Objectives: Non-ablative fractional lasers (NAFL) have increased in demand compared to ablative laser treatments as they provide lesser down time, fewer side-effects, and are safer to use. Non-ablative fractional treatment with lasers ranging from 1320 to 1927-nm have been shown to be safe and effective for skin resurfacing procedures. The objective of this study is to investigate healing of the 1940-nm NAFL-induced microthermal treatment zones (MTZs) in human skin from a histologic perspective. Methods: Three subjects received 1940-nm NAFL treatment to test areas on the abdomen at various timepoints during the study. The minimum 5 mJ/MTZ and maximum 20 mJ/MTZ energy settings were used at 20% coverage. Biopsies were taken coinciding with immediately posttreatment, 1, 3, 7 days, and 6 weeks posttreatment. Blinded analysis of hematoxylin and eosin stained slides was performed to measure the width and depth of the MTZs and evaluate the inflammatory and healing response of the skin over time (immediately to 6 weeks posttreatment). Safety was evaluated by assessing local skin responses and adverse events immediately after treatment and at all study visits. Results: Histological analysis of tissue following NAFL 1940-nm treatments showed mild early inflammatory response (presence of lymphotic infiltrate) in some test areas and zones of necrosis and coagulation having widths and depths (immediately-3 days posttreatment) that scaled with the 1940-nm pulse energy. Signs of healing such as presence of dermal mucin, evidence of fibrosis, and absence of necrosis were observed long-term (7 days to 6 weeks posttreatment). Evidence of the MTZ persisted beyond the 6-week study and was predicted to last for 100 days. All local clinical skin responses healed within 6 weeks and were limited to mild, transient erythema and edema which resolved in less than 12-24 h following treatment. No serious adverse events occurred during the study. Conclusions: NAFL 1940-nm treatments are safe for inducing small fractional coagulation and necrosis zones in abdominal skin. NAFL 1940-nm laser creates fractional columns of injury with sufficient depth and coverage that suggest effective skin resurfacing, like other non-ablative fractional lasers.

A 730 nm picosecond‐domain laser was developed to improve the clearance of pigmented lesion and reduce adverse events. This study assessed the safety and efficacy of this system for the clearance of lentigines and explores how the short picosecond pulses interact with tissue via histology.

BACKGROUND AND OBJECTIVES:Laser-pumped lasers enable driving a secondary wavelength through pumping with a primary device. Here we investigate the first 730 nm laser-pumped laser for efficacy in tattoo removal. STUDY DESIGN/MATERIALS AND METHODS:Fifteen subjects with 20 tattoos were enrolled to investigate the effect of a new 730 nm, titanium-sapphire laser-pumped laser at removing decorative tattoos. A total of four treatments were administered and photographic improvement of pre- and post-treatment cross-polarized digital images was evaluated by four blinded physician observers using an 11-point scale. RESULTS:Blinded assessment of pre- and post-treatment images found 70%, 77%, 83%, 83%, 26%, and 8% clearance from baseline images for black, green, blue, purple, red and yellow pigments, respectively. Side effects were limited to pinpoint bleeding and erythema immediately after treatment and some crusting and scale up to 1-2 weeks following treatment, and a localized allergic reaction in a single subject. There was no scarring or pigmentary alteration visible in any follow-up images. CONCLUSION:The new 730 nm, picosecond-domain, titanium-sapphire, laser-pumped laser is safe and effective for removing multicolored tattoos. Green, blue, and purple pigments cleared the most as expected, but black ink cleared more completely than was predicted. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.

BackgroundThe pulsed-dye laser has been used to treat facial redness and rosacea for decades. Recent advances in dye laser technology enable 50% higher output energies supporting 50% larger treatment areas, and beam-diameters up to 15mm with clinically-relevant fluences. In this study, we investigate this novel pulsed-dye laser using a 15mm diameter beam for treatment of rosacea. MethodsTwenty subjects with erythemato-telangiectatic rosacea were enrolled in the study. A total of 4 monthly treatments were administered, first treating linear vessels with a 3x10mm elliptical beam, then diffuse redness with a 15-mm diameter circular beam. Blinded assessment of digital, cross-polarized photographs taken 2 months following the last treatment was performed using an 11-point clearance scale. ResultsNineteen subjects completed the study. Blinded reviewers correctly identified baseline photos in 55 out of the total of 57 images (96.5%). The blinded reviewers scored 17 of the 19 subjects with an improvement greater than 40%, and 11 of the 19 subjects greater than 50%. The average improvement was 53.9%. Side effects were limited to mild edema, mild to moderate erythema, and mild to moderate bruising. ConclusionThis study demonstrates that a newly designed pulsed-dye laser having a novel 15-mm diameter treatment beam improves the appearance of rosacea with a favorable safety profile. Lasers Surg. Med. 50:808-812, 2018. (c) 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

BackgroundGreen, blue, and purple tattoo pigments are often the colors most resistant to laser removal. Recently, the first ever production picosecond‐domain laser with a 785 nm wavelength was developed to improve the rate of clearance of green, blue, and purple tattoo inks.MethodsTwenty‐two tattoos from 15 subjects with skin phototypes II–IV were enrolled in the study. A total of four treatments were administered using a single 785 nm picosecond‐domain laser wavelength. Blinded assessment of digital, cross‐polarized photographs taken approximately 8 weeks following the last treatment was performed using an 11‐point clearance scale.ResultsFourteen subjects with 21 tattoos completed all study visits. The 21 tattoos contained the following pigments: black (n = 15), green (n = 13), blue (n = 8), yellow (n = 5), purple (n = 4), and red (n = 3). Treatments were performed with a 2‐4‐mm beam diameter and fluences ranging from 1.1 to 3.1 J/cm2. Blinded assessment of photographs found 85%, 81%, 74%, 61%, 11%, and 5% clearance from baseline photos for purple, blue, green, black, red, and yellow pigments, respectively. Treatments were well tolerated with typical erythema, edema and one case of pinpoint bleeding. No scarring was noted.ConclusionThis first study of a new 785 nm picosecond‐domain laser demonstrates safe and effective removal of multicolor tattoos. Although clearance was shown for a multitude of colors including black, the 785 nm laser wavelength has special affinity to purple, blue and green tattoo pigments. Lasers Surg. Med. 50:704–710, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

ObjectivesThe pulsed‐dye laser has long been a gold standard in the treatment of poikiloderma of Civatte. Recent advances in pulsed dye laser technology enable output energies 50% higher, enabling beam diameters of up to 15 mm with clinically relevant fluences. In this study, we investigate this new laser for treatment of this condition.Materials and MethodsTwenty subjects were enrolled in the study. A total of four treatments were administered at monthly intervals. Blinded assessment of digital, cross‐polarized photographs taken at baseline and two months following the last treatment was performed by blinded physician raters using an 11‐point clearance scale. Subject reported pain scores immediately following treatment and side effects at all visits were recorded by the investigator.ResultsSeventeen subjects completed the study. Blinded reviewers correctly identified the baseline photo in 48 of 51 cases (94%). All three reviewers mis‐identified the same subjects. The blinded reviewers scored 14 out of the 17 subjects with an improvement greater than 40% and 10 out of the 17 subjects greater than 50%. Average improvement was 49% for all 17 subjects. Side effects were limited to mild edema, and mild to moderate erythema and purpura. Pain scores averaged 3.5 on using an 11‐point scale.ConclusionThis study demonstrates the safety and effectiveness of a new pulsed‐dye laser with a 15 mm spot and 50% higher fluences for the treatment of poikiloderma of Civatte. Lasers Surg. Med. 51:54–58, 2019. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

BACKGROUND: A dual-wavelength, picosecond-domain, fractionated laser delivering 1,064nm and 532nm laser energy through a holographic optic was investigated for safety and effectiveness at improving the appearance of chronic photoaging. MATERIALS AND METHODS:A total of 27 subjects were enrolled with 24 completing the study, and 14 subjects were treated with 1,064 nm and 10 with 532 nm. The 1,064 nm-treated subjects received 5 monthly treatments while the 532 nm-treated subjects received 4 monthly treatments. Improvement was measured by blinded evaluation of pre- and post-treatment images 12 weeks following the final treatment. Subjects also evaluated treatment effect and side-effects. RESULTS:Blinded reviewers correctly identified the baseline image in 52 of 72 paired images, or 72% of the time, with a mean improvement score of 1.4 using an 11-point rating scale (P less than 0.0001). Post-treatment erythema, mild edema, and petechiae were the only side effects noted. CONCLUSION:The fractionated, picosecond-domain, 532 nm and 1,064 nm laser is safe and effective for improvement of facial photodamage. The laser was well tolerated with mild erythema, edema, and petechiae as the most common side-effects.J Drugs Dermatol. 2017;16(11):1077-1082..

Background and Objectives: Fractional treatment with a dual wavelength 1,064 and 532nm picosecond-domain laser, delivering a 10 x 10 array of highly focused beamlets via a holographic optic, was investigated for the treatment of acne scars. Study: Twenty-seven of 31 subjects completed the study, 19 were treated using 1,064 nm and 8 were treated at 532nm, all having four-monthly treatments. Blinded evaluation of digital images by three physician evaluators comparing pre- and 3-month post-treatment images measured efficacy using a 10-point scale. Subject self-assessment of treatment effects were also recorded. Safety was measured by recording subject discomfort scores and adverse effects. Results: Blinded reviewers correctly identified the baseline image in 61 of the 81 image sets (75%), and baseline acne scar scores were 1.8 +/- 0.7 and 1.8 +/- 0.5 for the 1,064 and 532 nm cohorts, and decreased to 1.1 +/- 0.5 (P<0.001) and 1.1 +/- 0.0 (P<0.005), respectively. Post-treatment erythema, mild edema, and petechiae were the only side effects noted. Conclusion: The 1,064 and 532nm picosecond-domain laser incorporating a 10 +/- 10 holographic beam-splitting handpiece was found to be safe and effective for the treatment of facial acne scars. The treatments were well tolerated and the subjects experienced little to no downtime. (C) 2017 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Background and ObjectivesAlthough nanosecond-domain lasers have been the mainstay of laser tattoo removal for decades, recent disruptive innovations in laser design have introduced a new class of commercial Q-switched lasers that generate picosecond-domain pulses.StudyA picosecond-domain, Nd:YAG laser with a KTP frequency-doubling crystal was used to treat 31 decorative tattoos in 21 subjects. Safety and effectiveness were determined by blinded evaluation of digital images in this prospective clinical study.ResultsThe average clearance overall as evaluated by blinded observers evaluating randomized digital photographs was 790.9% (mean +/- sem) after an average of 6.5 treatments. Of the 31 tattoos completing treatment, 6 had evidence of mild hyper- or hypo-pigmentation by evaluation of photographs.ConclusionThe 350 picosecond, 532nm, and 450 picosecond 1,064nm Nd:YAG laser is safe and effective for removing decorative tattoos. Lasers Surg. Med. 47:542-548, 2015. (c) 2015 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.