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Picosecond LIOB – A potential new paradigm in acne scar treatment

Article-Picosecond LIOB – A potential new paradigm in acne scar treatment

Sponsored by LASEROPTEK

As a dermatologist working at one of the largest dermatology institutes in South Korea, achieving satisfactory outcomes for patients with acne scars is one of the most important tasks. To treat these patients there are a variety of treatment options, including ablative lasers, RF needles and even dermal fillers. And while the application of various types of energy-based devices is currently in use, patients tend to experience a high risk of side effects, including pain, hyperpigmentation, scarring, and prolonged social downtime, especially in dark-skinned patients.

Picosecond lasers were originally introduced as a novel technology for the clearance of tattoos and pigmented lesions. Interestingly, however, thru the process of laser-induced optical breakdown (LIOB), the single laser beam splits into distinct, separate beams, creating micro-injury zones present as dermal vacuoles.

LIOB is a non-linear absorption process related to plasma generation, followed by mechanical expansion, the physical principle of which is different from selective photothermolysis. With the initiation of wound repair processes and stimulation of dermal remodeling, these micro-vacuoles have been shown to clinically improve skin texture, atrophic scars and wrinkles, avoiding any damage to the epidermis.

In addition to daily uses for these indications, our institute rigorously conducted a clinical trial comparing Pico-LIOB and fractional laser directly in terms of efficacy and safety for the treatment of acne scars. We concluded that Pico-LIOB is superior to conventional fractional lasers in both efficacy and safety of acne scar treatment, proven by histological analysis showing elongation and increased density of elastic and collagen fibers, without notable damage to the epidermis.

I have used the picosecond laser, PicoLO, developed and manufactured by LASEROPTEK (Gyeonggi-do, South Korea), and have definitively concluded that the stability of PicoLO’s output energy and pulse duration enabled a reliable and reproducible LIOB process. I usually apply PICO-LIOB for the treatment of acne scars, enlarged pores and skin texture issues.

Interestingly, in addition to resurfacing issues, skin tone improvement is concurrently observed in many cases. The most distinctive feature of PicoLO from other picosecond lasers is that the targeted depth of the LIOB process is adjustable by using its proprietary diffractive optical element (DOE) type of fractional handpiece – the DIA FX. Taking into account that skin thickness, lesion depth and skin conditions vary by patient, this feature would be beneficial for more delicate treatment.

In conclusion, picosecond lasers have emerged as my foundational treatment option not only for well-known pigmentation treatments, but also for multiple resurfacing issues including acne scar treatment. It is for these reasons that I find myself seriously considering the possibility that the PICO- LIOB process could change the treatment paradigm of acne scar/enlarged pores in the near future.

About the author

HyuckHoon Kwon, MD, PhD
Dr. Kwon earned his biochemistry degree from Seoul National University College of Natural Science, followed by an MD at the Seoul National University College of Medicine. He is a board certified dermatologist and visiting scholar at Johns Hopkins University and Penn State University. Dr. Kwon is currently the main director at Nowon Oaro Dermatology Institute and is expected to become the representative director at the Gangdong Oaro Dermatology Institute (both in Seoul, Korea) in 2020.

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