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Usefulness of a 1,064 nm Microlens Array-type, Picoseconddominant Laser for Pigmented Scars with Improvement of Vancouver Scar Scale

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초록

Background and Objectives The picosecond 755 nm alexandrite laser was first approved by the US FDA in 2012. A previous study described the use of a 1,064 nm picosecond laser with a micro-lens array (MLA) in peri-areolar scarring from breast reconstruction surgery and reported significant improvement in the texture and aesthetic appearance of the scar without other wound complications. The purpose of this study was to evaluate the improvement of overall scarring, not just pigmentation, in the picosecond laser treatment of patients with pigmentations. Materials and Methods Sixteen patients who underwent 1,064 nm picosecond laser treatment from June 2016 to December 2018 were enrolled in this study. Patients received two to six sessions of picosecond laser treatment at intervals of 4 weeks. Before and after the laser treatment, the patients evaluated their own satisfaction score and a physician evaluated the Vancouver Scar Scale. To evaluate the satisfaction score and complication rate, a retrospective chart review was done. Results Seven were female and nine were male. The mean of the patients’ satisfaction score before the treatment was 1.44 (interquartile range [IQR], 1-2) and 3.00 (IQR 2.25-3.75) six months after treatment. The mean of the Vancouver Scar Scale before the treatment was 9.69 (IQR 8-11), and 6.25 (IQR 5-7.75) six months after treatment. All the results were statistically significant (p<0.01). Conclusion This study provides evidence that the use of a 1,064 nm picosecond laser treatment for pigmented scars can be effective in improving the pigmentation and overall scar status, including vascularity, height, and pliability, with the results of a decrease in the VSS scores between treatments.

Abstract

Background and Objectives The picosecond 755 nm alexandrite laser was first approved by the US FDA in 2012. A previous study described the use of a 1,064 nm picosecond laser with a micro-lens array (MLA) in peri-areolar scarring from breast reconstruction surgery and reported significant improvement in the texture and aesthetic appearance of the scar without other wound complications. The purpose of this study was to evaluate the improvement of overall scarring, not just pigmentation, in the picosecond laser treatment of patients with pigmentations. Materials and Methods Sixteen patients who underwent 1,064 nm picosecond laser treatment from June 2016 to December 2018 were enrolled in this study. Patients received two to six sessions of picosecond laser treatment at intervals of 4 weeks. Before and after the laser treatment, the patients evaluated their own satisfaction score and a physician evaluated the Vancouver Scar Scale. To evaluate the satisfaction score and complication rate, a retrospective chart review was done. Results Seven were female and nine were male. The mean of the patients’ satisfaction score before the treatment was 1.44 (interquartile range [IQR], 1-2) and 3.00 (IQR 2.25-3.75) six months after treatment. The mean of the Vancouver Scar Scale before the treatment was 9.69 (IQR 8-11), and 6.25 (IQR 5-7.75) six months after treatment. All the results were statistically significant (p<0.01). Conclusion This study provides evidence that the use of a 1,064 nm picosecond laser treatment for pigmented scars can be effective in improving the pigmentation and overall scar status, including vascularity, height, and pliability, with the results of a decrease in the VSS scores between treatments.

참고문헌 (11)

  1. Jakus J, "Picosecond lasers: a new and emerging therapy for skin of color, minocycline-induced pigmentation, and tattoo removal", J Clin Aesthet Dermatol, 10, pp.14~15 (2017)
  2. Khetarpal S, "Picosecond laser with specialized optic for facial rejuvenation using a compressed treatment interval", Lasers Surg Med, 48, pp.723~726 (2016)
  3. Yeansu Choi, "Subsurface Fractional Ablative Resurfacing of a Periareolar Scar Using 1,064-nm Picosecond Laser with Micro-Lens Array", Archives of Aesthetic Plastic Surgery, 24(1), pp.36~38 (2018), 대한미용성형외과학회[DOI]
  4. Torbeck RL, "Evolution of the picosecond laser: a review of literature", Dermatol Surg, 45, pp.183~194 (2019)
  5. Brauer JA, "Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring", JAMA Dermatol, 151, pp.278~284 (2015)
  6. Tanghetti EA, "The histology of skin treated with a picosecond alexandrite laser and a fractional lens array", Lasers Surg Med, 48, pp.646~652 (2016)
  7. Sullivan T, "Rating the burn scar", J Burn Care Rehabil, 11, pp.256~260 (1990)
  8. Thompson CM, "What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burncare providers", Burns, 41, pp.1442~1448 (2015)
  9. Nguyen TA, "A review of scar assessment scales", Semin Cutan Med Surg, 34, pp.28~36 (2015)
  10. 홍수정, "Effects of Minimizing Scar Formation by Early Fractional CO2 Laser Resurfacing", Archives of Aesthetic Plastic Surgery, 20(2), pp.109~113 (2014), 대한미용성형외과학회
  11. 조성은, "Local Flap Surgical Scar Management Caused by Skin Cancer Using Fractional CO2 Laser Treatment", Archives of Aesthetic Plastic Surgery, 21(1), pp.18~22 (2015), 대한미용성형외과학회

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