title: Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring.
abstract: OBJECTIVE
  Fractional laser technology is routinely used in the treatment of acne scarring, with thermal injury resulting in collagen synthesis and remodeling. Use of a picosecond pulse duration with a diffractive lens array may be a new technologic advancement in the treatment of acne scarring.
  
  
  OBJECTIVE
  To investigate the safety and efficacy of a 755-nm alexandrite picosecond pulse duration laser with diffractive lens array for the treatment of facial acne scarring.
  
  
  METHODS
  This single-center, prospective study performed in a private practice with a dedicated research department included patients with clinically diagnosed scarring secondary to inflammatory or cystic acne.
  
  
  METHODS
  Patients received 6 treatments with a 755-nm picosecond laser with a spot size of 6 mm, fluence of 0.71 J/cm2, repetition rate of 5 Hz, and pulse width of 750 picoseconds in combination with a diffractive lens array, allowing for greater surface area and pattern density per pulse.
  
  
  METHODS
  The pain and satisfaction scores for overall appearance and texture were recorded. Masked assessment of clinical photographs and analysis of 3-dimensional volumetric data were performed. Biopsy specimens were obtained for independent histologic evaluation by 2 investigators at baseline and at 3 months after last treatment.
  
  
  RESULTS
  Fifteen women and 5 men (mean age, 44 years; age range, 27-61 years) with Fitzpatrick skin types I through V and facial acne scarring were enrolled. The mean pain score was 2.83 of 10. Patients were satisfied to extremely satisfied with improvement in appearance and texture at their final treatment and follow-up visits. The masked assessment scores of 17 patients were 1.5 of 3 and 1.4 of 3 at 1 and 3 months, respectively (a score of 0 indicates 0%-25% improvement and a score of 3 indicates >75% improvement). A 3-dimensional analysis revealed a mean 24.3% improvement in scar volume, maintained at 1 (24.0%) and 3 (27.2%) months after treatment. Histologic analysis revealed elongation and increased density of elastic fibers, with an increase in dermal collagen and mucin.
  
  
  CONCLUSIONS
  Treatment of facial acne scars with a diffractive lens array and 755-nm picosecond laser produced improvement in appearance and texture at 3 months after the last treatment, with objective findings similar to those published for a series of fractional ablative laser treatments. Histologic findings suggest that improvement in scarring from this treatment goes beyond remodeling of collagen.
authors.affiliation: Laser & Skin Surgery Center of New York, New York, New York2Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, New York.
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Brauer
authors.affiliation: Ackerman Academy Dermatopathology, New York, New York.
authors.forename: Viktoryia
authors.initials: V
authors.lastname: Kazlouskaya
authors.affiliation: Laser & Skin Surgery Center of New York, New York, New York.
authors.forename: Hamad
authors.initials: H
authors.lastname: Alabdulrazzaq
authors.affiliation: Laser & Skin Surgery Center of New York, New York, New York.
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Bae
authors.affiliation: Laser & Skin Surgery Center of New York, New York, New York4Department of Dermatology, Weill Cornell Medical Center, New York, New York.
authors.forename: Leonard J
authors.initials: LJ
authors.lastname: Bernstein
authors.affiliation: Laser & Skin Surgery Center of New York, New York, New York2Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, New York4Department of Dermatology, Weill Cornell Medical Center, New York, New York.
authors.forename: Robert
authors.initials: R
authors.lastname: Anolik
authors.affiliation: Ackerman Academy Dermatopathology, New York, New York.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Heller
authors.affiliation: Laser & Skin Surgery Center of New York, New York, New York2Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, New York.
authors.forename: Roy G
authors.initials: RG
authors.lastname: Geronemus
mesh_terms: D000152:Acne Vulgaris / Q000150:complications* / Q000473:pathology; D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D003094:Collagen / Q000378:metabolism*; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D003094:Collagen