Usage ofNd:YAG Laser 1064 nm for treatment of Atrophic Acne Scars in Dark Skin Patients

Abstract

Acne scarring, is a common dermatologic condition. Effective treatment of facial acne scarring presents a major challenge. Nonablative laser irradiation has been introduced as a safer modality for the correction of acne scars, especially in patients with darker skin. Photothermal effect causing damage to the upper dermis, and initiating wound healing process leading to collagen synthesis, which improve the atrophic scars. Study objectives: 1- This study aimed to evaluate the effectiveness of the neodymium:yttriumaluminum- gamet (Nd: Y AG) laser in treating acne scars in dark skin patients Materials and Methods: This study is a prospective, clinical descriptive, interventional study, done in Sudan University of Science and Technology Institute Of laser, in collaboration with Alyaa Medical Centre, during the period between 1/2/2011 - 15/4/ 2011. Six patients were included in this study, only five of them received two treatments with Nd: Y AG laser I 064nm at 3 weeks interval. The laser parameters used were: Flounce 70 J/cm2, Spot size: 7 mm, Pulse duration: 70.5 ms, which fractionated into 3pulses: 3X (7.5 ms for each) with 24 ms delay, Repetition rate: 1 H.z, cooling spray was used 200 ms before and after the laser radiation. Before and after photographs were depicted. A written informed consent was signed, and laser safety precautions were followed. Three elements for response evaluation were considered, they are Photograph Analysis, patient satisfaction and side effects evaluation. Results and Discussion: After two treatments, result was excellent in 2 patients ( 40%) and good in the remaining 3 patients (60%). Four patients (80.0%) experienced mild side effects as crustation and blistering. Transient hyperpigmentation and/or hypopigmentation were seen in some of them. No patient experienced moderate or severe side effects. All patients reported > ( 60%) satisfaction Conclusion and Recommendation: The usage of long pulsed 1064 nm Nd: Y AG laser is effective in treating atrophic acne scars in dark skin patients. After only 2 treatments the result was excellent in ( 40.0%) of patients and good in ( 60.0% ). All patients were satisfied by the result, and the side effects were mild and transient The advisable parameters are 70 J/cm2, 70.5 ms duration with fractionated pulse: 3X (7.5 ms for each)+ 24 ms delay, 7 mm spot size, and Repetition rate: 1 H.z.