The American Society for Laser Medicine and Surgery (ASLMS) recently wrapped its 43rd Annual Conference on Energy-based Medicine and Science in Baltimore (ASLMS 2024), where leading practitioners and researchers gathered to share groundbreaking advancements and insights in the field of laser medicine and energy-based therapies. This conference provided a platform for fostering collaboration and pushing the boundaries of innovation in medical laser applications, while showcasing the latest in cutting-edge clinical research and laser technologies. Here, Practical Dermatology® highlights some of the most interesting research from the meeting.
Cryomodulation May Curb Acne Inflammation
Cryomodulation was associated with significant inflammation reduction in patients with acne vulgaris, based on data from a new pilot study presented at ASLMS 2024.
Previous research has shown the role of inflammation at all stages of acne lesion development. Cryomodulation has been associated with reduced skin inflammation, but its effect on acne vulgaris has not been well studied. To this end, Bruce E. Katz, MD, of the Icahn School of Medicine at Mount Sinai, New York, and colleagues, conducted a study to assess the efficacy of the technique in patients with acne vulgaris. in an abstract presented at the annual conference of the American Society for Laser Medicine and Surgery. The researchers conducted a pilot study of 14 adults with acne vulgaris. The participants ranged in age from range 19 to 62 years, and included Fitzpatrick skin types I to V.
All participants underwent five treatment sessions at 2-week intervals; each session consisted of 20 minutes of controlled cooling for facial acne, the researchers wrote. Efficacy was assessed using standardized grading scales; digital photography and acne lesion counts were performed at baseline and at 1, 2, and 3 months after the final session.
Based on physician ratings, 91.7%, 90.9%, and 100% of patients had a reduction in acne severity at 1, 2, and 3 months, respectively, after their final treatment. Acne lesion counts decreased in 100%, 91.7%, and 90.9% of the patients at 1-, 2-, and 3-months’ follow-up, respectively.
“Subjective feedback collected from study patients included reports of reduced redness, reduced papules and pustules, and less frequent acne break outs,” the researchers wrote.
The study team also assess patient pain, adverse events, and treatment satisfaction. None of the participants reported any treatment-related adverse events or side effects at follow-up, and patients rated their pain with scores of 0 on a scale of 0 to 10. Most (91%) said they would undergo the procedure again and would recommend it to others.
“These findings support the use of cryomodulation for the reduction of inflammation in patients with acne vulgaris,” the authors wrote. “Cosmetic benefits and reductions in acne severity were achieved in a simple, comfortable procedure with no treatment side effects. Further clinical research is necessary to clarify optimal patient selection and treatment parameters, and to establish treatment durability.”
Source: Katz BE et al. Pilot Clinical Evaluation of the Safety and Efficacy of Cryomodulation for Treatment of Patients with Acne. Presented at: American Society for Laser Medicine and Surgery 43rd Annual Conference on Energy-based Medicine and Science. April 11-14, 2024; Baltimore.
Study: Potential for Combined Laser Treating Vascular and Pigmented Lesions
A novel laser with cryogen cooling long-pulsed options of both 532nm and 1,064nm offers laser surgeons a safe and effective way to treat vascular and pigmented lesions with a single device and significantly different clinical endpoints, according to new research presented at ASLMS 2024.
The researchers evaluated one-year data from use of a combination laser in more than 200 patients at four centers for overall skin rejuvenation and treatment of vascular and pigmented lesions. At the 532nm wavelength, the device had beam diameter, pulse width, and cooling similar to the 595nm pulsed dye laser, the researchers said. For deeper and larger venous targets, the long pulse 1,064nm laser may be used with suggested presets or changed based on the size and depth of vessels, as well as vascular response, they noted.
Longer pulse durations and larger beam diameters yielded more effective penetration. In some cases, treated areas showed a blue grey color that disappeared after several seconds; in other cases, intravascular coagulation occurred and either persisted in place or shifted in a way similar to that observed with pulsed dye laser, the researchers said. Swelling was more common after use of shorter pulse durations (5ms). However, pulse durations of 10 ms were associated with improvement of port wine birthmarks and rosacea and minimal purpura, the researchers said.
Immediate darkening and slight scaling were the clinical endpoints for the treatment of pigmented lesions. Pre-cooling is essential when treating vessels, but lentigenes and flat seborrheic keratoses require significant post-cooling, the researchers explained.
Clinical endpoints for treatment of pigmented lesions were immediate darkening and slight scaling. Since the target is very superficial for lentigines, lower fluences with shorter pulse durations (sub-milli or sub-micro) are recommended. Pre-cooling is essential to protect the epidermis when treating vessels. By contrast, lentigenes and flat seborrheic keratoses require no pre-cooling but significant post-cooling. Flat seborrheic keratoses require more heat than lentigines and longer pulse durations can be employed.
The researchers concluded that the combination device is an effective option for both vascular and pigmented lesions when providers treat to appropriate clinical endpoints, with minimal side effects.
Source: Golbari NM, et al. Targeting Clinical Endpoints for the Successful Treatment of Vascular and Pigmented Lesions with a Novel Long-pulsed Dual Wavelength 532nm and 1,064nm. Presented at: American Society for Laser Medicine and Surgery 43rd Annual Conference on Energy-based Medicine and Science. April 11-14, 2024; Baltimore.
Mechanical Micro-Coring Shows Promise for Neck Treatment
Mechanical dermal micro-coring is a safe and effective option for improving skin laxity, texture, and wrinkles on the neck, based on new data appearing at ASLMS 2024.
While mechanical dermal micro-coring is approved by the U.S. Food & Drug Administration (FDA) for treatment of moderate-to-sever wrinkles on the midface and lower face, its use in the neck area has not been studied, according to an abstract presented by Mary Beth Mudd, MD, of New You Center for Advanced Medical Aesthetics in Columbus, Ohio, at the meeting.
The study researchers conducted the off-label study to assess the effects of a single treatment with micro-coring technology (MCT) on skin laxity, texture, and wrinkles in tissues of the neck. Two independent reviewers assessed the results based on 3 months of standardized follow-up photos; patient experience, safety, and down time also were assessed. All study participants were women, with a mean age of 64 years, and most were Fitzpatrick Skin Type II or III (two patients were FST IV). Each patient received one neck treatment with 5% density, and two were partially treated with 7% density.
Overall, 77% of patients saw mild or moderate improvement in skin texture, 18% saw no improvement, and one patient had an excellent result, according to the abstract. Approximately two-thirds (65%) of patients saw mild or moderate improvement in skin laxity, and 35% saw no improvement. Similarly, 72% of patients saw mild or moderate improvement in neck wrinkles/necklace lines, while 29% saw no improvement. Neck MCT was more difficult to perform than facial MCT, in part because of the more challenging neck anatomy, according to the researchers. However, the treated neck areas seemed to heal more quickly than treated facial areas, she said.
Patient satisfaction was high, and a majority said they would consider a second treatment. The perceived visual and photographic improvement following MCT correlated to pre-procedural skin laxity and textural irregularities.
“While MCT is FDA-approved for use on the mid and lower face, this study shows MCT can be used safely and effectively on the neck to improve skin laxity, texture, and wrinkles,” they team concluded in their abstract. “Further study is needed to determine the optimal number of treatments for best results and to determine which patients are ideal candidates for this minimally invasive procedure as opposed to surgical referral to achieve best results. It will also be interesting whether MCT should be used alone or in combination with energy-based treatments to achieve more dramatic results in patients with more clinically significant laxity and textural concerns.”
The findings were limited by the open-label design and small sample size, and more research is needed to determine the optimal number of treatments for best results and to identify the patients most likely to benefit as an alternative to surgical referral.
Source: Mudd M, et al. Evaluation of a Single Treatment of Mechanical Dermal Micro-coring for Skin Laxity, Texture, and Wrinkles of the Neck. Presented at: American Society for Laser Medicine and Surgery 43rd Annual Conference on Energy-based Medicine and Science. April 11-14, 2024; Baltimore.