We used a 1450 laser in our clinic for improvement of under
eye laxity and can report the significant amount of pain associated
with this wavelength based on our experience. The 4 mm
spot size that was used with the reported1450 laser is also much
larger than average 1-3 mm size of SH and would unnecessarily
treat the normal surrounding tissue.
CONCLUSION
There are several different laser modalities that can be utilized
to address the SH. Depending on the physician’s expertise with
lasers, satisfactory results can be achieved. However, Er:YAG
provides the best cosmetic outcome for the patients. The laser
non-specifically vaporizes the entire SH tissue and hence the lesion
would be completely removed in one session which can
significantly reduce the cost to the patient. The experienced
physician should inform the patient with regards to potential adverse
effects of the treatment and obtain proper consent form.
DISCLOSURES
Dr. Liu and Dr. Sotoodian have no conflicts of interest or funding
sources to declare. Dr. Taylor is a spokesman for Fotona Lasers
and has received discounted equipment from Fotona.
REFERENCES
1. Eisen DB, Michael DJ. Sebaceous lesions and their associated syndromes: part I. J Am Acad Dermatol. 2009;61(4):549-560; quiz 561-542.
2. Iacobelli J, Harvey NT, Wood BA. Sebaceous lesions of the skin. Pathology. 2017;49(7):688-697.
3. Burton CS, Sawchuk WS. Premature sebaceous gland hyperplasia: successful treatment with isotretinoin. J Am Acad Dermatol. 1985;12(1 Pt 2):182-184.
4. Bader RS, Scarborough DA. Surgical pearl: intralesional electrodesiccation of sebaceous hyperplasia. J Am Acad Dermatol. 2000;42(1 Pt 1):127-128.
5. Atas H, Gonul M. Evaluation of the efficacy of cryosurgery in patients with sebaceous hyperplasia of the face. J Cutan Med Surg. 2017;21(3):202-206.
6. Schonermark MP, Schmidt C, Raulin C. Treatment of sebaceous gland hyperplasia with the pulsed dye laser. Lasers Surg Med. 1997;21(4):313-316.
7. Kavoussi H, Rezaei M, Azimi M, et al. Combination of CO2 laser therapy and curettage for sebaceous gland hyperplasia. Light and laser therapies for the treatment of sebaceous gland hyperplasia a review of the literature. Acta Dermatovenerol Alp Pannonica Adriat. 2019;28(1):11-14.
8. Richey DF. Aminolevulinic acid photodynamic therapy for sebaceous gland hyperplasia. Dermatol Clin. 2007;25(1):59-65.
9. Wang SP, Chang YJ, Chi CC, Wang SH, Tsai TH. Using pulsed dye laser to treat sebaceous hyperplasia: comparison of short and long pulse-duration pulsed dye laser. Dermatologica Sinica. 2017;35(3):119-123.
10. Kim SK, Do JE, Kang HY, Lee ES, Kim YC. Combination of topical 5-aminolevulinic acid-photodynamic therapy with carbon dioxide laser for sebaceous hyperplasia. J Am Acad Dermatol. 2007;56(3):523-524.
11. Aghassi D, Gonzalez E, Anderson RR, Rajadhyaksha M, Gonzalez S. Elucidating the pulsed-dye laser treatment of sebaceous hyperplasia in vivo with real-time confocal scanning laser microscopy. J Am Acad Dermatol. 2000;43(1 Pt 1):49-53.
12. No D, McClaren M, Chotzen V, Kilmer SL. Sebaceous hyperplasia treated with a 1450-nm diode laser. Derm Surg. 2004;30(3):382-384.
13. Noh S, Shin JU, Jung JY, Lee JH. A case of sebaceous hyperplasia maintained on low-dose isotretinoin after carbon dioxide laser treatment. Inter J Dermatol. 2014;53(2):e151-153.
14. Gonzalez S, White WM, Rajadhyaksha M, Anderson RR, Gonzalez E. Confocal imaging of sebaceous gland hyperplasia in vivo to assess efficacy and mechanism of pulsed dye laser treatment. Lasers Surg Med. 1999;25(1):8-12.
2. Iacobelli J, Harvey NT, Wood BA. Sebaceous lesions of the skin. Pathology. 2017;49(7):688-697.
3. Burton CS, Sawchuk WS. Premature sebaceous gland hyperplasia: successful treatment with isotretinoin. J Am Acad Dermatol. 1985;12(1 Pt 2):182-184.
4. Bader RS, Scarborough DA. Surgical pearl: intralesional electrodesiccation of sebaceous hyperplasia. J Am Acad Dermatol. 2000;42(1 Pt 1):127-128.
5. Atas H, Gonul M. Evaluation of the efficacy of cryosurgery in patients with sebaceous hyperplasia of the face. J Cutan Med Surg. 2017;21(3):202-206.
6. Schonermark MP, Schmidt C, Raulin C. Treatment of sebaceous gland hyperplasia with the pulsed dye laser. Lasers Surg Med. 1997;21(4):313-316.
7. Kavoussi H, Rezaei M, Azimi M, et al. Combination of CO2 laser therapy and curettage for sebaceous gland hyperplasia. Light and laser therapies for the treatment of sebaceous gland hyperplasia a review of the literature. Acta Dermatovenerol Alp Pannonica Adriat. 2019;28(1):11-14.
8. Richey DF. Aminolevulinic acid photodynamic therapy for sebaceous gland hyperplasia. Dermatol Clin. 2007;25(1):59-65.
9. Wang SP, Chang YJ, Chi CC, Wang SH, Tsai TH. Using pulsed dye laser to treat sebaceous hyperplasia: comparison of short and long pulse-duration pulsed dye laser. Dermatologica Sinica. 2017;35(3):119-123.
10. Kim SK, Do JE, Kang HY, Lee ES, Kim YC. Combination of topical 5-aminolevulinic acid-photodynamic therapy with carbon dioxide laser for sebaceous hyperplasia. J Am Acad Dermatol. 2007;56(3):523-524.
11. Aghassi D, Gonzalez E, Anderson RR, Rajadhyaksha M, Gonzalez S. Elucidating the pulsed-dye laser treatment of sebaceous hyperplasia in vivo with real-time confocal scanning laser microscopy. J Am Acad Dermatol. 2000;43(1 Pt 1):49-53.
12. No D, McClaren M, Chotzen V, Kilmer SL. Sebaceous hyperplasia treated with a 1450-nm diode laser. Derm Surg. 2004;30(3):382-384.
13. Noh S, Shin JU, Jung JY, Lee JH. A case of sebaceous hyperplasia maintained on low-dose isotretinoin after carbon dioxide laser treatment. Inter J Dermatol. 2014;53(2):e151-153.
14. Gonzalez S, White WM, Rajadhyaksha M, Anderson RR, Gonzalez E. Confocal imaging of sebaceous gland hyperplasia in vivo to assess efficacy and mechanism of pulsed dye laser treatment. Lasers Surg Med. 1999;25(1):8-12.
AUTHOR CORRESPONDENCE
Annie Liu MD annieliu810@gmail.com