Biomedical subjects
Publications and source records attributed to George Hruza.
Lasers are a useful tool to combat signs of aging, photodamage, and environmental effects on the skin. This article reviews the history, basic science, indications, clinical considerations, and procedural techniques of various ablative lasers.
OBJECTIVE: The objective of this study was to assess the safety and efficacy of a 585 nm flashlamp pulsed-dye laser for the nonablative treatment of facial rhytides. METHODS: A multicenter prospective randomized controlled study on 58 volunteers was performed. A split-face approach was adopted, with one periorbital region acting as a control and the other receiving either one or two treatments. Patients were photographed and imaged three-dimensionally before and after treatment. Histologic sections were analyzed. RESULTS: Three-dimensional topographic evaluation showed improvements of 9.8% (p = .0022) and 15% (p = .0029) in surface roughness for single and double treatments, respectively. Histology revealed an increase in type I collagen messenger ribonucleic acid expression, type III procollagen, chondroitin sulfate, and grenz zone thickness. Two treatments resulted in greater improvement than one treatment. CONCLUSION: Clinical improvement was achieved following a single treatment. Further improvement was observed following a second treatment. The subjective evaluation of clinical improvement was consistent with both histologic and topographic quantitative measurements.
Because of its cosmetic implications in the treatment of photoaging and facial rejuvenation, CO2 and Er:YAG laser resurfacing has raised a lot of interest. It has replaced dermabrasion and medium and deep chemical peels in many clinical settings. The best technique or combination of techniques for any given treatment will depend on the judgment and experience of the skilled clinician. Treatment results have been impressive. As laser technology is refined, the side effect and complication profiles of laser resurfacing continue to improve.
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BACKGROUND: The authors previously reported their experience achieving non-ablative skin enhancement with serial, full-face, intense pulsed light treatments in a large series of patients. A new method for skin renewal electro-optical synergy (ELOS), which combines intense pulsed optical energy and conducted bipolar radiofrequency (RF) energy into a single pulse, has been recently introduced. Intense pulsed optical energy and bipolar RF energy have been used in dermatologic surgery for many years; however, this study represents the therapeutic impact of the combined energies. OBJECTIVE: The authors report their experience using an ELOS system (Aurora SR, Syneron, Yokneam, Israel) on 108 consecutive patients treated with a series of full-face procedures. METHODS: Patients received 5 full-face treatments every 3 weeks. Each treatment consisted of 1 to 8 full-face and segmental passes. The number of passes, specific wavelength of pulsed optical energy, and RF energy were determined by the patient's skin type, dyschromia, wrinkle pathology, and presence of a tan. A total of 540 treatments were performed on 108 subjects. All patients had pre- and post-procedural photographs. Results were assessed by double-blinded physician photographic evaluation and patient satisfaction scales. RESULTS: Overall skin improvement was rated at 75.3%. Overall average wrinkle improvement was 41.2%, with an average Class 1 wrinkle improvement of 64.7%, Class 2 wrinkle improvement of 38.6%, and Class 3 wrinkle improvement of 20.4%. Improvement in skin laxity was rated at 62.9%. Skin texture was reported to improve 74.1%. Improvement in the appearance of pore size was rated at 65.1%. Average improvement in erythema and telangiectasia was 68.4%. Average improvement in hyperpigmentation and dyschromia was 79.3%. Overall patient satisfaction was 92%. The overall minor complication rate, including blistering, crusting, and stripping was 8.3%, and the major complication rate was less than 1%. One small, depressed nasal scar was observed in one patient. CONCLUSIONS: This study demonstrates the safety and efficacy of a new technology using combined optical and conducted bipolar RF energies for noninvasive skin rejuvenation. The results show improvement in wrinkle reduction and amelioration of erythema, telangiectasia, and hyperpigmentation comparable to that reported for other intense pulsed light technologies.