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American Society for Laser Medicine and Surgery Abstracts 1 AMERICAN SOCIETY for LASER MEDICINE and SURGERY

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American Society for Laser Medicine and Surgery Abstracts 1 AMERICAN SOCIETY for LASER MEDICINE and SURGERY American Society for Laser Medicine and Surgery Abstracts 1 AMERICAN SOCIETY FOR LASER MEDICINE AND SURGERY ABSTRACTS Mt. Sinai Medical Center; Manhattan Eye & Ear Hospital, CUTANEOUS LASER New York, NY Background: Primary focal axillary hyperhidrosis is a chronic SURGERY disorder of sweating of the axilla that creates significant impairment of an individual’s daily activities. It is estimated that it affects over 1.4% of the U.S. population, a prevalence comparable to that of psoriasis. #1 Study: The purpose of this study was to determine the efficacy of a single laser treatment utilizing a new optical fiber to GRAVIMETRIC ANALYSIS OF HYPERHIDROSIS disrupt the glands located in the axilla. Efficacy was measured TREATMENT USING THE Nd:YAG 1440 nm LASER through both subjective and objective quantitative means. A WITH A SIDEFIRING FIBRE SIDELAZE 800 total of 20 patients with moderate to severe hyperhidrosis of Alina Fratila, Marina Reckmeyer the axilla (HDSS scores of 3 and 4) were enrolled in this prospective IRB approved study. Subjects were treated in a Jungbrunnen-Klinik Dr. Fratila GmbH, Bonn, Germany single session with a 1440 nm pulsed Nd:YAG laser with a Background: Primary Focal Hyperhidrosis is a chronic disorder new fiber designed to deliver targeted energy. Patients were presenting as excessive underarm sweating. Quality of life can assessed at 3 and 6 months post treatment by a patient significantly decrease by impacting emotional well-being, social questionnaire (HDSS scores), physician evaluations, imaging interactions and occupational duties. Current treatment methods software analysis of starch iodine tests as well as histologic for Primary Focal Hyperhidrosis are limited in duration and studies. efficacy. The purpose of this case support study is to evaluate the Results: A total of 20 patients completed the study. Significant efficacy and safety of a minimally invasive laser treatment using a improvement was reported by patient evaluations and subjective delivery system for smaller anatomic areas. A 1440 nm Nd:YAG physician assessments. The average HDSS score improved by 2 wavelength and a 800 mm sidefiring fiber inserted through a points. Imaging software analysis of starch iodine tests showed an 150 mm handpiece was used. average of 84% reduction in sweat area volume at three months Study: 13 patients (12 women and 1 man) with an average age of and 99% at six months. Histologic studies demonstrated a 31.4 years old, presenting a pretreatment 4 point Hyperhidrosis reduction in both eccrine and apocrine glands. Minimal adverse Disease Severity Score Scale (HDSS) score of 3 or greater, received effects were reported from patient diaries and physician a single treatment. Patients were seen at 3, 6, and 12 months assessments. follow-up. The amount of tumescent anesthesia in each axilla was Conclusion: The 1440 nm Nd:YAG laser with targeted energy 200 cc. The area treated, was divided into four 5 Â 5 cm squares to delivery fiber system is an effective tool in the treatment of axillary determine amount of energy to be delivered, which resulted in an hyperhidrosis. average of 6000 J/axilla. Gravimetric measurement, starch iodine test and pictures (digital image software analysis) were performed before, 3 and 6 months after the treatment. Results: All patients reported an average HDSS improvement of #3 3.1 at follow up. Gravimetric measurements showed an improve- ment of 81.2%. Patients’ satisfaction at follow up was rated as MULTI-CENTER STUDY EXAMINING REDUCTION 80.83%. Typical side effects like numbness, swelling, etc. were OF AXILLARY HAIR UTILIZING MICROWAVE reported after treatment. TECHNOLOGY Conclusion: Minimally invasive treatment with a 1440 nm Nd: Jeremy A. Brauer, Brian Zelickson, David Vasily, YAG laser, sidefiring fiber is an effective and safe option for the Lori A. Brightman, Elizabeth K. Hale, treatment of Primary Focal Axillary Hyperhidrosis. Additional Leonard J. Bernstein, Julie K. Karen, follow up will be done to confirm long-term results after one and Elliot T. Weiss, Robert Anolik, Roy G. Geronemus two years. Laser & Skin Surgery Center of New York, New York, NY; Zel Skin & Laser Associates, Edina, MN; Lehigh Valley Dermatology Associates, Bethlehem, PA #2 Background: Initial success utilizing microwave technology in the reduction of axillary hair has been observed in a single center EFFICACY OF A 1440 nm Nd:YAG LASER WITH A trial after one treatment. We present an update with involvement TARGETED ENERGY DELIVERY SYSTEM IN THE of two additional centers and three month follow up data. TREATMENT OF HYPERHIDROSIS Study: Multi-center, prospective study of individuals with Bruce Katz, David Cangello unwanted axillary hair growth. Subjects meeting all inclusion ß 2014 Wiley Periodicals, Inc. Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/lsm.22229 2 American Society for Laser Medicine and Surgery Abstracts and exclusion criteria were enrolled and treated with a non- #5 invasive microwave energy device. Standardized imaging was obtained and subjects were treated in one or two sessions SELECTIVE CRYOLYSIS OF SEBACEOUS GLANDS utilizing conservative settings. Hair counts were obtained by a H. Ray Jalian, Joshua Tam, Lilit Garibyan, single unblinded assessor, and compared at baseline and follow R. Rox Anderson up. Massachusetts General Hospital, Boston, MA Results: Twenty-seven patients (81% female, average age 34, 62% Background: Acne vulgaris is the most prevalent skin disease darker hair color) have completed the treatment course, with two worldwide. The overproduction and hyperactivity of the sebaceous sessions for 23 patients and one session for 4 patients. A median gland is an integral part of disease pathogenesis. Therapies aimed reduction of 41.6% was observed three months after one treatment at reducing sebum excretion are correlated with improvement in with similar results independent of hair color. At one month after acne outcome measures. Given that lipid rich tissue is preferen- two treatments, a median reduction of 71.1% was observed (light tially sensitive to cold injury, this purpose of this study was to 71.0%; dark 74.2%). evaluate the feasibility of selective injury to sebaceous glands Conclusion: We report updated findings of an expanded multi- using controlled cooling. center study investigating the use of a microwave technology for Study: Pre-clinical studies were conducted in a murine and axillary hair reduction. To date, a greater than 70% reduction in porcine ear models. Animals were placed under anesthesia and axillary hair of all colors has been noted at one month after two were treated with a thermoelectric cooling plate applied at a treatments. variety of temperatures and durations. The endpoint of the pre- clinical studies was histologic evaluation of sebaceous glands. A subsequent pilot human clinical trial was conducted in 11 subjects #4 on the back to evaluate the feasibility of reducing sebum production with trans-epidermal cooling. Primary study endpoint TREATMENT OF KERATOSIS PILARIS WITH was sebum excretion as measured by a sebumeter. Secondary 810 nm DIODE LASER: A RANDOMIZED endpoints were assessment for adverse events, and histologic CONTROLLED TRIAL evaluation of sebaceous glands. Wareeporn Disphanurat, Misbah Khan, Results: Selective damage to sebaceous glands was achieved in Diana Bolotin, Simon Yoo, Meghan Dubina, both the murine and porcine ear models. In the mouse model, peak Omer Ibrahim, Dennis West, Michael Nodzenski, of histologic damage was evident at 72 hours after treatment as Emily Poon, Murad Alam evidenced by an eosinophilic necrotic plug within the sebaceous Northwestern University, Chicago, IL; Cornell University, glands. Gland density and surface area were both reduced in the New York, NY; University of Chicago, Chicago, IL; University of porcine model for two weeks following treatment. A pilot clinical trial conducted on the back of healthy male volunteers showed Maryland, Baltimore, MD; Cleveland Clinic, Cleveland, OH Background: Keratosis pilaris is a common condition of statistically significant decrease in sebum production at 1 and 2 weeks following a single treatment cycle. Adverse effects were perifollicular prominence and erythema that can be resistant to limited to transient pain and post-treatment erythema. Biopsies treatment. There are reports of the use of vascular lasers, including 532 and 595 nm devices, but the therapeutic utility of from select patients demonstrated histologic evidence of damage to glands at 72 hours, 1 week, and 2 weeks following treatment. No longer-wavelength devices has not been studied. Study: Placebo-controlled randomized control trial of adults with clinical or histologic evidence of non-selective tissue damage was observed in any subject. Fitzpatrick skin types I-III and previously diagnosed keratosis Conclusion: Selective cryolysis of sebaceous glands is achievable pilaris of the bilateral upper arms. For each subject, four treatments of 810 nm laser at settings just below the purpura through non-invasive cooling. Given the histologic damage and functional reduction in gland activity, further studies are needed threshold were delivered to one arm, and the other was left untreated. Subjects rated each arm before treatment and at the to evaluate the utility of controlled cooling for the treatment of acne vulgaris. last follow-up on a 0–3 scale for erythema, and a separate 0–3 scale for roughness/bumpiness. Two blinded raters compared control and treatment sides at the final follow-up using
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