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

energy delivery for similar indications. We report the initial
experience with a fractional micro-plasma RF-based device in the
treatment of acne scars or facial rhytids.
Study: Porcine skin models demonstrated that the depth and
diameter of fractional plasma-RF penetration depend on the RF
power and pulse duration, and range from 100 to 150 mm in depth
and from 80 to 120 mm in diameter. Based on the results in this
model, 16 patients with facial acne scars or facial rhytids
underwent a series of treatments at 3- to 4-week intervals.
Results were monitored photographically 6 months after
treatment.
Results: Acne scars showed marked improvement after 2–4
treatments. Facial rhytids demonstrated reduced depth after two
treatments and marked improvement after four treatments.
Treatment was well tolerated by all participants, with transient
erythema and short downtime.
Conclusion: Fractional micro-plasma RF technology is a
beneficial, low downtime, and well-tolerated modality for the
treatment of acne scars and facial rhytids.
#137
American Society for Laser Medicine and Surgery Abstracts 43
#138
TREATMENT OF DEPRESSED ACNE SCARS
AND DEEP WRINKLES WITH A NOVEL
MULTI-SOURCE FRACTIONAL
RADIOFREQUENCY DEVICE—HISTOLOGICAL
AND CLINICAL RESULTS ON 50 PATIENTS WITH
LONG-TERM FOLLOW-UP
Yoram Harth, Klaus Fritz
OR Medical Center, Herzlya, Israel; University Hospital, Bern,
Switzerland
Background: Acne scars are one of the most difficult disorders to
treat in dermatology. The optimal treatment system will provide
minimal downtime resurfacing for the epidermis and non-ablative
deep volumetric heating for collagen remodeling in the dermis. A
novel therapy system (EndyMed Ltd, Cesarea, Israel) uses phase
controlled multisource RF to provide simultaneous one pulse
microfractional resurfacing with independent volumetric skin
tightening.
Study: In the first stage of the study we treated in vivo animal
skin. Skin specimens from treatment area were harvested for
histology immediately after, 3 days and 14 days after the
treatment. In the clinical study, 30 subjects (Fitzpatrick’s skin
types 2–5) with moderate to deep wrinkles (Fitzpatrick’s scale
> 3) and 20 subjects with depressed acne scars were enrolled.
Treatment was repeated each month up to a total of three
treatment sessions. Patients photographs were graded
according to accepted scales by two uninvolved blinded
evaluators.
Results: In vivo histologies showed various degrees of ablation,
coagulation and dermal heating according to power settings.
All treated subjects experienced mild-moderate edema and
erythema as an immediate response to treatment. Edema resolved
after up to 1-hour post-treatment and mild erythema lasted up to
2 days. Micro ablative crusts lasted up to 5 days. Significant
reduction in the depth of wrinkles and acne scars was noted 4
weeks after therapy with further improvement at the 3 months
follow-up.
Conclusion: Our data show the histological impact and clinical
beneficial effects of simultaneous RF fractional microablation and
volumetric deep dermal heating for treatment of wrinkles and
acne scars.
SEQUENTIAL PHOTOTHERMAL 1,064 ND:YAG
AND 2,940 NM ER:YAG FRACTIONAL
RESURFACING AND REMODELING VERSUS
2,940 NM ER:YAG FRACTIONAL RESURFACING
ALONE: A COMPARATIVE STUDY
Leonardo Marini
The Skin Doctors’ Center, Trieste, Italy
Background: The main objective of this study was to assess the
clinical and histologic effects of a sequential photo-thermal
short þ long pulse 1,064 nm Nd:YAG followed by a fractional
2,094 nm Er:YAG according to a laser layering technique (LLT)
compared to a 2,940 nm Er:YAG fractional resurfacing in facial
chrono- and photo-aged skin.
Study: Two different photo-thermal laser protocols were
randomly applied to facial skin of two groups (a. n.55—38–60
years, mean 45; b. n.45—40–62 years, mean 48) of Fitzpatrick
type 2–3 patients affected by photo- and chrono-aging. Group a
was treated with a sequence of short and long 1,064 nm laser
pulses (0.3 milliseconds–35 J/cm 2 —scanner-operated 3 mm spot;
followed by 35 milliseconds–50 J/cm 2 —scanner-operated 3 mm
spot) immediately followed by two passes of fractional 2,940 nm
Er:YAG laser resurfacing (0.250 mm spot–12 J/cm 2 –
600 microsecond—40% coverage). Group b was treated by two
passes of 2,940 nm Er:YAG laser resurfacing with the same
parameters. Standardized clinical photographs were taken at day
0–30–60–90. Three millimeter punch biopsies were performed at
30 and 90 days on the natural crease between the cheek and earlobule
just across treated and non-treated sites. Non-treated sites
were marked in blue. All histological specimens were processed
with standard EE. A self-evaluation clinical diary was given to all
patients.
Results: Clinical pictures were blindly evaluated by two
dermatologists with a 90% of concordance. Overall clinical
improvement was considered higher (37%) in group a
(Nd:YAG þ fractional Er:YAG) compared to group b (fractional
Er:YAG). Histologic evaluation was blindly performed by a
dermatopathologist who confirmed a 32% higher collagen
rearrangement in the same group of patients. The majority of
Patients considered the procedures acceptable (a. 85% b. 87%).
Patients’ perceived clinical improvement was higher (78%) in
group a than in group b (62%). Both patient groups confirmed
their willingness to repeat the procedures to progressively reach
and/or maintain a good level of anti-aging effect.
Conclusion: Sequential 1,064 nm Nd:YAG and 2,940 nm Er:YAG
photo-thermal fractional resurfacing and remodeling showed to be
clinically superior to fractional 2,940 nm Er:YAG laser
resurfacing alone according to both patients and dermatologists’
evaluation. More studies are needed to assess different sequences
of laser wavelenghts to further improve the clinical efficacy of
what can be described as laser layering technique (LLT)
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COMBINED FRACTIONAL, NON-ABLATIVE
TREATMENT OF STRIAE: CLINICAL AND
HISTOLOGICAL OBSERVATIONS
Vic Narurkar, Christine Dierickx, Carolyn Chang,
Ava Shamban
Bay Area Laser Institute/CPMC, San Francisco, CA; Skin and
Laser Center, Boom, Belgium; CPMC, San Francisco, CA; Laser
Institute for Derm and European Skin Care, Santa Monica, CA