40 patients, a mean of 37 patients self-reported side effects on day 1 posttreatment, including redness (mean percentage of patients over 6 treatments, laser: 89%; laser + serum: 84%), edema (laser: 67%; laser + serum: 63%), and heat sensation (laser: 56%; laser + serum: 63%), which were scored as mild to moderate in intensity. Mean duration of these 3 side effects was shorter with the 1927 nm wavelength handpiece + serum versus the 1927 nm wavelength handpiece alone (5 days vs 7 days, respectively). Mean pain score across 6 treatments was 3.9 ± 0.2. On average, patients in both treatment groups reported being “satisfied†or “very satisfied†at each of the 3 follow-up visits (average score, 4.4), supporting ongoing patient satisfaction through 12 weeks posttreatment.
Pigmentary skin changes on cheeks are a predominant feature of aging skin in individuals of East Asian descent.23 Treatment with the 1440 nm wavelength handpiece of the NFDL system has been shown to be safe and to improve photodamaged skin in an Asian population.15 Ten Asian patients with Fitzpatrick skin type III–V received 4 treatments over the face at 2-week intervals with the highest tolerable energy level (8 passes; 4, 7, or 9 mJ/pulse). Two clinicians independently assessed digital images using an 11-point scale (0 = absent; 10 = severe) for each parameter (ie, skin roughness, wrinkles, dyspigmentation, pore size, skin laxity). Significant improvements from baseline were observed for skin roughness (P=0.006), wrinkles (P=0.046), and dyspigmentation (P=0.01) at 4 weeks posttreatment; no significant improvements from baseline were observed for pore size and skin laxity. Four of the 10 patients reported being satisfied with the treatment. After the final treatment session, most of the 10 patients reported mild to moderate treatment-related erythema (n=9), edema (n=10), and pain (n=9). One patient developed transient PIH that resolved by the follow-up visit (4 weeks posttreatment).
Dyschromia
The 1927 nm wavelength handpiece of the NFDL system has demonstrated efficacy in facial resurfacing for photodamage, melasma, and PIH.16 In a prospective, noncomparative study, 23 women with facial photodamage, melasma, or PIH and Fitzpatrick skin type I–VI received 4 to 6 treatments with the 1927 nm wavelength handpiece over the face (≤8 passes; 5mJ/ pulse; coverage, 5%, 7.5%, or 10%) 2 weeks apart (± 3 days). Density coverage and number of passes were established by the clinician, taking into consideration skin type, clinical diagnosis, and treatment response. Women were offered a choice of topical anesthesia prior to treatment. Digital images using standardized settings and conditions were obtained at baseline, and 1 and 3 months posttreatment. Baseline and follow-up photographs were randomized, and 3 independent clinicians blindly graded digital images for facial skin appearance using a quartile scale (0 = no improvement; 4 = very significant improvement [76%–100%]). If the baseline photograph was identified as best, the score was negative. Patient satisfaction was rated at 3 months posttreatment using a 5-point scale (1 = very dissatisfied; 5 = very satisfied). After each treatment, adverse events (AEs) and side effects were reported on a 4-point scale (0 = none; 3 = marked) and pain assessment on an 11-point scale (0 = no pain; 10 = intolerable pain).
The results of this study showed mean improvement at 1 and 3 months posttreatment (range 1.8 ± 1.5 [mild to moderate] to 2.3 ± 1.5 [moderate to marked]) according to the independent clinicians’ assessment of photographs.16 In addition, 55% of women reported marked to very significant improvement in overall facial skin appearance (51%–100%) at the 1-month and 3-month posttreatment follow-up visits. At 3 months posttreatment, 85.0% of the women (17/20) were “satisfied†or “very satisfied†with treatment results. The mean pain score
