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J Cosmet Med 2021; 5(1): 1-6

Published online June 30, 2021

https://doi.org/10.25056/JCM.2021.5.1.1

Solar lentigines and ephelides removal in Asians using a combination of a novel 670 nm picosecond and 1,064 nm laser

Tin Hau Sky Wong , MBBS, MRCSEd, MScPD, MScAPS

Medaes Medical Centre, Hong Kong

Correspondence to :
Tin Hau Sky Wong
E-mail: drskywong2@gmail.com

Received: April 19, 2021; Revised: May 11, 2021; Accepted: May 21, 2021

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Picosecond (PS) lasers have evolved over the years, and several new wavelengths have been adopted for more efficient and safe treatment of various skin conditions. We specifically studied the 670 nm wavelength for its high melanin-hemoglobin ratio, effectiveness, and safety in laser-unfriendly Asian skin.
Objective: This study evaluated the effectiveness, safety, and patient satisfaction following treatment of solar lentigines and ephelides with a combination of a novel 670 nm PS and 1,064 nm wavelength laser in a series of Asian patients.
Methods: This retrospective study evaluated 30 patients who underwent treatment for solar lentigines and ephelides. A PS laser of wavelength 670 nm and 660 PS pulse width was adopted at a spot size of 2.0–3.5 mm, fluence of 0.7–0.8 J/cm2, and repetition of 2.0–3.3 Hz. Treatment intervals ranged from 3–5 weeks for a total of 3–6 sessions. Skin pigmentations in the patients were documented with a high-resolution camera and the results were assessed by physicians. In addition, patient satisfaction was evaluated.
Results: Thirty patients (27 females, 3 males), aged 21–66 years, with Fitzpatrick skin type III or IV were treated and evaluated. It was observed that 100% of the patients achieved at least good results (>50% improvement), 80% achieved good results (>75% improvement), and 40% achieved clinical clearance (>90% improvement). The average downtime with mild redness was 2–3 days and transient darkening of pigmentation (crème brulee reaction) was observed for 5–7 days. Higher-contrast lesions demonstrated better responses. The post-inflammatory hyper- and hypopigmentation rates were 3.3% and 6.67%, respectively.
Conclusion: PS laser is effective for the treatment of solar lentigines and ephelides. The 670 nm wavelength is beneficial in improving the efficacy and safety of the PS laser treatment, which is especially important in Asian skin that is prone to laser complications.

Keywords: Asian, freckles, hyperpigmentation, laser, pigment

Fig. 1.The melanin-hemoglobin absorption ratio of the 670 nm wavelength is higher than that of the contemporary wavelengths including 755 nm and 785 nm (Courtesy, Beard et al.).
  1. Negishi K, Akita H, Matsunaga Y. Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser. Lasers Surg Med 2018;50:851-8.
    Pubmed CrossRef
  2. Chung JH, Lee SH, Youn CS, Park BJ, Kim KH, Park KC, et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch Dermatol 2001;137:1043-51.
  3. Li EPH, Min HJ, Belk RW. Skin lightening and beauty in four Asian cultures. Adv Consum Res 2008;35:444-9.
  4. Arora P, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthet Surg 2012;5:93-103.
    Pubmed KoreaMed CrossRef
  5. Ho SG, Chan NP, Yeung CK, Shek SY, Kono T, Chan HH. A retrospective analysis of the management of freckles and lentigines using four different pigment lasers on Asian skin. J Cosmet Laser Ther 2012;14:74-80.
    Pubmed CrossRef

Article

Original Article

J Cosmet Med 2021; 5(1): 1-6

Published online June 30, 2021 https://doi.org/10.25056/JCM.2021.5.1.1

Copyright © Korean Society of Korean Cosmetic Surgery.

Solar lentigines and ephelides removal in Asians using a combination of a novel 670 nm picosecond and 1,064 nm laser

Tin Hau Sky Wong , MBBS, MRCSEd, MScPD, MScAPS

Medaes Medical Centre, Hong Kong

Correspondence to:Tin Hau Sky Wong
E-mail: drskywong2@gmail.com

Received: April 19, 2021; Revised: May 11, 2021; Accepted: May 21, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Picosecond (PS) lasers have evolved over the years, and several new wavelengths have been adopted for more efficient and safe treatment of various skin conditions. We specifically studied the 670 nm wavelength for its high melanin-hemoglobin ratio, effectiveness, and safety in laser-unfriendly Asian skin.
Objective: This study evaluated the effectiveness, safety, and patient satisfaction following treatment of solar lentigines and ephelides with a combination of a novel 670 nm PS and 1,064 nm wavelength laser in a series of Asian patients.
Methods: This retrospective study evaluated 30 patients who underwent treatment for solar lentigines and ephelides. A PS laser of wavelength 670 nm and 660 PS pulse width was adopted at a spot size of 2.0–3.5 mm, fluence of 0.7–0.8 J/cm2, and repetition of 2.0–3.3 Hz. Treatment intervals ranged from 3–5 weeks for a total of 3–6 sessions. Skin pigmentations in the patients were documented with a high-resolution camera and the results were assessed by physicians. In addition, patient satisfaction was evaluated.
Results: Thirty patients (27 females, 3 males), aged 21–66 years, with Fitzpatrick skin type III or IV were treated and evaluated. It was observed that 100% of the patients achieved at least good results (>50% improvement), 80% achieved good results (>75% improvement), and 40% achieved clinical clearance (>90% improvement). The average downtime with mild redness was 2–3 days and transient darkening of pigmentation (crème brulee reaction) was observed for 5–7 days. Higher-contrast lesions demonstrated better responses. The post-inflammatory hyper- and hypopigmentation rates were 3.3% and 6.67%, respectively.
Conclusion: PS laser is effective for the treatment of solar lentigines and ephelides. The 670 nm wavelength is beneficial in improving the efficacy and safety of the PS laser treatment, which is especially important in Asian skin that is prone to laser complications.

Keywords: Asian, freckles, hyperpigmentation, laser, pigment

Fig 1.

Figure 1.The melanin-hemoglobin absorption ratio of the 670 nm wavelength is higher than that of the contemporary wavelengths including 755 nm and 785 nm (Courtesy, Beard et al.).
Journal of Cosmetic Medicine 2021; 5: 1-6https://doi.org/10.25056/JCM.2021.5.1.1

References

  1. Negishi K, Akita H, Matsunaga Y. Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser. Lasers Surg Med 2018;50:851-8.
    Pubmed CrossRef
  2. Chung JH, Lee SH, Youn CS, Park BJ, Kim KH, Park KC, et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch Dermatol 2001;137:1043-51.
  3. Li EPH, Min HJ, Belk RW. Skin lightening and beauty in four Asian cultures. Adv Consum Res 2008;35:444-9.
  4. Arora P, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthet Surg 2012;5:93-103.
    Pubmed KoreaMed CrossRef
  5. Ho SG, Chan NP, Yeung CK, Shek SY, Kono T, Chan HH. A retrospective analysis of the management of freckles and lentigines using four different pigment lasers on Asian skin. J Cosmet Laser Ther 2012;14:74-80.
    Pubmed CrossRef

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