Presidential Greeting - American Society for Laser Medicine and ...

20 American Society for Laser Medicine and Surgery Abstracts
Results: Blinded assessment correctly identified the treated side
over control side in 11/12 patients. Patients (10/12) were graded as
having at least 50% improvement in the appearance, with 6/10
showing 75% or greater improvement. Average downtime as
reported by subjects was less than 4 days, and no incidence of
prolonged erythema or post-inflammatory hyperpigmentation
were noted by subjects or the blinded assessor. Histology of postauricular
treated skin showed typical fractional columnar
collagen heating.
Conclusion: In this pilot study, vacuum-assisted bipolar RF
energy delivered by microneedle array appears to be a safe and
effective treatment option for treating acne scarring. Other
attractive features of this technology included rapid treatment
times, minimal downtime, and no PIH.
#64
1,550 NM AND 1,927 NM FRACTIONAL LASER
RESURFACING FOR THE TREATMENT OF
ACTINIC KERATOSIS AND PHOTODAMAGE: A
COMPARATIVE STUDY
Paul M. Friedman, Jennifer M. Landau,
Megan N. Moody, Denise Marquez,
Jennifer D. Peterson, Leonard H. Goldberg,
Irene J. Vergilis-Kalner
DermSurgery Associates Houston, TX; Goldman, Butterwick &
Associates Cosmetic Laser Dermatology, San Diego, CA
Background: The primary objective of this study was to compare
the safety and efficacy of a combination treatment with a 1,550 nm
erbium-doped fiber laser and 1,927 nm thulium laser versus
treatment with the 1,927 nm thulium fiber laser alone for the
treatment of actinic keratosis (AK) on the face. Secondary
objectives included the evaluation of the improvement of skin
pigmentation and overall photodamage, specifically rhytides,
lentigines, and texture.
Study: Fifteen patients, ages 52–82 years, with Fitzpatrick skin
types I–III and multiple actinic lesions underwent 1–4 split-face
treatments at 3- to 5-week intervals. Half of the face was treated
with the 1,927 nm thulium fiber laser and the other half was
treated with a combination of the 1,550-nm erbium-doped fiber
laser followed by the 1,927 nm thulium fiber laser. Laser settings
were as follows: the 1,927 nm thulium fiber laser was set at
fluences of 10–20 mJ and treatment levels of 5–11, corresponding
to 40–70% surface area coverage, 4–8 passes. The 1,550-nm
erbium-doped fiber laser was set at fluences of 20–40 mJ and
treatment levels of 5–8, corresponding to 14–23% surface area
coverage, 4 passes. The number of AKs was counted at baseline
and at all treatment and follow-up visits. Photodamage and
pigmentation were assessed using a quartile grading scale.
Biopsies at baseline and 6-month follow-up were taken from both
sides of the face and stained for p16 and p53.
Results: The percent reduction in AK count 1 month after 1, 2, 3,
and 4 combination laser treatments was 47%, 66%, 75%, and 76%,
respectively. The percent reduction in AK count 1 month after 1, 2,
3, and 4 treatments with the 1,927 nm laser alone was 43%, 57%,
71%, and 83%, respectively. The percent reduction in AK count 3
months after 3–4 treatments (n ¼ 5) was 57% after combination
laser treatments and 67% after 1,927-nm laser treatments alone.
The percent reduction in AK count 6 months after four treatments
(n ¼ 4) was 55% after 1,927 nm laser alone treatments. The
majority of patients showed moderate to marked improvement in
pigmentation and photodamage. In the facial areas treated with
the 1,927 nm alone, evaluators noticed greater improvement in
pigmentation after fewer treatments as well as more persistent
improvement of photodamage at long-term follow-up.
Adverse effects were limited to transient erythema and edema
localized to the treatment site. Histologic results will be
presented.
Conclusion: Combination laser treatment with a 1,550 nm
erbium-doped fiber laser and 1,927 nm thulium fiber laser and
treatment with the 1,927 nm thulium fiber laser alone yielded a
significant decrease in the clinical appearance of actinic lesions
and improvement of pigmentation and overall photodamage. One
month after four treatments spaced 3–5 weeks apart, the mean
reduction in the number of AK lesions was greater than 75%. At 1month,
3-months, and 6-months after 3–4 treatments, the side
treated with the 1,927 nm laser alone experienced greater clinical
reduction in AK counts. Furthermore, pigmentation changes were
noticeably superior on the side treated by the 1,927 nm alone at
long-term follow-up.
#65
LONG-TERM FOLLOW-UP OF 1,927 NM
FRACTIONAL RESURFACING FOR ACTINIC
KERATOSES ON THE FACE
Elliot Weiss, Rob Anolik, Lori Brightman,
Anne Chapas, Elizabeth Hale, Julie Karen,
Leonard Bernstein, Roy Geronemus
Laser & Skin Surgery Center of New York, New York, NY
Background: Actinic keratoses (AK) are precancerous epidermal
proliferations seen on photo-damaged skin. A fractionated
1,927 nm thulium laser has received FDA approval for treating
AK. This device delivers microscopic thermal zones within treated
skin using a wavelength with moderate/high water absorption.
The resulting laser–tissue interaction creates precise, superficial
zones of thermal damage best suited for removal of epidermal
lesions such as AK. We assess the long-term safety and efficacy of
1,927 nm fractional resurfacing of facial AK.
Study: Twenty-five subjects with facial AK receiving up to four
treatments (2- to 6-week intervals) with a 1,927 nm laser (Fraxel
Dual, Solta Medical, Hayward, CA) were followed for 6 months.
Topical anesthetic and optional ketorolac were administered
1 hour before treatment. Treatment parameters ranged from 5 to
20 mJ/pulse with coverage densities of 30–70%.
Results: Individual AK counts decreased in all patients during
treatment. One month after the final treatment, average AK
clearance per patient was 88.9% (n ¼ 20, range 63–100%). At 3
months, average AK clearance was 87.5% (n ¼ 16, range 63–100).
At 6 months, average AK clearance was 75% (n ¼ 8, range 58–
100%). The average patient score for treatment discomfort was 3/
10. Post-treatment, mild/moderate erythema and mild exfoliation
lasted approximately 7 days. No incidents of infection or scarring
were observed. At 3 months, average scores for improvement in
photo-damage and AK were 3.3/4 for both subject and investigator
ratings. For skin texture and pigmentation, average improvement
scores were 3.0/4 and 3.1/4 for subject and investigator ratings,
respectively. At 6 months, average scores for improvement in
photo-damage and AK were 3.5/4 and 3.8/4 for subject and
investigator, respectively. For skin texture and pigmentation,
improvement scores were 3.5/4 and 3.7/4 for subject and
investigator, respectively.
Conclusion: 1,927 nm fractional resurfacing safely results in
dramatic clinical clearing of AK with sustained clearance
observed over 6 months follow-up. This well-tolerated treatment
is an effective new field therapy for facial AK.