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Background: Laser test spots are commonly suggested for the assessment of clinical response and adverse effects, but use by laser operators is not well described., Objective: To describe the use of laser test spots in the existing published literature regarding methodology (location, treatment parameters) and objective (clinical efficacy, safety, other)., Materials and Methods: This scoping review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and included indexed studies performing test spots in human subjects for dermatologic conditions with clinical reassessment at a subsequent visit., Results: Among 5,261 identified publications, 103 studies with 959 test spots were selected for inclusion. Test spots conducted were mostly on lesional skin (89.3%) assessing both clinical response and adverse effects (76.9%). Most test spots used multiple laser parameters with a single wavelength (48.3%). Fluence was most frequently adjusted either alone (30.1%) or in combination with pulse duration or spot size. Other described test spots examined single set of laser parameters, multiple wavelengths with various parameters, or were left unspecified., Conclusion: Laser test spot methodology was diverse and performed for dual objectives of efficacy and safety. The authors have compiled clinical considerations to assist laser operators in deciding whether performing a test spot may be beneficial to their patient., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Topical anesthesia has vasodynamic effects within the skin and therefore has the potential to change the presence of hemoglobin as a chromophore before intense pulsed light (IPL) and vascular laser treatments. It is unclear whether this is clinically relevant. Global consensus on the use of topical anesthetics in this context is lacking., Objective: Review the effects of topical anesthetics on the skin microvasculature and the clinical implications of such effects on vascular treatments., Methods: PubMed and Medline searches were performed to identify studies examining the vasodynamic effects of topical anesthesia on skin and evaluating differences in efficacy of IPL and vascular laser treatments with or without topical anesthetic use., Results: Published studies reveal variable effects of different topical anesthetic agents on skin microvasculature. Only 3 controlled studies that directly examined the effect of topical anesthesia on clinical outcomes for pulsed dye laser (PDL) treatment of vascular conditions were identified. They did not support a difference in clinical outcomes with or without the use of topical anesthesia before PDL treatment., Conclusion: Although topical anesthetic agents have vasodynamic effects within the skin, there is currently insufficient evidence to advise against their use before light and laser-based vascular treatments., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Preference in eyebrow shape has been studied in young women, but less so in older adults, men, and a wide variety of ethnic groups., Objective: To identify preference in eyebrow shape across age groups, genders, and ethnic groups for both the survey responder and the observed subject., Methods: Digital images of subjects from 3 age groups (18-39, 40-59, and 60+ years), 2 genders (female and male), and 4 self-identified ethnic backgrounds were edited to correspond to 5 brow shapes (Anastasia, head-up, horizontal, rounded, and tail-up). Panels of images representing the same subject with different brow shapes were displayed and responders ranked them in order of attractiveness via an online survey., Results: Six hundred fifty-two responders answered the survey. Survey responders generally preferred the Anastasia shape, but not in all subgroups. Strength of preference in eyebrow shape was more marked when observing images of women and less marked when observing men., Conclusion: An arched brow, such as the Anastasia shape, was the preferred eyebrow shape. This study is limited by its survey nature, underrepresentation of self-identified Black study responders, and categorization of data. Despite these findings, the authors advocate determining eyebrow shape preference individually with patients during cosmetic consultations., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: The eye is susceptible to damage during dermatologic laser treatments., Objective: Discuss the anatomy of the eye related to these procedures, the principles of laser-eye interactions, and ocular injuries reported with dermatologic laser treatments., Methods: PubMed and Embase searches were conducted to identify cases of eye injuries associated with dermatologic laser treatments., Results: One hundred nineteen cases of eye injury associated with dermatologic laser treatments were identified. Fifty-nine cases targeted the eyelid during resurfacing and caused ectropion, while 60 cases resulted from direct injury of ocular structures. In most of the cases of the latter, improper eye protection was used (44 of 60, 73%). In nearly all these cases, it was the patient who sustained a potentially avoidable ocular injury (52 of 60, 87%). Thirty-one patients had persistent ocular symptoms at follow-up (52%). The most common procedure in this context was laser hair removal of the face (35 of 60, 58%). Most of the cases developed injuries specific for the particular laser based on its wavelength and affinity to target certain ocular chromophores (59 of 60, 98%)., Conclusion: Most of the dermatologic laser-associated eye injury cases have occurred in the context of laser resurfacing or laser hair removal and are potentially preventable., (Copyright © 2022 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: OnabotulinumtoxinA (OnabotA) injections are effective to treat palmar hyperhidrosis (HH) but are quite painful., Objective: To evaluate efficacy and pain of OnabotA injection using a needle-free jet apparatus compared with the traditional needle injection to treat palmar HH., Methods: Twenty patients were recruited for a prospective open-label study. Their right hand was injected with 1% lidocaine with a jet injector, after which OnabotA was injected with a needle. The left hand was injected with OnabotA directly using the jet injector. Pain scores were recorded for both techniques. At 0, 1, 3, and 6 months, severity of palmar HH was evaluated with the Hyperhidrosis Disease Severity Scale (HDSS)., Results: One point reduction in the HDSS score at 1 month showed no statistical difference between both hands (p = .451). However, the HDSS score at 1 month from baseline dropped by 1.6 for the hand treated with traditional needle injection of OnabotA compared with 1.25 for the hand treated with jet injections (p = .031). There was no statistical difference in the pain on injection with both techniques (p = .1925)., Conclusion: This study demonstrates effective and relatively painless use of a low-pressure jet injector for OnabotA in palmar HH.