{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:12:42Z","timestamp":1785201162240,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>A 730\u2009nm picosecond\u2010domain laser was developed to improve the clearance of pigmented lesion and reduce adverse events. This study assessed the safety and efficacy of this system for the clearance of lentigines and explores how the short picosecond pulses interact with tissue via histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Twenty subjects with Fitzpatrick skin types II\u2013IV were enrolled in this prospective, IRB\u2010approved study. Four treatments were administered using a 730\u2009nm picosecond\u2010domain laser. Pre\u2010 and posttreatment photos were assessed by blinded reviewers at 4\u2010 and 12\u2010week follow\u2010up visits, using a 5\u2010point clearance scale. Subject satisfaction was measured using a 5\u2010point scale. Investigator Global Improvement Score (IGIS) was performed at the 4\u2010 and 12\u2010week follow\u2010up visits, using an 11\u2010point clearance scale. Subject pain level was measured using an 11\u2010point scale (no pain [0], extreme pain [10]). Histology of 730 and 532\u2009nm picosecond pulses was compared with 755 and 532\u2009nm nanosecond pulses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen subjects with a total of 118 discontinuous treatment areas, each comprised of 1\u201320 lesions, completed all study visits. Thirty body regions were studied, including arms (6), hands (16), scalp (1), forehead (2), face (3), and back (2). Spot sizes ranging from 2 to 5\u2009mm diameters were used with fluences ranging from 0.8 to 4.0\u2009J\/cm<jats:sup>2<\/jats:sup>. Mean pain score was 3.6 of 10 for all four treatments. Ninety\u2010nine percent of randomly paired 4\u2010week posttreatment images and 100% of 12\u2010week posttreatment images were correctly identified from their respective baseline images by three blinded reviewers. Mean IGIS demonstrated scores of 6.7 and 7.0 at 4\u2010 and 12\u2010week follow\u2010up visits, respectively. At the 4\u2010 and 12\u2010week follow\u2010up visits, 76% and 73% of subjects, respectively, were satisfied to highly satisfied. The mean clearance score for all 118 treatment areas was 3 of 4 in follow\u2010up visits. At 12\u2010week follow\u2010up, 36% of 118 treatment areas had a clearance score of 4, and 38% had a clearance score of 3. Post treatment, there was typical erythema, edema, dryness, crusting, and itching but negligible purpura, no pinpoint bleeding, blistering or scarring, and no significant hyperpigmentation or hypopigmentation. Histology showed diffuse, focal epidermal vacuolization ~5\u201310\u2009\u00b5m in diameter and mild extravasation of erythrocytes with 730\u2009nm picosecond pulses, while diffuse epidermal vacuolization was observed with coalescence of vacuoles (~20\u2013100\u2009\u00b5m), junctional clefting and mild extravasation of erythrocytes with 755\u2009nm nanosecond pulses. Picosecond pulses of the wavelength of 532\u2009nm produced diffuse, focal epidermal vacuolization and larger dermal vacuoles to depths of 500\u2009\u00b5m, while 532\u2009nm nanosecond pulses produced diffuse epidermal vacuolization with coalescence of vacuoles and marked dermal hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated the potential of a new 730\u2009nm picosecond\u2010domain laser for the clearance of lentigines. The results showed good clearance with no adverse events and good subject satisfaction in patients with skin type II\u2013III. Additional studies need to be conducted on darker skin types. The histopathologic findings demonstrate that the picosecond 730\u2009nm laser produces excellent selectivity for pigment with minimal disruption of the dermal\u2013epidermal junction and may therefore reduce healing times and the risk of adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23450","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T12:28:48Z","timestamp":1629203328000},"page":"89-97","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Treatment of facial and non\u2010facial lentigines with a 730\u2009nm picosecond titanium: Sapphire laser is safe and effective"],"prefix":"10.1002","volume":"54","author":[{"given":"Arielle N. 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