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Lentigines Treatment with a 730 nm Picosecond Laser

A prospective, IRB-approved study published in the journal Lasers in Surgery and Medicine investigated the safety and efficacy of the 730nm picosecond-domain laser for the clearance of lentigines, as well as the effect of the short picosecond pulses on the tissue's histological appearance after treatment.

In the trial, there were 20 patients with Fitzpatrick skin types II-IV who were enrolled, and they each received four treatments with the laser. Photos were taken before and after treatment, and they were evaluated by blinded reviewers at 4- and 12-week follow-up visits using a 5-point clearance scale. Patient satisfaction was also assessed using a 5-point scale at each visit. At the 4- and 12-week follow-ups, an investigator Global Improvement Score (IGIS) was calculated using an 11-point clearance scale, and the results were compared. It was determined how much pain the patient was experiencing on a scale from 0 to 10, and the histology of picosecond and nanosecond pulses at 730 and 532 nm was compared to 755 and 532 nm nanosecond pulses.

There were a total of 20 patients who were enrolled; 16 of them completed all of the study visits. The patients had an average age of 63 years and were divided into two groups: 75 percent were female and 25 percent were male. They had a total of 118 treatment areas, each of which contained 1 to 20 lesions, and 30 body regions were studied (arms (6), hands (16), scalp (1), forehead (2), face (3), back (2), and legs (2)). Spot sizes ranging from 2 to 5 mm in diameter were used, with fluences ranging from 0.8 to 4.0 J/cm2 being used in the experiments.

The mean pain score for each of the four treatments that the patients received was 3.6 out of 10 on a 10-point scale. As a result, 99 percent of randomly paired 4-week posttreatment images and 100 percent of randomly paired 12-week posttreatment images were correctly identified when the photos of the treated skin were assessed by the blind investigators.

The mean IGIS scores were 6.7 at the 4-week follow-up and 7.0 at the 12-week follow-up visits, with 76 percent and 73 percent of patients, respectively, indicating that they were satisfied to extremely satisfied with their treatment outcomes. At the time of the follow-up visits, the mean clearance score for the 118 treatment areas was 3 out of 4. According to the results of the 12-week follow-up study, 36 percent of 118 treatment areas had a clearance score of 4, and 38 percent had a clearance score of 3. By the study's authors, the adverse events (AEs) that participants experienced were considered typical, and included erythema, edema, dryness, crusting, and itching.

Histology revealed diffuse epidermal vacuolization in the joining of vacuoles (20–100 m in diameter), junctional clefting, and mild extravasation of erythrocytes with 730 nm picosecond pulses, according to the study authors, while diffuse epidermal vacuolization was observed in the joining of vacuoles (20–100 m), junctional clefting, and mild extravasation of ery

In the study, the authors found that 532 nm picosecond pulses caused diffuse and focal epidermal vacuolization, as well as larger dermal vacuoles to depths of 500 nm, while 532 nm nanosecond pulses caused diffuse epidermal vacuolization with coalescence of vacuoles and significant dermal hemorrhage.

According to the findings of the study, the use of a 730 nm picosecond-domain laser for the clearance of lentigines has demonstrated potential for treatment, with good clearance, safety, and patient satisfaction in patients with skin types II-III. According to the study's authors, the histology revealed that the laser produces excellent selectively for pigment with minimal disruption of the dermal-epidermal junction and that it may shorten healing times or adverse events.

According to the study's authors, additional research into darker skin tones is needed.

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