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

standardized treatment protocol supervised by a medical director.
Patients received one 30-minute treatment involving low level
laser acupuncture therapy and one 30-minute session of
behavioral modification therapy. Follow-up was conducted at 3
months by telephone or email communication to verify patients
were both cigarette and nicotine free.
Results: Between 2006 and 2009, 357 patients underwent the
treatment protocol. At 3 months, 179 patients were lost to followup.
Of the remaining 178 patients, 40 patients stated they had
relapsed one or more times and 138 patients stated they remained
cigarette and nicotine free.
Conclusion: Our data show that of all patients treated with
appropriate follow-up, 78% had a successful outcome. In
comparison to leading psychotherapy and pharmacotherapy
interventions for smoking cessation, one intervention of laser
acupuncture with behavioral modification has similar or better
results at three months. We recommend a multidisciplinary
treatment plan for patients to optimize their freedom from
chemical dependency.
#221
META-ANALYSIS OF LASER THERAPY FOR
MELASMA
Shlomit Halachmi, Marete Haedersdal,
Moshe Lapidoth
Rabin Medical Center, Petach Tikva, Israel;
University of Copenhagen, Copenhagen, Denmark
Background: Melasma is a common and challenging disorder.
The superficial location of the pigment should make the treatment
amenable to laser therapies. However, the pigmentation is due to
a life-long process of abnormal melanocyte activity and is
therefore difficult to halt for prolonged periods of time by the use
of episodic interventions. Furthermore, melasma is more common
in darker skin, which skin type poses a risk for energy-based
interventions. For all these reasons, laser treatments for melasma
are a topic of controversy.
Study: A meta-analysis was performed of English language
publications on Medline. Twenty-six studies were identified as
clinical studies in humans. Studies that combined topical
therapies were excluded.
Results: Studies of a wide range of energy-based approaches were
identified, including pigment based (melanin or vascular) lasers,
intense pulsed light, and fractional ablative and non-ablative
lasers. Of the 26, 19 studies demonstrated appreciable efficacy in
improvement of melasma. Duration of response was limited when
reported. Seven studies exhibited results that do not support the
use of lasers or light sources in melasma due to low efficacy, short
duration of effect, or risk of adverse events.
Conclusion: Lasers can offer benefit in melasma in certain
patients. However, they are not universally effective, and the
effects are in most cases temporary. The non-durable benefit as
well as the risk of adverse events may limit the widespread use of
lasers in melasma.
#222
American Society for Laser Medicine and Surgery Abstracts 65
NEOVASCULARIZATION FOLLOWING FACIAL
SURGERY: POSSIBLE ETIOLOGY AND
TREATMENT
Shlomit Halachmi, Maurice Adatto, Ran Kornowski,
Moshe Lapidoth
Rabin Medical Center, Petach Tikva, Israel; SkinPulse, Geneva,
Switzerland
Background: Angiogenesis is an integral part of any wound
healing process. However, following facial surgery the
angiogenic response can be exaggerated and result in
telangiectasia. We describe this relatively unknown phenomenon
and demonstrate the safety and efficacy of long-pulsed 595 nm
pulsed dye laser for the treatment of post-surgical facial
telangiectasia.
Study: Sixteen patients (14 women, 2 men) with Fitzpatrick skin
types II to IV who had undergone facelift (11 patients) or Mohs
surgery for basal cell carcinoma (5 patients) were studied. All
noticed peri-incisional telangiectasia 2–3 months post-surgery.
Patients underwent 1–3 treatments with pulsed dye laser. Lesion
clearance was evaluated by two specialists on the basis of digital
photographs taken before the first treatment and 2 months after
the last treatment.
Results: All patients had an excellent response (clearance rating
75–100%). Mild transient purpura and minimal pain were
present in all patients. No persistent adverse events were
recorded.
Conclusion: Long-pulse pulsed dye laser is a safe, effective, and
well-tolerated treatment for post-surgical facial telangiectasis.
The mechanism underlying post-surgical telangiectasis is unclear
but may include angiogenesis secondary to wound healing
processes, peri- or post-procedural ischemia, surgical
manipulation of the skin, or stretch.
#223
PURPURIC PULSE DYE LASER TREATMENTS OF
ACNE REDUCE LESIONS—A CHART REVIEW
Hadar Lev-Tov, Judith Hellman
Mount Sinai School of Medicine, New York, NY; SUNY Downstate
College of Medicine, Brooklyn, NY
Background: We report a highly successful acne treatment
modality using light energy, utilizing the 585 pulse dye laser
(PDL). Previous regimens with the 585 PDL were intent on
using non-purpuric settings and led to marginal results. We
used settings that deliberately were in the purpuric range, in a
monthly repeating protocol for 3–4 times in most cases. This
regimen consistently resulted in significant and dramatic
reduction in the severity of acne and often led to complete
remission.
Study: We reviewed all charts of patients who had laser
treatment for acne between November 2003 and November 2009
in our facility. We included in our analysis patients who had no
more than four treatments and had pre-operative and
post-operative pictures. The final number of patients included was
n ¼ 17. Acne severity was determined based on the type and
number of the lesions. All patients were treated with a 585 nm
PDL with spot size of 7 mm 2 Energy levels ranged from 4.2 to
6.7 J/cm 2 and were graded based on patients’ tolerance and
Fitzpatrick skin type.
Results: Ninety-four percent of patients had significant reduction
in severity of lesions. Based on our scoring system the average
starting score was 4.44 and the average score after treatments
was 0.88 (average reduction ¼ 3.6 points). Nine patients
experienced complete remission. Presently, two patients had
sustained the remission for over 3 years.
Conclusion: Five hundred eighty-five PDL treatments of acne
with purpuric settings may result in effective and lasting
reduction of lesions.