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Comparison of a 1450-nm Diode Laser and a 1320-nm Nd:YAG Laser in the Treatment of Atrophic Facial Scars: A Prospective Clinical and Histologic Study *

Background. Atrophic scar revision techniques, although numerous, have been hampered by inadequate clinical responses and prolonged postoperative recovery periods. Nonablative laser treatment has been shown to effect significant dermal collagen remodeling with minimal posttreatment sequelae. Although many studies have been published regarding the effectiveness of these nonablative lasers on rhytides, there are limited data demonstrating their specific effects on atrophic scars.
 
Objective. To evaluate and compare the efficacy and safety of long-pulsed 1320-nm Nd:YAG and 1450-nm diode lasers in the treatment of atrophic facial scarring.
 
Methods. A series of 20 patients (skin phototypes I–V) with mild to moderate atrophic facial acne scars randomly received three successive monthly treatments with a long-pulsed 1320-nm Nd:YAG laser on one facial half and a long-pulsed 1450-nm diode laser on the contralateral facial half. Patients were evaluated using digital photography and three-dimensional in vivo microtopography measurements at each treatment visit and at 1, 3, 6, and 12 months postoperatively. Histologic evaluations of cutaneous biopsies obtained before treatment, immediately after the first treatment, and at 1, 3, 6, and 12 months after the third treatment were performed. Clinical assessment scores were determined at each treatment session and follow-up visit. Patient satisfaction surveys were obtained at the end of the study.
 
Results. Mild to moderate clinical improvement was observed after the series of three treatments in the majority of patients studied. Patient satisfaction scores and in vivo microtopography measurements paralleled the photographic and histopathologic changes seen. Side effects of treatment were limited to mild transient erythema, edema, and hyperpigmentation. No scarring or adverse textural changes resulted from the use of either laser system.
 
Conclusions. Nonablative long-pulsed 1320-nm Nd:YAG and 1450-nm diode lasers each offer clinical improvement for patients with atrophic scarring without significant side effects or complications. The 1450-nm diode laser showed greater clinical scar response at the parameters studied. The use of nonablative laser systems is a good treatment alternative for patients with atrophic scarring who are unable or unwilling to endure the prolonged postoperative recovery process associated with ablative laser skin resurfacing procedures.
 
 

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As with any procedure, there could be pain or other substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.

THE INFORMATION IN THIS WEBSITE IS OFFERED FOR GENERAL EDUCATIONAL PURPOSES ONLY AND DOES NOT IMPLY OR GIVE MEDICAL ADVICE. No Doctor/Patient relationship shall be deemed to have arisen simply by reading the information contained on these pages, and you should consult with your personal physician/care giver regarding your medical treatment before undergoing any sort of treatment or therapy.

Published on 09-08-2008
Authors: Elizabeth L. Tanzi, MD * , and Tina S. Alster, MD *
Source: Washington Institute of Dermatologic Laser Surgery, Washington, DC