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The tendency to use less-invasive laser-based methods with far more obvious effectiveness has been taken into consideration today for improvement of burning scars. The present study thus aimed to assess the efficacy of two laser-based techniques including pulsed dye laser (PDL) and ablative fractional CO2 laser (AFCL) and its combination on improving different aspects of burning scars regardless of the types of scar as hypertrophic or keloid scars. This randomized single-blinded clinical trial was performed on patients suffering hypertrophic or keloid burning scars. The patients were randomly assigned into three groups scheduling for treatment with PDL alone, AFCL alone, or its combination. All patients were visited before and 40 days after the last treatment session, and their scars were assessed. In all groups, significant improvement was revealed in the Vancouver scar scale (VSS) score, the color of scar, vascular bed in the scar, the and height of scar and its pliability; however, the improvement in each item was more highlighted in the group receiving a combination therapy with PDL and AFCL techniques. In this regard, the highest improvement was found in vascular bed and pliability in the combination therapy group as compared to other groups. Although the superiority of the combined group was not statistically significant, due to the high percentage of improvement in total VSS and most of its indicators, it can be clinically significant. The efficacy of the treatment protocols was different considering subgroups of mature and immature scars (less than 1 year), so that more improvement in pliability of scar, vascularity, and color of scar was found in the group scheduling for PDL + AFCL as compared to those who were treated with PDL alone in immature scar group but not in mature scar group. Combined treatment can be much more effective in improving the appearance and pathological characteristics of scars than each individual treatment. This effectiveness can be seen mainly in immature scars.

Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500–600 nm), IPL with M22 590 (590–1200 nm), or IPL with M22 vascular filter (530–650 nm and 900–1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251.

To characterize midfrontal erythema and evaluate the clinical efficacy of 595 nm pulsed dye laser treatment for this condition. A total of 85 patients presenting with vascular lesions in the midfrontal area were analyzed who received the pulsed dye laser treatment between 2018 and 2023. The efficacy and safety of the treatment was assessed. The total effective rate of pulsed dye laser treatment for midfrontal erythema was 96.4%, with a cure rate of 69.4%. No adverse event was observed. Patients’ ages and color of the skin lesions affected the therapeutic outcomes. Younger patients had higher effective rates. And the patients with pink lesions show higher cure rates than those with purple-red lesions. Pulsed dye laser treatment was effective and safe for the treatment of midline frontal erythema, particularly when initiated early.So We propose the diagnosis of “midfrontal erythema” or “persistent salmon patch” for this condition. Clinical trial number: not applicable.

Background Top surgery masculinizes the chest appearance for transgender men (TM); however, some individuals may experience hypertrophic scars (HTS) or keloids following the surgery. Objectives This study aimed to evaluate the efficacy of combined 595‐nm pulsed dye laser (PDL) and intralesional triamcinolone acetonide injection (IL TAC) compared to IL TAC monotherapy for treating HTS and keloids. Methods Twenty‐five TM with 35 pairs of bilateral symmetric postmastectomy HTS or keloids were randomly allocated to receive the combined PDL and IL TAC on the scar(s) on one side of the chest and IL TAC monotherapy on the contralateral scar(s) in four monthly treatment sessions. Clinical improvement was evaluated using the Vancouver Scar Scale (VSS). Melanin index, hemoglobin index, and scar roughness were determined before each treatment session and at 1, 3, and 6 months after the last treatment. Participant‐rated satisfaction and adverse events were documented. Results After two treatment sessions, scars treated with combined PDL and IL TAC demonstrated significantly greater improvements in the VSS (p = 0.012) and melanin index (p = 0.004) compared to those treated with IL TAC alone. The superior outcomes of the combined therapy persisted for 3 and 6 months after the end of treatment sessions for the VSS (p = 0.001) and melanin index (p = 0.048), respectively. Participants reported higher satisfaction for combined PDL and IL TAC than IL TAC monotherapy (p = 0.005). No serious or permanent adverse event was reported. Conclusion The addition of 595‐nm PDL to IL TAC may provide more favorable outcomes for treating postmastectomy HTS and keloids among TM.

To evaluate the efficacy and safety of pulsed dye laser (PDL) alone, the combination of PDL and botulinum toxin type A (BTA) injection, and the combination of PDL and triamcinolone injection in the treatment of hypertrophic scars and keloids. In this three-arm, single-blind randomized controlled clinical trial, 10 patients over 18 years old with hypertrophic scars or keloids were enrolled. Each patient had at least 3 lesions, each measuring at least 10 × 10 square centimeters or 10 centimeters long. In the first treatment session, each of the 3 lesions was randomly assigned to one of three interventions: PDL (control), PDL with BTA injection (at a concentration of 2 units/cm 2 ), or PDL with triamcinolone injection (20 mg/cc). All the interventions carried out in the groups have been repeated in three sessions. One follow-up visit took place one month after the last session, without any intervention. Clinical images of the lesions were collected during the treatment sessions. A blinded dermatologist assessed the effectiveness of the treatment using a physician global assessment score and the Vancouver Scar Scale (VSS). Patient satisfaction and any side effects were recorded during follow-up visits. The average age of the cases under consideration was 36.00 ± 13.23 years. In terms of gender, 4 out of the cases (40.00%) were females. During the initial session, the mean VSS scores in the PDL, PDL–BTA, and PDL–Triamcinolone groups were 7.90 ± 1.52, 7.10 ± 0.56, and 7.30 ± 0.24, subsequently. These scores decreased to 7.30 ± 1.34, 4.90 ± 1.37, and 4.30 ± 0.95 in the PDL, PDL–BTA, and PDL–Triamcinolone groups, respectively ( P  = 0.001). The group that received both PDL and BTA showed the most significant enhancement in pliability ( P  = 0.001) and regarding scar vascularity and height the most improvement was related to PDL-triamcinolone group ( P  = 0.01 and 0.001, respectively). In addition, the level of physician’s satisfaction in the PDL–BTA and PDL–Triamcinolone groups were significantly higher than in the PDL group ( P  = 0.004). However, no significant difference was seen between the combined treatments. Finally, no significant side effects were observed in the studied methods during various treatment sessions. The findings of the study revealed that utilizing a combination of two modalities yielded better outcomes compared to a single treatment approach. Specifically, the combination of PDL and BTA demonstrated greater improvement in scar pliability. On the other hand, when considering scar vascularity and height, the combination of PDL with triamcinolone exhibited more significant enhancement. What’s already known about this topic? • Hypertrophic and keloid scars are often characterized by unsightly appearances and impose numerous restrictions on patients. Various treatments have been suggested for these skin lesions, each associated with different levels of effectiveness in promoting recovery. • The pulsed dye laser is an effective treatment option for vascular lesions, hypertrophic scars, and keloids. It is associated with improvements in color, reduction in height, and increased flexibility. What does this study add? • The combined treatment of PDL and BTA (at a dose of 2 units per square centimeters) is an effective option for treating hypertrophic scars and keloids. This combination is more effective than using pulsed dye laser alone and can serve as a novel treatment approach for these conditions. • The combined treatment of PDL and triamcinolone injection (at a concentration of 20 mg per 1 ml, with 1 ml injected for each lesion) is an effective option for managing hypertrophic and keloid scars. This approach is more effective than using PDL alone and can significantly improve hypertrophic and keloid scars. • The combination of PDL and triamcinolone injection, when compared to the combination of PDL and BTA injection, results in a more significant improvement in VSS reduction, especially regarding scar vascularity and height. • The greatest improvement in pliability was observed in the group that received PDL and BTA, followed by the group that received PDL and triamcinolone, while the group receiving PDL only showed the least improvement.

Light-based modalities appear to be effective for ameliorating surgical scar appearance; however, protocols for achieving such outcomes have yet to be established. We studied the safety and efficacy of a combination of pulsed dye laser (PDL) and fractional ablative CO2 laser (FACL) for the attenuation of post-lumpectomy scarring. We conducted a prospective, evaluator-blinded, comparative split-scar study in post-lumpectomy patients. One-half of the scar was treated with three sessions of 595-nm PDL and FACL at 1-month intervals, starting within 6 weeks after suture removal. The entire scar was also treated with standard moisturizers and silicone gels. Six months after the last treatment, the two halves of the scar were assessed by three uninvolved physicians who used the Observer Scar Assessment Scale as well as by the patients who used the Patient and Observer Scar Assessment Scale. Eighteen female patients (mean age, 51.3 years) with a mean scar length of 7.8 cm completed the treatment and follow-up. Six months after the last treatment, both the physician evaluators and the patients noted significant improvements for all assessed scar parameters in the laser-treated scar area compared with the untreated scar area. The treatment was well tolerated, and no remarkable adverse events were reported. All 18 participants were satisfied with the treated scar areas. A combination PDL and FACL protocol starting up to 6 weeks after suture removal is a safe and effective method for the attenuation of post-lumpectomy scar formation.

Background Comedone extraction provides greater satisfaction for acne treatment than conventional treatment alone; however, post‐comedone extraction erythema (PCEE) remains a concern for patients. Objectives To evaluate the efficacy of pulsed‐dye laser (PDL) in PCEE and comedone reduction. Methods Mild‐to‐moderate acne patients were randomly allocated in split‐face fashion. Three comedones were extracted on each facial side. On the PDL‐treated side, 595‐nm PDL was delivered to the entire side with an additional shot on three comedone‐extracted sites. Erythema index (EI) and total acne lesion counts (TALC) were evaluated at baseline, week 2 and 4. The comprehensive acne severity scale (CASS) was assessed by three blinded independent pediatric dermatologists. Participant satisfaction surveys were completed at the end of the study. Results Thirty‐five participants (age 12.9–24.2 years) showed no differences in the EI and TALC at baseline on both sides. At weeks 2 and 4, the EI on the PDL‐treated side was significantly lower (p < 0.001) with a greater EI reduction (p < 0.001) when compared to the control side regardless of gender and menstruation. There was significantly lower TALC on the PDL‐treated side at week 2 (p < 0.001) and week 4 (p = 0.02). No complications were noted with high participant satisfaction reported (median 8; IQR 7–9). PDL remained significantly associated with EI improvements after controlling for gender, menstruation cycle, and examination stress. Conclusion PDL can be an adjunctive intervention for the treatment of PCEE and comedone reduction due to its effectiveness and high participant satisfaction.

The importance of spot size in pulsed dye lasers for treatment of rosacea is frequently undervalued. This study aimed to compare the efficacy of 7-mm and 10-mm spot sizes of a 595-nm pulsed dye laser for treating erythematotelangiectatic rosacea.Twenty participants with erythematotelangiectatic rosacea were enrolled and received three treatments at 4-week intervals. The left and right cheeks were treated with a circular beam with diameters of 7 mm and 10 mm, respectively. The pulse duration was 10 ms. Therapeutic energy was adjusted by 5–10% based on the immediate reaction after treatment. The skin type, sex, age, lesion site, erythema severity score, telangiectasia severity score, VISIA percentile score, and clinical photographs were recorded at baseline and at 4-week intervals thereafter. The clinical erythema (CEA) score, patient global assessment (PGA) scale score, visual analog scale (VAS) score, and adverse events were evaluated at 4-week intervals. Two physicians blindly evaluated the results.Significant improvements in CEA and telangiectasia scores, VISIA percentile score, and PGA scores were observed on both sides at 3 months, without significant differences between the left and right cheeks. Participant satisfaction with the right side (10 mm; 90%) was significantly higher than that with the left side (7 mm; 85%). The average pain score (VAS) on the left (4.85 ± 0.81) was significantly higher than that on the right (3.95 ± 1.00).This study demonstrated that a 10-mm-diameter therapeutic beam can safely improve rosacea symptoms. The 10-mm light spot was less painful than the 7-mm light spot and had the same therapeutic efficacy; therefore, it is the optimal choice for rosacea.

Background Pulsed‐dye lasers (PDL) are one of the standard therapies for rosacea, but alternatives are needed. Aims To compare the efficacy and safety of the variable‐sequenced, large‐spot 532 nm KTP laser to the 595 nm PDL in treating rosacea. Materials and Methods A prospective, controlled, evaluator‐blinded study. Patients were treated with either a KTP or PDL with 1–3 sessions at intervals of 6–8 weeks. A follow‐up visit was scheduled on Week 6 post‐treatment. Clinical outcome was assessed by computer‐assisted analysis and by patients and two blinded dermatologists. Pain intensity during treatment and adverse events were documented. Results Forty‐five patients (mean age 51 years) were allocated in a 2:1 ratio to either the KTP or PDL. Erythema in both treatment arms decreased significantly (p < 0.01). Clinical evaluation revealed high improvement. Mean pain intensity was significantly lower with the KTP (2.5/10) than with the PDL (4.1/10). Both lasers showed a good safety profile. Relevant purpura was only seen in the PDL group. Conclusions Both the variable‐sequenced, large‐spot KTP and the PDL demonstrated comparable efficacy in treatment of rosacea. Regarding safety, the KTP exhibited fewer post‐treatment reactions. The KTP might serve as a potential alternative to PDL in the treatment of rosacea.

Acne vulgaris is a prevalent skin disorder with significant emotional and psychological impacts. Conventional treatments often have limitations, prompting exploration into alternative therapies like vascular lasers and light treatments. This systematic review evaluates the efficacy and safety of vascular lasers (IPL, PDL, Nd:YAG) on inflammatory acne lesions associated with acne vulgaris. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies from 2010 to 2024 were searched in databases (Scopus, Web of Science, PubMed, Embase) using preset terms. Inclusion criteria encompassed English language studies on vascular lasers for inflammatory acne lesions in comparative and randomized controlled trials. Data extraction included study characteristics, patient data, laser parameters, and treatment outcomes. Quality assessment utilized the Cochrane ROB 2 tool. Out of 904 initially retrieved studies, 32 studies involving 1,520 patients met the inclusion criteria. The studies focused on 18 Intense Pulsed Light (IPL), 9 Pulsed Dye Laser (PDL), and 10 Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) lasers, with 5 studies comparing two modalities. IPL demonstrated acne vulgaris lesion reduction rates ranging from 42.40% to 61.56%, while PDL achieved reductions of up to 82.5%. Combined therapies, such as PDL/Nd:YAG, resulted in reductions as high as 83.5%. Fractional CO₂ lasers showed acne vulgaris lesion improvement rates of 87.94% ± 14.31, with sustained results at follow-up. Red light-PDT achieved an 85.50% ± 5.39 reduction, outperforming IPL-PDT (75.55% ± 8.09). In comparative studies, Nd:YAG lasers demonstrated slightly superior outcomes over IPL. Adverse effects, including erythema and pain, were generally mild, with severe side effects being rare. Vascular lasers, including IPL, PDL, and Nd:YAG, demonstrate significant efficacy and safety in treating inflammatory active acne vulgaris, with combination therapies often showing superior outcomes. Fractional CO₂ lasers and red light-PDT further expand treatment options. Adverse effects, such as erythema and pain, are generally mild and transient. However, variability in study protocols highlights the need for standardized treatment guidelines and further well-designed trials to optimize protocols and ensure consistent, long-term outcomes.