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Pixel radiofrequency with microplasma technology: Fractional ablative radiofrequency for the treatment of acne scars
P8046
P7629
Pixel radiofrequency with microplasma technology: Fractional ablative radiofrequency for the treatment of acne scars Michael Gold, MD, Tennessee Clinical Research Center, Nashville, TN, United States
Studying the intense pulsed light method along with corticosteroid injection in treating keloid scars Simin Shamsi Meymandi, MD, Department of Dermatology, Kerman Leishmaniasis Research center, Kerman University of Medical Sciences, Kerman, Iran; Ali Ekhlasi, MD, Department of Dermatology, Kerman Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran; Azadeh Rezazadeh, MD, Department of Dermatology, Kerman Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
Background: Microplasma is a novel radiofrequency (RF) technology that generates a path of current from a tiny metal electrode to the surface of the biologic tissue, forming a plasma gas-discharge, causing microscopic fractional skin perforationablation event. Objective: To assess the safety and efficacy of a fractional ablative microplasma RF device in the treatment of acne scars. Study: Six subjects with documented mild to moderate atrophic acne scars were enrolled in the study. Acne scar clinical grading scale (ECCA) was used; the average score being 162.5. Fitzpatrick skin type distribution among the 6 subjects was 4 type II, 1 type V, and 1 type VI. Each subject received a single treatment with the (Pixel RF, Alma Lasers Inc) a fractional RF that deploys multiple pin electrodes on a handheld roller. Before treatment, subjects received topical anesthetic and were spot tested (30 minute postevaluation.) Subjects received 4 to 5 passes during treatment at an energy level ranging from 40 to 60 watts. Treatment areas were limited to the forehead and cheek areas of the subjects. Subjects were evaluated at 1, 5, 30, and 90 days posttreatment. Improvement was assessed by the investigator physician based on visual appearance rated on a 1 to 4 improvement scale: -1 (exacerbation), 0 (no change), 1 (1-25% improvement), 2 (25-50% improvement), 3 (50-75% improvement), and 4 (75-99% improvement). Results: Day 1: 1 subject was observed with an improvement rating of 1; 5 subjects showed no change (0 rating). Day 5: 2 subjects were observed with an improvement rating of 2; 3 subjects rated 1; 1 subject rated 0. Day 30: 1 subject was observed with an improvement rating of 3; 1 subject rated 2; 3 subjects rated 1 and 1 subject (subject 3) was not indicated. Day 90: 2 subjects were observed with an improvement rating of 3; 2 subjects rated 2; 2 subjects rated 1. Only 1 subject experienced a possible study related adverse affect; moderate worsening of facial acne that was subsequently resolved with medication. The ECCA scoring at the 90day follow-up ranged from a low of 65 to a high of 130; with an average score of 95. Conclusion: The pixel RF with microplasma technology, intended for skin ablation and perforation, is a safe and effective modality, even after a single treatment for the improvement in the appearance of acne scars.
Background: Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are annoying both physically and mentally. Objective: Because of the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars. Methods: Eighty-six subjects entered this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 nm filter, fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and pulsed delay 10-40 ms with an interval of 3 weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, criteria determined in the study of Eroll and Vancouver scar scale were used. Results: The level of clinical improvement, color improvement, and scar height was 89.1%, 88.8%, and 89.1%, respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases, and 2 atrophy cases) after treatment with IPL was 11.6%. Moreover, the participants’ satisfaction with IPL method was 88.8%. Conclusions: This study revealed that a combined therapy (intralesional corticosteroid injection plus IPL) increased the recovery level of hypertrophic and keloid scars. It was also shown that this method had no significant side effect and patients were highly satisfied with this method. Commercial support: None identified.
Supported by Alma Lasers Inc.
P8521 Prospective pilot evaluation of a novel unipolar radiofrequency device with dermal rolling mechanism for rejuvenation of Fitzpatrick skin phototypes III to V Hema Sundaram, MD, Dermatology, Cosmetic & Laser Surgery, Rockville, MD, United States Background: Core aesthetic specialty surveys show diversification of patients seeking nonsurgical rejuvenation and development of devices to address this need. Radiofrequency (RF) devices can be used safely and effectively in pigmented skin because of their lack of chromophore specificity and relative epidermal sparing. This pilot evaluation investigated efficacy, tolerability, and safety of a novel fractional ablative RF device. Design: Twelve healthy patients with Fitzpatrick skin types III to V were evaluated prospectively after appropriate washout periods for laser/light, fillers, toxins, chemical peels, surgery etc. Pretreatment assessment included 5-point scoring for fine lines and wrinkles, skin tightness, pore prominence, and skin color/tone, and standardized digital 3D imaging. Patients received 3 treatments at 3 to 4 weekly intervals with a unipolar fractional ablative RF roller device at 40.68 MHz and up to 80W, comprising 6 cogs with 50 microelectrodes on each cog. When rolled over the skin, they produce multiple microablative thermal conduits across the dermoepidermal junction. Full-face treatment was performed with 2 perpendicular passes. Evaluations at 1 week and 3 to 4 weeks after each treatment included 5-point scoring for fine lines and wrinkles, skin tightness, pore prominence, and skin color/tone; scoring on the validated Global Aesthetic Improvement Scale (GAIS); and standardized 3D imaging. Tolerability evaluation included assessment of posttreatment erythema. After 3 treatments, the same evaluations occurred during 2 followup visits at 3 to 4 weekly intervals. Patient questionnaires evaluated perception of improvement in the specific parameters and satisfaction with treatment. Results: All patients had significant improvement, with skin tightness, brightness, and color/tone most improved and fine lines and rhytids markedly improved for those patients who had them at baseline. All patients scored 1 (improved) or greater on the GAIS, and reported themselves satisfied or very satisfied. Treatment was well tolerated and there were no significant adverse events. Conclusion: Fractional ablative unipolar RF roller technology was found to be safe, efficacious, and well tolerated for pigmented skin. Larger, controlled studies would increase the evidence level. Pilot evaluation suggests comparable results, but decreased discomfort and shorter recovery than with conventional fractionated lasers. Extended evaluation to assess longevity of results is in process. The clinical evaluation was partially supported by an equipment and research grant from Alma Lasers.
AB200
J AM ACAD DERMATOL
P8162 Tattoo removal using QS Nd:Yag laser Gina Silva, MD, Leger Clinic, Porto Alegre, Brazil; Honorio Menezes, Leger Clinic, Porto Alegre, Brazil; Larissa Donini, Leger Clinic, Porto Alegre, Brazil; Michelle Gonc¸alves, Leger Clinic, Porto Alegre, Brazil; Nivea Chacur, MD, Leger Clinic, Porto Alegre, Brazil; Raphaela Ramos, Leger Clinic, Porto Alegre, Brazil; Roberto Chacur, MD, Leger Clinic, Porto Alegre, Brazil Introduction: Both dermabrasion and surgery are techniques that have been used for tattoo removal. Nowadays we have been using laser for that purpose. Objective: The objective of this study is to evaluate the removal of tattoos using the QS Nd:Yag laser. Methods: This is a retrospective study involving patients treated with QS Nd:Yag laser. The data have been collected from patients’ medical records and pictures, telephone contact, or e-mail. The statistical analysis was performed through the analysis of distribution, multivariate regression, and logistic regression. Results: We have evaluated 304 patients with an average age of 29.8 years old (6 7.86), having 297 (97.69%) been classified as white (phototypes I, II, and III), from which 270 (88.81%) were analyzed as professional tattoos. The oldest tattoo was 360 months and the most recent was 1 month, reaching an average of 64.56 months (6 63.54). The average size of the tattoos was 12.92 cm, with black as the predominant color, present in 291 (86.51%) tattoos. The average number of sessions per patient was 3.77 (6 2.99), with an interval of 49.23 days between sessions. Therefore, it has been observed by the therapist that 52.96% of tattoos had been partially removed, 21.38% had not been removed, 86.51% presented normal scar healing, 8.55%, hypertrophic scar healing, and 3.29% presented cheloid. Out of the 304 patients, 26.64% (81) reported satisfaction with the results, 58.88% (179) were partially satisfied. Hypochromia was present in 33.55% (102) individuals. Conclusion: The QS Nd:Yag laser is a safe and efficient method for tattoo removal, presenting a great degree of satisfaction and few adverse effects. Commercial support: None identified.
MAY 2014
P7629
Pixel radiofrequency with microplasma technology: Fractional ablative radiofrequency for the treatment of acne scars Michael Gold, MD, Tennessee Clinical Research Center, Nashville, TN, United States
Studying the intense pulsed light method along with corticosteroid injection in treating keloid scars Simin Shamsi Meymandi, MD, Department of Dermatology, Kerman Leishmaniasis Research center, Kerman University of Medical Sciences, Kerman, Iran; Ali Ekhlasi, MD, Department of Dermatology, Kerman Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran; Azadeh Rezazadeh, MD, Department of Dermatology, Kerman Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
Background: Microplasma is a novel radiofrequency (RF) technology that generates a path of current from a tiny metal electrode to the surface of the biologic tissue, forming a plasma gas-discharge, causing microscopic fractional skin perforationablation event. Objective: To assess the safety and efficacy of a fractional ablative microplasma RF device in the treatment of acne scars. Study: Six subjects with documented mild to moderate atrophic acne scars were enrolled in the study. Acne scar clinical grading scale (ECCA) was used; the average score being 162.5. Fitzpatrick skin type distribution among the 6 subjects was 4 type II, 1 type V, and 1 type VI. Each subject received a single treatment with the (Pixel RF, Alma Lasers Inc) a fractional RF that deploys multiple pin electrodes on a handheld roller. Before treatment, subjects received topical anesthetic and were spot tested (30 minute postevaluation.) Subjects received 4 to 5 passes during treatment at an energy level ranging from 40 to 60 watts. Treatment areas were limited to the forehead and cheek areas of the subjects. Subjects were evaluated at 1, 5, 30, and 90 days posttreatment. Improvement was assessed by the investigator physician based on visual appearance rated on a 1 to 4 improvement scale: -1 (exacerbation), 0 (no change), 1 (1-25% improvement), 2 (25-50% improvement), 3 (50-75% improvement), and 4 (75-99% improvement). Results: Day 1: 1 subject was observed with an improvement rating of 1; 5 subjects showed no change (0 rating). Day 5: 2 subjects were observed with an improvement rating of 2; 3 subjects rated 1; 1 subject rated 0. Day 30: 1 subject was observed with an improvement rating of 3; 1 subject rated 2; 3 subjects rated 1 and 1 subject (subject 3) was not indicated. Day 90: 2 subjects were observed with an improvement rating of 3; 2 subjects rated 2; 2 subjects rated 1. Only 1 subject experienced a possible study related adverse affect; moderate worsening of facial acne that was subsequently resolved with medication. The ECCA scoring at the 90day follow-up ranged from a low of 65 to a high of 130; with an average score of 95. Conclusion: The pixel RF with microplasma technology, intended for skin ablation and perforation, is a safe and effective modality, even after a single treatment for the improvement in the appearance of acne scars.
Background: Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are annoying both physically and mentally. Objective: Because of the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars. Methods: Eighty-six subjects entered this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 nm filter, fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and pulsed delay 10-40 ms with an interval of 3 weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, criteria determined in the study of Eroll and Vancouver scar scale were used. Results: The level of clinical improvement, color improvement, and scar height was 89.1%, 88.8%, and 89.1%, respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases, and 2 atrophy cases) after treatment with IPL was 11.6%. Moreover, the participants’ satisfaction with IPL method was 88.8%. Conclusions: This study revealed that a combined therapy (intralesional corticosteroid injection plus IPL) increased the recovery level of hypertrophic and keloid scars. It was also shown that this method had no significant side effect and patients were highly satisfied with this method. Commercial support: None identified.
Supported by Alma Lasers Inc.
P8521 Prospective pilot evaluation of a novel unipolar radiofrequency device with dermal rolling mechanism for rejuvenation of Fitzpatrick skin phototypes III to V Hema Sundaram, MD, Dermatology, Cosmetic & Laser Surgery, Rockville, MD, United States Background: Core aesthetic specialty surveys show diversification of patients seeking nonsurgical rejuvenation and development of devices to address this need. Radiofrequency (RF) devices can be used safely and effectively in pigmented skin because of their lack of chromophore specificity and relative epidermal sparing. This pilot evaluation investigated efficacy, tolerability, and safety of a novel fractional ablative RF device. Design: Twelve healthy patients with Fitzpatrick skin types III to V were evaluated prospectively after appropriate washout periods for laser/light, fillers, toxins, chemical peels, surgery etc. Pretreatment assessment included 5-point scoring for fine lines and wrinkles, skin tightness, pore prominence, and skin color/tone, and standardized digital 3D imaging. Patients received 3 treatments at 3 to 4 weekly intervals with a unipolar fractional ablative RF roller device at 40.68 MHz and up to 80W, comprising 6 cogs with 50 microelectrodes on each cog. When rolled over the skin, they produce multiple microablative thermal conduits across the dermoepidermal junction. Full-face treatment was performed with 2 perpendicular passes. Evaluations at 1 week and 3 to 4 weeks after each treatment included 5-point scoring for fine lines and wrinkles, skin tightness, pore prominence, and skin color/tone; scoring on the validated Global Aesthetic Improvement Scale (GAIS); and standardized 3D imaging. Tolerability evaluation included assessment of posttreatment erythema. After 3 treatments, the same evaluations occurred during 2 followup visits at 3 to 4 weekly intervals. Patient questionnaires evaluated perception of improvement in the specific parameters and satisfaction with treatment. Results: All patients had significant improvement, with skin tightness, brightness, and color/tone most improved and fine lines and rhytids markedly improved for those patients who had them at baseline. All patients scored 1 (improved) or greater on the GAIS, and reported themselves satisfied or very satisfied. Treatment was well tolerated and there were no significant adverse events. Conclusion: Fractional ablative unipolar RF roller technology was found to be safe, efficacious, and well tolerated for pigmented skin. Larger, controlled studies would increase the evidence level. Pilot evaluation suggests comparable results, but decreased discomfort and shorter recovery than with conventional fractionated lasers. Extended evaluation to assess longevity of results is in process. The clinical evaluation was partially supported by an equipment and research grant from Alma Lasers.
AB200
J AM ACAD DERMATOL
P8162 Tattoo removal using QS Nd:Yag laser Gina Silva, MD, Leger Clinic, Porto Alegre, Brazil; Honorio Menezes, Leger Clinic, Porto Alegre, Brazil; Larissa Donini, Leger Clinic, Porto Alegre, Brazil; Michelle Gonc¸alves, Leger Clinic, Porto Alegre, Brazil; Nivea Chacur, MD, Leger Clinic, Porto Alegre, Brazil; Raphaela Ramos, Leger Clinic, Porto Alegre, Brazil; Roberto Chacur, MD, Leger Clinic, Porto Alegre, Brazil Introduction: Both dermabrasion and surgery are techniques that have been used for tattoo removal. Nowadays we have been using laser for that purpose. Objective: The objective of this study is to evaluate the removal of tattoos using the QS Nd:Yag laser. Methods: This is a retrospective study involving patients treated with QS Nd:Yag laser. The data have been collected from patients’ medical records and pictures, telephone contact, or e-mail. The statistical analysis was performed through the analysis of distribution, multivariate regression, and logistic regression. Results: We have evaluated 304 patients with an average age of 29.8 years old (6 7.86), having 297 (97.69%) been classified as white (phototypes I, II, and III), from which 270 (88.81%) were analyzed as professional tattoos. The oldest tattoo was 360 months and the most recent was 1 month, reaching an average of 64.56 months (6 63.54). The average size of the tattoos was 12.92 cm, with black as the predominant color, present in 291 (86.51%) tattoos. The average number of sessions per patient was 3.77 (6 2.99), with an interval of 49.23 days between sessions. Therefore, it has been observed by the therapist that 52.96% of tattoos had been partially removed, 21.38% had not been removed, 86.51% presented normal scar healing, 8.55%, hypertrophic scar healing, and 3.29% presented cheloid. Out of the 304 patients, 26.64% (81) reported satisfaction with the results, 58.88% (179) were partially satisfied. Hypochromia was present in 33.55% (102) individuals. Conclusion: The QS Nd:Yag laser is a safe and efficient method for tattoo removal, presenting a great degree of satisfaction and few adverse effects. Commercial support: None identified.
MAY 2014