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

Introdução:There is no standardized approach to immediate post-procedure care for epidermal ablation; the conscientious choice of products can provide greater comfort to the patient, reduced risks and complications, and shorter recovery times. Objective: To analyze the safety and effectiveness of silicone spray in tissular restoration after two epidermal ablation procedures – fractional ablative 2,790 nm YSGG laser and dermabrasion. Methods: Patients with photoaging or acne scars (n = 20) applied silicone spray on one side of the face and liquid Vaseline (control) on the other side of the face after the procedures.Transepidermal loss of water was measured in all patients. Results: Erythema and burning sensation were the most common findings, and were significantly more frequent in the areas where Vaseline was applied. Conclusions: Silicone spray is safe and effective for use after epidermal ablative procedures, and is significantly superior to Vaseline in controlling burning sensations and erythema

Keywords: SILICONES, WOUND HEALING, DERMABRASION, LASER THERAPY

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

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: The skin is a marker of chronological age and appearance, being important for self-esteem and quality of life. Fractional ablative radiofrequency is one of the treatments aimed at delaying the effects of aging. Objective: To describe the operating principles, methodology, and results of rejuvenation of the lower eyelids when treated with fractional ablative radiofrequency, and the resulting thermal damage observed on histology. Methods: Twenty female patients with aging skin on the lower eyelids were selected for treatment with this method. In one of the patients, who concurrently underwent upper blepharoplasty, ablative fractional radiofrequency was carried out on the skin fragment to be removed from the upper eyelid for anatomical-pathological examination and measurement of thermal damage. The evaluation of clinical results was performed using photographic comparison and analysis of satisfaction questionnaires answered by patients. Results: Photographic comparison showed significant skin retraction effects on the skin of the lower eyelids, while the analysis of questionnaires revealed a significant degree of patient satisfaction. Ten percent of patients experienced reversible local hyperpigmentation as a complication. Ablative and non-ablative damage was observed up to the superficial reticular dermis, with negligible thermal effects on the sides. Conclusion: Fractional ablative radiofrequency was proven safe, effective, and cost-effective in skin rejuvenation, nevertheless further studies should be conducted with the aim of determining the optimal parameters, as well as the ideal number of sessions needed to achieve the best result with the lowest percentage of side effects.

Keywords: PULSED RADIOFREQUENCY TREATMENT; REJUVENATION; SKIN AGING; ABLATION TECHNIQUES; LASER COAGULATION; LASERS.

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

A survey on the opinion of specialists regarding skin resurfacing was performed, with the objective of comparing costs and benefits between the techniques: totally ablative CO2 laser, fractional ablative lasers, fractional non-ablative lasers, ablative fractional radiofrequency, microneedling, dermabrasion, medium peels, phenol-croton oil peels. The most effective option for the treatment of static wrinkles was the phenol-croton oil peel, in first place by 71.4% of the experts, followed by totally ablative CO2 laser, by 28.6%. Regarding downtime, procedures ranked as fastest recovery were microneedling and fractional non-ablative lasers, with 42.9% each, followed by ablative fractional radiofrequency, with 14.3%. Complete recovery period for side and adverse effects was perceived as shorter with microneedling by 50% of the experts. Regarding operating costs. The less costly procedure was medium peels, according to the opinion of 71.4% of the experts. Such results point towards a better cost/benefit of procedures such as chemical peels and micro-needling, according to the opinion of 14 Brazilian specialists who answered the questionnaire.

Keywords: Chemexfoliation; Dermabrasion; Lasers; Needles; Phenol; Pulsed radiofrequency treatment

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