ABSTRACTObjectivesThis work highlights the methods used to develop a multi‐pulse 1726 nm laser system combined with bulk air‐cooling for selective sebaceous gland (SG) photothermolysis using thermal imaging and software algorithms. This approach enables treating to a desired tissue temperature and depth to provide a safe, effective, reproducible, and durable treatment of acne.MethodsWe designed and built a 1726 nm laser system with a 40 W maximum power output, a highly controlled air‐cooling device, and a thermal camera in the handpiece, which permits real‐time temperature monitoring of the epidermis. IRB‐approved safety and efficacy trials demonstrated SG damage at depth, resulting in safe, efficacious, and durable clinical outcomes. Bioheat transfer and light transport modeling confirmed that the pulsing protocols could produce therapeutic temperatures at various SG depths, while protecting the epidermis and dermis with bulk air‐cooling. Similarly, we employed clinical observations and photothermal modeling to identify pain mitigation opportunities while maintaining therapeutic efficacy. Biopsies were subsequently taken for histological evaluation.ResultsClinical and histological data, confirmed with modeling, demonstrated that multi‐pulse laser delivery with bulk air‐cooling selectively increased SG temperature compared to surrounding dermis and at depths unachievable by a single pulse. Subjects showed an average 71% ILC reduction at 3 months posttreatment. We identified two different pulsing protocols with similar selective photothermolysis (SP) of the SG with very different pain responses. Thus, changing the pulsing protocols allowed for pain mitigation and eliminated the need for injectable anesthetic. Histology confirmed the selective damaging of the SG at depth and the preservation of the surrounding dermis and the epidermis.ConclusionsThe multi‐pulse 1726 nm laser with bulk air‐cooling, thermal monitoring, treat‐to‐temperature (and depth) control, and a unique pulsing protocol, is capable of selectively damaging SGs at depth without damage to the surrounding dermis or the epidermis. The system offers two different protocols that were developed with different levels of discomfort allowing for two different methods for pain mitigation (injectable vs. topical anesthesia).
BACKGROUND Patients commonly complain about the appearance of acne scars. While various lasers and energy-based devices can offer clinical improvement, many of them are limited in treating patients with skin of color. Concerns exist regarding efficacy and safety, including risks of scarring, prolonged dyspigmentation, necrosis, and burns. OBJECTIVE To examine the utility of a 755-nm picosecond laser with fractionated lens array in improving the clinical appearance of acne scars in patients with Fitzpatrick skin types V and VI. MATERIALS AND METHODS A prospective clinical study investigated this laser using up to 5 monthly treatments. RESULTS Twenty-four subjects were enrolled, while 17 subjects completed a 3-month follow-up. The mean age was 33.9 years, and 95.8% of the subjects were women. Fitzpatrick skin types V and VI were represented. Assessments compared baseline to 3-month follow-up. Two of the 3 blinded reviewers agreed on identifying pretreatment and post-treatment photographs for 82.4% of the cases. For physician Global Aesthetic Improvement Scale, 100% of the subjects had clinical improvement. Overall, 94.1% of subjects were satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION A 755-nm picosecond laser with fractionated lens array can safely and effectively improve acne scars in patients with Fitzpatrick skin types V and VI.
BACKGROUND:From the theoretical foundations of laser and energy-based applications for the skin to the development of advanced medical devices, the field of dermatologic surgery has undergone transformative changes. OBJECTIVE:To review the scientific and clinical advancement of laser and energy-based therapies within dermatologic surgery. MATERIALS AND METHODS:A literature search was conducted to identify important scientific advancements and landmark studies on light, laser, and energy-based devices within the field of dermatologic surgery. RESULTS:Since the introduction of selective photothermolysis principles in the 1980s, numerous laser and energy-based devices have been developed to effectively treat vascular lesions, target pigmentation, remove tattoos, rejuvenate the skin, and remove hair. Beyond aesthetic applications, photodynamic therapy was introduced to treat various neoplastic and inflammatory conditions. Lasers have also been employed to enhance transcutaneous drug delivery, and new lasers continue to emerge for treating common inflammatory conditions, such as acne. These innovations have contributed to a paradigm shift toward safe and effective, but less invasive, procedure-based treatment in addressing medical and aesthetic concerns in dermatology. CONCLUSION:Dermatologists have consistently led the way in the continuous development and innovative application of laser and energy-based devices to effectively address a variety of skin conditions.
BACKGROUND:Regenerating Skin Nectar with TriHex+ Technology (Nectar 2.0; Alastin Skincare Inc., Carlsbad, CA) is a next-generation anhydrous serum reformulated with Octapeptide-45 to improve skin healing and hydration. Clinical trials and case studies assessed the safety, effectiveness, and patient satisfaction of Nectar 2.0 across various aesthetic procedures, including nonablative and ablative laser treatments, as well as microcoring technology. METHODS:A multimodal clinical approach was used, including a randomized, double-blind, split-face study for nonablative laser procedures, an in-use study assessing skin barrier function and hydration, and case studies for ablative laser and Ellacor microcoring treatments. Investigator and subject assessments, standardized photography, and bioinstrumentation measurements (TEWL and Corneometry) were utilized to evaluate outcomes. RESULTS:Nectar 2.0 showed superior outcomes in reducing edema and enhancing tactile roughness and fine lines in nonablative laser procedures. In ablative and microcoring treatments, faster healing, less crusting, and decreased exudation were noted, along with higher patient satisfaction compared to the control. Bioinstrumentation confirmed statistically significant improvements in skin barrier recovery and hydration over 14 days. The product was well tolerated. CONCLUSION:Regenerating Skin Nectar with TriHex+ Technology Serum (Alastin Skincare Inc., Carlsbad, CA) has proven to be a safe and effective periprocedural skincare solution that enhances healing, improves skin quality, and increases patient satisfaction across various aesthetic procedures. Its benefits are especially significant in deeper treatments, supporting its widespread use in clinical practice.
