A. Campo-Voegeli , M.P. Arboles
Introduction: We present a new modality of facial treatment program based on the combination of 4 light sources (two IPL systems, a fractional YSGG and a non fractional YSGG laser) applied sequentially on the same treatment session, to correct aging signs or acne scars.
Material and methods: Patients with photoaging and acne scars were included in this studuy. Standardized photographs were taken to assess skin pigmentation (actinic len- tigines and non speciﬁ c actinic pigmentation), presence of telangiectasia, skin textural changes (pore size, elastosis, acne scars) and lower face laxity. Wrinkle types (Fitzpatricks scale) were assessed through clinical evaluation. Two IPL systems with cut off ﬁ lters in the 520–550 nm ranges were selected for pigmented or vascular lesions. A fractional 2790 nm YSGG laser was applied on areas of severe elastosis or Fitzpatricks type 2–3 wrinkles and a full face pass with a non-fractional 2790 nm YSGG was performed to improve textural changes. All four systems were used sequentially on the same treatment session. After 4 weeks a second treatment was offered to those patients with persistent actinic damage or acne scars. Patients were evaluated at 1, 2 and 5 days after the procedure to establish recovery time, social downtime, and clinical evolution. Clinical pictures and wrinkle assessment were repeated at 4, 12 and 24 weeks after the treatment and compared with initial data by 2 independent observers. Patient satisfaction was assessed 6 months after the procedure and the time between start and achievement of ﬁ nal results was evaluated.
Results: 34 patients with actinic damage and 9 with acne scars were included in this study. 25 of 34 patients with actinic damage and 5 of 9 with acne scars were treated with all the 4 light sources. The remaining patients did not receive the fractional procedure. An average downtime of 5.8 days was referred by the patients, with transient hyperpigmentation in 3 patients and erythema in 6 patients as the main secondary reaction. Moderate to high improvement on all signs of aging were referred by clinical and photographical assessment in 28/34 patients with photoaging and in 8/9 patients with acne scars. No signiﬁ cant improvement was observed in 2 patients with photoaging and 1 patient with acne scars. 93% of the patients referred to be satisﬁ ed or very satisﬁ ed (40/43). A mean of 7.3 weeks and 12.5 weeks were needed to achieve ﬁ nal results in photaging and acne scars respectively.
Discussion: The combination of different light sources that target different cromophores and depths in the same treatment session permits us to reduce the number of total treatments, the total downtime and the time for ﬁnal results optimizing the results with no apparent increase in the incidence and severity of secondary reactions.