Download PDF
Facial Plast Surg 2019; 35(03): 248-255
DOI: 10.1055/s-0039-1688846
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diode Laser and Fractional Laser Innovations

Kaete A. Archer
1   Private Practice, Aesthetic Institute of Manhattan for Facial and Plastic Surgery, New York, New York
,
Paul Carniol
2   Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Summit, New Jersey
› Author Affiliations
Further Information

Publication History

Publication Date:
12 June 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Laser technology continues to increase in popularity and expand treatment options for patients with common but challenging skin conditions including facial telangiectasias, facial aging, striae distensae, and acne scars. Facial telangiectasias have been estimated to occur in tens of millions of people worldwide. The 585-nm laser was the first to follow the principle of selective photothermolysis for the treatment of cutaneous vascular lesions, but it caused significant postoperative purpura. Newer diode lasers target superficial and deep telangiectasias without the side effects of the 585-nm laser. Ablative resurfacing was introduced in the 1990s with the carbon dioxide laser to address facial rhytids and photoaging. While effective, the risks and downtime were significant. The newest fractionated nonablative lasers are demonstrating impressive results, with decreased risks and downtime. This new generation of lasers is being used extensively and in unique combinations for facial aging, striae, and acne scars.

Keywords

diode laser - fractionated laser - acne scar - striae - scar
 

  • References

  • 1 Silver BE, Livshots YL. Preliminary experience with the KTP/532nm laser in the treatment of facial telangiectasia. Cosmet Dermatol 1997; 9: 61-64
    PubMedSearch in Google Scholar
  • 2 Goldberg DJ, Meine JG. A comparison of four frequency-doubled Nd:YAG (532 nm) laser systems for treatment of facial telangiectases. Dermatol Surg 1999; 25 (06) 463-467
    CrossrefPubMedSearch in Google Scholar
  • 3 Goldman MP, Bennett RG. Treatment of telangiectasia: a review. J Am Acad Dermatol 1987; 17 (2 Pt 1): 167-182
    CrossrefPubMedSearch in Google Scholar
  • 4 Goldman MP, Weiss RA, Brody HJ, Coleman III WP, Fitzpatrick RE. Treatment of facial telangiectasia with sclerotherapy, laser surgery, and/or electrodesiccation: a review. J Dermatol Surg Oncol 1993; 19 (10) 899-906 , quiz 909–910
    CrossrefPubMedSearch in Google Scholar
  • 5 Tretti Clementoni M, Lavagno R. A novel 1565 nm non-ablative fractional device for stretch marks: a preliminary report. J Cosmet Laser Ther 2015; 17 (03) 148-155
    CrossrefPubMedSearch in Google Scholar
  • 6 Majid I, Imran S. Fractional CO2 laser resurfacing as monotherapy in the treatment of atrophic facial acne scars. J Cutan Aesthet Surg 2014; 7 (02) 87-92
    CrossrefPubMedSearch in Google Scholar
  • 7 Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983; 220 (4596): 524-527
    CrossrefPubMedSearch in Google Scholar
  • 8 Niamtu J. Clinical applications of the 532-nm diode laser for the treatment of facial telangiectasia and pigmented lesions: literature review, history, and discussion of clinical experience. Am J Cosmet Surg 2001; 18 (02) 71-81
    CrossrefPubMedSearch in Google Scholar
  • 9 Anderson RR, Parrish JA. Microvasculature can be selectively damaged using dye lasers: a basic theory and experimental evidence in human skin. Lasers Surg Med 1981; 1 (03) 263-276
    CrossrefPubMedSearch in Google Scholar
  • 10 Tierney E, Hanke CW. Randomized controlled trial: comparative efficacy for the treatment of facial telangiectasias with 532 nm versus 940 nm diode laser. Lasers Surg Med 2009; 41 (08) 555-562
    CrossrefPubMedSearch in Google Scholar
  • 11 Cassuto DA, Ancona DM, Emanuelli G. Treatment of facial telangiectasias with a diode-pumped Nd:YAG laser at 532 nm. J Cutan Laser Ther 2000; 2 (03) 141-146
    CrossrefPubMedSearch in Google Scholar
  • 12 Carniol PJ, Farley S, Friedman A. Long-pulse 532-nm diode laser for nonablative facial skin rejuvenation. Arch Facial Plast Surg 2003; 5 (06) 511-513
    CrossrefPubMedSearch in Google Scholar
  • 13 Sadick NS. Nonablative Skin Rejuvenation. Paper presented at the Laser Meeting of the American Academy of Cosmetic Surgery; February 3, 2002 , Fort Lauderdale, FL
    PubMedSearch in Google Scholar
  • 14 Clark C, Cameron H, Moseley H, Ferguson J, Ibbotson SH. Treatment of superficial cutaneous vascular lesions: experience with the KTP 532 nm laser. Lasers Med Sci 2004; 19 (01) 1-5
    PubMedSearch in Google Scholar
  • 15 Carniol PJ, Price J, Olive A. Treatment of telangiectasias with the 532-nm and the 532/940-nm diode laser. Facial Plast Surg 2005; 21 (02) 117-119
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Alster TS, Tanzi EL, Lazarus M. The use of fractional laser photothermolysis for the treatment of atrophic scars. Dermatol Surg 2007; 33 (03) 295-299
    PubMedSearch in Google Scholar
  • 17 Bak H, Kim BJ, Lee WJ. , et al. Treatment of striae distensae with fractional photothermolysis. Dermatol Surg 2009; 35 (08) 1215-1220
    CrossrefPubMedSearch in Google Scholar
  • 18 Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004; 34 (05) 426-438
    CrossrefPubMedSearch in Google Scholar
  • 19 Laubach HJ, Tannous Z, Anderson RR, Manstein D. Skin responses to fractional photothermolysis. Lasers Surg Med 2006; 38 (02) 142-149
    CrossrefPubMedSearch in Google Scholar
  • 20 Geronemus RG. Fractional photothermolysis: current and future applications. Lasers Surg Med 2006; 38 (03) 169-176
    CrossrefPubMedSearch in Google Scholar
  • 21 Rostan EF. Laser treatment of photodamaged skin. Facial Plast Surg 2005; 21 (02) 99-109
    Thieme ConnectPubMedSearch in Google Scholar
  • 22 Glaich AS, Rahman Z, Goldberg LH, Friedman PM. Fractional resurfacing for the treatment of hypopigmented scars: a pilot study. Dermatol Surg 2007; 33 (03) 289-294 , discussion 293–294
    PubMedSearch in Google Scholar
  • 23 Hu S, Chen MC, Lee MC, Yang LC, Keoprasom N. Fractional resurfacing for the treatment of atrophic facial acne scars in asian skin. Dermatol Surg 2009; 35 (05) 826-832
    CrossrefPubMedSearch in Google Scholar
  • 24 Rokhsar CK, Fitzpatrick RE. The treatment of melasma with fractional photothermolysis: a pilot study. Dermatol Surg 2005; 31 (12) 1645-1650
    PubMedSearch in Google Scholar
  • 25 Tannous ZS, Astner S. Utilizing fractional resurfacing in the treatment of therapy-resistant melasma. J Cosmet Laser Ther 2005; 7 (01) 39-43
    CrossrefPubMedSearch in Google Scholar
  • 26 Wanner M, Tanzi EL, Alster TS. Fractional photothermolysis: treatment of facial and nonfacial cutaneous photodamage with a 1,550-nm erbium-doped fiber laser. Dermatol Surg 2007; 33 (01) 23-28
    PubMedSearch in Google Scholar
  • 27 Haedersdal M, Moreau KE, Beyer DM, Nymann P, Alsbjørn B. Fractional nonablative 1540 nm laser resurfacing for thermal burn scars: a randomized controlled trial. Lasers Surg Med 2009; 41 (03) 189-195
    CrossrefPubMedSearch in Google Scholar
  • 28 Vasily DB, Cerino ME, Ziselman EM, Zeina ST. Non-ablative fractional resurfacing of surgical and post-traumatic scars. J Drugs Dermatol 2009; 8 (11) 998-1005
    PubMedSearch in Google Scholar
  • 29 Quarato D, Pascali M, Carinci F. Traumatic and surgical scars: successful treatment with a 1,565nm erbium-glass NAFL combined with IPL. J Biol Regul Homeost Agents 2018; 32 (02) (Suppl. 01) 159-165
    PubMedSearch in Google Scholar
  • 30 Manstein D, Zurakowski D, Thongsima S, Laubach H, Chan HH. The effects of multiple passes on the epidermal thermal damage pattern in nonablative fractional resurfacing. Lasers Surg Med 2009; 41 (02) 149-153
    CrossrefPubMedSearch in Google Scholar
  • 31 Kim BJ, Lee DH, Kim MN. , et al. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol 2008; 9 (01) 33-37
    CrossrefPubMedSearch in Google Scholar
  • 32 Stotland M, Chapas AM, Brightman L. , et al. The safety and efficacy of fractional photothermolysis for the correction of striae distensae. J Drugs Dermatol 2008; 7 (09) 857-861
    PubMedSearch in Google Scholar
  • 33 Yang YJ, Lee GY. Ga-Young Lee. Treatment of striae distensae with nonablataive fractional laser versus ablative CO2 fractional laser: a randomized controlled trial. Ann Dermatol 2011; 23 (04) 481-489
    CrossrefPubMedSearch in Google Scholar
  • 34 Malekzad F, Shakoei S, Ayatollahi A, Hejazi S. The safety and efficacy of the 1540nm non-ablative fractional XD probe of star lux 500 device in the treatment of striae alba: before-after study. J Lasers Med Sci 2014; 5 (04) 194-198
    PubMedSearch in Google Scholar
  • 35 de Angelis F, Kolesnikova L, Renato F, Liguori G. Fractional nonablative 1540-nm laser treatment of striae distensae in Fitzpatrick skin types II to IV: clinical and histological results. Aesthet Surg J 2011; 31 (04) 411-419
    CrossrefPubMedSearch in Google Scholar
  • 36 Hedelund L, Moreau KE, Beyer DM, Nymann P, Haedersdal M. Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation. Lasers Med Sci 2010; 25 (05) 749-754
    CrossrefPubMedSearch in Google Scholar
  • 37 Sachdeva S. Nonablative fractional laser resurfacing in Asian skin--a review. J Cosmet Dermatol 2010; 9 (04) 307-312
    CrossrefPubMedSearch in Google Scholar
  • 38 Hui Q, Chang P, Guo B, Zhang Y, Tao K. The clinical efficacy of autologous platelet-rich plasma combined with ultra-pulsed fractional CO2 laser therapy for facial rejuvenation. Rejuvenation Res 2017; 20 (01) 25-31
    CrossrefPubMedSearch in Google Scholar
  • 39 Kar BR, Raj C. Fractional CO2 laser vs fractional CO2 with topical platelet-rich plasma in the treatment of acne scars: a split-face comparison trial. J Cutan Aesthet Surg 2017; 10 (03) 136-144
    CrossrefPubMedSearch in Google Scholar
  • 40 Bailey JK, Blackstone BN, DeBruler DM. , et al. Effects of early combinatorial treatment of autologous split-thickness skin grafts in red duroc pig model using pulsed dye laser and fractional CO2 laser. Lasers Surg Med 2018; 50 (01) 78-87
    CrossrefPubMedSearch in Google Scholar
  • 41 Chen KH, Tam KW, Chen IF. , et al. A systematic review of comparative studies of CO2 and erbium:YAG lasers in resurfacing facial rhytides (wrinkles). J Cosmet Laser Ther 2017; 19 (04) 199-204
    CrossrefPubMedSearch in Google Scholar
  • 42 Toyos MM. Continuous wave fractional CO2 laser for the treatment of upper eyelid dermatochalasis and periorbital rejuvenation. Photomed Laser Surg 2017; 35 (05) 278-281
    CrossrefPubMedSearch in Google Scholar
  • 43 Ayyash MH. Eyebrows lifting using fractional CO2 laser. Int J Adv Res Biol Sci 2018; 5 (04) 218-225
    PubMedSearch in Google Scholar