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

Study: Institutional based prospective study conducted on 24
patients with tattoo from July 2009 to August 2010. Body tattoo
was divided into two equal units, one unit received 700 mJ/pulse
and other received 900 mJ/pulse. Bindi tattoo patients were
treated alternately with 700 and 900 mJ/pulse. Total number of
tattoos included in study was 40. Spot size of 3 mm at a
wavelength of 1,064 nm and frequency of 2 Hz was used. During
the procedure cooling was done using Cryo5. Three sittings were
given at 6 weeks interval and follow-up period was for 9–12
months after the third sitting. Percentage of clearance of tattoo
was evaluated by two blinded physicians using visual analogue
scale at the end of the treatment. The occurrence of adverse events
was assessed and graded accordingly.
Results: There was more than 75% clearance in 85% of patients.
There was no statistically significant difference in clearance of
tattoos and adverse events using 700 or 900 mJ/pulse. Transient
hyperpigmentation was present in 52.5% of tattoos which
improved over the period. There was higher incidence of scarring
and depression in forehead tattoos as compared to body tattoos.
Hypopigmentation was not seen in present study.
Conclusion: Using higher fluences good tattoo clearance could be
achieved in 95% of patients. Hyperpigmentation was seen more
frequently with higher fluences and use of cooling which was
transient. Scarring and depression were more common in
forehead tattoos.
#252
American Society for Laser Medicine and Surgery Abstracts 75
PRELIMINARY RESULTS OF A CLINICAL TRIAL
USING A NOVEL INTRALESIONAL FRACTIONAL
RADIOFREQUENCY DEVICE FOR DEEP DERMAL
HEATING OF FACIAL SKIN
Nark-Kyoung Rho, Jeong-Yeop Lee, Soohong Kim,
Kyung-Ae Jang, Seok-Beom Park
Leaders Aesthetic Laser & Cosmetic Surgery Center, Seoul, Korea
Background: The objective of this preliminary study was to
evaluate the clinical efficacy and safety of a novel intralesional
fractional radiofrequency device for deep dermal heating.
Study: The device used for the study was equipped with a
treatment tip of 25 non-insulated radiofrequency insertion
needles in 1 cm 2 . The range of needle penetration depth was from
0.5 to 3.5 mm in 0.1 mm increment. Histologic study using porcine
skin and human fresh cadaver skin was performed before clinical
trial. Standard treatment protocol was 0.8–3.0 mm of penetration
depth, 7–9 level of radiofrequency energy (arbitrary scale), 100–
200 milliseconds of pulse duration, depending on the treatment
area. Before treatment, topical anesthetic cream was applied for
30 minutes. Thirty Korean subjects were treated and evaluated 1
day, 7 days and 1 month, and 2 months after the procedure.
Results: The treatment was well-tolerated in all subjects.
Immediate post-treatment erythema and edema were evident in
all subjects; however, these resolved spontaneously within an
hour. Minimal microcrusts in a fractional pattern, mainly on the
lateral cheek area, developed 1–2 days after treatment and
spontaneously resolved after 7–8 days. At the 1-month follow-up,
clinical improvement was seen regarding the skin tone and
pigmentation (95%), prominent facial pores (89%), fine winkles
(76%), midface laxity (70%), mentolabial folds (62%), and
nasolabial folds (57%). After 3 months, mild improvement of acne
scarring was noticed in some subjects. Interestingly, facial
flushing and rosacea improved in three subjects. No serious side
effects were noticed.
Conclusion: According to the preliminary study, intralesional
deep dermal heating by fractional radiofrequency was found to be
effective and safe treatment for the facial rejuvenation in
Koreans.
#253
TREATMENT OF PORT WINE STAIN USING A NEW
OPTIMIZED PULSED LIGHT HANDPIECE
E. Victor Ross, Emily Yu
Scripps Clinic, San Diego, CA
Background: Pulsed dye lasers (PDL) have been preferred for
port wine stain (PWS) treatments. Approximately 20% of PWS,
however, are poor responders. Intense pulsed-light devices are
increasingly popular because of their versatility. This study
evaluates PWS treatments with a new optimized pulsed light
(OPL) device.
Study: This study was performed under IRB approval. No PWS
had prior light-based treatments. Thus far, four female and one
male (mean age 38) have been enrolled. Extra-facial PWS received
up to four treatments with the OPL (MaxG TM , Palomar Medical
Technologies, Inc., Burlington, MA) approximately 1 month apart.
Using the OPL, 3, 5, and 10 milliseconds pulse widths were
applied over three respective regions of the PWS at the highest
fluence without epidermal side effects. The OPL provided a
spectral range of 500–670 and 870–1,200 nm and fluences 20–
40 J/cm 2 . Another area of each PWS was treated with a PDL
(VBeam 1 , Candela Corporation, Wayland, MA) at 1.5–
3 milliseconds, and 6.0–8.5 J/cm 2 . Photographs were taken and
improvement was assessed clinically at each treatment. A
reflectance spectrophotometer measured hemoglobin and melanin
levels and tracked PWS clearance.
Results: Most patients underwent three to four treatments; one
patient relocated after two. Purpura, edema, blanching, and
erythema were commonly observed immediately post 3 and
5 milliseconds OPL pulses and post 1.5 and 3 milliseconds PDL
pulses. Patients had overall fair (26–50%) improvement after one
treatment and good (51–75%) to excellent (76%–99%)
improvement after three or four treatments. The 3 and
5 milliseconds pulses demonstrated lower purpura thresholds (24
and 28 J/cm 2 respectively) with improved clearance per
treatment. However, hemosiderin deposition was also noted at
purpuric sites. Reflectance device hemoglobin levels correlated
with PWS clearance.
Conclusion: The new optimized light handpiece is effective in the
treatment of PWS. Immediate response and subsequent
lightening post-OPL was comparable to that post-PDL. Longer
follow-ups will clarify the role of purpura in PWS clearance.
#254
CLINICAL APPLICATIONS OF LOW LEVEL
LASERS IN A DENTAL PRACTICE
Gerry Ross
General Practice, Tottenham, Canada
Background: I have been using low level lasers in my dental
practice since 1993 and the have proven to be an extremely
valuable tool in delivering high quality low pain dentistry. I will
outline their uses in restorative dentistry, implants, orthodontics,
facial pain, soft tissue lesions, endodontics’ nerve regeneration
and neuropathic pain.