DOCSLIB.ORG

Photoepilation and Skin Photorejuvenation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Photoepilation and Skin Photorejuvenation Dermatology Reports 2017; volume 9:7116 Photoepilation and skin damage to pigmented structures, cells, and photorejuvenation: an update organelles in vivo with suitably brief pulses Correspondence: Mauro Raichi, of selectively absorbed radiation over- E-mail: [email protected] comes the need of precise aiming because 1 2 Alessandro Martella, Mauro Raichi inherent optical and thermal properties pro- Key words: Photoepilation; photorejuvena- 1Former Senior Consultant in vide target selectivity.1 tion; intense pulsed light; dermal remodeling. Dermatology, University of Modena and Proper selection of wavelength in the Sponsor: Novavision Group S.p.A., Misinto recommended visible to near-infrared Reggio Emilia Medical School, Tiggiano (MB), Italy. (LE); 2Clinical Pharmacology and region up to about 1100-1200 nanometers Biophysics Consultant, Milan, Italy (nm), pulse duration, and the energy density Conflict of interest: the authors declare no administered over the exposure time or flu- potential conflict of interest. ence are the three paramount parameters. Compromise among these three parameters Received for publication: 6 March 2017. is crucial to ensure deep dermal penetration, Accepted for publication: 2 May 2017. Abstract maximum thermal damage to the melanin This work is licensed under a Creative The effectiveness of intense pulsed light chromophore, and minimum absorption by oxyhemoglobin and water.2,3 Commons Attribution-NonCommercial 4.0 (IPL) and laser devices is widely accepted International License (CC BY-NC 4.0). in aesthetic dermatology for unwanted hair The second landmark date was 1996. In removal and treatment of a variety of cuta- that year the American Food and Drug ©Copyright A. Martella and M. Raichi 2017 neous conditions. Overall, most compara- Administration approved the first ruby-laser Licensee PAGEPress, Italy tive trials have demonstrated similar effec- device for hair removal. It was so feasible Dermatology Reports 2017; 9:7116 tiveness for IPL and laser devices. to overcome at least the most severe risks of doi:10.4081/dr.2017.7116 Literature studies alternatively favor the scarring or hyperpigmentation inherent to IPL and laser concepts, but the incidence of electrolysis, performed since 1875 and the only other technology then available for severe local pain and side effects were nm alexandrite laser, the long-pulsed 800, long-term destruction of follicles.4 Today generally lower with IPL. IPL phototherapy, 810-nm diode laser and the long-pulsed light-based hair removal technologies are already established as a sound option in 1064-nm neodymium:yttrium-aluminium- based either on narrow-waveband lasers or photoepilation and treatment of photoaging, garnet (Nd:YAG) laser allow for the overall high-intensity incoherent and multi-chro- hyperpigmentation and other skin condi- best compromise.6,9 matic pulsed light (intense pulsed light, tions, is also considered first choice in the The Nd:YAG laser, less effective in IPL). Long-term unwanted hair removal has phototherapy of skin vascular malforma- light-skinned subjects, could find a some- become one of the fastest growing, nonsur- tions. When treating large areas, as often what limited but elective niche in dark-skin required in photoepilation and many aes- gical aesthetic procedures in Europe and all 2 individuals (Fitzpatrick skin type IV-VI), thetic dermatology indications, IPL tech- over the world. Specifically as regards 8,10 broad-spectrum IPL epilation based on non- especially with pseudofolliculitis barbae. nologies show advantages over laser-based The Nd:YAG has the least overall hair devices because of their high skin coverage coherent 590-1200 nm light sources - typi- cally xenon flash lamps emitting energy in removal efficiency while the alexandrite rate. Compared to lasers, the wide range of and diode lasers are the best for extensive selectable treatment settings, though a short bursts and operated with cut-off filters use. However, post-laser pigmentation may strong advantage of IPL, may also imply - already in 2014 it had become the seventh be troublesome with alexandrite devices some more risk of local thermal side effects, most popular procedure among plastic sur- whilst the need for high levels of fluence but almost only in the hands of poorly geons and related specialists, according to increase the risk of complications with trained operators. Overall, the strongest the American Society for Aesthetic Plastic 5 diode systems in darker skin types.11 advantages of the IPL technologies are Surgery. IPL systems are possibly more tech- robust technology, versatility, lower pur- nique-dependent to limit the risk of local chase price, and the negligible risk of seri- pain and irritation. However, they offer the ous adverse effects in the hands of skilled and experienced operators. The relative merits and liabilities benefit to be highly versatile due to the wide of intense pulsed light and laser range of emitted wavelengths when hair or skin colors are not ideal for laser photoepi- systems lation.8 The hair removal benefits of IPL How the photoepilation story Any chromophore-based photoepilation technologies are most significant in individ- uals with dark hair and light skin, a com- began technology should be an efficient compro- mise between dermal penetration and tar- mon Caucasian phenotype and the domi- Two landmark dates mark the history of geting of the endogenous melanin in the nant phenotype in East Asia. Hair that is photoepilation and, generally, the applica- hair shaft, the outer sheath of the hair folli- growing after epilation is also thinner and tion of pulsed light sources in dermatology cle infundibulum and the matrix areas lighter in color, and thus often another ideal and aesthetic dermatology. (Figure 1). The hair bulb and the germinal candidate for IPL re-treatment several The introduction of the selective pho- matrix are rich in amelanotic stem cells that months after the first IPL or laser tothermolysis concept in 1984 was the first are most efficiently targeted during the ana- procedure.8 A decade ago, there had been landmark event. It was a crucial step that gen phase of development, when the non- some isolated criticism of IPL, related to the deserved a Science paper and opened the pigmented germinal matrix is closest to pig- need for early IPL devices to be very highly way to major advances in photoepilation mented structures.2,6-8 IPL and laser devices powered to destroy hair.12 Yet, a decade ago technology over the past quarter of a centu- that operate in the red or near-infrared is much time in this rapidly evolving field. ry. In the words of the authors, selective wavelength region like the long-pulsed 755- Some recent intra-patient-controlled split- [Dermatology Reports 2017; 9:7116] [page 9] Article face comparisons seem to indicate that IPL Since those years, many features of could offer some benefits compared with The expanding scope for intense first-generation IPL devices have under- laser devices in terms of hair reduction, pulsed light beyond photoepilation gone technological refinements, with spe- patient satisfaction, and local pain. A 2013 cial reference to the xenon gas-discharge left-to-right split-face assessor-blinded In 1990, a high-intensity flash lamp was flash lamp and the electronic control of the first described as a new tool for treating vas- study compared a IPL (λem=600-950 nm) capacitor banks. Such capacitors store and and a diode laser device for removal of cular lesions; the first IPL medical device discharge the electrical energy that gener- aimed to benign vascular lesions was com- ates the pulsed polychromatic high-intensi- unwanted axillary hair (6 sessions at 4- 15 week intervals in 30 subjects with skin type mercially launched in 1994. ty light. The computer-assisted selection of II-III; hair counts assessed with close-up photographs).13 The 3- and 12-month mean hair reduction was slightly higher with the A diode laser system (59.7% vs 42.4% and 69.2% vs 52.7% from baseline for laser and IPL treatments, respectively), but at signifi- cantly higher pain cost compared with the almost pain-free IPL technology (3.7±2.1 vs 1.6±1.4, respectively; 10-cm visual ana- logue scale).13 Similar results were seen in a double-blind, intra-patient-controlled ran- domized study of axillary hair removal in 21 women after application (6 sessions) of a diode laser on one axilla and IPL on the other one. The number of hair shafts was lastingly and similarly reduced with both hair reduction systems, but local pain was significantly more disturbing with the diode laser.14 Ultra-refining the chromophore targeting process Some advanced IPL systems are being introduced that allow to concentrate almost B all emitted energy in very narrow wave- lengths selected within the ample waveband of IPL xenon flash lamps. For instance, an advanced Italian IPL-derived technology [IFL™ (Incoherent Fast Light), Novavision Group S.p.A., 20826 Misinto (MB), Italy], when used in photoepilation mode at up to 3.3 light pulses per second, allows an extremely high selection of the wide xenon lamp waveband by focusing the energy emission on 700, 810 and 890 nm wave- lengths. Ultraviolet emissions are prelimi- nary filtered away by default by the ultra- transparent cerium-supplemented borosili- cate glass of the IFL™ light emitter acting together with a permanently installed 420- Figure 1. A) Relationship between intense pulsed light (IPL) and laser wavelength and nm cut-off filter. The local safety allowed depth of penetration into the epidermis and dermis. At wavelengths within the low by wavelength selection is further improved absorption index of water (400 to 1000 nm, visible and near-infrared spectrum), dispersal by avoiding all contacts of the device with within the dermis decreases with increasing wavelengths whilst penetration deepens and the skin. At the same time, the technological photothermolytic effects become stronger. The IPL wavelength window is about 590 to improvements of the system allow to 1,200 nm.
Load more

Recommended publications
  • A Practical Comparison of Ipls and the Copper Bromide Laser for Photorejuvenation, Acne and the Treatment of Vascular & Pigmented Lesions
    A practical comparison of IPLs and the Copper Bromide Laser for photorejuvenation, acne and the treatment of vascular & pigmented lesions. Authors: Peter Davis, Adelaide, Australia, Godfrey Town, Laser Protection Adviser, Haywards Heath, United Kingdom Abstract: The recent rapid growth in demand for non-invasive light-based cosmetic treatments such as removal of unwanted facial and body hair, skin rejuvenation, removal of age-related and sun induced blemishes including pigment and vascular lesions as well as lines and wrinkles has led to a boom in the sale of medical devices that claim to treat these conditions. The often onerous safety regulations governing the sale and use of Class 4 lasers has contributed disproportionately to the popularity of similarly powerful non-laser Intense Pulse Light sources (“IPL”), particularly in the salon and spa sector. The practical science-based comparisons made in this review and the well- documented case studies in peer reviewed literature show that single treatment success in eradicating vascular and pigmented lesions may only be achieved by high fluence, wavelength-specific laser treatment and without the need for skin cooling. Introduction: hair removal with IPL The recent success of IPL in delaying hair re-growth (“hair management”) and permanent hair reduction (“photo-waxing”) is dependant upon using high energy settings for the former and is thought to work primarily because melanin absorbs energy across a wide spectrum of wavelengths. Cumulatively enough energy is absorbed to damage the hair follicle. It is also suggested that the longer wavelengths absorbed by blood and tissue water may also collectively damage hair follicle support structures such as the blood supply to the hair bulb aided by the overall temperature rise in the adjacent tissue.
    [Show full text]
  • Skin Rejuvenation Using Intense Pulsed Light a Randomized Controlled Split-Face Trial with Blinded Response Evaluation
    STUDY Skin Rejuvenation Using Intense Pulsed Light A Randomized Controlled Split-Face Trial With Blinded Response Evaluation Lene Hedelund, MD; Eva Due, MD; Peter Bjerring, MD, DMSc; Hans Christian Wulf, MD, DMSc; Merete Haedersdal, MD, PhD, DMSc Objective: To evaluate efficacy and adverse effects of Results: Skin texture was significantly improved at all intense pulsed light rejuvenation in a homogeneous group clinical assessments except at the 6-month examination of patients. (PϽ.006). The improvements peaked at 1 month after treatment, at which time 23 (82%) of 28 patients had bet- Design: Randomized controlled split-face trial. ter appearances of treated vs untreated sides. Most pa- tients obtained mild or moderate improvements, and 16 Setting: University dermatology department. patients (58%) self-reported mild or moderate efficacy on skin texture. Rhytids were not significantly different Patients: Thirty-two female volunteers with Fitzpa- on treated vs untreated sides, and 19 patients (68%) re- trick skin type I through III and class I or II rhytids. ported uncertain or no efficacy on rhytids. Significant im- provements of telangiectasia (PϽ.001) and irregular pig- Interventions: Subjects were randomized to 3 intense Ͻ pulsed light treatments at 1-month intervals or to no treat- mentation (P .03) were found at all assessments. Three ment of right or left sides of the face. patients withdrew from the study because of pain re- lated to treatment. Main Outcome Measures: Primary end points were skin texture and rhytids. Secondary end points were tel- Conclusions: Three intense pulsed light treatments im- angiectasia, irregular pigmentation, and adverse effects. proved skin texture, telangiectasia, and irregular pig- Efficacy was evaluated by patient self-assessments and mentation but had no efficacy on rhytids.
    [Show full text]
  • TREATMENTS Laser Hair Removal If Noticeable Hair Is Making You
    TREATMENTS Laser Hair Removal If noticeable hair is making you self conscious – like on the face, neck, abdomen, back, bikini, legs, or anywhere – and if you are tired of wasting time and money on temporary remedies such as shaving, plucking, waxing, or chemical depilatories, Laser Hair Removal is an excellent alternative. Laser Hair Removal is the most effective solution in removing unwanted hair quickly and permanently for women and men. The LightSheer laser produces a beam of highly concentrated light that is well absorbed by the pigment located in hair follicles. The laser pulses just long enough to heat the hair, which impedes the follicle’s ability to re-grow. The length of a laser treatment may last anywhere from a few minutes to an hour or more depending on the areas treated. Even the largest body-areas can be treated quickly and effectively. We typically attain an 80-90% permanent reduction when the treatment is repeated 4 times and spaced 6-8 weeks apart. Topical anesthetic creams are recommended for pre-treatment to minimize pain and increase comfort. Sample Procedures Time 1 Visit Pkg. (4) female chin 15 min. $150 $450 upper lip 15 min. $150 $450 upper lip/chin combo 20 min. $200 $650 underarms 15 min. $150 $450 bikini 20 min. $200 $650 bikini/underarm combo 30 min. $250 $850 male neck (back) 15 min. $150 $450 chest only 30 min. $250 $850 chest/abdomen 60 min. $400 $1,350 shoulders 60 min. $400 $1,350 full back 2 hrs. $700 $2,500 Photorejuvenation – IPL (Intense Pulsed Light) Facial imperfections or abnormalities can detract from your well being and appearance, no matter how healthy and young you feel.
    [Show full text]
  • Laser-Based Treatment of the Aging Face for Skin Resurfacing: Ablative
    PART 3 • Aesthetic Surgical Procedures Laser-based Treatment of the Aging Face for Skin Resurfacing: 34 Ablative and Non-ablative Lasers Omar A Ibrahimi MD PhD , Nazanin Saedi MD , and Suzanne L. Kilmer MD several years has shifted towards fractional resurfacing CHAPTER SUMMARY (both ablative and non-ablative) as described by Manstein • Many aspects of dermatoheliosis are amenable to and colleagues, 4 due to its faster recovery time and safer treatment with a variety of ablative and non-ablative side-effect profi le. Nonetheless, it provides an important lasers and light sources. • Ablative laser skin resurfacing offers the most substantial historical framework for understanding cutaneous resurfac- clinical improvement, but is associated with greater ing and in a few instances, may be preferable over fractional postoperative recovery. resurfacing for certain dermatological conditions. • Non-ablative laser skin remodeling is a good alternative for patients who desire modest improvement of Proper patient selection dermatoheliosis with a limited post-treatment recovery period. A focused history should be obtained prior to any resurfac- • Fractionated laser systems provide the benefi ts of higher ing procedure. In particular, it is important to document if energy treatments with fewer side-effects and faster the patient has had any previous procedures or any contra- recovery than traditional lasers. indications to resurfacing. Ablative laser resurfacing may • Continued developments in laser technology will lead to greater effi cacy with an improved safety profi le. unmask hypopigmentation or fi brosis produced by prior dermabrasion, cryosurgery, or phenol peels. In addition, the presence of fi brosis may limit the vaporization potential of ablative lasers, thereby decreasing clinical effi cacy.
    [Show full text]
  • Devices for Rejuvenation of the Aging Face P
    Review Devices for Rejuvenation of the Aging Face P. Mark Neal, MD; Adrian Dobrescu, MD; John Chapman, MD; Mara Haseltine, MD Over the last 30 years, there has been a substantial increase in the number of ablative and nonablative devices that can be used to treat the signs of skin aging. Some devices have found new indications or new technology to refine older indications. In this article, we review the ablative and nonablative devices that are currently available for photorejuvenation of the aging face. Cosmet Dermatol. 2012;25:412-418. n the field of cosmetic dermatology, there are a vari- side effects, such as scarring and dyspigmentation. Patients ety of options to reverse the physical signs of aging. also experienced substantial downtime (approximately Many of these options include treatment with 2 weeks) following the procedure. Because of the need for devicesCOS that induce remodeling of the dermis andDERM more controlled ablation with less severe side effects, the epidermis, resulting in a more youthful appearance erbium:yttrium-aluminum-garnet (Er:YAG) laser as well I(Table). In the 1980s, the continuous wave CO2 laser was as the high-energy superpulsed and scanning CO2 lasers introduced with impressive results in reversing the signs were developed for cutaneous use. These newer devices of aging but also was associated with a high potential for help control the excess thermal injury that previously side effects and substantial downtime. Since then, many had led to unwanted side effects. The Er:YAG laser offers new devices have been made available to laser surgeons modes of variable long- and short-pulse durations to that Dooffer varying degrees of facial Notrejuvenation with fewer promote Copy more controlled ablation.
    [Show full text]
  • PHOTOREJUVENATION of FACIAL SKIN with TOPICAL 20% 5,AMINOLEVULINIC ACID and INTENSE PULSED LIGHT TREATMENT: a SPLIT,FACE COMPARISON STUDY Tina S
    35 COPYRIGHT © 2005 JOURNAL OF DRUGS IN DERMATOLOGY 'PHOTOREJUVENATION OF FACIAL SKIN WITH TOPICAL 20% 5,AMINOLEVULINIC ACID AND INTENSE PULSED LIGHT TREATMENT: A SPLIT,FACE COMPARISON STUDY Tina S. Alster MD," Elizabeth L. Tanzi MD,b Esperanza C. Welsh, MD,c a. Director, Washington Institute of Dermatologic Laser Surgery b. Co-Director, Washington Institute of Dermatologic Laser Surgery c. Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine Abstract Background: Photorejuvenation of facial skin has been reported after intense pulsed light (IPL) therapy alone and in conjunc- tion with topica15-aminolevulinic acid (5-ALA), but no comparative studies between these regimens have been performed. Objective: To evaluate the safety and effectiveness of combination topica15-ALA and IPL compared to IPL treatment alone. Methods: Ten patients with mild to moderate photodamage were randomly assigned treatment with 5-ALA + IPL on one facial half and IPL alone on the contralateral side. Two treatments were delivered at 4-week intervals. Clinical improvement scores were determined by masked evaluations of digital photographs obtained at baseline, prior to each treatment session, and at 1, 3, and 6 months after the final treatment. Results: High~r clinical improvement scores were noted on the combination 5-ALA + IPL treated areas. Mild edema, erythe- ma, and desquamation Wereobserved on the facial halves where 5-ALA was applied. No scarring or unwanted pigmentary alter- ation was seen. Conclusions: Photodynamic therapy with combination topica15-ALA + IPL is safe and more effective for facial rejuvenation than IPL treatment alone. Introduction PpIX has a large absorption peak in the Soret band (400- Photodynamic therapy (PDT) with topical 5-aminole- 430 nm) and smaller absorption peaks at longer wave- vulinic acid (5-ALA) is an evolving, non-invasive treat- lengths (509,544,584,630,690 nm), therefore, many dif- ment for a variety of dermatologic conditions.
    [Show full text]
  • Using Optical Imaging Methods to Assess Laser-Tissue Interactions
    USING OPTICAL IMAGING METHODS TO ASSESS LASER-TISSUE INTERACTIONS By Gerald Joseph Wilmink Dissertation Submitted to the Faculty of the Graduate School of Vanderbilt University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY in Biomedical Engineering December, 2007 Nashville, Tennessee Approved: Professor Eric Duco Jansen Professor Anita Mahadevan-Jansen Professor Jeffrey M. Davidson Professor Lillian B. Nanney Professor Susan R. Opalenik Professor Frederick R. Haselton Copyright © 2007 by Gerald Joseph Wilmink All Rights Reserved ACKNOWLEDGEMENTS I thank God for the gift of life and for all of the wonderful service opportunities that He has made available to me. I am very grateful for my supportive mother, my dad, Joe Gambino, my grandparents, and my lovely wife Kimberly. Without such a wonderful support system this dissertation would not have been possible. I am also grateful for my wonderful adviser, Dr. Eric Duco Jansen. For without his patience and support I would not be where I am today. I will never forget the trips we took together to ASLMS and the Jansen summer lab parties. I am also grateful for Dr. Jansen and Anita Mahadevan- Jansen for paving the way for my next research opportunity down in San Antonio. I feel honored to have the chance to work with Dr. Pat Roach, and I look forward to having the opportunity to use my laser skills in the area of Terahertz radiation research. I am also very grateful for each member of my Ph.D. committee. I doubt I will ever meet anyone quite like Dr. Susan Opalenik.
    [Show full text]
  • Shedding Light: Nonablative Lasers -- Fountain of Youth Or High-Tech Snake Oil?
    Shedding Light: Nonablative Lasers -- Fountain of Youth or High-tech Snake Oil? Graeme M Lipper, MD Staff Physician, Department of Medicine, Danbury Hospital, Danbury, Connecticut Medscape Dermatology. 2002;3(1) © 2002 Medscape Nonablative Lasers -- Fountain of Youth or High-tech Snake Oil? Without a doubt, nonablative lasers have become outrageously popular over the past 2-3 years, with both laser practitioners and consumers clamoring to try out the next latest thing in cosmetic skin care. Laser companies have popularized them as a new fountain of youth, capable of erasing wrinkles without the lengthy recovery time and painful side effects seen with conventional ablative laser skin resurfacing. But does nonablative photorejuvenation really work? And what exactly is photorejuvenation in the first place? The efficacy (or lack thereof) of nonablative lasers and IPLs became one of the hottest topics of the conference -- a theme that was revisited time and again. Robert A. Weiss, MD,[2] of the Maryland Laser, Skin, and Vein Institute, Hunt Valley, Maryland, and his expert panel of colleagues defined nonablative photorejuvenation as consisting of 2 major components: (1) removal of the epidermal signs of photodamage such as mottled pigmentation (lentigines, ephelides) and telangiectases; and (2) nonablative dermal remodeling. The former component is hardly new, since lasers have been used to lighten epidermal pigment and vascular lesions for decades. Lasers such as the pulsed-dye, 532-nm Nd:YAG and IPLs are well absorbed by both melanin and hemoglobin, and can therefore significantly improve the epidermal components of photoaging. This improvement should be distinguished from the dermal remodeling and wrinkle flattening seen with ablative lasers such as the CO2 and erbium.
    [Show full text]
  • Precise Spatially Selective Photothermolysis Using Modulated
    Theranostics 2017, Vol. 7, Issue 3 513 Ivyspring International Publisher Theranostics 2017; 7(3): 513-522. doi: 10.7150/thno.17596 Research Paper Precise Spatially Selective Photothermolysis Using Modulated Femtosecond Lasers and Real-time Multimodal Microscopy Monitoring Yimei Huang1, 2, Harvey Lui1, 2, Jianhua Zhao1, 2, Zhenguo Wu1, 2, Haishan Zeng1, 2 1. Imaging Unit – Integrative Oncology Department, BC Cancer Agency Research Center, Vancouver, BC, Canada. 2. Photomedicine Institute – Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. Corresponding author: [email protected]. © Ivyspring International Publisher. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions. Received: 2016.09.15; Accepted: 2016.11.17; Published: 2017.01.06 Abstract The successful application of lasers in the treatment of skin diseases and cosmetic surgery is largely based on the principle of conventional selective photothermolysis which relies strongly on the difference in the absorption between the therapeutic target and its surroundings. However, when the differentiation in absorption is not sufficient, collateral damage would occur due to indiscriminate and nonspecific tissue heating. To deal with such cases, we introduce a novel spatially selective photothermolysis method based on multiphoton absorption in which the radiant energy of a tightly focused near-infrared femtosecond laser beam can be directed spatially by aiming the laser focal point to the target of interest. We construct a multimodal optical microscope to perform and monitor the spatially selective photothermolysis.
    [Show full text]
  • Pushing the Spectrum Optimizing Treatment of Vascular and Pigmented Lesions
    Pushing the sPectrum Optimizing treatment Of Vascular and pigmented lesiOns Funding and content assistance provided by Pushing the sPectrum Optimizing treatment Of Vascular and pigmented lesiOns s the aesthetic challenge presented by vascular and Dr. arnDt: For a long time, we have known how to induce some selective pigmented lesions adequately addressed by current laser damage to vascular targets, and for and light-based technologies? Might clinicians benefit from some time, we have settled on 585, 595 Ia review of innovations in their clearance—using optimized nanometers as being selective. As intense IPL technology in particular? Are there condition-specific tools pulse light has evolved over time, it has become clear that it is close to the equal and techniques that can leverage treatment—even foster skin of—or perhaps better than—the sort of rejuvenation? Recently, an expert panel convened to explore classical therapy, which has been the pulsed these multifactorial dermatological conditions, to assess the dye laser. The MaxG™ (Palomar Medical science that may optimize outcomes, and to share how they’ve Technologies, Inc., Burlington, MA) is very exciting because it takes us to another level approached some of their most challenging patient cases. in which we are able to either damage vessels so they slowly go away or destroy mechanism of Action of iPLs on them entirely immediately. Pigmented and Vascular Lesions Dr. ross: I think there are two mechanisms that are Drilling Down on Selective Damage active here. One is the coagulation of the vessel and the Dr. ross: What is the best mechanism of action (MOA) associated thrombus, and the second is the actual collagen for clearance of vascular lesions particularly on the face— shrinkage of the vessel as the wall is heated from the heat and maybe the legs as well—and how does that relate to the conduction from the blood.
    [Show full text]
  • Treatment of Hypertrophic Scars and Keloids with a Radiofrequency Device: a Study of Collagen Effects
    UC Irvine UC Irvine Previously Published Works Title Treatment of hypertrophic scars and keloids with a radiofrequency device: a study of collagen effects. Permalink https://escholarship.org/uc/item/0z5336xq Journal Lasers in surgery and medicine, 37(5) ISSN 0196-8092 Authors Meshkinpour, Azin Ghasri, Peyman Pope, Karl et al. Publication Date 2005-12-01 DOI 10.1002/lsm.20268 License https://creativecommons.org/licenses/by/4.0/ 4.0 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Lasers in Surgery and Medicine 37:343–349 (2005) Treatment of Hypertrophic Scars and Keloids With a Radiofrequency Device: A Study of Collagen Effects 1,2 1,2 3 1 Azin Meshkinpour, MD, Peyman Ghasri, MD, Karl Pope, MS, Julia G. Lyubovitsky, PhD, 4 1 1,2 Juha Risteli, MD, PhD, Tatiana B. Krasieva, PhD, and Kristen M. Kelly, MD * 1Beckman Laser Institute, University of California, Irvine, 92612 2Department of Dermatology, University of California, Irvine 92697 3Thermage, Inc., Hayward, California, 94545 4Department of Clinical Chemistry, University of Oulu, Finland Background and Objective: To determine the efficacy used to couple capacitively the electrode to the skin and and safety of the ThermaCool1 TC radiofrequency system produce a uniform distribution of charge. Tissue ions and for treatment of hypertrophic and keloid scars and evaluate charged molecules within the electric field move and/or treatment associated collagen changes. rotate and inherent resistance to this movement causes Materials and Methods: Six subjects with hypertrophic heat. Depth of treatment effect can be changed by altering and four with keloid scars were treated with the Therma- electrode geometry, power delivered, delivery time, and Cool1 device: one-third of the scar received no treatment cooling parameters.
    [Show full text]
  • PL101 Vitamin D and Photoprotection
    and/or necrotic cell death) and secondary effects (i.e., damage to PL101 the vasculature and inflammatory reaction ending in the systemic Vitamin D and photoprotection: progress to date immunity). In recent times, more and more efforts are addressed Katie Marie Dixon to recognize the better PS employing in cancer PDT. Rose Department of Anatomy and Histology, Bosch Institute, Bengal Acetate (RBAc), administrated for 60 minutes at 10-5M University of Sydney, Sydney, NSW, Australia 2 and activated with 1,6 J/cm green light, is a powerful PS. It is Vitamin D compounds are produced in the skin following able to initiate in HeLa cells several signaling processes leading exposure to ultraviolet radiation (UVR). We previously reported to rapid, independent, successive, long-lasting and time-related that vitamin D compounds protect against UVR-induced cell onset of apoptosis and autophagic cell death by signals death and DNA damage (cyclobutane pyrimidine dimers; CPD originating from or converging on almost all intracellular and 8-oxoguanine) in cultured human skin cells. We have further organelles, i.e. mitochondria, lysosomes, Golgi apparatus and evidence that these photoprotective effects are mediated by the ER, despite RBAc primary perinuclear localization. Particularly, non-genomic pathway for vitamin D. We used an in vivo model apoptosis occurs as early as 1h after PDT via activation of to investigate the photoprotective effects of topical 1,25- intrinsic pathway, followed by activation of extrinsic, caspase- dihydroxyvitamin D3 (1,25D) and low calcemic analogs 12-dependent and caspase-independent pathways. The clearance (including a non-genomic agonist) in Skh:hr-1 mice exposed to 3 of RBAc photokilled HeLa cells, in terms of recruitment, MED of UVR, showing significant reductions in apoptotic recognition and removal, is very efficient both in vitro and in sunburn cells (SBCs) and CPDs.
    [Show full text]