Chang Kyun Lee

Fractional Photothermolysis for the Treatment of Striae Distensae in Asian Skin

AbstractBackground:Striae distensae (SD) are dermal scars characterized by linear atrophic depressions. Fractional photothermolysis (FP) is an effective modality for the treatment of cutaneous scars. Objective:To evaluate the safety and efficacy of FP for the treatment of SD in Asian skin. Methods:Six female volunteers aged between 20 and 35 years with chronic striae albae phase SD on both buttocks were enrolled. SD lesions on the right buttock were irradiated with a 1550-nm FP laser and patients were followed every 4 weeks for a total of 8 weeks. Outcome assessments included serial photographs, erythema index and melanin index tracking, skin elasticity, histologic examination, and the patients’ subjective satisfaction scores. Results:FP treatment was associated with a substantial improvement in the appearance of SD at 8 weeks post-treatment. The erythema index and melanin index of the treated SD lesions tended to converge with those of the control skin at 4-week follow-up. Skin elasticity was found to be partially normalized after FP. In addition, there was a significant increase in epidermal thickness, collagen, and elastic fiber deposition after FP as demonstrated by histologic examination. Adverse effects of FP included mild and transient pain and hyperpigmentation. Conclusion:FP can reduce SD by stimulating new collagen and elastic fiber synthesis. In addition, repetitive treatments might constitute an effective approach to improving the treatment of SD.

Efficacy of 694-nm Q-Switched Ruby Fractional Laser Treatment of Melasma in Female Korean Patients

BACKGROUND Melasma is a common acquired symmetrical hypermelanosis of sun‐exposed areas of the skin. Although the classical Q‐switched ruby laser (QSRL) has been used successfully for the removal of tattoos and for the treatment of cutaneous pigmented lesions, its efficacy for melasma remains controversial. OBJECTIVE We used repeat low‐dose fractional QSRL treatment for melasma and analyzed the clinical results. METHODS Fifteen Korean women with melasma were enrolled. Each patient received six low‐dose fractional QSRL treatments to the face at 2‐week intervals. Two investigators independently evaluated Melasma Area and Severity Index (MASI) scores before each session and 4 and 16 weeks after the final session. The intensities of pigmentation and erythema were assessed by measuring skin reflectance using a tristimulus color analyzer. RESULTS Mean MASI score decreased from 15.1 ± 3.3 before treatment to 10.6 ± 3.9 16 weeks after the final treatment. The lightness of pigmentation (L‐value) increased from 56.6 ± 3.5 before treatment to 59.9 ± 2.8 16 weeks after the final treatment. CONCLUSIONS Multiple treatment sessions of low‐dose fractional QSRL may be an effective strategy for the treatment of dermal or mixed‐type melasma. The authors have indicated no significant interest with commercial supporters.

Long-Pulsed Nd:YAG Laser Treatment of Warts: Report on a Series of 369 Cases

Various treatment methods have been adopted in the management of warts; however, there is still no consensus on first-line treatment. This study was designed to evaluate the efficacy of long-pulsed Nd:YAG laser in the treatment of warts. Over the course of 1 yr, 369 patients with recalcitrant or untreated warts were exposed to a long-pulsed Nd:YAG laser. The following parameters were used: spot size, 5 mm; pulse duration, 20 msec; and fluence, 200 J/cm2. No concomitant topical treatment was used. In all, 21 patients were lost during follow up; hence, the data for 348 patients were evaluated. The clearance rate was 96% (336 of the 348 treated warts were eradicated). The clearance rate of verruca vulgaris after the first treatment was very high (72.6%), whereas the clearance rate of deep palmopantar warts after the first treatment was low (44.1%). During a median follow-up period of 2.24 months (range, 2-10 months), 11 relapses were seen (recurrence rate, 3.27%). In conclusion, long-pulsed Nd:YAG laser is safe and effective for the removal or reduction of warts and is less dependent on patient compliance than are other treatment options.

Subdermal Minimal Surgery with Hyaluronic Acid as an Effective Treatment for Neck Wrinkles

BACKGROUND Neck wrinkles are common, troublesome aesthetic deformities for which a limited number of treatments exist. Although previous study has demonstrated the safety and efficacy of subdermal minimal surgery technology in treatment of acne scarring, this technology has never been applied to treatment of wrinkles. OBJECTIVE To evaluate the efficacy and safety of subdermal minimal surgery technology in the treatment of horizontal neck wrinkles. MATERIALS AND METHODS All 12 enrolled participants were Koreans (Fitzpatrick skin types II–IV) with horizontal neck wrinkles. Participants underwent up to four sessions of treatment with subdermal minimal surgery technology at 4‐week intervals. Wrinkle assessments were conducted at baseline and 2 months after the final treatment session. Participants and physicians evaluated improvement using pre‐ and post‐treatment photographs. RESULTS All participants completed the study. Improvement of wrinkling by at least 50% was observed at 6 months (2 months after the final treatment session) in more than half of the participants, as determined according to physician and participant evaluation. CONCLUSION Findings from this preliminary study demonstrate that use of subdermal minimal surgery technology results in an effective decrease of the appearance of neck wrinkles. The authors have indicated no significant interest with commercial supporters.

Treatment of Periorbital Wrinkles Using a 2,790-nm Yttrium Scandium Gallium Garnet Laser

BACKGROUND Wrinkle formation usually accompanies skin aging. Periorbital wrinkles in particular are an early sign of skin aging. Therefore, several modalities have been developed to treat periorbital wrinkles, including topical applications, surgical techniques, and laser resurfacing. The 2,790‐nm yttrium scandium gallium garnet (YSGG) laser has been increasing in popularity recently, but there have been no investigations into the use of a 2,790‐nm YSGG laser for the treatment of periorbital wrinkles. OBJECTIVE To evaluate the clinical efficacy of a 2,790‐nm YSGG laser for treating periorbital wrinkles. MATERIALS AND METHODS Ten Korean patients (Fitzpatrick skin type II–V) with periorbital wrinkles were enrolled in this study. They were treated two times with a 4‐week interval using a 2,790‐nm YSGG laser. The treatment parameters were an average 2‐J/cm2 fluence, 6‐mm spot size, and 0.3‐ms pulse width. Treatment consisted of two to three passes of the laser with 20% overlap until a clinical end point of mild erythema was observed. Patients were examined 1 week after each treatment and 3 months after the last treatment. Two independent, blinded dermatologists evaluated clinical improvement using the Fitzpatrick Wrinkle Classification System (FWCS) by comparing digital photographs taken before treatment (baseline) and 3 months after the last treatment. Efficacy was assessed by subtracting the baseline score from the score at 3 months after the last treatment (wrinkle improvement<0; no change=0; worsening>0). At each visit, the patients were also evaluated for any side effects. At the end of the study, the patients documented their degree of satisfaction on a scale of very satisfied, satisfied, slightly satisfied, and unsatisfied. RESULTS All patients completed the two treatment sessions, and all experienced clinical improvement of periorbital wrinkles based on the physician assessments. The mean treatment efficacies for the right and left sides using the FWCS were −1.85±0.82 and −1.70±0.71, respectively. Nine of 10 participants were satisfied with the procedure. Transient hyperpigmentation and slight exfoliation were observed in one patient after the last treatment, but this disappeared within 10 weeks. CONCLUSION In treating periorbital wrinkles, a 2,790‐nm YSGG laser treatment might be an effective treatment modality with minimal complications. The authors have indicated no significant interest with commercial supporters.