Expert Consensus on Clinical Recommendations for Fractional Ablative CO Laser, in Facial Skin Rejuvenation Treatment.

Background: For three decades, fractional ablative CO lasers have been used for skin rejuvenation. With breakthroughs in laser technology and expanding popularity, new recommendations and suggestions arise on a regular basis.

Objective: To develop up-to-date clinical recommendations on safety measures, therapeutic framework, and techniques to improve treatment outcomes.

A Prospective, Multicenter, Study of Laser-Activated Gold Microparticles for Treating Patients Using Concomitant Topical Retinoids for Mild-to-Moderate Inflammatory Acne.

Gold microparticles are indicated as an accessory to 1064 nm lasers to facilitate photo-thermal heating of sebaceous glands for treating mild-to-moderate inflammatory acne vulgaris (Sebacia Microparticles, Coronado Aesthetics LLC, Southlake, TX). The following study assessed the safety and clinical benefit of gold microparticles/laser therapy when used together with commercially available topical acne products. Healthy patients, 12 to 45 years old with mild-to-moderate inflammatory facial acne were prescribed a topical pre-treatment retinoid for 3 to 4 weeks.

Scar Therapy of Skin.

Scar therapy is truly important in medicine. Patients experience great loss in quality of life with scars. There are many treatment modalities that help treat scars, including topical, intralesional, surgical, and energy-based devices.

Dermal Micro-coring for the Treatment of Moderate to Severe Facial Wrinkles.

Unlabelled: Micro-coring technology (MCT) removes cores of skin without formation of scars, thereby tightening skin and reducing skin wrinkling. The purpose of this study was to evaluate the safety and efficacy of MCT with the dermal micro-coring device for the treatment of facial wrinkles.

Methods: This prospective, multicenter clinical trial included fifty-one subjects who underwent MCT treatments of the mid to lower face.

An Atlas of Optical Coherence Tomography (OCT): Elucidating Differences of Scar Types Using OCT in Order to Guide Laser Treatment Parameters.

Objective: When using laser therapy to effectively treat scars, the choice of treatment parameters depends on the knowledge accuracy of the underlying scar pathology, which is often difficult to judge by gross physical exam. As such, more quantitative measures are needed. In recent years, optical coherencetomography (OCT) has shown promise as a real-time imaging technolgoy of skin microstructure.

1,550 nm Erbium-Doped and 1,927 nm Thulium Nonablative Fractional Laser System: Best Practices and Treatment Setting Recommendations.

Background: The Fraxel Dual laser system (Solta Medical, Inc., Bothell, WA) contains a 1,550 and 1,927 nm wavelength single handpiece with different indications for each wavelength.

Objective: To discuss treatment setting recommendations and best practices for select on-label and investigational applications of the 1,550 and 1,927 nm dual laser system.

Prospective study of intense pulsed light versus pulsed dye laser with or without blue light in the activation of PDT for the treatment of actinic keratosis and photodamage.

Background: Exposure to ultraviolet (UV) light from the sun is known to have a deleterious effect on the skin. Repeated insults to the dermal matrix from UV radiation result in the clinical signs of photodamage, including changes in skin elasticity, color, and texture. UV radiation also leads to the accumulation of DNA mutations and promotes tumor development, resulting in the formation of cutaneous precancerous and cancerous lesions.

The contribution of itch and skin severity improvements to the Dermatology Life Quality Index in patients with atopic dermatitis in baricitinib phase III trials.

With data from three monotherapy baricitinib phase III randomized clinical trials (RCTs), we conducted a posthoc mediator analysis to assess whether changes in itch or skin severity mediated the treatment effect over placebo on changes in health-related quality of life. In this analysis, baricitinib demonstrated significant improvement in the Dermatology Life Quality Index for which itch mediated approximately half of the changes at weeks 4 and 16.

Analysis of port-wine birthmark vascular characteristics by location: Utility of optical coherence tomography mapping.

Introduction: Port-wine birthmarks (PWBs) are congenital capillary malformations that can be located on any area of the body. Vascular features include vessel size, depth, and density, which can greatly differ between patients, individual lesions, and even sites within the same lesion. Previous studies have determined that the location of PWB lesions has impacted their clinical response to laser treatment.

Clinical Tailoring of Baricitinib 2 mg in Atopic Dermatitis: Baseline Body Surface Area and Rapid Onset of Action Identifies Response at Week 16.

Introduction: Baricitinib, an oral Janus kinase (JAK)1/JAK2 inhibitor, is indicated in the European Union and Japan for treatment of moderate-to-severe atopic dermatitis (AD) in adults who are candidates for systemic therapy. In the ongoing, placebo-controlled, phase 3 trial BREEZE-AD5, once-daily oral baricitinib 2-mg monotherapy improved disease in moderate-to-severe AD patients who had an inadequate response or intolerance to topical corticosteroids. This post-hoc analysis aimed to identify responders to baricitinib 2 mg, using a proposed clinical tailoring approach based on baseline body surface area (BSA) affected and early clinical improvement, in BREEZE-AD5.

Optimizing Outcomes With the 1550/1927 nm Dual Wavelength Non-Ablative Fractional Laser: Experienced User Recommendations.

Background: Fractional laser treatment was introduced in 2004 as a non-invasive technique to treat sun-damaged and aging skin. Since then, numerous ablative and non-ablative photothermolysis technologies and devices have been introduced, increasing the options for clinicians and patients but also increasing the complexity regarding which system to use and the techniques to optimize outcomes. No two devices are the same and the user-manuals preset dosimetry does not address many clinical situations, which can create confusion for new and inexperienced users.

Energy-based devices for the treatment of Acne Scars: 2022 International consensus recommendations.

Background And Objectives: Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers.

Prospective, Randomized, Double-Blind, Placebo-Controlled Study on Efficacy of Copaiba Oil in Silicone-Based Gel to Reduce Scar Formation.

Introduction: Scars are the end result of a biologic and natural process of wound repair after injury, surgery, acne, illness, burns, and infection. When skin is damaged, a fast and coordinated body response is triggered by four highly integrated and overlapping phases including homeostasis, inflammation, proliferation, and tissue remodeling. Healing of a skin wound may result in an abnormal scar if the balance among these four phases is lost during the healing process.

Vascular characteristics of port wine birthmarks as measured by dynamic optical coherence tomography.

Background: Port wine birthmarks (PWBs) are congenital capillary malformations. Vessel characteristics, such as diameter and depth, may impact presentation and outcomes. They can be imaged using dynamic optical coherence tomography, a high-resolution, noninvasive imaging method.

Medical and aesthetic improvement of photodamaged skin by the combination of intense pulsed light and photodynamic therapy with 10% aminolevulinic acid hydrochloride gel.

Objective: To evaluate the efficacy and safety of photodynamic therapy (PDT) with the novel 10% aminolevulinic acid (ALA) hydrochloride gel (10% ALA gel) and BF-RhodoLED® light (635 nm; 37 J/cm ) in combination with intense pulsed light (IPL) to augment the medical and aesthetic improvement of photodamaged skin of the décolleté.

Methods: This was a single-site prospective, randomized, intraindividual split chest pilot study with 20 female subjects with moderate to severe photodamage of the décolleté. Subjects were randomized to ALA-PDT + IPL to one split-side of the chest and ALA-PDT only to the contralateral side.

Baricitinib in patients with moderate-to-severe atopic dermatitis: Results from a randomized monotherapy phase 3 trial in the United States and Canada (BREEZE-AD5).

Background: Baricitinib, an oral selective Janus kinase 1/Janus kinase 2 inhibitor, is being studied for moderate-to-severe atopic dermatitis (AD) in adults.

Objective: To evaluate the efficacy and safety of baricitinib monotherapy in a North American phase 3 trial (BREEZE-AD5/NCT03435081) of adults with moderate-to-severe AD who responded inadequately or were intolerant to topical therapy.

Methods: Patients (N = 440) were randomized 1:1:1 to once-daily placebo or baricitinib (1 mg or 2 mg).

Improvement of Burn Scars Treated With Fractional Ablative CO2 Lasers-A Systematic Review and Meta-analysis Using the Vancouver Scar Scale.

Fractional ablative CO2 laser is being used increasingly to treat burn scars; however, objective measures of outcome success vary widely. This systematic review and meta-analysis extracts and pools available data to assess the outcomes of patients with burn scars treated with fractional ablative CO2 laser. A search of MEDLINE, EMBASE, and the gray literature was performed.

Incorporating Aesthetic Devices into a Dermatologic Practice.

Lasers and energy-based devices allow physicians to provide quality care to patients and achieve optimal clinical results. We sought to review the benefits and drawbacks of purchasing and leasing energy-based devices and to highlight key factors that are important to consider when incorporating these devices into a practice. A PubMed search was conducted for articles on purchasing or leasing lasers and energy-based devices in dermatology.

Treatment of Hypertrophic Burn and Traumatic Scars With a 2,940-nm Fractional Ablative Erbium-doped Yttrium Aluminium Garnet Laser: A Pilot Study.

Background: In recent years, fractional ablative lasers at low density have proven to be the centerpiece in a multimodality approach to treating hypertrophic burn scars.

Objective: To determine the safety and efficacy of fractional ablative erbium-doped yttrium aluminium garnet (Er:YAG) laser in the treatment of hypertrophic burn scars.

Methods: Eleven patients received 3 fractional ablative Er:YAG laser to hypertrophic burn scars at 400 to 800 μm, density 11%, no coagulation, and single pass at 4-week intervals.

Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations.

Background And Objectives: There is currently intense multidisciplinary interest and a maturing body of literature regarding laser treatments for traumatic scars, but international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the tremendous potential of laser techniques, offer recommendations for safe and efficacious treatment, and promote wider patient access guided by future high-quality research.

Study Design/materials And Methods: An international panel of 26 dermatologists and plastic and reconstructive surgeons from 13 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the laser treatment of traumatic scars.