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Infantile hemangiomas clear faster with Nd:YAG treatment
BOSTON – Using a 650-microsecond, pulsed 1064nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser to treat infantile hemangiomas can yield high clearance rates after one treatment, without adverse reactions, according to a study presented at the annual meeting of the American Society for Laser Medicine and Surgery.
“[Hemangiomas] have historically been treated with a bunch of different devices; most commonly, the pulsed dye laser and also propranolol, either orally or topically,” said Dr. David J. Goldberg of Skin Laser & Surgery Specialists of New York and New Jersey. While use of an Nd:YAG laser for treating infantile hemangiomas is not exactly new, “what’s new about this is it was not a millisecond Nd:YAG laser; it was a microsecond Nd:YAG laser, [which] generally makes it much safer for treatment in general.”
The study enrolled 250 children between age 1 month and 4 months at the time of recruitment; they were followed for one year. They received a single treatment with an Nd:YAG 1064nm laser using a 650 microsecond pulse duration, a spot size of 2-3 millimeters, and a fluence of 42-64 joules per square centimeter. Photographs were taken for evaluation immediately before and after each treatment, and 30 and 180 days after each treatment.
Treatments lasted 3-5 minutes each, covering an area no larger than three square centimeters. Infants who started treatment in the first six weeks of life had the best results, according to Dr. Goldberg. Treated areas immediately turned gray after each treatment on all subjects, and all subjects showed “substantial improvement” in hemangioma size after only a single treatment, based on photographic evaluation taken 6 months after treatment. Over 75% of hemangiomas were either completely or almost completely (over 75% clearance) eliminated over the 1-year follow-up period.
There was no downtime or adverse events experienced by any patients following treatments. Overall, parents of the children who received treatment were “highly satisfied” with the results.
“The big takeaway is that you may not need multiple treatments [and] you may not need to use a pulse dye laser – one treatment may be enough,” Dr. Goldberg explained. “This [Nd:YAG] device is also a very small device that you can put into a suitcase, so it’s not that big device that we’re used to using.”
Dr. Goldberg did not report any relevant financial disclosures.
BOSTON – Using a 650-microsecond, pulsed 1064nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser to treat infantile hemangiomas can yield high clearance rates after one treatment, without adverse reactions, according to a study presented at the annual meeting of the American Society for Laser Medicine and Surgery.
“[Hemangiomas] have historically been treated with a bunch of different devices; most commonly, the pulsed dye laser and also propranolol, either orally or topically,” said Dr. David J. Goldberg of Skin Laser & Surgery Specialists of New York and New Jersey. While use of an Nd:YAG laser for treating infantile hemangiomas is not exactly new, “what’s new about this is it was not a millisecond Nd:YAG laser; it was a microsecond Nd:YAG laser, [which] generally makes it much safer for treatment in general.”
The study enrolled 250 children between age 1 month and 4 months at the time of recruitment; they were followed for one year. They received a single treatment with an Nd:YAG 1064nm laser using a 650 microsecond pulse duration, a spot size of 2-3 millimeters, and a fluence of 42-64 joules per square centimeter. Photographs were taken for evaluation immediately before and after each treatment, and 30 and 180 days after each treatment.
Treatments lasted 3-5 minutes each, covering an area no larger than three square centimeters. Infants who started treatment in the first six weeks of life had the best results, according to Dr. Goldberg. Treated areas immediately turned gray after each treatment on all subjects, and all subjects showed “substantial improvement” in hemangioma size after only a single treatment, based on photographic evaluation taken 6 months after treatment. Over 75% of hemangiomas were either completely or almost completely (over 75% clearance) eliminated over the 1-year follow-up period.
There was no downtime or adverse events experienced by any patients following treatments. Overall, parents of the children who received treatment were “highly satisfied” with the results.
“The big takeaway is that you may not need multiple treatments [and] you may not need to use a pulse dye laser – one treatment may be enough,” Dr. Goldberg explained. “This [Nd:YAG] device is also a very small device that you can put into a suitcase, so it’s not that big device that we’re used to using.”
Dr. Goldberg did not report any relevant financial disclosures.
BOSTON – Using a 650-microsecond, pulsed 1064nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser to treat infantile hemangiomas can yield high clearance rates after one treatment, without adverse reactions, according to a study presented at the annual meeting of the American Society for Laser Medicine and Surgery.
“[Hemangiomas] have historically been treated with a bunch of different devices; most commonly, the pulsed dye laser and also propranolol, either orally or topically,” said Dr. David J. Goldberg of Skin Laser & Surgery Specialists of New York and New Jersey. While use of an Nd:YAG laser for treating infantile hemangiomas is not exactly new, “what’s new about this is it was not a millisecond Nd:YAG laser; it was a microsecond Nd:YAG laser, [which] generally makes it much safer for treatment in general.”
The study enrolled 250 children between age 1 month and 4 months at the time of recruitment; they were followed for one year. They received a single treatment with an Nd:YAG 1064nm laser using a 650 microsecond pulse duration, a spot size of 2-3 millimeters, and a fluence of 42-64 joules per square centimeter. Photographs were taken for evaluation immediately before and after each treatment, and 30 and 180 days after each treatment.
Treatments lasted 3-5 minutes each, covering an area no larger than three square centimeters. Infants who started treatment in the first six weeks of life had the best results, according to Dr. Goldberg. Treated areas immediately turned gray after each treatment on all subjects, and all subjects showed “substantial improvement” in hemangioma size after only a single treatment, based on photographic evaluation taken 6 months after treatment. Over 75% of hemangiomas were either completely or almost completely (over 75% clearance) eliminated over the 1-year follow-up period.
There was no downtime or adverse events experienced by any patients following treatments. Overall, parents of the children who received treatment were “highly satisfied” with the results.
“The big takeaway is that you may not need multiple treatments [and] you may not need to use a pulse dye laser – one treatment may be enough,” Dr. Goldberg explained. “This [Nd:YAG] device is also a very small device that you can put into a suitcase, so it’s not that big device that we’re used to using.”
Dr. Goldberg did not report any relevant financial disclosures.
AT LASER 2016
Key clinical point: Infantile hemangiomas can be effectively treated with a 650-microsecond pulsed Nd:YAG 1064nm laser, with no evidence of adverse skin effects.
Major finding: Substantial improvement in hemangiomas were seen after one treatment administered in 5 minutes or less.
Data source: The study enrolled 250 infants with hemangiomas aged 1 to 4 months at baseline, and were followed for one year.
Disclosures: Dr. Goldberg did not report any relevant financial disclosures.
Multispectral laser safe, fast, effective for removing multicolored tattoos
BOSTON – For the removal of unwanted tattoos, particularly those made up of more than one color, a multispectral laser system of 755 nm, 532 nm or 1,064 nm with a picosecond pulse duration has been found to be safe, fast, and highly effective, without leaving any residual scarring.
“Q-switch lasers with nanosecond pulse rates have been the gold standard of treating unwanted tattoos for years; however, they’re not without their limitations,” said Dr. Bradley Bloom, who presented the results of a prospective, single center study at the annual meeting of the American Society for Laser Medicine and Surgery.
Over the past several years, fewer than 60% of patients achieve complete clearance despite numerous treatments for tattoo removal, explained Dr. Bloom, of Skin Laser and Surgery Specialists of NY & NJ in New York City. “These limitations include the need for many treatments, and the difficulty in clearing green, blue, and yellow inks,” but these challenges could be alleviated by using picosecond lasers with short pulse durations, he said.
The study involved 44 individuals with a total of 53 noncosmetic tattoos. All tattoos were photographed at baseline and before each treatment; the subjects received anywhere between 1 and 10 treatments. Photographs were taken 2 months after the final treatment. Individuals were treated every 6 weeks, plus or minus 2 weeks, with either a 532-nm, 755-nm, or a 1,064-nm laser with a 450-500 picosecond, 500-750 picosecond, and 500-600 picosecond pulse duration, respectively (0.5-6 J per square centimeter, and 1-10 millimeters).
The majority (84%) of the treated tattoos were made up of several different ink colors, including black, red, orange, yellow, green, blue, pink, and white.
“The results we saw with the 532-nm [laser] were over 75% clearance of red, orange, and yellow [inks] with just an average of two treatments,” said Dr. Bloom, adding that these data compare favorably against historical data.
Patients who received at least four treatments reached 75% improvement in tattoo visibility with the 532-nm laser. In addition, 82% of those treated with at least four treatments with the 1,064-nm laser improved by at least 50% and 85% of those treated at least four times with the 755-nm laser treatment improved by at least 50%.
Investigators noted that both wavelength and pulse duration were critical variables in determining the efficacy of the treatment on a given tattoo. For example, 532 nm was found to be “extremely useful” in clearing red, orange, and yellow inks, while the 755-nm laser was found to be the most effective on blue and green inks.
For black inks, both the 755-nm and 1,064-nm were found to be effective, but Dr. Bloom advised that “greater caution [is] required” when using the former on darker skin types.
Some patients did see “mild hypopigmentation” which improved with time, Dr. Bloom said. In addition, a patient who had a biopsy after receiving 10 laser treatments revealed no evidence of fibrosis or scar formation, which “underscores the safety of this device.”
For handling multicolor tattoos, Dr. Bloom suggested dividing the tattoos based on which colors are dominant so that they can be targeted with the laser best suited to remove that color.
Cynosure, maker of the multispectral laser system, supported in the study. Dr. Bloom disclosed advisory, consulting, and financial ties to Aerolase and Cutera
BOSTON – For the removal of unwanted tattoos, particularly those made up of more than one color, a multispectral laser system of 755 nm, 532 nm or 1,064 nm with a picosecond pulse duration has been found to be safe, fast, and highly effective, without leaving any residual scarring.
“Q-switch lasers with nanosecond pulse rates have been the gold standard of treating unwanted tattoos for years; however, they’re not without their limitations,” said Dr. Bradley Bloom, who presented the results of a prospective, single center study at the annual meeting of the American Society for Laser Medicine and Surgery.
Over the past several years, fewer than 60% of patients achieve complete clearance despite numerous treatments for tattoo removal, explained Dr. Bloom, of Skin Laser and Surgery Specialists of NY & NJ in New York City. “These limitations include the need for many treatments, and the difficulty in clearing green, blue, and yellow inks,” but these challenges could be alleviated by using picosecond lasers with short pulse durations, he said.
The study involved 44 individuals with a total of 53 noncosmetic tattoos. All tattoos were photographed at baseline and before each treatment; the subjects received anywhere between 1 and 10 treatments. Photographs were taken 2 months after the final treatment. Individuals were treated every 6 weeks, plus or minus 2 weeks, with either a 532-nm, 755-nm, or a 1,064-nm laser with a 450-500 picosecond, 500-750 picosecond, and 500-600 picosecond pulse duration, respectively (0.5-6 J per square centimeter, and 1-10 millimeters).
The majority (84%) of the treated tattoos were made up of several different ink colors, including black, red, orange, yellow, green, blue, pink, and white.
“The results we saw with the 532-nm [laser] were over 75% clearance of red, orange, and yellow [inks] with just an average of two treatments,” said Dr. Bloom, adding that these data compare favorably against historical data.
Patients who received at least four treatments reached 75% improvement in tattoo visibility with the 532-nm laser. In addition, 82% of those treated with at least four treatments with the 1,064-nm laser improved by at least 50% and 85% of those treated at least four times with the 755-nm laser treatment improved by at least 50%.
Investigators noted that both wavelength and pulse duration were critical variables in determining the efficacy of the treatment on a given tattoo. For example, 532 nm was found to be “extremely useful” in clearing red, orange, and yellow inks, while the 755-nm laser was found to be the most effective on blue and green inks.
For black inks, both the 755-nm and 1,064-nm were found to be effective, but Dr. Bloom advised that “greater caution [is] required” when using the former on darker skin types.
Some patients did see “mild hypopigmentation” which improved with time, Dr. Bloom said. In addition, a patient who had a biopsy after receiving 10 laser treatments revealed no evidence of fibrosis or scar formation, which “underscores the safety of this device.”
For handling multicolor tattoos, Dr. Bloom suggested dividing the tattoos based on which colors are dominant so that they can be targeted with the laser best suited to remove that color.
Cynosure, maker of the multispectral laser system, supported in the study. Dr. Bloom disclosed advisory, consulting, and financial ties to Aerolase and Cutera
BOSTON – For the removal of unwanted tattoos, particularly those made up of more than one color, a multispectral laser system of 755 nm, 532 nm or 1,064 nm with a picosecond pulse duration has been found to be safe, fast, and highly effective, without leaving any residual scarring.
“Q-switch lasers with nanosecond pulse rates have been the gold standard of treating unwanted tattoos for years; however, they’re not without their limitations,” said Dr. Bradley Bloom, who presented the results of a prospective, single center study at the annual meeting of the American Society for Laser Medicine and Surgery.
Over the past several years, fewer than 60% of patients achieve complete clearance despite numerous treatments for tattoo removal, explained Dr. Bloom, of Skin Laser and Surgery Specialists of NY & NJ in New York City. “These limitations include the need for many treatments, and the difficulty in clearing green, blue, and yellow inks,” but these challenges could be alleviated by using picosecond lasers with short pulse durations, he said.
The study involved 44 individuals with a total of 53 noncosmetic tattoos. All tattoos were photographed at baseline and before each treatment; the subjects received anywhere between 1 and 10 treatments. Photographs were taken 2 months after the final treatment. Individuals were treated every 6 weeks, plus or minus 2 weeks, with either a 532-nm, 755-nm, or a 1,064-nm laser with a 450-500 picosecond, 500-750 picosecond, and 500-600 picosecond pulse duration, respectively (0.5-6 J per square centimeter, and 1-10 millimeters).
The majority (84%) of the treated tattoos were made up of several different ink colors, including black, red, orange, yellow, green, blue, pink, and white.
“The results we saw with the 532-nm [laser] were over 75% clearance of red, orange, and yellow [inks] with just an average of two treatments,” said Dr. Bloom, adding that these data compare favorably against historical data.
Patients who received at least four treatments reached 75% improvement in tattoo visibility with the 532-nm laser. In addition, 82% of those treated with at least four treatments with the 1,064-nm laser improved by at least 50% and 85% of those treated at least four times with the 755-nm laser treatment improved by at least 50%.
Investigators noted that both wavelength and pulse duration were critical variables in determining the efficacy of the treatment on a given tattoo. For example, 532 nm was found to be “extremely useful” in clearing red, orange, and yellow inks, while the 755-nm laser was found to be the most effective on blue and green inks.
For black inks, both the 755-nm and 1,064-nm were found to be effective, but Dr. Bloom advised that “greater caution [is] required” when using the former on darker skin types.
Some patients did see “mild hypopigmentation” which improved with time, Dr. Bloom said. In addition, a patient who had a biopsy after receiving 10 laser treatments revealed no evidence of fibrosis or scar formation, which “underscores the safety of this device.”
For handling multicolor tattoos, Dr. Bloom suggested dividing the tattoos based on which colors are dominant so that they can be targeted with the laser best suited to remove that color.
Cynosure, maker of the multispectral laser system, supported in the study. Dr. Bloom disclosed advisory, consulting, and financial ties to Aerolase and Cutera
AT LASER 2016
Key clinical point: Multispectral laser system consisting of 755 nm, 532 nm, and 1,064 nm with picosecond pulse durations was effective at removing tattoos, regardless of ink color, without residual scarring.
Major finding: Among patients who had at least four laser treatments, there was 75% improvement for those treated with the 532 nm laser, and at least 50% improvement in the majority of those treated with the 1,064 nm laser, and the majority of those treated with the 755 nm laser.
Data source: A prospective, single-center study of 1-10 treatments with one of three types of lasers, in 44 individuals with 53 mostly multicolored tattoos.
Disclosures: Cynosure, maker of the multispectral laser system, supported in the study. Dr. Bloom disclosed advisory, consulting, and financial ties to Aerolase and Cutera.
Aggressive approach to photodamaged skin is safe, effective, in small study
BOSTON – A more aggressive approach with fractional radiofrequency treatment of photodamaged facial skin in a single treatment achieved the same results as multiple treatments, with no increase in adverse events, in a small study.
“All of these nonablative fractional devices that are out there [are] generally dependent on multiple treatments; they’re fractional by their very nature, so you have to treat people three, five [or more] times,” Dr. David J. Goldberg, a dermatologist in group practice in New York and New Jersey, said in an interview at the annual meeting of the American Society for Laser Medicine and Surgery.
In the study of 25 individuals with photodamaged skin, “we took a somewhat more aggressive approach, and wanted to see what would happen after just one treatment,” Dr. Goldberg explained, adding that historically, single-treatment approaches with conventional fractional radiofrequency (RF) treatments cover only about 10% of photodamaged skin.
All patients were treated in his group practice at an energy setting of 60 mJ/pin using the Fractora RF device, a 60-pin bipolar RF device manufactured by InMode. Dr. Goldberg and his coinvestigators collected data on skin texture (or roughness), photodamage, wrinkling, tone, luminosity, and overall quality at baseline and 30, 60, 90, and 180 days after treatment.
All patients had their entire face treated during the single session, with downtime due to erythema lasting 3-4 days in all cases. By the end of day 4, all subjects were satisfied enough with the results that they were able to resume normal daily routines. Furthermore, all subjects showed signs of improvement after undergoing one treatment, and there were no adverse reactions, Dr. Goldberg said.
After a single treatment, skin tone improvement was evident in 40% of patients and improvements in texture, photodamage, and wrinkling were evident in 50% of subjects. For most patients, these improvements were seen between 60 and 90 days after treatment. However, some patients saw improvements in skin luminosity, texture, tone, and overall quality as early as the 30-day follow-up, according to Dr. Goldberg. Skin roughness improved by a “statistically significant” margin at 60- and 90-day follow-up, compared with baseline, and continued to improve through the 180-day follow-up.
“Patients don’t want to come in five times for treatment,” he said. “You can treat them safely and effectively with just one treatment by being just a little bit more aggressive.”
Dr. Goldberg disclosed speaking, consulting, and honoraria relationships with Cutera, as well as consulting and honoraria relationships with Cutera, InMode, Endymed and Aerolase.
BOSTON – A more aggressive approach with fractional radiofrequency treatment of photodamaged facial skin in a single treatment achieved the same results as multiple treatments, with no increase in adverse events, in a small study.
“All of these nonablative fractional devices that are out there [are] generally dependent on multiple treatments; they’re fractional by their very nature, so you have to treat people three, five [or more] times,” Dr. David J. Goldberg, a dermatologist in group practice in New York and New Jersey, said in an interview at the annual meeting of the American Society for Laser Medicine and Surgery.
In the study of 25 individuals with photodamaged skin, “we took a somewhat more aggressive approach, and wanted to see what would happen after just one treatment,” Dr. Goldberg explained, adding that historically, single-treatment approaches with conventional fractional radiofrequency (RF) treatments cover only about 10% of photodamaged skin.
All patients were treated in his group practice at an energy setting of 60 mJ/pin using the Fractora RF device, a 60-pin bipolar RF device manufactured by InMode. Dr. Goldberg and his coinvestigators collected data on skin texture (or roughness), photodamage, wrinkling, tone, luminosity, and overall quality at baseline and 30, 60, 90, and 180 days after treatment.
All patients had their entire face treated during the single session, with downtime due to erythema lasting 3-4 days in all cases. By the end of day 4, all subjects were satisfied enough with the results that they were able to resume normal daily routines. Furthermore, all subjects showed signs of improvement after undergoing one treatment, and there were no adverse reactions, Dr. Goldberg said.
After a single treatment, skin tone improvement was evident in 40% of patients and improvements in texture, photodamage, and wrinkling were evident in 50% of subjects. For most patients, these improvements were seen between 60 and 90 days after treatment. However, some patients saw improvements in skin luminosity, texture, tone, and overall quality as early as the 30-day follow-up, according to Dr. Goldberg. Skin roughness improved by a “statistically significant” margin at 60- and 90-day follow-up, compared with baseline, and continued to improve through the 180-day follow-up.
“Patients don’t want to come in five times for treatment,” he said. “You can treat them safely and effectively with just one treatment by being just a little bit more aggressive.”
Dr. Goldberg disclosed speaking, consulting, and honoraria relationships with Cutera, as well as consulting and honoraria relationships with Cutera, InMode, Endymed and Aerolase.
BOSTON – A more aggressive approach with fractional radiofrequency treatment of photodamaged facial skin in a single treatment achieved the same results as multiple treatments, with no increase in adverse events, in a small study.
“All of these nonablative fractional devices that are out there [are] generally dependent on multiple treatments; they’re fractional by their very nature, so you have to treat people three, five [or more] times,” Dr. David J. Goldberg, a dermatologist in group practice in New York and New Jersey, said in an interview at the annual meeting of the American Society for Laser Medicine and Surgery.
In the study of 25 individuals with photodamaged skin, “we took a somewhat more aggressive approach, and wanted to see what would happen after just one treatment,” Dr. Goldberg explained, adding that historically, single-treatment approaches with conventional fractional radiofrequency (RF) treatments cover only about 10% of photodamaged skin.
All patients were treated in his group practice at an energy setting of 60 mJ/pin using the Fractora RF device, a 60-pin bipolar RF device manufactured by InMode. Dr. Goldberg and his coinvestigators collected data on skin texture (or roughness), photodamage, wrinkling, tone, luminosity, and overall quality at baseline and 30, 60, 90, and 180 days after treatment.
All patients had their entire face treated during the single session, with downtime due to erythema lasting 3-4 days in all cases. By the end of day 4, all subjects were satisfied enough with the results that they were able to resume normal daily routines. Furthermore, all subjects showed signs of improvement after undergoing one treatment, and there were no adverse reactions, Dr. Goldberg said.
After a single treatment, skin tone improvement was evident in 40% of patients and improvements in texture, photodamage, and wrinkling were evident in 50% of subjects. For most patients, these improvements were seen between 60 and 90 days after treatment. However, some patients saw improvements in skin luminosity, texture, tone, and overall quality as early as the 30-day follow-up, according to Dr. Goldberg. Skin roughness improved by a “statistically significant” margin at 60- and 90-day follow-up, compared with baseline, and continued to improve through the 180-day follow-up.
“Patients don’t want to come in five times for treatment,” he said. “You can treat them safely and effectively with just one treatment by being just a little bit more aggressive.”
Dr. Goldberg disclosed speaking, consulting, and honoraria relationships with Cutera, as well as consulting and honoraria relationships with Cutera, InMode, Endymed and Aerolase.
AT LASER 2016
Key clinical point: More aggressive high-energy fractional radiofrequency treatment is safe enough on photodamaged facial skin that patients can avoid coming back for multiple treatments.
Major finding: 50% of patients showed improvement in skin texture, photodamage, and wrinkling at 60-, 90-, and 180-day follow-ups, and 40% showed improvement in skin tone after only one treatment.
Data source: A single-center study of high-energy laser treatment (60 mJ/pin) to repair photodamaged facial skin in 25 individuals.
Disclosures: Dr. Goldberg disclosed speaking, consulting, and honoraria relationships with Cutera, as well as consulting and honoraria relationships with Cutera, InMode, Endymed, and Aerolase.
