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New Picosecond-Domain Laser Decreases Acne Scarring

A new holographic beam splitter in a picosecond-domain laser effectively and safely treated facial acne scars, investigators found.

The study, published in Lasers in Surgery and Medicine and led by Eric F. Bernstein, MD, MSE, director of the Main Line Center for Laser Surgery in Ardmore, Pennsylvania, also showed that the treatments were well tolerated and subjects had little or no downtime.

The team investigated the safety and efficacy of a frequency-doubled Nd:YAG picosecond-domain laser system (PicoWay®, Syneron-Candela Corporation, Wayland, MA), fitted with a holographic beam-splitting optic for acne scarring.

“It produces a beautiful, high-energy treatment grid that you can very rapidly administer to the skin,” Bernstein told MedPage Today.

“There have been other lasers in the past using different wavelengths in a fractionated way that made little dots to create small injuries in the skin to stimulate healing and remodeling. But some of those lasers have not been easy to use without causing increased pigmentation in people with darker skins. So we were very hopeful when the picosecond-domain lasers came out that we would be able to treat darker skin for photoaging, photodamage, and rejuvenation, as well as for acne scarring. And that’s been the case.”

A total of 31 subjects ages 18 to 75 were enrolled, with Fitzpatrick skin types I-VI; 21 were treated at 1,064 nm wavelength, and 10, at 532 nm.

All had either rolling or boxcar type acne scars. Nineteen of the 21 subjects treated at 1,064 nm completed the study (three males and 16 females with an age range of 23 to 70), as did eight of the 10 subjects treated at 532 nm (one male and seven females with an age range of 23 to 70).

Three physicians were tasked with reviewing digital images comparing pre- and 3-month post-treatment images and measuring efficacy using a 10-point scale.

Subjects were asked to self-assess treatment effects and safety was measured by recording subject discomfort scores, as well as adverse effects.

The three blinded reviewers correctly identified the baseline image in 61 of the 81 image sets (75%, 27 subjects multiplied by the three reviewers)

Using the 10-point scale, the reviewers noted a mean improvement score of 1.4 (range -4 to 6, 95% CI 0.85-1.9) for all subjects, with no difference in mean improvement between those subjects treated at 1,064 nm compared with those treated at 532 nm.

Averaging the scores of the three reviewers showed that 22 of the 27 subjects (81%) showed some level of improvement, while 13 (48%) had a mean improvement score of at least 2, and seven (26%) had a mean improvement score of 3 or better.

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About Dr. J. Kim

Dr Kim developed (and is continuing to develop) dermatology research news as we way from dermatologists to stay on top of the latest advances in the field of dermatology.

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