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BACKGROUND Laser pretreatment of skin can be used to enable drugs used in dermatology to penetrate the skin to the depth necessary for their effect to take place. OBJECTIVE To compare the permeation of tranexamic acid after conventional non-fractionated ablative Er:YAG and CO2 laser pretreatment in a laser-aided transdermal delivery system. MATERIALS AND METHODS An erbium-doped yttrium aluminium garnet (Er:YAG) and a CO2 laser were used to pretreat dorsal porcine skin. Scanning electron microscopy was used to examine disruption of the skin surface. Confocal laser scanning microscopy was used to determine the depth of penetration of a reporter molecule (fluorescein isothiocyanate) into the skin. A Franz diffusion assembly was used to examine fluency-related increases in transdermal delivery of transexamic acid. RESULTS Transdermal delivery of tranexamic acid increased as Er:YAG laser fluency increased. Transdermal delivery was higher when CO2 laser pretreatment was used than when Er:YAG laser pretreatment was used, but a "ceiling effect" was present and increasing the wattage did not cause a further increase in delivery. CO2 laser pretreatment also caused more extensive and deeper skin disruption than Er:YAG laser pretreatment. CONCLUSION For conventional, non-fractionated ablative laser pretreatment, the Er:YAG laser would be an optimal choice to enhance transdermal penetration of transexamic acid.

BACKGROUND The introduction of fractional photothermolysis (FP) for the treatment of atrophic acne scars has been proven to provide satisfactory results. For severe atrophic acne scarring, nonablative FP achieves fair improvement and takes multiple treatment sessions. Ablative fractional resurfacing provides an alternative modality with greater satisfaction. OBJECTIVE To evaluate the effectiveness and safety of the ablative fractional 2,940-nm erbium-doped yttrium aluminum garnet (Er:YAG) laser with coagulation mode for the treatment of atrophic facial acne scars in Asian skin. METHODS Thirty-four patients aged 19 to 44 (mean 34.2) with Fitzpatrick skin types III and IV, received one ablative fractional 2,940-nm Er:YAG laser treatment with an adjustable coagulation mode and were followed for 3 months. Physician evaluation and patient satisfaction were graded on a 4-point scale. Side effects were recorded at each follow-up visit. RESULTS Almost three-quarters of the patients rated their satisfaction as good to excellent (score of 3 or 4). All patients experienced short downtime, and the incidence of postinflammatory hyperpigmentation was low (3.0%). CONCLUSIONS The ablative fractional Er:YAG laser with coagulation mode is recommended for the treatment of moderate to severe atrophic acne scars, with acceptable downtime and high satisfaction in Asian patients.

BACKGROUND In recent years, using the 1,064-nm Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser (QSNYL) with or without exogenous topical carbon solution application for facial skin rejuvenation has become popular in Southeast Asia, but there has not been any published clinical report discussing the rejuvenation effect of QSNYL for Asian patients. OBJECTIVE To evaluate the efficacy of QSNYL in improvement of pore size, sebaceous secretion, skin texture, and skin tone of Asian patients. We also observed whether there is any enhancement of application of topical carbon solution before the therapy. METHODS Twenty-four female patients completed four sessions of treatments at 4-week intervals. The assessment was evaluated by the patients, two independent physicians, and Canfield VISIA Complexion Analysis. In addition, we conducted a split-face study such that, in each case, topical carbon solution was applied to the right side of the face before the laser treatment. RESULTS All evaluations showed significant improvement in rejuvenation effect. There was no difference in improvement in skin texture even after the application of topical carbon solution in our split-face study. CONCLUSION The QSNYL is a safe and effective rejuvenation modality in Asian patients. Topical carbon solution application did not enhance laser efficacy.

Atrophic facial acne scars is one of the most common problems in patients with inflammatory acne. Ablative laser resurfacing has unpleasant complications and a long recovery period. Nonablative therapies yield less improvement and satisfaction. The introduction of fractional photothermolysis (FP) is an alternative treatment for atrophic acne scars.To evaluate the effectiveness and safety of a nonablative 1,550-nm erbium-doped fiber laser in the FP of atrophic facial acne scars in one treatment session.Forty-five patients (skin type III-IV, mean age 29) with atrophic facial acne scars were enrolled in the study. Each patient received one treatment of FP. Comparative photographs were taken using specific complexion analysis to identify and quantify depressed scars and texture. Physician evaluations and patient satisfaction were graded on a 4-point scale. Side effects were recorded at each follow-up visit.The improvement in atrophic scars and texture after a FP treatment were significant. Twenty-seven (60%) of the patients had good to excellent results after 1 month.The FP of atrophic facial acne scars resulted in significant improvement even in a single treatment, with good satisfaction and unremarkable side effects.