Picosecond‐Domain Fractional Laser Treatment Over Hyaluronic Acid Fillers: In Vivo and Clinical Studies

• Published in: Lasers in surgery and medicine Vol. 52; no. 10; pp. 928 - 934
• Main Authors: Kim, Jung E., Hong, Jeong Y., Lee, Ho J., Lee, Sung Y., Kim, Hyun J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.12.2020
• Subjects: Acne; Aluminum; Domains; Fillers; Hyaluronic acid; In vivo methods and tests; Injection; Laser arrays; laser therapy; Lasers; Microlenses; Neodymium lasers; Patient satisfaction; Patients; rats; Scars; Semiconductor lasers; Skin; YAG lasers; Yttrium; skin; rats; laser therapy; hyaluronic acid
• ISSN: 0196-8092; 1096-9101; 1096-9101
• DOI: 10.1002/lsm.23254

Background and Objectives Combined sequential treatments with multiple modalities such as lasers and soft‐tissue fillers are commonly required for the treatment of atrophic acne scars. Recently, fractional treatment with picosecond‐domain lasers has proven to be effective for skin rejuvenation and scar treatment. However, little is known about the effects of picosecond‐domain fractional laser treatment over hyaluronic acid fillers (HAFs). We aimed to evaluate the in vivo tissue responses to 1064 nm picosecond‐domain fractional neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser treatments using microlens array (MLA) applied over pre‐injected HAF in rats. In addition, we evaluated the efficacy and safety of this combined same‐day treatment for atrophic acne scars in patients. Study Design/Materials and Methods Sprague–Dawley rats were subjected to 1064 nm picosecond‐domain fractional Nd:YAG laser treatment immediately after HAF dermal injection. Skin specimens were histologically evaluated on days 0, 7, and 21. In a clinical study, 36 patients with acne scars were treated concurrently with 1064 nm MLA‐type picosecond lasers and HAFs. The patients were scheduled to receive two consecutive treatments at 4‐week intervals, with a follow‐up visit at 12 weeks after the final treatment. Acne scar photographs were graded using the Goodman and Baron's qualitative and quantitative scales at baseline and 12 weeks post‐procedure. Results Picosecond‐domain fractional laser treatment immediately after the dermal injection of HAF into rats did not cause any histological changes in the filler or surrounding skin. In a clinical study, treated subjects (n = 36) achieved significant improvement in acne scars and patient satisfaction. No serious adverse events were observed. Conclusions Combined picosecond laser and HAF treatment were proven to be safe and effective based on in vivo and clinical study results. Facial rejuvenation and scar treatment using a picosecond‐domain fractional laser may be performed immediately after HAF injection. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.