Advanced Laser Eases Acne Scars, Melasma, and Wrinkles

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Laser technology has become a prominent treatment for various skin disorders, including acne scars, vascular lesions, and pigmented lesions.¹ Traditional treatments for hyperpigmentation often involve topical agents like hydroquinone and oral formulations like tranexamic acid, which can cause adverse events such as erythema and dryness and require long periods to show results.² Scar treatments, while varied, face challenges such as recurrence, adverse events, and efficacy issues, underscoring the need for safer and more effective options.³

Non-ablative lasers, particularly the 675-nm wavelength device, are emerging as a promising alternative. These lasers use selective photo-thermolysis to target specific skin components, promoting biological effects such as collagen synthesis without damaging surrounding tissues.⁴ Preclinical studies have shown that the 675-nm laser can stimulate type III collagen production in fibroblasts without cytotoxic effects.⁵

Clinical studies have validated the efficacy of the 675-nm laser in various applications, including facial rejuvenation, acne scars, and melasma, even in darker skin types.⁶ The laser improves skin texture and reduces wrinkles by activating dermal fibroblasts to produce new collagen. Additionally, in trichology, this wavelength prolongs the anagen phase of hair follicles, enhancing hair growth and strength.⁷

With this new research at the forefront, a recent review used in vitro and clinical investigations to test the efficacy, safety, and speed of treatment of high-powered laser systems emitting a 675-nm in the management of various skin conditions.⁸

“The high-powered 675 nm laser has shown excellent results on various skin conditions including diffuse pigmented lesions, melasma, skin rejuvenation, acne scars, acne vulgaris and vascular lesions, and patients treated have reported no serious adverse events,” researchers wrote.

Materials and Methods

The study utilized the Red Touch PRO laser system (DEKA M.E.L.A; Italy) with a 675 nm wavelength to treat patients with various skin issues, including pigmented lesions, wrinkles, and acne scars. The laser generates micro-areas of selective thermal damage (DOTs) while protecting the epidermis with a cooling system. For in vitro experiments, human dermal fibroblasts (hDFA) cells were cultured and irradiated with different energy levels to evaluate cellular responses, followed by immunocytochemistry to assess protein expression.Treatments were adjusted based on skin response, with outcomes assessed using clinical photos, global aesthetic improvement scales, and patient satisfaction ratings.

In Vitro Results

Researchers found irradiation of hDFA cells with a 675-nm laser did not induce Ki-67 positivity after 24 hours. However, after 48 hours, they stated a fluence of 390 J/cm² led to a significant increase in Ki-67+ cells. By 72 hours, researchers reported both the 390 J/cm² and 520 J/cm² doses resulted in a notable rise in Ki-67+ cells. Additionally, for androgenetic alopecia, preliminary in vitro experiments on hDFA cells showed that a 675-nm laser at 3.3 J/cm² stimulated cell proliferation after 48 hours.

Clinical Data

For pigmented lesions, patients with diffuse solar lentigines were treated using parameters of 12–15 W, a 150 ms dwell time, and an energy/DOT range of 1.80 to 6.75 J. Researchers found the treatment led to a reduction or disappearance of lesions, with minimal adverse events including mild redness and crusting. The GAIS score averaged 3.67, and patient satisfaction was 2.83. In cases of melasma, which researchers treated with 15 W and 2.25 J energy/DOT, there was significant reduction in hyperpigmentation, with only slight erythema and mild-to-moderate crusting observed. The GAIS score was 3.20, and patient satisfaction was 3.00.

The study stated skin rejuvenation treatments involved 16 patients using a 15 W laser with energy/DOT between 2.25 and 4.5 J. Results showed an improvement in skin texture, pore size, skin laxity, and wrinkles, with a mean GAIS score of 2.93 and patient satisfaction of 2.44. The study stated most patients experienced transient redness and mild crusting.

For prejuvenation, researchers stated 7 women were treated with a 15 W laser at 2.25 J energy/DOT. Results were reported to be favorable, with a GAIS score of 3.40 and patient satisfaction of 2.83. Adverse events included mild redness and crusting, which resolved quickly.

In the case of acne scars, the study stated 5patients underwent 2 to 3 sessions with a 15 W laser and energy/DOT ranging from 2.25 to 11.25 J. Researchers discovered the treatment resulted in scar flattening and improved skin texture, with a GAIS score of 3.50 and patient satisfaction of 2.75. Pain was minimal, and the study stated crusting was short-lived.

Other treatments included acne vulgaris and vascular lesions. For acne vulgaris, researchers stated 2 patients were treated with 15 W and 2.25 J energy/DOT, resulting in reduced acne lesions and improved texture, with a GAIS score of 3.5 and patient satisfaction of 3.00. For vascular lesions, including rosacea and diffuse redness, the study stated the same laser parameters led to improved skin brightness and a reduction in vascular components, with a GAIS score of 3.33 and patient satisfaction of 3.00. Mild redness and crusting were noted but were generally resolved within a few days.

Conclusion

The study found the high-power 675-nm laser demonstrated significant effectiveness in treating various skin conditions such as acne scars, pigmented lesions, melasma, and vascular lesions, while also offering benefits for skin rejuvenation. Researchers stated this technology provides a promising alternative in aesthetic medicine due to its ability to stimulate fibroblast proliferation and collagen production without inducing serious adverse events.

References

1. Paasch U, Zidane M, Baron JM, et al. S2k guideline: Laser therapy of the skin. J Dtsch Dermatol Ges. 2022;20(9):1248-1267. doi:10.1111/ddg.14879
2. Nautiyal A, Wairkar S. Management of hyperpigmentation: Current treatments and emerging therapies. Pigment Cell Melanoma Res. 2021;34(6):1000-1014. doi:10.1111/pcmr.12986
3. Liu Y, Wang S, Yang F, et al. Application and progress of new technologies and new materials in the treatment of pathological scar. Front Chem. 2024;12:1389399. 2024. doi:10.3389/fchem.2024.1389399
4. Ciocon DH, Doshi D, Goldberg DJ. Non-ablative lasers. Curr Probl Dermatol. 2011;42:48-55. doi:10.1159/000328249
5. Magni G, Pieri L, Fusco I, et al. Laser emission at 675 nm: In vitro study evidence of a promising role in skin rejuvenation. Regen Ther. 2023;22:176-180. 2023. doi:10.1016/j.reth.2023.01.007
6. Alter I, Pennati BM, Madeddu F, et al. The 675 nm laser for the treatment of facial acne scars in dark skin type. Skin Res Technol. 2023 Nov;29(11):e13514. doi: 10.1111/srt.13514. PMID: 38009031; PMCID: PMC10603311.
7. Leavitt M, Charles G, Heyman E, et al. HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: A randomized, double-blind, sham device-controlled, multicentre trial. Clin Drug Investig. 2009;29(5):283-292. doi:10.2165/00044011-200929050-00001
8. Vitale MDF, Madeddu F, Fusco I, et al. High-powered 675-nm laser: Safety and efficacy in clinical evaluation and in vitro evidence for different skin disorders. Skin Res Technol. 2024; 30:e70019. doi:10.1111/srt.70019