Introduction: Fractional ablative procedures offer more robust results, with shorter recovery time and lower risk of adverse effects compared to non-fractional ablative methods. Objective: To evaluate the effects of a new fractional ablative technology employing Erbium laser(2,940nm) in facial photoaging. Methods: Female patients with moderate facial photodamage were subjected to treatment with a 2,940nm fractional Erbium laser (Palomar Inc., Burlington MA).The parameters varied from 5 to 9 mJ/µb, with pulses of a duration from 250 microseconds to 5 milliseconds.Two to six passes with a 50% overlap were carried out.The clinical evaluations occurred 3 days, 1,4,8 and 12 weeks, and 15 months after the procedure.Three dermatologists who were not involved in the study evaluated the global improvement of the photodamage before and 3 months after the procedures, by reviewing digital pictures, and classified the results according to the following scale: grade 1 = improvement less than 25%; grade 2 = improvement of 26% to 50%; grade 3 = improvement of 51% to 75% and grade 4 = improvement from 76 to 100%. Results: Female patients (n =12), aged 48 to 78 were studied.After 3 months, 23% of the patients were classified as grade 3, 55% as grade 2 and 22% as grade 1. Significant improvement (grade 2) was observed in 78% and 63% of the periorbital and perioral wrinkles, respectively.Two patients developed transitory post-inflammatory hyperpigmentation. Conclusion: The fractional Erbium laser was shown to be effective and safe in the treatment of moderate photoaging.

Keywords: ERBIUM, LASERS, ABLATION TECHNIQUES, REJUVENATION, LASER THERAPY

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

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: Scars caused by burns have the potential to cause clinical, social, and functional disruptions. Dermatologists should be able to intervene in this process by combining technological advances with traditional techniques. Objective: To evaluate the effect of Intense Pulsed Light applications on scars after burns, based on clinical parameters described in the international Vancouver Scar Scale. Methods: A prospective study was carried out with six patients who underwent five monthly Intense Pulsed Light sessions over the entire area of a wound. The analysis of the results was conducted by three evaluation groups: 3 physician researchers, the patients included in the study, and 3 physician observers. The evaluation was implemented using the Vancouver Scale, a questionnaire based on this scale, and additionally a general rating used by all evaluators based on a numerical scale. The data obtained by examining the differences before and after the treatment, was analyzed through the Wilcoxon signed-rank test. Results: A statistically significant decrease was observed in the analyses of all clinical parameters of the scars, when evaluated before and after the completion of the treatment. Conclusions: The present pilot study demonstrates the advantages of Intense Pulsed Light as an approach to this specific type of scar, with an aim of stimulating further studies in order to improve this low-cost technology, as compared to lasers.

Keywords: LASERS; INTENSE PULSED LIGHT THERAPY; CICATRIX; BURNS.

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 range of treatment options is available to restore and increase dermal collagen. The purpose of the present review, based on articles selected on PubMed database, is to study the histological effect of four methods for skin rejuvenation: Intense Pulsed Light, non-ablative fractional laser, ablative fractional laser and percutaneous collagen induction. The therapeutic implications of each type of treatment will depend on the induced collagen type and its ability to elicit a regenerative healing response versus a fibrotic scarring response. Intense Pulsed Light and the percutaneous collagen induction produced regenerative healing response with increased collagen type I.

Keywords: INTENSE PULSED LIGHT; LASER THERAPY; COLLAGEN; REJUVENATION; SKIN AGING

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

Necrobiosis Lipoidica (NL) is a granulomatous dermatosis, mainly affecting people with diabetes due to collagen degeneration. Although there are different treatments, all have little response. Among the options, the Intense Pulsed Light (IPL) and the Laser Erbium-YAG enhance the production and remodeling of the collagen treating the atrophy, besides reducing the erythema by the coagulation of blood vessels. We report a case of a 24-year-old woman with type I Diabetes Mellitus who underwent NL treatment on her left forearm in seven sessions with the association of IPL and 2940 nm Erbium-YAG laser. We observed improvement in central atrophy and erythema.

Keywords: Necrobiosis lipoidica; Diabetes mellitus; Lasers; Laser therapy; Intense pulsed light therapy; Collagen

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

Facial surgeries are often challenging for surgeons due to their complex anatomy, aesthetic and functional importance. Interventions in the cosmetic subunit that comprises the eyebrows can be particularly difficult. This case report aims to demonstrate the use of island flap in this region. We performed the excision of melanocytic nevus, with a good outcome and absence of postoperative complications. This technique is commonly used for facial reconstruction; however, the literature describes only a few cases using this method for eyebrow reconstruction.

Keywords: Scleroderma, Systemic; Microstomia; Lasers; Laser Therapy; Intense Pulsed Light Therapy; Combined Modality Therapy

Case study of exceptional response to treatment of recurrent xanthelasma palpebrarum with an ablative laser. The patient underwent a single session of laser Erbium: Yttrium-aluminum-garnet (Fotona^®) 2940 nm, and we performed photographic records with Vectra^® H2 2019 before and after the procedure. Satisfactory clinical results were reported, with good pain tolerability and early recovery compared to surgical procedures and, consequently, less time away from work activities.

Keywords: Lasers; Laser therapy; Laser coagulation; Xanthelasma palpebraum

Congenital vascular lesions can be subdivided into tumors and malformations. Hemangiomas are benign vascular tumors resulting from the abnormal proliferation of endothelial cells, whereas port-wine stains are vascular malformations of a possible autosomal dominant inheritance. To date, there are no studies associating the use of intense pulsed light and CO2 laser as a therapeutic form for these pathologies. We present a series of 10 cases of vascular injuries treated with the combination of these forms of irradiation. This combined therapy can be effective in reducing the thickness of the lesions or in attenuating the color.

Keywords: Hemangioma; Lasers, gas; Laser therapy; Intense pulsed light therapy; Vascular malformations

Exogenous ochronosis is a cutaneous hyperpigmentation condition caused by the accumulation of substances derived from phenol on the skin or mucous membranes without affecting other tissues. It occurs mainly due to the use of bleaching agents, most frequently hydroquinone. The lesions are difficult to treat, being resistant to several approaches. Sometimes it’s necessary to use laser technologies or intense pulsed light to achieve some degree of improvement. The present work consists of a literature review of publications on these technologies in exogenous ochronosis from January 1990 to July 2020.

Keywords: Hyperpigmentation; Intense pulsed light therapy; Lasers; Ochronosis