DOI QR코드

DOI QR Code

Potential Efficacy of Multiple-shot Long-pulsed 1,064-nm Nd:YAG in Nonablative Skin Rejuvenation: A Pilot Study

  • Received : 2020.12.21
  • Accepted : 2020.12.21
  • Published : 2020.12.31

Abstract

Background and Objectives The ultimate goal in current skin rejuvenation practice is to achieve a good result with minimal pain and downtime. Nonablative skin rejuvenation (NSR) is one technique. The efficacy of the long-pulsed 1064 nm Nd:YAG laser (LPNDY) has not been assessed in NSR. Materials and Methods Three target areas were selected (bilateral cheeks and glabellar region) in six volunteer subjects. A LPNDY with an integral skin temperature monitor delivered three stacked shots to each target area (1064 nm, 12 mm spot, 13 J/cm2, 1 Hz) without any skin cooling or anesthesia. The skin temperature was recorded before, during, and after each set of shots using the system monitor and in real-time using a high-sensitivity (±0.001℃) near-infrared video camera. The skin reaction was observed with the naked eye, and pain and discomfort were assessed by the subjects during and after treatment. Results The subjects reported a mild feeling of heat with no discomfort during or after the test treatments. Mild erythema was observed around the treatment areas, without noticeable edema. A series of three ascending skin temperature stepwise peaks, with a decrease in skin temperature towards the baseline after the third shot, was observed consistently. The mean temperatures for shots 1, 2, and 3 for the cheeks were 39.5℃, 42.0℃, and 44.4℃, respectively, and for the glabella, 40.8℃, 43.9℃, and 46.2℃, respectively. Similar ranges were indicated on the system integral temperature monitor. Conclusion A set of three stacked pulses with the LPNDY at a low fluence achieved ideal dermal temperatures to achieve some dermal remodeling but without any downtime or adverse events. The temperature data from the integral thermal sensor matched the video camera measurements with practical accuracy for skin rejuvenation requirements. These data suggest that LPNDY would satisfy the necessary criteria to achieve effective NSR, but further studies will be needed to assess the actual results in clinical practice.

Keywords

References

  1. Trelles MA. Laser ablative resurfacing for photorejuvenation based on more than a decade's experience and 1200 patients: personal observations. J Cosmet Dermatol 2003;2:2-13. https://doi.org/10.1111/j.1473-2130.2003.00001.x
  2. Sapijaszko MJ, Zachary CB. Er:YAG laser skin resurfacing. Dermatol Clin 2002;20:87-96. https://doi.org/10.1016/s0733-8635(03)00048-2
  3. Bernstein LJ, Kauvar AN, Grossman MC, Geronemus RG. The short- and long-term side effects of carbon dioxide laser resurfacing. Dermatol Surg 1997;23:519-25. https://doi.org/10.1111/j.1524-4725.1997.tb00677.x
  4. Zdinak LA, Summerfield ME. Nonablative skin therapies. Ophthalmol Clin North Am 2005;18:237-48, v. https://doi.org/10.1016/j.ohc.2005.02.002
  5. Trelles MA, Alvarez X, Martin-Vazquez MJ, Trelles O, Velez M, Levy JL, et al. Assessment of the efficacy of nonablative longpulsed 1064-nm Nd:YAG laser treatment of wrinkles compared at 2, 4, and 6 months. Facial Plast Surg 2005;21:145-53. https://doi.org/10.1055/s-2005-872416
  6. Trelles MA, Allones I, Levy JL, Calderhead RG, Moreno-Arias GA. Combined nonablative skin rejuvenation with the 595- and 1450-nm lasers. Dermatol Surg 2004;30:1292-8. https://doi.org/10.1097/00042728-200410000-00003
  7. Hantash BM, Mahmood MB. Fractional photothermolysis: a novel aesthetic laser surgery modality. Dermatol Surg 2007;33:525-34. https://doi.org/10.1097/00042728-200705000-00001
  8. Geronemus RG. Fractional photothermolysis: current and future applications. Lasers Surg Med 2006;38:169-76. https://doi.org/10.1002/lsm.20310
  9. Nelson JS, Majaron B, Kelly KM. What is nonablative photorejuvenation of human skin? Semin Cutan Med Surg 2002;21:238-50. https://doi.org/10.1016/S1085-5629(02)80011-6
  10. Levy AS, Grant RT, Rothaus KO. Radiofrequency physics for minimally invasive aesthetic surgery. Clin Plast Surg 2016;43:551-6. https://doi.org/10.1016/j.cps.2016.03.013
  11. Fitzpatrick RE, Smith SR, Sriprachya-anunt S. Depth of vaporization and the effect of pulse stacking with a high-energy, pulsed carbon dioxide laser. J Am Acad Dermatol 1999;40:615-22. https://doi.org/10.1016/S0190-9622(99)70447-0
  12. Oni G, Robbins D, Bailey S, Brown SA, Kenkel JM. An in vivo histopathological comparison of single and double pulsed modes of a fractionated CO2 laser. Lasers Surg Med 2012;44:4-10. https://doi.org/10.1002/lsm.21150
  13. Berge U, Kristensen P, Rattan SI. Hormetic modulation of differentiation of normal human epidermal keratinocytes undergoing replicative senescence in vitro. Exp Gerontol 2008;43:658-62. https://doi.org/10.1016/j.exger.2007.12.009
  14. Dierickx CC. The role of deep heating for noninvasive skin rejuvenation. Lasers Surg Med 2006;38:799-807. https://doi.org/10.1002/lsm.20446
  15. Verrico AK, Moore JV. Expression of the collagen-related heat shock protein HSP47 in fibroblasts treated with hyperthermia or photodynamic therapy. Br J Cancer 1997;76:719-24. https://doi.org/10.1038/bjc.1997.452
  16. Motta MM, Stelini RF, Calderoni DR, Gilioli R, Kharmandayan P. Lower energy and pulse stacking. A safer alternative for skin tightening using fractional CO2 laser. Acta Cir Bras 2016;31:28-35. https://doi.org/10.1590/S0102-865020160010000005
  17. Lee MS. Treatment of vaginal relaxation syndrome with an erbium:YAG laser using 90° and 360° scanning scopes: a pilot study & short-term results. Laser Ther 2014;23:129-38. https://doi.org/10.5978/islsm.14-OR-11