Introduction: The 2940-nm Erbium Laser has been used for years in photoaging treatment, with pulse duration of 0.25 ms. Currently, it has been widely used in fractionated mode.New pulse duration of 5 ms was introduced in an attempt to promote tissue coagulation,in addition to ablation, improving its treatment performance. Objective: To investigate the mechanism by which this laser rays act on cutaneous tissue, in its fractionated and dual pulse mode, clinically and histopathologically. Material and methods: Six female patients with marked photoaging (Fitzpatrick Classifi cation Scale, degrees III and IV) were designated to this technique. Biopsies were performed 1 week before and 2 months after treatment. Clinical and histological assessments were conducted using the following stains: hematoxylin-eosin, Verhoeff, and Masson’s trichrome. Results: There was signifi cant clinical improvement in all patients, and histology showed foci sizes compatible with the laser microbeam shot in areas where decreased solar elastosis occurred. In two cases with more signifi cant results, these areas were measured. Conclusions: Clinically, there was marked improvement in six patients treated. Focal changes were found and they were similar in size to the rays shot, while previous studies with fractionated 2940- nm Erbium showed areas of non-circumscribed neocollagenesis.

Keywords: REJUVENATION, PHOTOAGING, LASERS

Introduction: Vitiligo is an acquired idiopathic disorder characterized by hypochromic and achromic well-delimited macules.The 308 nm excimer laser can be used to treat this condition. Objective:To analyze studies published in indexed medical journals on the use of the 308 nm excimer laser in the treatment of vitiligo. Method: Adopting a qualitative approach, a survey of related articles from 2001 to 2009 was carried out using the Medline, Lilacs and Scielo databases. Results: According to the literature review, the 308 nm excimer laser achieved positive results in the treatment of vitiligo. Recent lesions and those located on the face responded better than those located elsewhere.The extremities of the body were more difficult to treat using this method.The patient’s age did not affect the outcome. On average, 11 sessions were necessary before the re-pigmentation started. Ideally, the laser application should be carried out from one to three times a week, with at least 48-hour intervals. Conclusion: The 308 nm excimer laser is effective and safe in the treatment of vitiligo when compared to other treatment modalities.The results depend on the location and the timeline of the disorder.

Keywords: VITILIGO, LASERS EXCIMER, SKIN

Introduction: Diode laser and intense pulsed light are among the most frequently used technologies for epilation.
Objective: To compare diode laser with intense pulsed light in axillary epilation.
Methods: Patients with phototypes II and III (n = 15) were subjected to 3 regular sessions of intense pulsed light (695 nm) - Quantum HR® Platform (Lumenis,Yokneam, Israel) in the right axilla and diode laser (810 nm) - Light Sheer ® (Lumenis,Yokneam, Israel) in the left axilla. The number of axillary hairs were counted before and after treatment, and patients were administered a questionnaire about adverse effects, pain and satisfaction.
Results: Both techniques provided a similar and significant reduction in hair density.The pain score and degree of inflammation were significantly higher for intense pulsed light (p < 0.01 and p = 0.03, respectively).There was a significant correlation between the fluence employed, the severity of pain, and the degree of inflammation for the two techniques (p < 0.05).The patients considered the final results to be similar, however more side effects were attributed to intense pulsed light.There was no difference in the proportion of preference between the two methods (p = 0.80).
Conclusion: The two techniques produced similar results, but the diode laser caused less pain and fewer side effects compared to intense pulsed light.

Keywords: HAIR REMOVAL, HAIR, LASERS

Introduction:The treatment of cutaneous aging with fractional non-ablative lasers has been intensely studied in the last few years, yet the number of publications describing specific equipments is limited.
Objective: To describe patient and dermatologist satisfaction after treatment with the Lux 1540®laser.
Methods: Retrospective study of patients (n=16) who have undergone facial rejuvenation therapy with Lux 1540® laser. Photographic assessments were performed by a dermatologist not involved in the treatments. Patient satisfaction was analyzed before treatment and after three sessions. The study variables were spots, sagging, wrinkles, enlarged pores, telangiectasias, and general satisfaction.
Results: In the dermatologist''''''''s evaluation, good or excellent improvement was found in the majority of the patients, for all studied variables. Regarding the improvement in the patients'''''''' general appearance, 82% were rated good or excellent. Regarding patients'''''''' opinions, 63% expressed good to excellent general satisfaction.
Conclusions: Treating cutaneous aging with Lux 1540® laser yields satisfactory results and maybe a good option for patients that do not want or cannot undergo more aggressive treatments.

Keywords: LASERS, SKIN AGING, LASER THERAPY

Introduction: In 2006 the US Food and Drug Administration approved the use of fractional photothermolysis for the treatment of melasma. Objectives:To evaluate the treatment of melasma patients with fractional photothermolysis. Methods: Patients with a clinical diagnosis of melasma (n = 20) received three non-ablative laser sessions at 4-week intervals.The parameters used were: pulse = 15 ms, and progressively increasing energies in each session (8, 10 and 12 J). Results were evaluated using the Melasma Area and Severity Index and colorimetry analysis (with indices ITA, L, a, b) at baseline and 4 weeks after the last session. Results: Female patients (n = 18), with ages between 23 and 48 and Fitzpatrick phototypes from II to IV, completed the study. One patient did not complete both Melasma Area and Severity Index evaluations.There was a statistically significant decrease in the Severity Index (p <0.0001, CI = 95%) and an average increase in the colorimetry indices L (p = 0.0003, CI = 95%) and ITA (p = 0.0017, CI = 95%), meaning a decrease in the pigmentation. Conclusions: Fractional photothermolysis is a safe and effective option in the treatment of melasma, and should be considered an alternative to conventional methods.

Keywords: MELANOSIS, LASERS, COLORIMETRY

When outdated techniques and large skin grafts are used in hair transplants, the results are unattractive and disfiguring. More recently, natural looking results have been achieved by transplanting follicular units. The correct shape and implantation level in the hairline contribute to a natural appearance. Correction methods include: camouflage with follicular units, removal of transplanted hairs and suture, reduction of the scalp, correction of scars, and laser therapy. In this article, the combination of different surgical techniques and laser epilation are described with satisfactory results in the correction of hair transplants.

Keywords: HAIR, TRANSPLANTATION, LASERS

Introduction: Melasma is a common pigmentary disorder. Notwithstanding, its treatment is frustrating, and slow to take effect. Although depigmenters still are the main treatment modality, lasers have recently emerged as an innovative option. Objective: To preliminarily determine the effects of non-ablative photothermolysis on persistent melasma.
Methods: Ten patients with resistant melasma underwent three 1540 nm fractional nonablative erbium laser sessions (with one month intervals), with a 15 mm spot size handpiece. No additional treatment was carried out 3 months before or after. The energy level used ranged from 8 to 15 mJ/MB, and the pulse duration was 15 ms. Responses were evaluated by both the researcher physician and the patients.
Results: Seven patients completed the study; three patients left due to side effects. The researching physician reported that the patients who completed the study obtained 50-75% improvement one month after the last session. The patient''''''''s analysis resulted 50-75% improvement for 5 patients, and 75-100% for the remaining two. The physician and the patients reported that the improvement was maintained at the 3-month follow-up visit.
Conclusions: Although the preliminary results were satisfactory, further, longer-term studies are necessary to establish more efficient protocols and to observe possible recurrences.

Keywords: MELANOSIS, LASERS, TREATMENT OUTCOME

Introduction: An online questionnaire on the use of lasers and other technologies for treating cutaneous disorders or unattractive conditions was sent to 6517 members of the Brazilian Society of Dermatology.
Objective: To quantify the use of those technologies by dermatologists by region, in order to identify regional needs in Brazil.
Methods: The survey included 17 questions about the devices, relating to topics such as the place of application, ownership or rental equipment status, number of devices used, indications and types, and the member''''''''s region. The respondents used the Society''''''''s website to submit answers between February and March 2011. The answers were coded in graphs with percentages.
Results: The response rate was 859: 68% of Brazilian dermatologists perform the procedures at their private offices, 32% are owners of the equipment and 80% live in the southeast / south of Brazil.
Conclusions: While some results met the expectations -the Brazilian Southeast region had the greatest number of dermatologists who answered the questionnaire and use the technologies in question-, others were surprising -variety of equipment used-. This survey allowed the Brazilian Society of Dermatology to analyze how Brazilian dermatologists employ those devices, as well as the geographical locations that have a greater need for their use.

Keywords: LASERS, STATISTICAL ANALYSIS, DERMATOLOGY

Tattooing has existed in humankind's culture since the onset of civilization. Tattoo removal attempts are also very ancient. The following current methods are reported for the removal of tattoos: dermabrasion, surgical excision, and laser procedures. The most commonly used lasers for tattoo removal are: QS-Nd:YAG (1,064 and 532nm), QS-Ruby (694nm) and QS-Alexandrite (755nm). The present review is aimed at studying the action mechanism of lasers for tattoo removal and the correct indication for each type of pigment, in addition to describing complications and the best manner of preventing them.

Keywords: LASERS; LASER THERAPY; TATTOOING.

Introduction: Acne is one of the most prevalent skin conditions, representing a constant challenge to dermatologists, especially in severe cases as nodulocystic acne, which can be resistant to medicament based treatment. Traditional therapy includes topical and oral drugs that are not always effective and often lead to bacterial resistance and side effects. The use of lasers in the treatment of inflammatory acne has increased lately due to the ease, clinical efficacy, and minimal side effects of this type of therapy. Objective: To evaluate the effects of fractional laser in patients with nodulocystic acne resistant to treatment with isotretinoin. Methods: Application of laser therapy sessions with Nd:YAP in 9 patients. Assessment of the degree of patient satisfaction and comparison of photographs taken before and after treatment by dermatologists not linked to the study. Results: Average reduction of 65% in inflammatory lesions, satisfaction of all patients who underwent treatment, and approval in the assessment carried out by dermatologists. Conclusions: The fractional Nd:YAP laser was proven effective in the treatment of inflammatory acne and may represent a new therapeutic option for this pathology, especially for patients who do not respond to conventional treatment.

Keywords: ACNE VULGARIS; LASERS; LASER THERAPY.

Introduction: Onychomycosis is responsible for over 50% of the conditions affecting fingernails. Several factors contribute to poor topical or systemic therapeutic response. Objective: A retrospective, monocentric study was carried out with the aim of observing the effects of Nd:YAG laser in patients who had not responded to other previous treatments. Methods: Thirty patients were photographed and subsequently underwent collection of material for fungi culture, and then treated with sub-millisecond 1,064nm Nd:YAG laser sessions with real time temperature control. Results: Clinical improvement of the treated nails was observed, with minimal discomfort. Conclusions: 1,064nm Nd:YAG laser promotes the acceleration of growth and improves the clinical appearance of the treated nails.

Keywords: LASERS; LASERS, SOLID-STATE; ONYCHOMYCOSIS; PHOTOTHERAPY;SPECTRUM ANALYSIS; TRICHOPHYTON.

Introduction: Hidradenitis is a chronic inflammatory disease that has a negative impact on the patient's quality of life but which has few effective therapeutic options. Currently, the use of laser technology has been standing out as a treatment. Objective: To evaluate the use of 1,340nm ND:YAP laser (Neodimiun:Ytrium Aluminum Perovskite) to treat hidradenitis. Methods: Performing 4 1,340nm ND:YAP laser sessions in 3 patients bearing hidradenitis. Results: All patients had a clinically and histologically evidenced reduction of inflammatory lesions. Conclusions: In the present study, the 1,340nm ND:YAP laser was effective in the treatment of hidradenitis, and can potentially become a new therapeutic option.

Keywords: HIDRADENITIS; LASERS; LASER THERAPY

This study demonstrated the clinical and histologic result of the treatment of one disseminated superficial actinic porokeratosis patient with non-ablative fractional laser. The patient was treated with seven sessions of 1340-nm Nd:YAP laser, with 4 or 5 week-intervals. Biopsies and photographs were performed before and after treatment, which was well tolerated and lead to improvement in the erythema and texture of the lesions. There was a 1-year follow-up. Histopathologic examination after treatment revealed little changes in the cornoid lamella.

Keywords: Biopsy; Laser Therapy; Lasers; Porokeratosis

INTRODUCTION: The treatment of hypochromic scars is challenging, and the techniques used so far show unsatisfactory results. Bimatoprost, an analog of prostaglandin F2-alpha, has been used as a topical pigment agent, and its application as drug delivery can optimize its delivery to the dermis and potentiate pigmentation.
OBJECTIVE: To evaluate the safety and efficacy of Ablative Fractional Laser (AFL) treatment associated with bimatoprost 0.03% drug delivery in hypopigmented scars.
METHODS: The patients were submitted to the AFL, followed by the application of bimatoprost 0.03% in 4 sessions with biweekly intervals. Clinical evaluations and standardized photographs were performed. Patients’ satisfaction was assessed using a 5-question questionnaire.
RESULTS: All patients had clinical improvement in the treated areas. The degree of patient satisfaction agreed with the clinical evaluation and photographic records.
CONCLUSION: The application of AFL associated with bimatoprost 0.03% drug delivery can be a potentially effective and safe treatment for hypochromic scars.

Keywords: Lasers; Hypopigmentation; Laser Therapy

Q-switched lasers are widely used for tattoo removal. A 48-year-old-woman with a black tattoo on the left thigh was submitted to ten sessions of Q-switched Nd:YAG 1064nm laser associated with fractional CO2 laser, performed every two months. Six months after treatment end, we observed almost complete tattoo removal, besides improvement in skin texture. Q-switched lasers promote tattoo removal by a photoacoustic phenomenon. The association with fractional ablative lasers is an option for intensely pigmented tattoos or for tattoos with several colors, which are hard to remove.

Keywords: Laser Therapy; Lasers; Tattooing