This study evaluated the long-term anti-aging effects of regular BroadBand Light (BBL) therapy treatments over 5 to 11 years. Fifteen participants received at least one full-face BBL treatment per year. Before and after photographs were evaluated by 491 blinded evaluators who estimated the participants' ages. While the participants' skin actually aged a median of 9 years, their skin appeared to age by only a median of -2 years. The median estimated post-treatment age was significantly lower than the actual post-treatment age, indicating BBL therapy reduced and delayed signs of skin aging over the long term with regular annual or biannual treatments.
A Comparative Study of Hyfrecator Ablation to that of Cryosurgery in the Mana...inventionjournals
: 605 patients in a Tertiary care center during a period of one year with benign skin growths were treated with either Electro surgery or Cryo surgery. 314 were treated with Hyfrecator and 291 were treated with Cryo surgery. Both procedures were done as op procedures without much complications and they were very much cost effective. There were no recurrences in both groups with a follow up period of 30 days. Hyfrecator scores slightly better compared to Cryo-surgery in this study with regards to scar formation and costwise.
A Comparative Study of Hyfrecator Ablation to that of Cryosurgery in the Mana...inventionjournals
: 605 patients in a Tertiary care center during a period of one year with benign skin growths were treated with either Electro surgery or Cryo surgery. 314 were treated with Hyfrecator and 291 were treated with Cryo surgery. Both procedures were done as op procedures without much complications and they were very much cost effective. There were no recurrences in both groups with a follow up period of 30 days. Hyfrecator scores slightly better compared to Cryo-surgery in this study with regards to scar formation and costwise.
Role of Topical Tranexamic Acid in Hemostasis of Locally Advanced Basal Cell ...J W
Tranexamic acid (TXA) is a synthetic derivative of
the amino acid, lysine. Conventionally used orally or
intravenously, topical administration of TXA has the
ability to reduce bleeding with minimal systemic
absorption and, in turn, reduce the risk of systemic
side effects. Previous clinical trials found that topical
TXA reduces blood loss in cardiac, orthopedic, and
otolaryngologic surgery.1 However, the hemostatic
role of topical TXA for the skin has not been fully
established. We describe a case of an elderly female
with locally advanced basal cell carcinoma (BCC) of
the scalp that was managed conservatively. The
bleeding from the tumor was reduced with the aid
of topical TXA.
Narrowband ultraviolet B (NBUVB)
phototherapy is a well-established treatment modality
for psoriasis. We performed a retrospective analysis
of children of East Asian descent with psoriasis
treated with NBUVB phototherapy at the National Skin
Centre, Singapore, over a 5-year period between 2004
and 2008 and found that NBUVB phototherapy is safe
and effective for the treatment of psoriasis in children
of East Asian descent.
Alma 2016 Clinical Publication - Legato II Treats Scars Hamutal Gozlan
Clinical and histological results in the treatment of atrophic
and hypertrophic scars using a combined method of
radiofrequency, ultrasound and transepidermal drug delivery
Inter-grader Agreement in the Diabetic Retinopathy Screening Program in Pales...Riyad Banayot
e audit demonstrates an adequate level of quality and accuracy for primary grading in the diabetic
retinopathy screening program in the occupied Palestinian territories.
Development of Best Practice Guidelines for Cutaneous T-Cell Lymphoma (CTCL) ...DUNCAN RASUGU
The use of the traditional method of whirlpools in controlling ulcerations in MF remains a great challenge. According to research, removal of the gross contaminants and toxic debris from the wounds together with the dilution of the surface bacteria is a threat that has been observed among many patients that undergo the traditional treatment. The purpose of this work is to develop the guidelines for an alternative treatment of wounds using Vashe Solution Therapy.
Inter grader agreement in the diabetic retinopathy screening program in pales...Riyad Banayot
This audit aims to assess the quality and accuracy of primary graders in the diabetic retinopathy screening program in the occupied Palestinian territories
Miaderm®'s evidence based approach to decrease the severity of radiation dermatitis through preventative care. Miaderm® comes with a 100% unconditional guarantee of satisfaction
Role of Topical Tranexamic Acid in Hemostasis of Locally Advanced Basal Cell ...J W
Tranexamic acid (TXA) is a synthetic derivative of
the amino acid, lysine. Conventionally used orally or
intravenously, topical administration of TXA has the
ability to reduce bleeding with minimal systemic
absorption and, in turn, reduce the risk of systemic
side effects. Previous clinical trials found that topical
TXA reduces blood loss in cardiac, orthopedic, and
otolaryngologic surgery.1 However, the hemostatic
role of topical TXA for the skin has not been fully
established. We describe a case of an elderly female
with locally advanced basal cell carcinoma (BCC) of
the scalp that was managed conservatively. The
bleeding from the tumor was reduced with the aid
of topical TXA.
Narrowband ultraviolet B (NBUVB)
phototherapy is a well-established treatment modality
for psoriasis. We performed a retrospective analysis
of children of East Asian descent with psoriasis
treated with NBUVB phototherapy at the National Skin
Centre, Singapore, over a 5-year period between 2004
and 2008 and found that NBUVB phototherapy is safe
and effective for the treatment of psoriasis in children
of East Asian descent.
Alma 2016 Clinical Publication - Legato II Treats Scars Hamutal Gozlan
Clinical and histological results in the treatment of atrophic
and hypertrophic scars using a combined method of
radiofrequency, ultrasound and transepidermal drug delivery
Inter-grader Agreement in the Diabetic Retinopathy Screening Program in Pales...Riyad Banayot
e audit demonstrates an adequate level of quality and accuracy for primary grading in the diabetic
retinopathy screening program in the occupied Palestinian territories.
Development of Best Practice Guidelines for Cutaneous T-Cell Lymphoma (CTCL) ...DUNCAN RASUGU
The use of the traditional method of whirlpools in controlling ulcerations in MF remains a great challenge. According to research, removal of the gross contaminants and toxic debris from the wounds together with the dilution of the surface bacteria is a threat that has been observed among many patients that undergo the traditional treatment. The purpose of this work is to develop the guidelines for an alternative treatment of wounds using Vashe Solution Therapy.
Inter grader agreement in the diabetic retinopathy screening program in pales...Riyad Banayot
This audit aims to assess the quality and accuracy of primary graders in the diabetic retinopathy screening program in the occupied Palestinian territories
Miaderm®'s evidence based approach to decrease the severity of radiation dermatitis through preventative care. Miaderm® comes with a 100% unconditional guarantee of satisfaction
Abstract—Scarring is a well recognized sequel of acne. Because of the prevalence of acne scarring and strong negative emotions it engendering affected patients, several approaches have been developed for its treatment with varying success rates. Glycolic acid 50% peels and Salicylic acid 30% Peels are classified as superficial peel and are consider safe in Indian patients. While chemical peels are widely being used in India for various indications. There is a paucity of published studies on the efficacy of chemical peel specifically for acne scars in Indian patients.
Purpose of this study was to evaluate and compare the effectively of these two agents in the treatment of acne scars. Eighty cooperative patients[≥18 years age]with predominantly moderately atrophic acne scarring were randomly divided into 2groups of 40each.Patients of group A received Glycolic acid peels and patients in group B, Salicylic acid was used at 3weeks interval for four sessions. Objective evaluations of treatment response. Subjective assessments of treatment response were also done separately by the researcher, an independent observer and the patients separately.
Both of agents led to significant reduction in the total acne scar score[p< 0.05]but no significant difference was noted between the two peels. Side effects were lesser with Salicylic acid peel.
Hence conclusion was drawn that both 50% Glycolic acid and 30% Salicylic acid peels are safe in Indian skin and equally effective in the treatment of mild to moderate acne scarring.
Article looks at 'Multi Procedural Approach to Facial Rejuvenation' as it combines Microneedling, Omnilux 633 Phototherapy, Blood group factors injection to stimulate neocollagenesis within facial area.
Dr Patrick Treacy on combining therapies for optimal outcomes in treating the...Dr. Patrick J. Treacy
This paper looks at the possibility of combining five
established therapies in an attempt to address
common concerns related to facial ageing. The
therapies included microneedling, low dose
Ultralase laser, (PRP) plasma rich protein growth
factors, Omnilux 633 light and neurotoxins. The technique is
called the DUBLiN face-lift as an acronym of the procedures
involved. D Dermaroller U Ultralase Laser B Blood growth
factors Li Light (near red 633) N Neurotoxin.
The author compared this method to fractionalised laser
skin resurfacing (FLSR) in terms of reduction of photoageing
and overall aesthetic effect. Neurotoxin was used in
both studies.
Journal Club Presentation on Barcitinib for Alopecia Areata.pptxJoel M Johns
Background: There are no treatments approved by the Food and Drug Administration for alopecia areata.
Objective: To evaluate the efficacy and safety of baricitinib in patients with $50% scalp hair loss in a phase 2 study of adults with alopecia areata (BRAVE AA1).
Methods: Patients were randomized 1:1:1:1 to receive placebo or baricitinib 1 mg, 2mg, or 4 mg once daily. Two consecutive interim analyses were performed after all patients completed weeks 12 and 36 or had discontinued treatment prior to these time points. The primary endpoint was the proportion of patients achieving a Severity of Alopecia Tool (SALT) score #20 at week 36. Logistic regression was used with nonresponder imputation for missing data.
Results: A total of 110 patients were randomized (placebo, 28; baricitinib 1-mg, 28; 2-mg, 27; 4-mg, 27). The baricitinib 1-mg dose was dropped after the first interim analysis based on lower SALT30 response rate. At week 36, the proportion of patients achieving a SALT score of #20 was significantly greater in baricitinib 2-mg (33.3%, P = .016) and 4-mg (51.9%, P = .001) groups versus placebo (3.6%). Baricitinib was well tolerated with no new safety findings.
The use of adipose tissue transfer in plastic and reconstructive surgery is not new and has been studied for more than a century but problems such as unpredictability in results and a low rate of graft survival due to partial necrosis were always among major concerns. However, emerging information regarding the potential of adipose derived stem cells, new methods of cell extraction, graft preparation and injection techniques have increased the popularity of fat transfer and the efforts toward development of cell based therapies for various diseases from Adipose Derived Stem Cells (ADSC’s) and Stromal Vascular Fraction (SVF) of the adipose tissue. Although the mechanism of action of those stem cells is not fully known, their paracrine activities and transformation to various cell types can be responsible for reported clinical outcomes [1,2]. Many clinicians and researchers report better outcomes in fat grafting upon addition of SVF cells [1,2]. This study aims to investigate the long-term (3 years) safety of Antria’s cell preparation process utilizing a digestive enzyme in SVF assisted fat grafting. The outcomes of this study was utilized to conduct further safety and efficacy studies to obtain regulatory and marketing approval for a novel SVF extraction method in the US.
CANDIDATES FOR HIPPOCAMPAL SPARING14MethodologyTo evaluate .docxhumphrieskalyn
CANDIDATES FOR HIPPOCAMPAL SPARING 14
Methodology
To evaluate which patients would be higher priority candidates for hippocampal sparing, 3,000 participant treatment plans were evaluated via a cross-sectional differential research method. The method of research used in this study is considered differential and cross-sectional because groups of participants are different ages are compared on a set of variables and because participates of this study were assigned to groups based on preexisting factors.
Patients over the age of 18 and parents of participants under the age of 18 were asked to take part in the research. The aim of research was explained to them and informed consent was obtained by all participants prior to participating in the study. It was explained to participants, or parents of the participants, that data was going to be collected based on the treatment they received and that no additional experimentation with radiation was to be added to their treatment for the benefit of the research study, therefore, there was no additional risk to their treatment plan implemented by this differential research study. The study was subject to external review several credible institutions including the American Society for Therapeutic Radiology and Oncology (ASTRO).
Participants. Participants of this study were subjects who required WBRT and were evaluated in two categories. The two categories were based on treatment intent and will be separated into preexisting palliative and prophylactic categories. With age thought to be the most influential variable, participants in each category were further categorized into two subcategories based on age. Subjects of this study included subcategory A participates who were required to be 25 years of age and younger and subcategory B participants who were required to be 26 years old age and older based on prior research on brain development studies done by Giedd & Rapoport.
The cumulative sample size for the research study was 2,000 participants. 500 subcategory A and 500 subcategory B participants were included in each intent category. Subject exclusions included patients who were on hospice care, those on a concurrent chemotherapy regimen during their radiation therapy treatment and patients who had a treatment plan change after beginning their initially recommended treatment.
Treatment Intent
Total Number of Participants
A: Under 25
B: Over 25
Prophylactic
500
500
Palliative
500
500
Table 1. Visual representation of participants.
Data Collection Method. Data was collected from 20 Radiation Oncologist between 21 different cancer centers over a course of 18 months between January 2014 and June 2015. Two Oncologists at each cancer center participated in the study by collecting research and all had an average of 3 new WBRT patients per month. Each cancer center then treated an average of 6 new WBRT patients per month, 2,000 of which agreed to participate in the study. Data was collected from each ph ...
Laser Resurfacing, Dermabrasion, Chemical Peel In The Asian Ethnic ClientelePhilip Young
Laser Resurfacing, Dermabrasion, Chemical Peel in the East Asian Clientele
Philip A Young, MD Aesthetic Facial Plastic Surgery, PLLC
Face to Face
Ho Chi Minh City, Vietnam 2014
http://www.drphilipyoung.com/procedures/laser-resurfacing/
Similar to Long term-evaluation-of-the-anti aging-effects-of-broadbandlight-therapy (20)
Laser Resurfacing, Dermabrasion, Chemical Peel In The Asian Ethnic Clientele
Long term-evaluation-of-the-anti aging-effects-of-broadbandlight-therapy
1. Restorative Aesthetic Therapy
34 A Supplement to Cutis®
• FEBRUARY 2013 www.cosderm.com
L
ong-term exposure to UV radiation results
in photodamage of human skin that is char-
acterized by reduced epidermal and dermal
thickness, wrinkles, dyspigmentation, telangi-
ectases, coarse skin texture, and in some cases
actinic keratosis and epidermal malignancies.1
Although
they can be effective, ablative treatments require long
recovery periods, may result in scarring, and are not always
a desirable option for patients.2,3
BroadBand Light (BBL)
offers a more gentle approach to treat skin aging and can
provide impressive results, as demonstrated in this study.
Retrospective Evaluation of the
Long-term Antiaging Effects of
BroadBand Light Therapy
Patrick Bitter Jr, MD; Jason Pozner, MD
BroadBand Light (BBL), which utilizes visible and infrared light (400–1400 nm) delivered for photother-
apy, is a nonablative treatment designed to rejuvenate the skin on the face, chest, neck, forearms, legs,
and hands.The objective of this retrospective study was to evaluate if participants who underwent regu-
lar treatment with BBL over a period of 5 to 11 years looked noticeably younger than their actual age.
Fifteen participants aged 38 to 69 years (median, 46.0 years; interquartile range, 19.7 years) with
Fitzpatrick skin types I to IV received at least 1 full-face treatment per year with a BBL device (BBL,Sciton,
Inc) during the study period. Blinded evaluators (N491) analyzed clinical photographs taken before
the first treatment and after the last treatment to estimate pretreatment and posttreatment ages of
participants over 5 to 11 years.
Before treatment,the median estimated age of participants was slightly lower than the median actual
age, but the difference was not significant. The median estimated age at the end of the study period,
which varied from 5 to 11 years depending on the participant, was significantly lower than the corre-
sponding median actual age (P.0084).Although treated skin actually aged a median of 9 years,partici-
pants appeared to have aged a median of 2 years.
Results from our study indicate that patients who maintain a regular annual or biannual regimen of
BBL treatments over 5 to 11 years can reduce and delay the long-term signs of skin aging such as pho-
todamage, telangiectases, fine lines and wrinkles, and skin laxity in a natural-looking way.
Dr. Bitter is from Advanced Aesthetic Dermatology, Los Gatos,
California. Dr. Pozner is from Sanctuary Plastic Surgery, Boca
Raton, Florida.
Dr. Bitter is an investigator, preceptor, and speaker for Sciton, Inc.
Dr. Pozner is an investigator, preceptor, shareholder, and speaker for
Sciton, Inc. Sciton, Inc, provided support for completing the large
survey but did not provide direct funding for the study.
Correspondence: Patrick Bitter Jr, MD, Advanced Aesthetic
Dermatology, 14651 S Bascom Ave, Ste 202, Los Gatos, CA 95032
(bitterjrmd@aol.com).
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35
After almost 2 decades of using BBL, our experience
has shown that patients appear younger than their actual
age following long-term treatment and routine mainte-
nance with BBL. This retrospective study includes blinded
evaluations of clinical pretreatment and posttreatment
photographs by physicians and nonphysicians, including
members of the public with no aesthetic experience.
Photorejuvenation refers to the visible improvement of
photodamaged skin using a laser or other light source.1
When used for phototherapy, BBL (visible and infrared
light, 400–1400 nm) allows for targeted treatment of
many skin types and conditions. This range of light has
emerged as a nonablative modality to rejuvenate the skin
on the face, chest, neck, forearms, legs, and hands.1,4-6
BroadBand Light devices consist of a noncoherent, fil-
tered, multiwavelength light source. After BBL originally
was marketed to treat telangiectases of the legs, users soon
recognized that, unlike pulsed dye lasers, this treatment
option caused minimal purpura.7
BroadBand Light also
has been shown to improve wrinkles, coarseness, pigmen-
tation abnormalities, and pore size with minimal down-
time and no scarring.1,4,8,9
Clinical results are supported
by pretreatment and posttreatment pathology studies
that show new collagen formation1,10-13
and strong stain-
ing for types I and III procollagen14
; however, El-Domyati
et al15
reported only slight insignificant histologic changes
3 months after treatment.
An advantage of BBL versus laser devices is that it per-
mits large spot sizes, which allows physicians to treat
large areas, such as the extremities, with rapid results and
minimal discomfort for the patient.6
BroadBand Light has
been widely used as a skin rejuvenation technique in Asian
countries because treatment is effective and does not result
in persistent hyperemia, hyperpigmentation, scarring, or
other complications that typically are associated with abla-
tive lasers.10,14,16
Recommendations for physician training,
indications, patient information, documentation, diagno-
sis, and test treatment have been reported.17
Weiss et al18
previously reported 4-year results in
80 participants who were treated with visible and infra-
red light (520–1200 nm) from 1996 to 1997. Participants
received a median of 3 treatments and results were evalu-
ated 4 years later. Four years following initial treatment,
83% of participants showed improvement in skin texture,
82% showed improvement in telangiectases, and 79%
showed improvement in pigmentation.18
The objective of our retrospective study was to deter-
mine if regular maintenance treatments with BBL over
5 to 11 years results in sustained improvements in skin
quality as well as noticeable effects in the actual versus
estimated ages of participants as determined by a panel of
blinded evaluators.
METHODS
Participants
Fifteen participants (3 males; 12 females) aged 38 to
69 years (median, 46.0 years; interquartile range,
19.7 years) with Fitzpatrick skin types I to IV were
included in this retrospective study. All of the participants
meeting the minimum criterion of having undergone BBL
treatments for a minimum of 5 years were included in the
study. Participants had presented with varying degrees of
photodamage. All participants provided signed informed
consent to treatment and use of photographs.
Study Design
Each participant received a series of full-face treatments
with a BBL device (BBL, Sciton, Inc) for skin rejuvenation
during the 5- to 11-year study period. Pregnancy and
current use of retinoids and photosensitizing medication
were grounds for exclusion. Participants were allowed
to use tretinoin during the study period, but cosmetic
surgery, laser treatment, and chemical peels were not
permitted. Each participant followed their own skin care
regimen throughout the study period. All treatments were
administered by the investigators. Participants underwent
at least 1 BBL treatment per year after the initial series and
did not undergo facial aesthetic surgery or laser resur-
facing during the study period. Photographs obtained
before and after the final treatment were analyzed by
491 blinded evaluators (51 [10.4%] dermatologists;
122 [24.8%] aesthetic physicians; 44 [9.0%] other physi-
cians; 177 [36.0%] physician extenders; and 97 [19.8%]
public, non–medically oriented individuals [did not work
in the medical or aesthetic industry]). Survey participants
were asked to estimate the ages of the participants before
and after BBL treatment. Pretreatment photographs were
taken with a Polaroid (Polaroid Macro 5 SLR, Polaroid
Corporation) camera; posttreatment photographs were
taken with a digital camera (EOS Rebel T3i, Canon USA,
Inc). Pretreatment and posttreatment photographs were
taken from a standardized position. Polaroid photographs
were stored away from heat and light until they were
digitally scanned and stored. As a control, photographs
of non–sun-exposed and untreated skin from the partici-
pants were included in the survey. Aesthetic physicians
who were blinded evaluators included plastic surgeons
and other nondermatologists who considered aesthetic
medicine their primary focus, while other physicians
were nondermatologists who did not consider aesthetic
medicine their primary focus.
Procedure
Treatment settings for BBL therapy usually followed
manufacturer recommendations for skin rejuvenation
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• FEBRUARY 2013 www.cosderm.com
and skin type.19
Cooling gel was used in all treatments,
while contact cooling was used only in later treatments as
the technology advanced.
Filter selection depended on skin type and severity of
photodamage. The treatments consisted of a multiple of
2 to 4 BBL passes using the 515-, 560-, or 590-nm filter;
a fluence of 8 to 12 J/cm2
; a 10- to 20-millisecond pulse
duration; a large 4515-mm spot size; and cooling of
10°C to 20°C for the first and second passes. The forehead
was routinely treated with the square 1515-mm adaptor
and a 1 to 2 J higher fluence. The third and fourth passes
were made using the 560- or 590-nm filter, a fluence of
15 to 18 J/cm2
, a 15- to 20-millisecond pulse duration,
and the square 1515-mm adaptor. These passes were
localized to the cheeks, chin, nose, and perioral areas.
Pretreatment care was limited to application of a topical
anesthetic and sunscreen; posttreatment care included
regular use of sunblock and the participant’s skin care
regimen. No other aesthetic procedures were performed
during the duration of the study period.
Data Collection
Using only the photographs of skin, which were pre-
sented randomly via standard online survey software
(SurveyMonkey), evaluators estimated the pretreatment
and posttreatment ages of each participant. Photographs
were cropped to focus only on the treated skin to avoid
showing other signs of aging (eg, graying hair). Posttreat-
ment photographs were obtained 5 to 11 years following
initial BBL treatment. Actual ages of the participants both
before and after treatment were compared with the blinded
evaluators’ estimated ages at these same time points.
Data Analysis
Nonparametric statistics were used because the data
were not continuous and were not normally distributed
as shown by the Shapiro-Wilk test. The median esti-
mated ages before and after treatment were calculated
and compared to the median actual ages according to
the Wilcoxon signed rank test. The difference between
the median estimated posttreatment age and the median
actual pretreatment age also was calculated and tested for
a statistically significant difference.
RESULTS
The actual ages of all participants before and after
BBL treatment are presented in Table 1. The median
actual posttreatment age (55 years) was significantly
higher (P.0001) than the median actual pretreatment
age (46 years). The median difference was 8 years.
Before treatment, the median estimated age was slightly
lower than the median actual age, but the difference was
not significant. The median estimated age at the end of the
study period (45 years) was significantly lower than the
corresponding median actual age (55 years)(P.0084)
(Table 2). Clinical examples are presented in Figures 1
through 4.
The median estimated posttreatment age (45 years) was
slightly lower than the actual pretreatment age (46 years),
but the difference was not significant (Table 2).
Photographs of non–sun-exposed and untreated skin
for all participants also were included in the blinded
evaluation; evaluators estimated the ages correctly (data
not shown).
COMMENT
To our knowledge, our study is the longest blinded evalu-
ation of visual skin quality and rejuvenative effects result-
ing from BBL treatment in the current literature. Although
the participants’ skin actually aged a median of 9 years
during the study period, treated skin appeared to have
aged a median of 2 years (Table 2). This value is the
median difference between the estimated posttreatment
ages and the actual pretreatment ages.
In 2002, Weiss et al18
conducted a retrospective chart
review of 80 randomly selected participants at 4 years
following initial treatment with visible and infrared light
(520–1200 nm)(median, 3 treatments). The face, neck,
and chest areas were treated for conditions that included
poikiloderma, telangiectasia, and mottled hyperpigmen-
tation. Ninety-seven percent of participants also applied
a daily regimen of various topical agents, including sun
protection, during the 4-year study period. Results were
evaluated using 2 methods: (1) comparison of pretreat-
ment and posttreatment photographs by an independent
nontreating physician graded on a 4-point scale (worse;
no change; slightly better [less than 50% improve-
ment]; much better [more than 50% improvement]); and
(2) participant self-assessment of improvement in tex-
tural smoothness, telangiectasia severity, and blotchy
pigmentation. Self-assessment scores were based on the
participant’s memory of baseline severity. At 4 years fol-
lowing initial treatment, 83% of participants showed
improvement in skin texture, 82% showed improve-
ment in telangiectases, and 79% showed improvement
in pigmentation.18
Their study focused on the 4-year effects of a series of
several initial BBL treatments without regular follow-up
treatments other than a topical skin care regimen and
sun protection,18
whereas our study targeted changes in
perceived age for up to 11 years after a series of initial
treatments followed by maintenance treatments at least
once per year. Concerning their 4-year results, the authors
reported that the longer-lasting effects were likely the
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37
Actual Age, y
Participant No. Pretreatment Posttreatment Differenceb
1 46 51 5
2 60 67 7
3 65 75 10
4 46 54 8
5 47 57 10
6 61 71 10
7 46 56 10
8 38 49 11
9 39 50 11
10 39 49 10
11 53 61 8
12 69 75 6
13 38 46 8
14 50 55 5
15 40 48 8
a
Median (interquartile range):pretreatment,46.0 (19.7) years; posttreatment,55.0 (16.8) years; difference,8.0 (2.8) years.The interquartile range is a
measure of dispersion (75th to 25th percentile).The difference was significant (P.0001).
b
Posttreatment age pretreatment age.
Table 1
Participant Actual Ages and Age Differences Before and After Treatmenta
Actual Estimated Differencea
P Valueb
Actual Estimated Differencea
P Valueb
Final
Difference,
y (IQR)c
P Valued
46.0
(19.7)
45.0
(11.0)
1.0
(10.7)
.5416e
55.0
(16.8)
45.0
(11.0)
11.0
(12.3)
.0084f
2.0
(13.7)
.4361e
Abbreviation:IQR,interquartile range.
a
Estimated age actual age.
b
Estimated age vs actual age (Wilcoxon signed rank test).
c
Estimated posttreatment age actual pretreatment age.
d
Estimated posttreatment age vs actual pretreatment age.
e
Not significant.
f
Significant.
Posttreatment Age, y (IQR)Pretreatment Age, y (IQR)
Table 2
Median Ages and P Values
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38 A Supplement to Cutis®
• FEBRUARY 2013 www.cosderm.com
result of the patients’ use of topical retinoids and ascorbic
acid; however, they stated that the continued absence of
telangiectases indicateed that the light source had a nota-
ble effect.18
Participants in our study also used a variety of
skin care regimens that undoubtedly contributed to the
long-lasting treatment effects.
One of the authors (P.B.) recommended in a prior
report that optimal results can be obtained with a series of
Figure 3. A 38-year-old woman before (A) and 8 years after treat-
ment of the left cheek with BroadBand Light therapy at least once
per year (B).
B
A
Figure 2. A 39-year-old man before (A) and 11 years after treatment
of the right lateral neck with BroadBand Light therapy at least once
per year (B).
B
A
Figure 1. A 46-year-old woman before (A) and 5 years after treatment of the right cheek with BroadBand Light therapy at least once per year (B).
BA
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39
gentle (not painful) BBL treatments spaced several weeks
apart, which produces gradual improvement, minimal
adverse effects, and decreased downtime.1
In our current
study, BBL treatment effects were maintained with regular
treatments (at least one per year) for 5 to 11 years, which
was noted by the evaluators. Treatment intervals in our
study were much longer than the several weeks of prior
short-term studies, indicating that the effects of BBL treat-
ment persist much longer than previously realized. It is
not known if the widely spaced treatments also produced
progressive improvements.
In 2003, Laury20
showed that patients could expect
on average a 2-year reduction in their perceived age per
treatment with a visible and infrared light device in the
range of 560 to 1200 nm. The study was prompted by
the author’s desire to answer patients who ask, “How
much younger will the procedure make me look?” In this
5-patient study, initial treatment settings were based on
the patient’s Fitzpatrick skin type, while settings in later
treatments were individualized by observing skin charac-
teristics during and after treatment. Each patient received
5 treatments at 3-week intervals. Patients estimated their
ages on a visual analog scale ranging from 0 to 100 years
in 10-year increments at the beginning of the study and
before each treatment. All patients showed improve-
ment during the study period. Subjective age reductions
ranged from 3.9 to 11.5 years and averaged 1.9 years per
treatment over the 15-week period. Complications were
not observed. No signs of aging were noted to worsen,
and perceived improvements did not regress during the
study period.20
Laury’s20
study differs from our study in several impor-
tant respects; for instance, the number of patients (n5)
was smaller, the study period was much shorter, and
estimated age reductions were evaluated by patients
rather than blinded evaluators using photographs. The
study does, however, provide data that are useful in pre-
treatment counseling of patients who are considering
facial rejuvenation by visible and infrared light devices in
the range of 520 to 1200 nm.
The limitations of our study included the small num-
ber of participants, the nonstandardization of the before
and after photographs, and the lack of specific grading
criteria for the evaluators. The objective of the study was
to determine if blinded evaluators could estimate the
ages of participants by observing treated and untreated
skin; thus they were not asked to use grading criteria to
assess improvement in wrinkles, pigmentation, or other
signs of aging. The quality of the clinical photographs
also was a limitation; pretreatment photographs were
taken with a Polaroid camera, and although they were
stored in ideal conditions, they were not in the same for-
mat as the posttreatment photographs, which were taken
years later with a digital camera. Although the data are
not shown, the blinded evaluators did estimate the ages
correctly from photographs of non–sun-exposed and
untreated skin that were taken pretreatment and post-
treatment, indicating photograph quality did not bias
their responses. The encouraging results warrant addi-
tional studies with more patients, histologic evaluations,
and assessments of individual skin characteristics to
determine if improvements are progressive with regular
BBL treatments.
CONCLUSION
The results of this study demonstrate that patients who
maintain a regular annual or biannual regimen of BBL
treatment can both reduce and delay the long-term
Figure 4. A 69-year-old woman before (A) and 6 years after treatment of the perioral area with BroadBand Light therapy at least once per
year (B).
BA
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7. Antiaging Effects of BBL Therapy
40 A Supplement to Cutis®
• FEBRUARY 2013 www.cosderm.com
signs of skin aging such as photodamage, telangiectases,
fine lines and wrinkles, and skin laxity in a natural-
looking way.
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