Laser hair removal is the treatment of choice for reducing unwanted hair in hirsute patients. However, preventing hair regrowth remains a challenge. This study aimed to evaluate the combined effect of laser and enzymatic hair removal. Fifty-nine Greek women with facial hirsutism were divided into 2 groups. Group I was treated with combination of Alexandrite laser and iontophoresis of chymotrypsin and papain solutions. Group II was treated with laser alone. Outcomes included trichoscopic hair counts and patient-reported hair-free intervals (HFIs). Hair reduction from baseline was significantly higher in group I than in group II both after the 10th session (83.88 ± 10.63% vs 44.56 ± 23.52%) and at follow-up (80.28 ± 11.56% vs 25.68 ± 29.97%). The increase in HFI from the 1st to the 10th session was significantly higher in group I (38.05 ± 24.47% vs 19.82 ± 12.42%). Combination of Alexandrite laser and iontophoresis of proteolytic enzymes led to greater hair reduction, better early maintenance of the achieved result and longer HFIs than laser alone.
Vascular anomalies commonly affect the head and neck region and may result in functional and aesthetic impairment when involving the oral cavity Minimally invasive therapies, such as photocoagulation, have emerged as promising alternatives. Thus, the aim of this case series was to evaluate the efficacy of high-power diode laser (808 nm) photocoagulation in the treatment of oral vascular anomalies (OVA). This study included 12 patients presenting 13 OVA treated using diode laser photocoagulation (808 nm) with power settings ranging from 1.5 to 2.0 W in continuous mode. A 400-µm optical fiber was positioned perpendicular to the lesion in a non-contact technique, approximately 2 mm from the tissue. Clinical data regarding demographics, lesion characteristics, treatment sessions, complications, and follow-up were collected to assess clinical outcomes. Most patients were female (n = 9; 75%), and the lower lip was the most frequently affected site (n = 7; 53.8%). Lesion size ranged from 0.6 to 7.0 cm. Most lesions were successfully treated in a single session (n = 11; 84.2%). Postoperative ulceration occurred in all cases. Lesion reduction was predominantly classified as excellent. High-power diode laser photocoagulation is a safe and effective minimally invasive treatment for OVA, promoting significant clinical improvement.
Pyogenic granuloma may recur when an underlying vascular anomaly remains untreated. We report a case of recurrent pyogenic granuloma of the finger pulp associated with a deep venous malformation successfully treated using sequential dual-wavelength pulsed dye laser (PDL, 585-595 nm) and Nd:YAG laser (1064 nm). Four sessions were performed at three-month intervals (PDL 6 J/cm2; Nd:YAG 50 J/cm2; 10-mm spot; long delay sequential mode) with integrated cooling. Complete clinical resolution was achieved without adverse effects or recurrence after five years. Sequential PDL-Nd:YAG therapy represents an effective etiologic approach for complex vascular lesions involving both superficial and deep components.
Energy-based devices play a crucial role in aesthetic medicine for treating facial skin aging. Non-ablative thermolifting improves skin firmness and elasticity. This randomized trial evaluates Zaffiro® infrared technology and microfocused ultrasound (MFU) on dermal thickness and facial skin rejuvenation. Thirty healthy women were randomized (1:1) into two groups: Zaffiro® (N = 15) and MFU (N = 15). Each received a single treatment session and was evaluated at 30, 60, and 90 days. High-frequency ultrasound imaging assessed dermal thickness. Wrinkle severity (Fitzpatrick Wrinkle Scale), Subject Global Aesthetic Improvement Scale (SGAIS), patient satisfaction, and treatment tolerance were recorded. Both groups showed a ~ 40% increase in dermal thickness. Wrinkle reduction reached 52.8% in Zaffiro vs 40.5% in MFU. At 30 days, 62% of Zaffiro patients reported significant improvement vs 15% in MFU. Satisfaction was 85% (Zaffiro) and 61% (MFU) at 30 days; 92.5% in both groups at 90 days. Both technologies improved dermal thickness and wrinkle severity. Zaffiro demonstrated earlier and greater improvements in aesthetics and comfort, making it a favorable noninvasive treatment.
Neurogenic rosacea (NR) poses a therapeutic challenge due to its resistance to conventional treatments. This study explores the efficacy of pulsed-dye laser (PDL) therapy in managing NR. We present two cases of NR with severe facial discomfort and photoaging, treated with PDL alongside oral medications. Remarkably, PDL significantly alleviated pain and improved skin appearance in both cases, with sustained relief for over 2 years. Mechanistically, PDL may modulate neuropeptides and nerve fiber density implicated in NR pathogenesis. Our findings suggest PDL as a promising therapeutic avenue for NR, warranting further investigation and consideration in clinical practice.
Minimally invasive treatments such as fractional lasers are well-established options for addressing the aging skin in the periorbital region. Among energy-based devices, radiofrequency microneedling (RFMN) has emerged as a potential alternative. To evaluate the effectiveness and safety of RFMN for periorbital rejuvenation. In this prospective, evaluator-blinded clinical study, patients with periorbital wrinkles and fine lines received 1-3 RFMN sessions at 6-8-week intervals. Follow-up occurred 6 months after the final treatment. Outcomes were assessed using automated imaging software and a 5-point numeric rating scale (1 = very much improved; 5 = worsened) by two blinded, board-certified dermatologists. Adverse events (AEs) were documented. In total, 25 patients were included. Imaging analysis showed mean wrinkle reduction of 25.3 ± 40.4% in the infraorbital area and 37.3 ± 64.0% in the crow's feet region. Blinded evaluators reported a mean clinical score of 3.21 ± 0.98, reflecting variable improvement. All patients experienced transient erythema and edema, resolving within days. No severe AEs occurred. RFMN appears to be a promising option for periorbital rejuvenation with minimal downtime. Larger comparative studies are needed to confirm efficacy and define its role relative to established treatments.
Severe acne, left untreated, lead to permanent scarring and facial deformities, causing significant physical and psychological distress. Traditional ablative lasers, while effective for treating facial atrophic acne scars, are often limited by long recovery times and complications such as erythema, hyperpigmentation, and scarring. This study aims to compare the efficacy of fractional carbon dioxide (CO2) laser treatment with and without subcision for improving facial acne scars, seeking a more effective treatment with minimal recovery time. A total of 30 patients (18-40 years) with facial atrophic scars, attending the Dermatology OPD of a tertiary hospital, allocated into Group A (Fractional CO2 with subcision) and Group B (Fractional CO2 without subcision). The study used Goodman and Baron's quantitative and qualitative acne scar grading system for objective assessment and patients provided feedback using a 5-point Likert scale to gauge satisfaction. The scar improvement was better in Group A compared to Group B (p-value = .007), which was statistically significant. Patients receiving Fractional Carbon Dioxide Laser with subcision were more satisfied with the treatment outcome compared to those receiving Fractional Carbon Dioxide Laser alone. Keywords: Facial acne scars, Fractional carbon dioxide laser, Subcision.
Evaluate safety and aesthetic outcomes of combining lower eyelid skin pinch blepharoplasty with full-field erbium:YAG resurfacing for lower eyelid rejuvenation. Retrospective case series of 25 consecutive patients undergoing simultaneous lower eyelid skin pinch excision and full-field erbium:YAG resurfacing as part of a standardized lower-eyelid rejuvenation protocol that also included tear trough/lid-cheek autologous microfat grafting with blunt orbital retaining ligament release; transconjunctival fat removal and canthopexy were performed as indicated. Two masked oculoplastic surgeons graded standardized photos using the Barton Tear Trough Scale (0-3). MRD2 was measured to assess lid position. Complications and clinically evident lower lid tightening were recorded. Barton scores were compared with Wilcoxon signed-rank testing and MRD2 with paired t-testing. Mean Barton scores improved from 2.88 ± 0.33 to 0.52 ± 0.51 (p < .0001), with improvement in all patients. All patients had Fitzpatrick skin types I - III. Mean MRD2 was unchanged (3.75 ± 0.79 mm vs 3.71 ± 0.53 mm; p = .65), indicating preserved lid position. Lower lid tightening was noted in 21/25 patients. No ectropion, lower lid retraction, new scleral show, or vision-threatening complications occurred. Transient chemosis occurred in 6 patients and prolonged erythema in 2, all resolving with conservative care. Combined lower eyelid skin pinch surgery and full-field erbium:YAG resurfacing, within a comprehensive lower-eyelid rejuvenation protocol, significantly improved tear trough appearance and wrinkles while preserving lid position, with mostly transient complications.
This study aimed to evaluate pain levels, patient satisfaction, and preferences for different anesthetic techniques during the cosmetic application of botulinum toxin A in the upper third of the face. A randomized, double-blind, split-face clinical trial was conducted with 100 women undergoing esthetic procedures for facial wrinkle reduction. Patients were assigned to three groups: vibratory anesthesia versus placebo (Group I), topical anesthesia versus placebo (Group II), and vibratory anesthesia versus topical anesthesia (Group III). Pain levels were assessed using the visual analog scale (VAS). Patients identified the side with better pain control, expressed satisfaction, and provided recommendations for each technique. Group I (vibration 5.02 ± 2.56 vs. placebo 6.00 ± 2.75, p = .034), Group II (topical anesthetic 4.69 ± 2.45 vs. placebo 5.50 ± 2.38, p = .039), and Group III (topical anesthetic 4.89 ± 2.29 vs. vibration 6.06 ± 2.22, p = .048). While satisfaction levels showed no statistically significant differences between techniques, topical anesthesia in Group III received the highest recommendations (p = .010). This study suggests that topical anesthesia and vibratory stimulation both offer small-to-medium analgesic benefits over placebo during BoNT-A injections. Despite comparable satisfaction scores, patients preferred topical anesthesia for future use.
INTRODUCTION:Acne scars, stemming from collagen irregularities in acne vulgaris, pose psychosocial challenges. This study evaluates the efficacy and safety of 1064 nm Q-switched Nd:YAG laser (QSNL) and microneedling for atrophic acne scars. METHODS:A retrospective study at Ege University included 30 patients with moderate-to-severe atrophic facial acne scars. Patients received three monthly sessions of either QSNL or microneedling from September 2020 to April 2022. Outcome measures included scar size reduction, Goodman and Baron scales (GBQN), Patient Healing Assessments (PHA), Investigator's Global Assessments (IGA), Dermatology Life Quality Index (DLQI), and side effects, evaluated at baseline, 1 month, and 4 months. RESULTS:Scar sizes decreased by 52.63% and 57.14% post-laser, and 62.99% and 69.23% post-microneedling at 1 and 4 months. GBQN scores declined by 28.46% and 38.05% for laser, and 27.18% and 34.38% for microneedling. IGA and PHA improvements were significant, with DLQI scores decreased by 58.28% and 50% for laser and microneedling, respectively. Both treatments proved effective with minimal side effects, with microneedling causing mild erythema and no persistent dyspigmentation or infection. CONCLUSION:QSNL and microneedling effectively and safely treat atrophic acne scars, improving scar dimensions, quality of life, and satisfaction. Long-term collagen remodeling highlights the importance of follow-up.
The retrograde approach to mid-face thread lift, utilizing reverse temporal vectors, offers an innovative advancement in minimally invasive facial rejuvenation. This study evaluates its efficacy and safety in 20 female patients aged 30-60 years presenting with moderate midface ptosis but minimal jowling and neck laxity. The technique involves inserting poly L-lactide-co-ε-caprolactone bi-directional threads into anchor points near the zygomatic body, leveraging the structural support of ligaments and minimizing neurovascular risks. Immediate post-procedure results revealed significant improvements, with lateral mouth angles elevated by 0.3-0.5 cm and medial cheek points by 0.2-0.3 cm. Patient satisfaction scores (PSS) were consistently high (2-3). During the one-month follow-up, additional gains of 0.1-0.2 cm were noted at the same points, alongside enhanced skin quality and firmness. At six months, outcomes remained stable for patients without adjunctive procedures, maintaining high PSS scores (2-3). The study reinforces the retrograde reverse-vector method as a safe, effective option for midface rejuvenation. Future research should explore its long-term benefits, optimization for varying patient profiles, and integration with other aesthetic modalities for enhanced results. This innovation exemplifies progress in minimally invasive solutions for age-related facial concerns.
Melasma is a persistent and recurrent condition that remains difficult to manage effectively. Both fractional 1064 nm picosecond Nd:YAG (PSNY) and low-fluence Q-switched Nd:YAG (QSNY) lasers have been applied in treatment, yet there is currently insufficient data to compare their efficacy and safety. This retrospective study evaluated 99 female patients with melasma, including 54 treated with PSNY laser and 45 with QSNY laser. Each patient received two to five laser sessions at 2-4-week intervals. Clinical efficacy was evaluated by the modified Melasma Area and Severity Index (mMASI) at baseline, as well as four weeks following the second and fifth treatment sessions, with adverse events carefully documented. The PSNY laser produced a mean mMASI reduction of 23.7% and 40.7% after two and five sessions, respectively, while QSNY treatment achieved reductions of 9.8% and 29.5%. Although both modalities were safe and effective, PSNY laser demonstrated faster clinical improvement and required lower energy fluence. Post-inflammatory hyperpigmentation occurred in 7.4% of PSNY-treated patients and 13.3% of QSNY-treated patients, with no significant difference between groups. In conclusion, fractional PSNY laser therapy provides a rapid, safe, and effective alternative to QSNY laser for managing melasma.
The use of high-power lasers for facial rejuvenation has been growing every year. In particular, the Thulium laser in non-ablative mode has gained prominence due to its safety, postoperative comfort, and wide clinical indication. This report details the first documented case of a varicella-zoster virus expression following the use of a non-ablative fractional 1927 nm Thulium laser for facial skin aging and pigmentated lesions. The treatment proposed involved a combination of phototherapies as an adjunctive local strategy, alongside systemic acyclovir therapy. In nine days, herpetic lesions and skin areas with altered sensory function were no longer present. Varicella-zoster virus expression should be considered following aesthetic skin treatments with fractional Thulium laser, and the need for prophylaxis with antiviral agents may be appropriate for certain cases. Moreover, the combination of phototherapies proposed herein seemed to be beneficial for accelerating the resolution of such a condition.
Scars from skin cancer surgery impact patients' quality of life. In recent years, fractional CO2 (fCO2) laser has been used for scar improvement. A single-center retrospective study (n = 22) was conducted to evaluate the safety and efficacy of the fCO2 laser in improving the aesthetic outcome of post-surgical skin cancer scars, using the validated Vancouver Scar Scale (VSS). We obtained a mean VSS reduction of 44.5% and an absolute decrease of 2.77 points (p < .001). Statistically significant improvements were observed in all VSS parameters except for pigmentation. No significant correlation was found between time since surgery and reduction in VSS. Fractional CO2 laser is a safe and effective approach for improving surgical scars following skin cancer treatment. Its efficacy is not limited to early scars.
BACKGROUND:Nevus of Ota (NO) "oculodermal melanocytosis" is prevalent in Asians. Bilateral nevus of Ota (BNO) is a rare condition and comprises 5% of the cases seen. Picosecond laser (PS) is useful in treating various cutaneous benign pigmentary disorders including NO. We analyzed the clinical data on BNO in Vietnamese patients and evaluated the efficacy of treatment of the 1064 nm Nd:YAG picosecond laser (PSNY). SUBJECTS AND METHODS:Twenty-nine Vietnamese patients (ages 2-67 years, mean 23.36 ± 17.5) with BNO received at least 3 treatment sessions with 1064-nm PSNY (4-5 mm spot size; 1.5-2.4J/cm2, 4-week intervals). Improvement was documented through serial photographs that were taken at baseline (T0), after 4 weeks of the 3rd session (T1), 6th session (T2), 9th session (T3), and more than 10 sessions (T4). Response to the treatment was graded based on a 5-point grading scale. RESULTS:The participants were predominantly female (23 females, 6 males). Sclera, nasal mucosa, and pharyngeal NO lesions were observed in 24 patients (51.7%, 69%, and 6.9%, respectively). Two cases (6.89%) had lesions combined with Port-Wine-Stains. In the majority of cases, more than two branches of the trigeminal nerve were involved (89.66%). Onset of the lesions at <10 years old was 69% and involvement of more than two branches of the trigeminal nerve in these patients was 89.66%. Overall, 100% of patients demonstrated an improvement of the BNO lesions following treatment. A total of 88.9% of patients demonstrated a score compatible with good improvement to complete clearance after 9 treatment sessions on the treatment scoring scale. No severe adverse events or complications were observed. The 1064-nm PSNY laser has the potential to achieve faster clearance for treating dermal pigmentary disorders in Asians. To our knowledge, this is the largest reported series of BNO treated with a laser. CONCLUSION:Our results suggest that 1064-nm PSNY laser treatment is efficacious and an appropriate therapeutic modality for the treatment of BNO with minimal downtime and minimal adverse side effects.
Colloid milium (CM) is a rare degenerative deposition skin disorder known by multiple small, domed, flesh-colored papules that may coalesce into large plaques or highly disfiguring nodules. CM frequently involves sun-exposed body areas, such as the face and dorsal hands. Currently, there is no single effective treatment for CM. Herein, we present a case of adult colloid milium (ACM) with lesions around his nasolabial fold and perioral region who was successfully treated with long-pulsed Erbium: YAG laser with no scarring, textural changes, pigment alterations, or evidence of clinical recurrence at the 3 years follow-up. A systematic search was conducted in PubMed and Scopus until 25 Jan 2025, evaluating all studies with treatment procedure comprehension for ACM. CO2 laser effectively ablated the lesions, while increasing the risk of thermal damage and scarring. Dermabrasion showed favorable efficacy; however, the authors did not specify whether textural changes or pigmentation disorders occurred. Non-Ablative fractional laser has minimal side effects, while multiple sessions are required for satisfactory results. The long-pulsed Er: YAG laser offers high precision and minimal invasiveness, however, its shallow penetration may require multiple sessions for deeper lesions. Long-pulsed Er: YAG laser should be considered an effective treatment for facial CM lesions. Future studies should compare laser types, optimize parameters, and explore adjunct therapies to improve outcomes.
Energy-based devices, especially lasers and ultrasound (HIFU/MFU-V), have transformed esthetic medicine, yet evidence remains scattered. This hybrid review couples systematic retrieval of quantitative studies with expert synthesis to define areas of strength and caution. Searches of MEDLINE, Embase, Scopus, and Cochrane captured RCTs, observational series, and meta-analyses on laser- and ultrasound-guided interventions. Efficacy, downtime, satisfaction, and complications were extracted and tabulated, focusing on Fitzpatrick IV-VI skin, BMI sub-groups, and emerging AI-guided planning.
This study aims to investigate the underlying mechanisms and triggers of delayed-onset inflammatory responses DIRs after hyaluronic acid (HA) fillers injections. The literature review included articles on DIRs following HA filler treatments and identified immunological triggers, bacterial contamination, and filler degradation as key factors contributing to DIRs. Additionally, patient data were analyzed from patients treated for DIRs and showed possible immune activation events prior to DIRs included flu-like symptoms. This study underscores the complexity of DIRs following HA filler treatments and the need for transparency from manufacturers. Comprehensive ingredient data are crucial to better understand DIRs and ensure patient safety.
Laser resurfacing and chemical peels have emerged as options for the field treatment of actinic keratoses (AKs). We aimed to evaluate the efficacy of lasers and chemical peels for field treatment of AKs and prevention of non-melanoma skin cancer (NMSC). A PubMed search of all relevant literature describing the use of laser resurfacing and chemical peels as field treatment in AK management or NMSC prevention was performed. Articles published through February 15, 2025, were included. Fifty-three unique studies evaluating laser and chemical resurfacing alone, or in combination with other treatments, for the treatment of AKs were identified; 45 focused on laser resurfacing and nine on chemical peels. Fifteen studies evaluated either recurrence of AKs or progression to NMSC. Combination therapies using ablative lasers with photodynamic therapy had the greatest clearance of AKs, and ablative lasers alone were more effective than non-ablative lasers. Chemical peels exhibited a more tolerable side effect profile but were less effective in treating AKs. Further studies are needed to optimize procedural protocols and evaluate long-term outcomes, including recurrence of AKs and progression to NMSC, following these field treatments.
Filler injection-associated alopecia is a rare complication. To date, including our case, we have identified 17 reported cases of alopecia following filler injection. Although uncommon, this complication should not be overlooked, especially given the increasing popularity of cosmetic procedures and the potential for misuse by unqualified individuals. In our case, unilateral partial cicatricial alopecia developed in the temporoparietal region following hyaluronic acid (HA) filler injection into the temporal area. The patient presented one month after the procedure, with no signs of vascular occlusion. Topical minoxidil was prescribed, resulting in approximately 80% hair regrowth in the affected area.
