Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation

Summary

Here, we present a protocol to describe using a 1064-nm picosecond Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) laser with a microlens array for treating periorbital hyperpigmentation.

Abstract

Periorbital hyperpigmentation is a complex condition with multiple underlying causes, such as pigmented, vascular, structural, and mixed factors. The multifaceted nature of the disease presents significant challenges and complexities in its treatment, making it a difficult condition to address effectively. These options include topical cosmetics that can improve the appearance of the affected areas and various chemical treatments. Additionally, fillers are available to enhance volume and smoothen texture, while surgical methods can be employed in more severe cases. Despite these advancements, treating periorbital hyperpigmentation remains challenging. Nowadays, lasers have proven to be highly effective tools in the treatment of a wide range of pigmented diseases. However, there are many types of lasers, and the lack of corresponding guidelines makes the treatment of periorbital hyperpigmentation difficult. Here, we present a protocol describing the use of a 1064-nm picosecond Nd:YAG laser with a microlens array for treating periorbital hyperpigmentation. We discuss optimal energy settings, treatment endpoints, and other side effects while enhancing treatment effectiveness. This approach provides a basis for clinicians to screen and treat patients with eyelids dark circles, ensuring efficacy and safety.

Introduction

Periorbital hyperpigmentation (POH), also known as eye dark circles, is a common cosmetic skin disordercausedby various conditions. Clinically, it presents as symmetric hyperpigmented patches around the eyes distributed on the lower and upper eyelid and may extend to involve the glabella and upper nose¹.Some etiologies that contribute to POH are pigmentation, prominent vasculature, skin laxity, and mixed factors.The dark circle around the eyes causes a tired and old appearance, which becomes a psychological concern for patients, so they seek ways to treat it. The disease is easily diagnosed but refractory to treat. Various....

Protocol

All procedures that involve the participation of human subjects strictly adhere to the established ethical standards set forth by the Ethics Committee of The First Affiliated Hospital of Soochow University and follow the Declaration of Helsinki. Image data collection was conducted with patient consent, and routine examination photographs were captured before treatment.

1. Preoperative evaluation

1. Review the patient's medical history.
   NOTE: Patient's medical history, including medication history, allergy history, contraindications to treatment, pigmentary changes, previous cosmetic treatments, and m....

Results

We evaluated 20 patients aged 21 to 44 years old(8 females and 12 males, mean age 32.4 ± 6.05 years). A total of 4 patients were classified as having Fitzpatrick skin type III, and 16 patients were classified as having Fitzpatrick skin type IV. A total of 7 patients had a family history of POH, and 13 patients had no family history of POH (Table 1).

All patients received three consecutive treatment sessions using a 1064-nm picosecond laser with a microlens array at 1-month int.......

Discussion

POH manifested as brown or dark brown pigmentation spots in the bilateral periocular area. There are different causes of periorbital hyperpigmentation, such as genetics, gender, age, physical conditions, anatomical differences, excessive blood vessels, etc. It is a concern at any age because it can make a person look sad, old, or tired and weaken their sense of well-being and self-esteem. The therapeutic approach must vary depending on the cause, as POH is caused by a variety of factors. For POH due to melanin, there are.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
1064-nm Nd:YAG picosecond laser	Syneron-Candela, Wayland, MA, USA	Resolve 1064 handpiece	1064-nm Nd:YAG picosecond laser with fractional microlens array