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Trattamento dell’acne con laser Nd:YAG da 1064nm a 650 microsecondi: uno studio di controllo, randomizzato, in doppio cieco

Journal of Cosmetic Dermatology, luglio 2020 Dott. David J. Goldberg, MD, JD; Dott. Katarina Kesty, MD, MBA; Specialisti in chirurgia e laser cutanei di New York e del New Jersey, New Jersey, USA

L’Acne vulgaris è una delle malattie più comuni trattata dai dermatologi. 1 La patogenesi dell’acne è multifattoriale. L’iperproliferazione epidermica e l’eccesso di sebo comportano il blocco delle unità pilosebacee. A questo segue un aumento della proliferazione dell’attività dei batteri commensali della pelle proprionibacterium cnes, con il risultato di causare infiammazione.2,3 L’acne moderata è di solito trattata con detergenti topici, retinoidi e antibiotici. L’acne da moderata a grave può talvolta richiedere un trattamento aggiuntivo con antibiotici o retinoidi per via sistemica.4 I trattamenti possono spesso risultare irritanti e insoddisfacenti; le esacerbazioni croniche e le remissioni durante tutta l’adolescenza e l’età adulta possono avere un forte impatto sulla qualità della vita del paziente.5,6 Spesso come trattamento aggiuntivo per l’acne e le cicatrici acneiche si usano dispositivi e laser. I trattamenti comuni comprendono i peeling chimici, la radiofrequenza non ablativa e il microneedling a radiofrequenza.711 Alcuni studi hanno individuato una certa efficacia del trattamento laser.1216 La terapia laser può avere successo nel ridurre le lesioni dell’acne vulgaris, bloccando l’attività delle ghiandole sebacee iperattive e alleviando gli effetti dell’infiammazione. Si pensa che il meccanismo d’azione operi tramite l’attivazione delle porfirine prodotte dal propionibacterium acnes, con il risultato di distruggere le membrane cellulari di questi batteri. Si è studiata l’applicazione dei laser con lunghezza d’onda 1064nm per l’acne. Uno studio condotto da Ballin e Ubelhoer ha trattato un unico paziente con 10 sessioni di laser Nd:YAG da 1064nm, con conseguente rimozione di pressoché il 100% delle lesioni.17 Un altro studio confronta la luce intensa pulsata con il laser Nd:YAG da 1064nm senza trovare differenze significative nel trattamento dell’acne.18

I tipici laser Nd:YAG da 1064nm funzionano con durate di impulso più lunghe da 3 a 30 millisecondi. Il laser usato in questo studio ha una durata degli impulsi di 650 microsecondi. Si tratta di una nuova tecnologia, in cui tutte le necessarie impostazioni di potenza da 4 J/cm2 a 255 J/ cm2 possono essere trasmesse all’interno di una pulsazione di 650 microsecondi in una varietà di dimensioni di punto e ad una frequenza di ripetizione rapida, fino a 2,0 Hz. Il totale di 650 microsecondi è al di sotto del tempo di rilassamento termico del tessuto cutaneo. La cute ha quindi il tempo di raffreddarsi tra gli impulsi, confinando il calore nel target assorbito selettivamente per una maggiore efficacia clinica e sicurezza rispetto alla cute circostante.19 L’impulso ad alta energia viene applicato al target in tale breve durata. La struttura a cui si mira ha meno tempo per disperdere calore, per conduzione, alla cute circostante, per cui il target raggiunge una temperatura superiore.

Una più alta temperatura nel tessuto target si traduce in una maggiore distruzione del tessuto target e una maggiore efficacia. Abbiamo svolto uno studio controllato randomizzato per valutare l’uso di un laser Nd:YAG da 1064nm da 650 microsecondi confrontandolo con un placebo nel trattamento dell’acne da moderata a grave.

Table of Contents

Hyperpigmentation

Photos Courtesy of Cheryl Burgess, MD.

Photos Courtesy of Jennifer Parker-Porter, MD.

Learn more about treating hyperpigmentation today.

Vascular Lesions

Photos Courtesy of Dr. Guilia Kasimova.

Photos Courtesy of Michael Gold, MD.

Learn more about treating vascular lesions today.

Rosacea / Redness

Photos Courtesy of Yelena Kipervas, DO.

Photos Courtesy of Dr. Nabil Fakih.

Learn more about treating rosacea and redness today.

Hair Removal

Photos Courtesy of Dr. Andrew Nnadi.

Photos Courtesy of Steik Spa.

Learn more about treating hair removal today.

PFB

Photos Courtesy of Dr. Michelle Henry.

Photos Courtesy of Wendy Roberts, MD.

Learn more about treating PFB today.

Scars

Photos Courtesy of Dr. William Watfa.

Photos Courtesy of Bradley Bloom, MD.

Learn more about treating scars today.

Autoimmune Disorders

Photos Courtesy of Dr. Passeron.

Photos Courtesy of Dr. Sakhiya.

Learn more about treating autoimmune disorders today.

Skin Rejuvenation

Photos Courtesy of Catie Cutler, LE.

Photos Courtesy of Chesahna Kindred, MD.

Learn more about skin rejuvenation today.

Acne

Photos Courtesy of Michael Gold, MD.

Photos Courtesy of Michael Gold, MD.

Learn more about treating acne today.

Staff Accountant / Junior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Staff Accountant / Junior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Staff Accountant / Junior Accountant

• Provide support to the Controller and the management team
• Maintain day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Support the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Uploading annual budget and tracking actual to budget variances
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Participation in quarterly inventory reconciliations
• Assist team with projects such as policy creation, system implementation, client support etc.

• Some experience with and strong understanding of the monthly close process and technical accounting
• Detailed oriented, with ability to see the big picture
• Self-starter who can work independently and employ time management skills to meet deadlines.
• Knowledge of MS Excel (V-lookup, formulas, pivot tables).
• Strong interpersonal and communication skills
• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP
• 1-3 years’ experience in an accounting function (including internship)
• General Ledger/Operational Accounting experience
• Knowledge of Quickbooks or other reporting software a plus (more the better)
• Industry experience a plus

Senior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Senior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Senior Accountant:

• Provide support to the Controller and the management team
• Own day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Assist in establishing and maintaining policies & procedures in accordance with GAAP and Aerolase policy
• Key contributor to the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Assist in the preparation of management reports – (cash management, various projections, month end reporting package)
• Involvement with the annual budget process
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Prepare and submit payroll
• Participation in quarterly inventory reconciliation to the perpetual
• Ad hoc projects

• Strong knowledge of the monthly close process and technical accounting

• Detailed oriented, with ability to see the big picture

• Experience in continuous improvement and accounting best practices

• Self-starter who can work independently and employ time management skills to meet deadlines.

• System savvy – ability to learn new financial software

• Intermediate knowledge of MS Excel (V-lookup, formulas, pivot tables).

• Global consolidations experience a plus

• Strong interpersonal and communication skills

• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP

• 3+ years’ experience working as a staff/senior accountant

• General Ledger/Operational Accounting experience a must

• Extensive knowledge of Quickbooks and other reporting software

• Prior involvement with system implementation

• Prior public accounting experience (any size firm) a plus

• Industry experience a plus

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