{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T01:26:27Z","timestamp":1791509187438,"version":"4.3.4"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T00:00:00Z","timestamp":1640217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"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>Background<\/jats:title><jats:p>Depending on wavelength and pigmentation, human skin can reflect up to 70% of incident laser light.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We tested the hypothesis that returning (\u201crecycling\u201d) this diffusely reflected light to the site of laser exposure would increase cutaneous response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Thirteen adult volunteers with Fitzpatrick skin types I\u2013IV participated in this IRB\u2010approved study. Matched contralateral test sites on the volar forearms were exposed to a pulsed dye laser operated at 585\u2009nm, 450\u2009microseconds pulse duration in a uniform 5\u2009mm circular exposure spot without skin cooling. On one arm, the laser handpiece was fitted with an aluminized hemispherical mirror with a reflectance of 67%. The minimum fluence causing skin purpura, and the purpura lesion diameter were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean purpura threshold fluence with the reflector was 3.1\u2009J\/cm<jats:sup>2<\/jats:sup> (0.5\u2009SD), and 3.7\u2009J\/cm<jats:sup>2<\/jats:sup> without the reflector (0.36\u2009SD) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mean laser\u2010induced purpura lesion diameter was approximately 5.3\u2009mm with the reflector and 5.0\u2009mm without the reflector.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Consistent with a theoretical model and in vitro measurements, this human study confirms that \u201crecycling\u201d reflected laser light can increase skin response. Potentially, the therapeutic response can also be improved with \u201cphoton recycling.\u201d<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23505","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T12:10:31Z","timestamp":1640261431000},"page":"152-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cPhoton recycling\u201d can enhance cutaneous response to lasers: A pilot human study"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0923-3578","authenticated-orcid":false,"given":"Edward V.","family":"Ross","sequence":"first","affiliation":[{"name":"Department of Laser and Cosmetic Dermatology Scripps Clinic San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Raythen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Massachusetts General Hospital Wellman Center for Photomedicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Rox","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Massachusetts General Hospital Wellman Center for Photomedicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1109\/10.42108"},{"key":"e_1_2_6_3_1","volume-title":"Spectral reflectance varaibility of skin and attributing factors","author":"Cooksey C","year":"2015"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.1981.tb09030.x"},{"key":"e_1_2_6_5_1","first-page":"87","article-title":"\u201cRecycling\u201d wasted photons: a device to increase laser energy used in surgery","volume":"8","author":"Ross EV","year":"1996","journal-title":"Lasers Surg Med"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12456368"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/03091900903402089"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1961.01580080079009"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20005"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12479191"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.10233"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20134"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.2004.tb00054.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9101(1999)24:3<236::AID-LSM9>3.0.CO;2-I"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00249-018-1342-y"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.23505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lsm.23505","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.23505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T12:14:05Z","timestamp":1693138445000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.23505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,23]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/lsm.23505"],"URL":"https:\/\/doi.org\/10.1002\/lsm.23505","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,23]]},"assertion":[{"value":"2021-07-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}