P8046Pixel radiofrequency with microplasma technology: Fractional ablativeradiofrequency for the treatment of acne scars

Michael Gold, MD, Tennessee Clinical Research Center, Nashville, TN, UnitedStates

Background: Microplasma is a novel radiofrequency (RF) technology that generatesa path of current from a tiny metal electrode to the surface of the biologic tissue,forming a plasma gas-discharge, causing microscopic fractional skin perforation-ablation event.

Objective: To assess the safety and efficacy of a fractional ablative microplasma RFdevice in the treatment of acne scars.

Study: Six subjects with documented mild to moderate atrophic acne scars wereenrolled in the study. Acne scar clinical grading scale (ECCA) was used; the averagescore being 162.5. Fitzpatrick skin type distribution among the 6 subjects was 4 typeII, 1 type V, and 1 type VI. Each subject received a single treatment with the (Pixel RF,Alma Lasers Inc) a fractional RF that deploys multiple pin electrodes on a handheldroller. Before treatment, subjects received topical anesthetic and were spot tested(30 minute postevaluation.) Subjects received 4 to 5 passes during treatment at anenergy level ranging from 40 to 60 watts. Treatment areas were limited to theforehead and cheek areas of the subjects. Subjects were evaluated at 1, 5, 30, and 90days posttreatment. Improvement was assessed by the investigator physician basedon visual appearance rated on a 1 to 4 improvement scale: -1 (exacerbation), 0 (nochange), 1 (1-25% improvement), 2 (25-50% improvement), 3 (50-75% improve-ment), and 4 (75-99% improvement).

Results: Day 1: 1 subject was observed with an improvement rating of 1; 5 subjectsshowed no change (0 rating). Day 5: 2 subjects were observedwith an improvementrating of 2; 3 subjects rated 1; 1 subject rated 0. Day 30: 1 subject was observed withan improvement rating of 3; 1 subject rated 2; 3 subjects rated 1 and 1 subject(subject 3) was not indicated. Day 90: 2 subjects were observed with animprovement rating of 3; 2 subjects rated 2; 2 subjects rated 1. Only 1 subjectexperienced a possible study related adverse affect; moderate worsening of facialacne that was subsequently resolved with medication. The ECCA scoring at the 90-day follow-up ranged from a low of 65 to a high of 130; with an average score of 95.

Conclusion: The pixel RF with microplasma technology, intended for skin ablationand perforation, is a safe and effective modality, even after a single treatment for theimprovement in the appearance of acne scars.

AB200

d by Alma Lasers Inc.

Supporte

P8521Prospective pilot evaluation of a novel unipolar radiofrequency devicewith dermal rolling mechanism for rejuvenation of Fitzpatrick skinphototypes III to V

Hema Sundaram, MD, Dermatology, Cosmetic & Laser Surgery, Rockville, MD,United States

Background: Core aesthetic specialty surveys show diversification of patientsseeking nonsurgical rejuvenation and development of devices to address thisneed. Radiofrequency (RF) devices can be used safely and effectively in pigmentedskin because of their lack of chromophore specificity and relative epidermal sparing.This pilot evaluation investigated efficacy, tolerability, and safety of a novel fractionalablative RF device.

Design: Twelve healthy patients with Fitzpatrick skin types III to V were evaluatedprospectively after appropriate washout periods for laser/light, fillers, toxins,chemical peels, surgery etc. Pretreatment assessment included 5-point scoring forfine lines and wrinkles, skin tightness, pore prominence, and skin color/tone, andstandardized digital 3D imaging. Patients received 3 treatments at 3 to 4 weeklyintervals with a unipolar fractional ablative RF roller device at 40.68 MHz and up to80W, comprising 6 cogs with 50 microelectrodes on each cog. When rolled over theskin, they produce multiple microablative thermal conduits across the dermoepi-dermal junction. Full-face treatment was performed with 2 perpendicular passes.Evaluations at 1 week and 3 to 4weeks after each treatment included 5-point scoringfor fine lines and wrinkles, skin tightness, pore prominence, and skin color/tone;scoring on the validated Global Aesthetic Improvement Scale (GAIS); andstandardized 3D imaging. Tolerability evaluation included assessment of posttreat-ment erythema. After 3 treatments, the same evaluations occurred during 2 follow-up visits at 3 to 4 weekly intervals. Patient questionnaires evaluated perception ofimprovement in the specific parameters and satisfaction with treatment.

Results: All patients had significant improvement, with skin tightness, brightness,and color/tone most improved and fine lines and rhytids markedly improved forthose patients who had them at baseline. All patients scored 1 (improved) or greateron the GAIS, and reported themselves satisfied or very satisfied. Treatment was welltolerated and there were no significant adverse events.

Conclusion: Fractional ablative unipolar RF roller technology was found to be safe,efficacious, and well tolerated for pigmented skin. Larger, controlled studies wouldincrease the evidence level. Pilot evaluation suggests comparable results, butdecreased discomfort and shorter recovery than with conventional fractionatedlasers. Extended evaluation to assess longevity of results is in process.

cal evaluation was partially supported by an equipment and rm Alma Lasers.

The clini esearchgrant fro

J AM ACAD DERMATOL

P7629Studying the intense pulsed light method along with corticosteroidinjection in treating keloid scars

Simin Shamsi Meymandi, MD, Department of Dermatology, KermanLeishmaniasis Research center, Kerman University of Medical Sciences,Kerman, Iran; Ali Ekhlasi, MD, Department of Dermatology, KermanLeishmaniasis Research Center, Kerman University of Medical Sciences,Kerman, Iran; Azadeh Rezazadeh, MD, Department of Dermatology, KermanLeishmaniasis Research Center, Kerman University of Medical Sciences, Kerman,Iran

Background: Results of various studies suggest that the hypertrophic and keloidscars are highly prevalent in the general population and are annoying both physicallyand mentally.

Objective: Because of the variety of existing therapies, intense pulsed light (IPL)method along with corticosteroid injection was evaluated in treating these scars.

Methods: Eighty-six subjects entered this clinical trial. Eight sessions of therapeuticintervention were done with IPL along with corticosteroid intralesional injectionusing 450 to 1200 nm filter, fluence 30-40 J/cm2, pulse duration of 2.1-10 ms andpulsed delay 10-40 ms with an interval of 3 weeks. To specify the recoveryconsequences and complication rate and to determine features of the lesion, criteriadetermined in the study of Eroll and Vancouver scar scale were used.

Results: The level of clinical improvement, color improvement, and scar height was89.1%, 88.8%, and 89.1%, respectively. The incidence of complications (1telangiectasia case, 7 hyperpigmentation cases, and 2 atrophy cases) after treatmentwith IPL was 11.6%. Moreover, the participants’ satisfaction with IPL method was88.8%.

Conclusions: This study revealed that a combined therapy (intralesional corticoste-roid injection plus IPL) increased the recovery level of hypertrophic and keloidscars. It was also shown that this method had no significant side effect and patientswere highly satisfied with this method.

cial support: None identified.

Commer

P8162Tattoo removal using QS Nd:Yag laser

Gina Silva, MD, Leger Clinic, Porto Alegre, Brazil; Honorio Menezes, Leger Clinic,Porto Alegre, Brazil; Larissa Donini, Leger Clinic, Porto Alegre, Brazil; MichelleGoncalves, Leger Clinic, Porto Alegre, Brazil; Nivea Chacur, MD, Leger Clinic,Porto Alegre, Brazil; Raphaela Ramos, Leger Clinic, Porto Alegre, Brazil; RobertoChacur, MD, Leger Clinic, Porto Alegre, Brazil

Introduction: Both dermabrasion and surgery are techniques that have been used fortattoo removal. Nowadays we have been using laser for that purpose.

Objective: The objective of this study is to evaluate the removal of tattoos using theQS Nd:Yag laser.

Methods: This is a retrospective study involving patients treated with QS Nd:Yaglaser. The data have been collected from patients’ medical records and pictures,telephone contact, or e-mail. The statistical analysis was performed through theanalysis of distribution, multivariate regression, and logistic regression.

Results: We have evaluated 304 patients with an average age of 29.8 years old (67.86), having 297 (97.69%) been classified as white (phototypes I, II, and III), fromwhich 270 (88.81%)were analyzed as professional tattoos. The oldest tattoowas 360months and the most recent was 1 month, reaching an average of 64.56 months (663.54). The average size of the tattoos was 12.92 cm, with black as the predominantcolor, present in 291 (86.51%) tattoos. The average number of sessions per patientwas 3.77 (6 2.99), with an interval of 49.23 days between sessions. Therefore, it hasbeen observed by the therapist that 52.96% of tattoos had been partially removed,21.38% had not been removed, 86.51% presented normal scar healing, 8.55%,hypertrophic scar healing, and 3.29% presented cheloid. Out of the 304 patients,26.64% (81) reported satisfaction with the results, 58.88% (179) were partiallysatisfied. Hypochromia was present in 33.55% (102) individuals.

Conclusion: The QS Nd:Yag laser is a safe and efficient method for tattoo removal,presenting a great degree of satisfaction and few adverse effects.

cial support: None identified.

Commer

MAY 2014