Laser, Light Combo Improves Pigmentation in Single Session

KISSIMMEE, FLA. – The combined use of a nonablative, fractional 1,540-nm laser and optimized pulsed light provided significantly greater improvement in dyspigmentation after a single treatment session, compared with the 1,540-nm laser alone, based on findings from a study comparing the two treatments in 36 patients.

The observation of improved pigment after a single treatment in the combination group represents a reduced time course for achieving outcomes; typically, several treatments are required to produce results, Dr. Chung-Yin Stanley Chan said at the annual meeting of the American Society for Laser Medicine and Surgery.

The novel combined approach to facial rejuvenation also modestly improved wrinkles, although this outcome did not differ significantly between the two groups, Dr. Chan and his colleagues noted.

The mean pigment improvement score in the 10 subjects assigned to the combination treatment group was 2.4 points on a 1- to 4-point scale, indicating at least 50% improvement, with 96% of patients in that group experiencing improvement. The mean pigment improvement score in the 26 subjects assigned to the laser-only treatment group was 1.2 points.

Fitzgerald wrinkle scores improved from 6.4 to 6.0 (on a scale of 1-9) in the combination group, and from 5.3 to 4.9 in the laser-only treatment group, said Dr. Chan, a dermatologist in private practice in Chestnut Hill, Mass., where the study was conducted.

Both groups received treatment with an Er:Glass laser (at 1,540 nm, with 50 mJ/microbeam and a 15-millisecond pulse duration), and the combination group also received treatment with optimized pulsed light (operated at 500-670 nm and 870-1,200 nm, with a fluence of 32 J/cm², and with a 20-millisecond pulse duration). The order of treatment in the combination group was randomized, and the order had no effect on the outcome. However, treatment was better tolerated when optimized pulsed light was applied first, followed by the laser treatment, Dr. Chan noted.

The side effects were similar in the two groups, and included only effects "that would be expected with nonablative fractional laser treatment," he said, explaining that erythema and edema occurred in all patients, flaking and xerosis occurred in some patients, and postinflammatory hyperpigmentation was extremely rare. "In fact, all side effects resolved within 1 month, and most resolved within 1 week," he said, adding that no difference was seen in the incidence of adverse effects between the combination and laser-only treatment groups.

All patients reported being satisfied with the outcome, and most reported being "very satisfied," he said.

Outcomes were assessed by three blinded dermatologists trained in the evaluation of wrinkles and pigmentation, one of whom was Dr. Chan. The dermatologists compared clinical photographs taken at baseline and at 1 month following treatment.

A single treatment with this combined approach to facial rejuvenation can lead to modest improvement in wrinkles and significant improvement in pigmentation, he concluded, noting that multiple treatments using this combined approach could hypothetically lead to further improvements.

The study was sponsored by Palomar. Dr. Chan said he had no other relevant financial disclosures.

KISSIMMEE, FLA. – The combined use of a nonablative, fractional 1,540-nm laser and optimized pulsed light provided significantly greater improvement in dyspigmentation after a single treatment session, compared with the 1,540-nm laser alone, based on findings from a study comparing the two treatments in 36 patients.

The observation of improved pigment after a single treatment in the combination group represents a reduced time course for achieving outcomes; typically, several treatments are required to produce results, Dr. Chung-Yin Stanley Chan said at the annual meeting of the American Society for Laser Medicine and Surgery.

The novel combined approach to facial rejuvenation also modestly improved wrinkles, although this outcome did not differ significantly between the two groups, Dr. Chan and his colleagues noted.

The mean pigment improvement score in the 10 subjects assigned to the combination treatment group was 2.4 points on a 1- to 4-point scale, indicating at least 50% improvement, with 96% of patients in that group experiencing improvement. The mean pigment improvement score in the 26 subjects assigned to the laser-only treatment group was 1.2 points.

Fitzgerald wrinkle scores improved from 6.4 to 6.0 (on a scale of 1-9) in the combination group, and from 5.3 to 4.9 in the laser-only treatment group, said Dr. Chan, a dermatologist in private practice in Chestnut Hill, Mass., where the study was conducted.

Both groups received treatment with an Er:Glass laser (at 1,540 nm, with 50 mJ/microbeam and a 15-millisecond pulse duration), and the combination group also received treatment with optimized pulsed light (operated at 500-670 nm and 870-1,200 nm, with a fluence of 32 J/cm², and with a 20-millisecond pulse duration). The order of treatment in the combination group was randomized, and the order had no effect on the outcome. However, treatment was better tolerated when optimized pulsed light was applied first, followed by the laser treatment, Dr. Chan noted.

The side effects were similar in the two groups, and included only effects "that would be expected with nonablative fractional laser treatment," he said, explaining that erythema and edema occurred in all patients, flaking and xerosis occurred in some patients, and postinflammatory hyperpigmentation was extremely rare. "In fact, all side effects resolved within 1 month, and most resolved within 1 week," he said, adding that no difference was seen in the incidence of adverse effects between the combination and laser-only treatment groups.

All patients reported being satisfied with the outcome, and most reported being "very satisfied," he said.

Outcomes were assessed by three blinded dermatologists trained in the evaluation of wrinkles and pigmentation, one of whom was Dr. Chan. The dermatologists compared clinical photographs taken at baseline and at 1 month following treatment.

A single treatment with this combined approach to facial rejuvenation can lead to modest improvement in wrinkles and significant improvement in pigmentation, he concluded, noting that multiple treatments using this combined approach could hypothetically lead to further improvements.

The study was sponsored by Palomar. Dr. Chan said he had no other relevant financial disclosures.

KISSIMMEE, FLA. – The combined use of a nonablative, fractional 1,540-nm laser and optimized pulsed light provided significantly greater improvement in dyspigmentation after a single treatment session, compared with the 1,540-nm laser alone, based on findings from a study comparing the two treatments in 36 patients.

The observation of improved pigment after a single treatment in the combination group represents a reduced time course for achieving outcomes; typically, several treatments are required to produce results, Dr. Chung-Yin Stanley Chan said at the annual meeting of the American Society for Laser Medicine and Surgery.

The novel combined approach to facial rejuvenation also modestly improved wrinkles, although this outcome did not differ significantly between the two groups, Dr. Chan and his colleagues noted.

The mean pigment improvement score in the 10 subjects assigned to the combination treatment group was 2.4 points on a 1- to 4-point scale, indicating at least 50% improvement, with 96% of patients in that group experiencing improvement. The mean pigment improvement score in the 26 subjects assigned to the laser-only treatment group was 1.2 points.

Fitzgerald wrinkle scores improved from 6.4 to 6.0 (on a scale of 1-9) in the combination group, and from 5.3 to 4.9 in the laser-only treatment group, said Dr. Chan, a dermatologist in private practice in Chestnut Hill, Mass., where the study was conducted.

Both groups received treatment with an Er:Glass laser (at 1,540 nm, with 50 mJ/microbeam and a 15-millisecond pulse duration), and the combination group also received treatment with optimized pulsed light (operated at 500-670 nm and 870-1,200 nm, with a fluence of 32 J/cm², and with a 20-millisecond pulse duration). The order of treatment in the combination group was randomized, and the order had no effect on the outcome. However, treatment was better tolerated when optimized pulsed light was applied first, followed by the laser treatment, Dr. Chan noted.

The side effects were similar in the two groups, and included only effects "that would be expected with nonablative fractional laser treatment," he said, explaining that erythema and edema occurred in all patients, flaking and xerosis occurred in some patients, and postinflammatory hyperpigmentation was extremely rare. "In fact, all side effects resolved within 1 month, and most resolved within 1 week," he said, adding that no difference was seen in the incidence of adverse effects between the combination and laser-only treatment groups.

All patients reported being satisfied with the outcome, and most reported being "very satisfied," he said.

Outcomes were assessed by three blinded dermatologists trained in the evaluation of wrinkles and pigmentation, one of whom was Dr. Chan. The dermatologists compared clinical photographs taken at baseline and at 1 month following treatment.

A single treatment with this combined approach to facial rejuvenation can lead to modest improvement in wrinkles and significant improvement in pigmentation, he concluded, noting that multiple treatments using this combined approach could hypothetically lead to further improvements.

The study was sponsored by Palomar. Dr. Chan said he had no other relevant financial disclosures.