Randomized Split-Face Clinical Study

DERMATOLOGIC SURGERY, Issue 11 2009
SEONG UK MIN MD
BACKGROUND Nonablative laser is gaining popularity because of the low risk of complications, especially in patients with darker skin. OBJECTIVE To compare the efficacy and safety of a long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and a combined 585/1,064-nm laser for the treatment of acne scars. MATERIALS AND METHODS Nineteen patients with mild to moderate atrophic acne scars received four long-pulse Nd:YAG laser or combined 585/1,064-nm laser treatment sessions at fortnightly intervals. Treatments were administered randomly in a split-face manner. RESULTS Acne scars showed mild to moderate improvement, with significant Echelle d'évaluation clinique des cicatrices d'acné (ECCA) score reductions, after both treatments. Although intermodality differences were not significant, combined 585/1,064-nm laser was more effective for deep boxcar scars. In patients with combined 585/1,064-nm laser-treated sides that improved more than long-pulse Nd:YAG laser-treated sides, ECCA scores were significantly lower for combined 585/1,064-nm laser treatment. Histologic evaluations revealed significantly greater collagen deposition, although there was no significant difference between the two modalities. Patient satisfaction scores concurred with physicians' evaluations. CONCLUSION Both lasers ameliorated acne scarring with minimal downtime. In light of this finding, optimal outcomes might be achieved when laser treatment types are chosen after considering individual scar type and response. [source]

Clinical Trial of Dual Treatment with an Ablative Fractional Laser and a Nonablative Laser for the Treatment of Acne Scars in Asian Patients

DERMATOLOGIC SURGERY, Issue 7 2009
SANGEUN KIM MD
BACKGROUND Many methods have been proposed for the treatment of acne scars, with variable cosmetic results. Nonablative skin resurfacing is one method that has been proposed. Because of a need for more noticeable clinical improvements, the ablative fractional laser was recently introduced. OBJECTIVE To reduce complications and improve the results of ablative fractional laser resurfacing by combining this treatment of acne scars with nonablative lasers. METHODS A series of 20 patients (skin phototypes IV,V) with atrophic facial acne scars were randomly divided into two groups that received three successive monthly treatments with an ablative fractional laser using high (group A) and low (group B) energy on one facial half and an ablative fractional laser with low energy plus a nonablative resurfacing laser on the other facial half. Patients were evaluated using digital photography at each treatment visit and at 3 months postoperatively. Clinical assessment scores were determined at each treatment session and follow-up visit. RESULTS Although the use of the ablative fractional laser with high energy resulted in an improvement in patients' acne scars, the combination of ablative fractional laser resurfacing and nonablative laser resurfacing yielded the best results, as assessed in photographs as well as by the overall appearance of the acne scars. With the combination method, fewer complications were observed. [source]

Minimally Ablative Erbium:YAG Laser Resurfacing of Facial Atrophic Acne Scars in Asian Skin: A Pilot Study

DERMATOLOGIC SURGERY, Issue 5 2008
YONG-KWANG TAY MD
BACKGROUND Atrophic scars are dermal depressions caused by collagen damage most commonly occurring after inflammatory acne vulgaris. There are little published data regarding the effectiveness and safety of minimally invasive lasers in the treatment of atrophic acne scars in darker skin types. OBJECTIVE The purpose was to evaluate the efficacy and safety of a low-fluence 2,940-nm erbium:YAG laser in the treatment of atrophic acne scars in Asian patients. MATERIALS AND METHODS Nine patients aged 19 to 45 years with mild to moderate atrophic facial scars and Skin Types IV and V were treated with topical anesthesia and one to two passes with an erbium:YAG laser two times at 1-month intervals. Treatment parameters were 6-mm spot size, fluence of 400 mJ, pulse duration of 300 ,s, and repetition rate of 2 Hz. RESULTS At 2 months after the last treatment, mild to moderate clinical improvement was noted in all patients compared to baseline. Treatment was well tolerated. Side effects consisted of posttreatment erythema, peeling, and crusting, which resolved within 1 to 2 weeks. There was no postinflammatory hyper- or hypopigmentation, blistering, or hypertrophic scarring. CONCLUSION Low-fluence erbium:YAG facial resurfacing was effective and safe in patients with mild to moderately severe atrophic acne scarring. [source]

Autologous Cultured Fibroblast Injection for Facial Contour Deformities: A Prospective, Placebo-Controlled, Phase III Clinical Trial

DERMATOLOGIC SURGERY, Issue 3 2007
ROBERT A. WEISS MD
BACKGROUND Previous data indicate that injections of autologous fibroblasts increase collagen formation, accompanied by a concomitant increase in thickness and density of dermal collagen. OBJECTIVE The purpose of this study was to determine efficacy and side effects of autologous living fibroblast injections versus placebo in a randomized Phase III trial for the treatment of various facial contour defects. METHODS This was a double-blind, randomized comparison of injectable living autologous fibroblast cells and placebo for the treatment of facial contour defects (N=215). Live fibroblasts (20 million/mL) or placebo (the transport medium without living cells) were given as three doses administered at 1- to 2-week intervals. Efficacy evaluations were performed 1, 2, 4, 6, 9, and 12 months after the first injection. RESULTS Living fibroblasts produced statistically significantly greater improvements in dermal deformities and acne scars than did placebo. The difference between live fibroblast injections and placebo achieved statistical significance at 6 months (p<.0001). At 9- and 12-month follow-up, live fibroblast,treated patients continued to demonstrate benefit from treatment with response rates of 75.0 and 81.6%, respectively. No serious treatment-related adverse events were reported. CONCLUSIONS Our results indicate that autologous fibroblast injections can safely and effectively produce improvements in rhytids, acne scars, and other dermal defects continuing for at least 12 months after injection. [source]

Histologic Study of Depressed Acne Scars Treated with Serial High-Concentration (95%) Trichloroacetic Acid

DERMATOLOGIC SURGERY, Issue 8 2006
ANTHONY YUG MD
BACKGROUND Acne scarring is a common manifestation that remains a therapeutic challenge to dermatologists, dermatologic surgeons, and plastic surgeons. Although multiple therapeutic modalities exist, treatment often remains inadequate. The use of high-concentration (95%) trichloroacetic acid (TCA) applied focally to atrophic acne scars has been described. OBJECTIVE The current study confirms the utility of focal application of 95% TCA to acne scars in addition to a histologic examination of this technique. METHODS Acne scars in three patients were treated with focal 95% TCA by serial application. Wooden applicators were used to apply TCA focally and repeated at 6-week intervals for a total of six treatments. Punch biopsies were performed at baseline and at 1 year postoperatively. Histologic examination was performed with routine hematoxylin/eosin, Masson trichrome, and Verhoeff-van Gieson staining. RESULTS Clinical examination revealed apparent cosmetic improvement in both depth and appearance of acne scars. Patient satisfaction was high. Histologic examination demonstrated a decrease in the depth of acne scars. In addition, increased collagen fibers and fragmentation of elastic fibers were noted. There were no complications from the procedure. CONCLUSION Focal application of high-concentration TCA to atrophic and "ice-pick" acne scars appears to produce clinical improvement. Histologic changes of this technique are described. [source]

Nonablative Acne Scar Reduction after a Series of Treatments with a Short-Pulsed 1,064-nm Neodymium:YAG Laser

DERMATOLOGIC SURGERY, Issue 8 2006
GRAEME M. LIPPER MD
BACKGROUND Effective treatment of facial acne scarring presents a major challenge. Nonablative lasers and radiofrequency devices work by thermally stimulating dermal collagen remodeling, thereby softening acne scars in a minimally invasive fashion. One such laser, a 1,064-nm short-pulsed Nd:YAG, uses rapidly scanned low-energy infrared pulses to heat the dermis selectively through the normal dermal microvasculature. OBJECTIVE In this pilot study, the safety and efficacy of a novel short-pulsed Nd:YAG laser were investigated for the treatment of moderate to severe facial acne scarring. MATERIALS AND METHODS Nine of 10 enrolled patients with moderate to severe facial acne scarring received eight sequential 1,064-nm Nd:YAG treatments (laser parameters 14 J/cm2, 0.3 milliseconds, 5-mm spot size, 7-Hz pulse rate, 2,000 pulses per side of face). Patients were graded for the presence and severity of three scar morphologies: superficial (rolling), medium-depth (boxcar), and deep (ice pick). Outcome measures included blinded evaluation of before and after photographs by three physician observers (scar severity score) and patient self-assessment. RESULTS Acne scarring improved in 100% of the nine patients completing the study. Scar severity scores improved by a mean of 29.36% (95% confidence interval, 16.93%,41.79%; p=.006); 89% of patients noted greater than 10% scar improvement. No treatment-related adverse events were seen. CONCLUSION Our findings support the use of a short-pulsed, low-fluence 1,064-nm Nd:YAG laser as a safe, effective treatment for facial acne scarring. Scar improvement was noted in all treated subjects with minimal discomfort and no downtime. This protocol appears to be most effective at reducing scar depth and softening scar contours. [source]

Nonablative Laser Surgery for Pigmented Skin

DERMATOLOGIC SURGERY, Issue 10 2005
David J. Goldberg MD
Background. Nonablative laser surgery has been proven to improve early photodamaged skin and acne scars. These techniques include treatments with lasers, light sources, and/or radiofrequency devices. Objectives. To review the history of nonablative technology and its applicability to darker skin types and to provide an objective look at the various published studies documenting the efficacy of nonablative technology. Conclusion. Nonablative laser surgery can improve skin quality and acne scars in all skin types. Complications are rare but can occur. Future studies are required to compare the efficacy of the various nonablative technologies. DAVID J. GOLDBERG, MD, HAS INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source]

Nonablative 1450-nm Diode Laser in the Treatment of Facial Atrophic Acne Scars in Type IV to V Asian Skin: A Prospective Clinical Study

DERMATOLOGIC SURGERY, Issue 10 2004
Sze-Hon Chua MRCP (UK)
Background. There is presently little published data on the clinical effectiveness of nonablative lasers in the treatment of atrophic acne scars and the safety of their use in patients with darker skin types. Objective. This study aims to determine the clinical effectiveness and safety of the nonablative 1450 nm diode laser with cryogen cooling spray in the treatment of facial atrophic acne scars in Type IV-V Asian skin. Methods. This is a prospective non-comparative open study. 4 to 6 laser treatment sessions were performed on patients with atrophic acne scars. Final clinical assessment was performed 6 months after the last treatment. Results. 57 patients were evaluated. Patient's self-assessment of scar improvement as compared with doctor's assessment was as follows: patients who completed 4 treatments (15.7% vs 6.6%), patients who completed 5 treatments (20% vs 7.9%) and patients those who completed 6 treatments (17.3% vs 5.0%). Main side effects were mild to moderate pain during the procedure, transient erythema, and hyperpigmentation which occurred in 39% of treated patients. Conclusion. The nonablative 1450 nm diode laser may be effective in achieving mild to moderate gradual clinical improvement in the treatment of facial atrophic acne scars. The procedure is associated with minimal downtime and is safe for use in darker skin types IV and V. [source]

Resurfacing of Different Types of Facial Acne Scar With Short-Pulsed, Variable-Pulsed, and Dual-Mode Er:YAG Laser

DERMATOLOGIC SURGERY, Issue 4 2004
Sang-Hyuk Woo MD
Background. Laser skin resurfacing has become a popular therapeutic modality for the correction of acne scars, but it is not always effective in all types of acne scars. Objective. To evaluate the clinical effects of resurfacing with the short-pulsed Er:YAG laser, the variable-pulsed Er:YAG laser, and the dual-mode Er:YAG laser for each type of facial acne scars. Methods. One hundred fifty-eight patients with facial acne scars were included in this study. Eighty three patients (18 deep boxcar scars, 8 ice-pick scars, 11 rolling scars, and 46 shallow boxcars) were treated with the 350-,s short-pulsed Er:YAG laser at the setting of 12.5 to 15%/cm2. Thirty-five patients (8 deep boxcar scars, 4 ice-pick scars, 12 rolling scars, and 11 shallow boxcars) were treated with the variable-pulsed Er:YAG laser at the setting of 7.0 to 7.5%/cm2 and 7-ms pulse duration. Forty patients (8 deep boxcar scars, 4 ice-pick scars, 17 rolling scars, and 11 shallow boxcars) were treated with the dual-mode Er:YAG laser with 350-, ablation mode at 17.5%/cm2 and 8-ms coagulation mode at 3.15%/cm2. Facial photographs were obtained at baseline and at 2- to 4-week intervals postoperatively. Acne scars were classified into four types, and clinical improvements of facial acne scars were evaluated. Results. Resurfacing with the short-pulsed Er:YAG laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and poor to fair for rolling scars. Resurfacing with the variable-pulsed laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and good for rolling scars. Resurfacing with the dual-mode laser shows good to excellent results for ice-pick, shallow, and rolling scars and produced good results on deep boxcar scars. Conclusion. Shallow boxcar and ice-pick scars can be treated successfully using any types of Er:YAG laser. In cases of rolling and deep boxcar scars, however, Er:YAG laser with a long-pulse duration for a thermal effect is needed for successful treatment. [source]

Atrophic and a Mixed Pattern of Acne Scars Improved With a 1320-nm Nd:YAG Laser

DERMATOLOGIC SURGERY, Issue 9 2003
Arlene S. Rogachefsky MD
Background. Acne scar correction remains a challenge to the dermatologic surgeon. With nonablative laser resurfacing, this correction is imputed to dermal collagen remodeling and acne scar reorganization. Although atrophic acne scars tend to respond to laser treatment, the deeper ice pick and boxcar scars tend to be laser resistant. Objective. To investigate the treatment of atrophic and a mixed pattern of facial acne scars, we evaluated a 1320-nm Nd:YAG laser. Twelve subjects with atrophic facial acne scars (N=6) or a combination of atrophic and pitted, sclerotic, or boxcar scars (N=6) received three laser treatments. Physician and patient acne scar ratings were performed at baseline and at 6 months after the last treatment. Acne scars were rated with a 10-point severity scale. Results. Mean acne scar improvement was 1.5 points on physician assessments (P=0.002) and 2.2 points on patient assessments (P=0.01). Acne scars were rated more severely by patients than by the physician at all intervals. There were no noted complications at 6 months. Conclusion. The 1320-nm Nd:YAG laser is a safe and effective nonablative modality for the improvement of atrophic and a mixed pattern of facial acne scars. [source]

Injecting 1000 Centistoke Liquid Silicone With Ease and Precision

DERMATOLOGIC SURGERY, Issue 3 2003
Anthony V. Benedetto DO, FACP
BACKGROUND Since the Food and Drug Administration approved the use of the 1000 centistoke liquid silicone, Silikon 1000, for intraocular injection, the off-label use of this injectable silicone oil as a permanent soft-tissue filler for facial rejuvenation has increased in the United States. Injecting liquid silicone by the microdroplet technique is the most important preventive measure that one can use to avoid the adverse sequelae of silicone migration and granuloma formation, especially when injecting silicone to improve small facial defects resulting from acne scars, surgical procedures, or photoaging. OBJECTIVE To introduce an easy method for injecting a viscous silicone oil by the microdroplet technique, using an inexpensive syringe and needle that currently is available from distributors of medical supplies in the United States. METHOD We suggest the use of a Becton Dickinson 3/10 cc insulin U-100 syringe to inject Silikon 1000. This syringe contains up to 0.3 mL of fluid, and its barrel is clearly marked with an easy-to-read scale of large cross-hatches. Each cross-hatch marking represents either a unit value of 0.01 mL or a half-unit value of 0.005 mL of fluid, which is the approximate volume preferred when injecting liquid silicone into facial defects. Because not enough negative pressure can be generated in this needle and syringe to draw up the viscous silicone oil, we describe a convenient and easy method for filling this 3/10 cc diabetic syringe with Silikon 1000. RESULTS We have found that by using the Becton Dickinson 3/10 cc insulin U-100 syringe, our technique of injecting minute amounts of Silikon 1000 is facilitated because each widely spaced cross-hatch on the side of the syringe barrel is easy to read and measures exact amounts of the silicone oil. These lines of the scale on the syringe barrel are so large and clearly marked that it is virtually impossible to overinject the most minute amount of silicone. CONCLUSION Sequential microdroplets of 0.01 cc or less of Silikon 1000 can be measured and injected with the greatest ease and precision so that inadvertent overdosing and complications can be avoided. [source]

3D In-Vivo Optical Skin Imaging for Topographical Quantitative Assessment of Non-Ablative Laser Technology

DERMATOLOGIC SURGERY, Issue 3 2002
Paul M. Friedman MD
background. A new method for treating facial rhytides and acne scars with nonablative laser and light source techniques has recently been introduced. Given the inherent limitations of photographic and clinical evaluation to assess subtle changes in rhytides and surface topography, a new noninvasive objective assessment is required to accurately assess the outcomes of these procedures. objective. The purpose of this study was to measure and objectively quantify facial skin using a novel, noninvasive, In-vivo method for assessing three-dimensional topography. This device was used to quantify the efficacy of five treatment sessions with the 1064 nm QS Nd:YAG laser for rhytides and acne scarring, for up to six months following laser treatment. methods. Two subjects undergoing facial rejuvenation procedures were analyzed before and after therapy using a 30-mm, three-dimensional microtopography imaging system (PRIMOS, GFM, Teltow, Germany). The imaging system projects light on to a specific surface of the skin using a Digital Micromirror Device (DMDÔ Texas Instruments, Irving, TX) and records the image with a CCD camera. Skin Surface microtopography is reconstructed using temporal phase shift algorithms to generate three-dimensional images. Measurements were taken at baseline, at various times during the treatment protocol, and then at three and six-month follow-up visits. Silicone skin replicas (FLEXICO, Herts, England) were also made before and after the laser treatment protocol for comparison to In-vivo acquisition. results. Skin roughness decreased by 11% from baseline after three treatment sessions in the wrinkles subject, while a 26% improvement of skin roughness was recorded by 3D In-vivo assessment six months following the fifth treatment session. The subject with acne scarring demonstrated a 33% decrease in roughness analysis after three treatment sessions by 3D In-vivo assessment. A 61% improvement in surface topography was recorded 3-months following the fifth treatment session, which was maintained at the 6-month follow-up. conclusion. Three-dimensional In-vivo optical skin imaging provided a rapid and quantitative assessment of surface topography and facial fine lines following multiple treatment sessions with a 1064-nm QS Nd:YAG laser, correlating with clinical and subjective responses. This imaging technique provided objective verification and technical understanding of nonablative laser technology. Wrinkle depth and skin roughness decreased at the three and six-month follow-up evaluations by 3D In-vivo assessment, indicating ongoing dermal collagen remodeling after the laser treatment protocol. Future applications may include comparison of nonablative laser technology, optimization of treatment regimens, and objective evaluation of other aesthetic procedures performed by dermatologists. [source]

Resurfacing of Pitted Facial Acne Scars with a Long-Pulsed Er:YAG Laser

DERMATOLOGIC SURGERY, Issue 2 2001
Jeung-Tae Jeong MD
Background. Conventional short-pulsed Er:YAG lasers show less effective hemostasis and weak photothermal damage on papillary dermis. Recently, newer long-pulsed Er:YAG laser systems has been developed. Objective. To evaluate the clinical and histologic effects of long-pulsed Er:YAG laser resurfacing for pitted facial acne scars. Methods. Thirty-five patients with pitted facial acne scars were treated with a long-pulsed Er:YAG laser. All patients had Fitzpatrick skin phototypes III,V. A pulsed Er:YAG laser with a 5 mm handpiece at a setting of 7.0,7.5 J/cm2 with a 10-msec pulse duration was used. The laser was fired at 5 Hz, with four to five passes. In 28 patients, the results of laser treatment were evaluated for the degree of clinical improvement, duration of erythema, pigmentary change, and any adverse events at 2 weeks, 1 month, and 3 months. In seven patients, skin biopsy specimens were obtained at the following intervals: immediately, 1 week, 2 weeks, 4 weeks, and 8 weeks postoperatively for histologic examination. Results. The results of long-pulsed Er:YAG laser resurfacing for pitted facial acne scars were excellent in 10 patients (36%), good in 16 patients (57%), and fair in 2 patients (7%). Erythema occurred in all patients after laser treatment and lasted longer than 3 months in 15 patients (54%). Postinflammatory hyperpigmentation occurred in 8 patients (29%). But the pigmentation faded or disappeared within 3 months. One patient (4%) experienced mild hypopigmentation. Pruritic symptoms that required medical intervention occurred in 16 patients (57%). Mild to moderate postoperative acne flare-up occurred in 8 patients (29%). No other adverse effects such as scarring, bacterial infection, or contact dermatitis were observed. Conclusion. In conclusion, resurfacing with a long-pulsed Er:YAG laser is a safe and very effective treatment modality for pitted facial acne scars. [source]

Wire Scalpel for Surgical Correction of Soft Tissue Contour Defects by Subcutaneous Dissection

DERMATOLOGIC SURGERY, Issue 2 2000
Marlen A. Sulamanidze MD
Background. Increasing demand exists for cosmetic correction of soft tissue contour defects. Treatments include simple tissue augmentation techniques or more complex surgeries with consequent relevant recuperation time for the patient. The search for new simple techniques to correct scars and age-related wrinkles and folds is therefore one of the main goals of cosmetic dermatologic surgery. Objective. To improve the cosmetic outcome of patients suffering from soft tissue contour defects by the use of a novel surgical instrument and technique, subcutaneous dissection by wire scalpel. Methods. Fifty-four patients were treated with the wire scalpel technique with no skin incisions to correct a total of 132 depressed cosmetic defects of the face. Forehead lines, glabellar, nasolabial and oral commissure folds, upper lip wrinkles, and acne scars were treated. A 2-month to 4-year follow-up allowed subjective and photographic evaluation of results. Results. Good or satisfactory results were obtained in 79.7% and 16.6% of the cases, respectively. Minor complications did not change the overall positive outcome of the surgery. Conclusion. Subcutaneous dissection by wire scalpel is a simple, safe, and effective method to improve the contour appearance of patients affected with scars or age-related contour defects. [source]

Skin rejuvenation with microthermal fractional photothermolysis

DERMATOLOGIC THERAPY, Issue 2007
Vic A. Narurkar
ABSTRACT:, Fractional resurfacing is gaining acceptance as a preferred method for skin resurfacing. Experience in treating photoaging, acne scars, and melasma is reviewed. [source]

Tetracycline/doxycycline-induced cutaneous depressed pigmentation

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2006
Esra Adisen MD
Pigmentary disorders are recognized adverse effects of tetracyclines. Unlike minocycline, which occasionally causes black pigmentation of a variety of tissues, tetracycline itself or doxycycline is rarely attributed to the pigmentation of skin. Herein, we report the first case report of blue-black discoloration developed within depressed acne scars following tetracycline/doxycycline therapy for acne. [source]

Long-term efficacy of a fractional resurfacing device,,§

LASERS IN SURGERY AND MEDICINE, Issue 2 2010
Arisa E. Ortiz MD
Abstract Background and Objective Recently, there has been much debate regarding the long-term efficacy of fractional resurfacing devices. While pulsed CO2 laser resurfacing is considered a highly effective treatment, fractionated resurfacing is a newer modality and its long-term efficacy has yet to be assessed. We report the long-term outcomes of subjects previously treated with fractional CO2 resurfacing for photodamaged skin and acne scars. Study Design/Materials and Methods Ten subjects from our previous studies who received fractional resurfacing for the treatment of acne scarring and photodamage returned for long-term follow-up visits at 1 and 2 years, respectively. Investigators graded maintenance of improvement on a quartile scale based on clinical photography. Results Subjects maintained 74% of their overall improvement at their long-term visits compared to 3-month follow-up visits. While clinical improvement was maintained long-term, the results were not as remarkable as those seen at 3-month visits. The authors speculate that results seen at 3 months may be enhanced by persistent inflammatory changes, as evidenced by heat shock protein 47 activity and ongoing collagen remodeling seen in previous histologic studies. Relaxation of tightening is to be expected with any procedure along with the natural progression of aging. However, patient satisfaction was upheld long-term. Conclusion Fractional CO2 laser resurfacing does have long-term efficacy and persistence of improvement of acne scarring and photodamage compared to baseline. However, additional treatments may be necessary to enhance long-term results. Lasers Surg. Med. 42:168,170, 2010. © 2010 Wiley-Liss, Inc. [source]

Comparison of a 1,550,nm Erbium:Glass fractional laser and a chemical reconstruction of skin scars (CROSS) method in the treatment of acne scars: A simultaneous split-face trial

LASERS IN SURGERY AND MEDICINE, Issue 8 2009
Hee Jung Kim MD
Abstract Background and Objective Acne scarring is a common complication of acne but no effective single treatment modality has been developed. To compare the efficacy of 1,550,nm Er:Glass fractional laser and chemical reconstruction of skin scar (CROSS) method in the treatment of acne scars. Study Design/Materials and Methods A split-face trial was conducted in 20 patients (10 rolling, 10 icepick types) with acne scars. One side was treated with the 1,550,nm Er:Glass fractional laser three times with a 6-week interval. And the other side was treated with CROSS method two times every 12 weeks. Results Significant improvement was observed in both sides of the face. In rolling type, the objective and subjective improvement rates were significantly higher in the sides treated with laser than CROSS method. However, in icepick type, there were no statistically significant differences between the two treatment sides. In the laser sides, grades of pain were significantly higher than that of treated with CROSS method. However, downtimes and lasting days of erythema were significantly longer in the sides treated with CROSS method. Conclusion A 1,550,nm Er:Glass fractional laser and CROSS method are both well-tolerated and effective treatment options in the acne scars. However, there was a relatively small difference between the two treatment modalities. Therefore, dermatologists should consider the acne scar type to select the treatment options. Lasers Surg. Med. 41:545,549, 2009. © 2009 Wiley-Liss, Inc. [source]

A new type of minocycline-induced cutaneous hyperpigmentation

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2004
R. W. Mouton
Summary Pigmentary disorders are recognized adverse effects of the semi-synthetic tetracycline derivative antibiotic, minocycline. Three distinct types of minocycline-induced cutaneous pigmentation have been described. Type I, blue,black pigmentation confined to sites of scarring or inflammation on the face; Type II, blue,grey circumscribed pigmentation of normal skin of the lower legs and forearms; and Type III, diffuse muddy brown pigmentation of normal skin accentuated in sun-exposed areas. We report two patients with acne vulgaris with a fourth type of minocycline-induced cutaneous pigmentation. They presented with circumscribed blue,grey pigmentation within acne scars confined to the back. Histology showed pigment within dendritic cells, and extracellularly throughout the dermis. Histochemistry identified a calcium containing melanin-like substance. Iron was absent. Immunohistochemistry confirmed some pigment-containing cells to be macrophages. Electron microscopy demonstrated electron-dense granules, free and membrane-bound, within macrophages and fibroblast-like cells. Energy-dispersive X-ray analysis confirmed the presence of calcium. Iron was absent. This fourth type of cutaneous minocycline hyperpigmentation may be a variant of Type I, but based on clinical, pathological and microanalytical differences, appears to be a new entity. The pigment may be a drug metabolite,protein complex chelated with calcium, or an insoluble minocycline,melanin complex. We propose a classification of cutaneous minocycline pigmentation based on clinico-pathological criteria. [source]