Skin rejuvenation is a vital aspect of dermatology aimed at countering intrinsic and extrinsic aging effects, such as wrinkles, dyspigmentation, and texture irregularities. This study evaluates the efficacy and safety of the fractional 1064 nm Nd:YAG picosecond laser in a Vietnamese cohort, addressing unique challenges posed by Asian skin’s high melanin content. 44 Vietnamese participants treated at the University Medical Center of Ho Chi Minh City for facial skin rejuvenation were retrospectively analyzed. Outcomes were assessed via standardized imaging and patient-reported satisfaction scores, with statistical analyses applied to evaluate changes in skin indices and identify epidemiological correlations. Measurements using the VISIA ^® system indicated statistically significant reductions in wrinkles, spots, and texture irregularities starting from the first month of treatment ( p < 0.01) and sustained through three months ( p < 0.0001). Adverse effects were minimal, with transient erythema being the most common (68.18%), and pain levels were generally mild to moderate. Epidemiological analysis revealed that prolonged sun exposure adversely affected UV spot improvement ( p = 0.01), while consistent mask-wearing correlated with enhanced outcomes for pigmentation reduction ( p = 0.03). This study underscores the fractional 1064 nm Nd:YAG picosecond laser’s effectiveness as a safe and versatile tool for skin rejuvenation, particularly for Asian populations prone to post-inflammatory hyperpigmentation. Recommendations for consistent photoprotection and addressing environmental factors further optimize results. Future studies should explore long-term outcomes and comparative efficacy with alternative modalities.

The management of traumatic facial atrophic scars presents significant aesthetic and functional challenges. Traditional surgical approaches, while having documented efficacy, carry inherent risks of invasive procedures and the potential for creating secondary scarring. Therefore, this study aims to evaluate the effectiveness of a combined laser therapy approach, specifically utilizing potassium titanyl phosphate (KTP)/Nd:YAG, variable-pulse picosecond fractional laser, and Er:YAG lasers, as a non-surgical alternative for treating these complex traumatic scars.

BACKGROUND Steroid-induced atrophy is a common complication of intralesional corticosteroid use, characterized by thinning of the dermis and epidermis, reduced fibroblast activity, and subcutaneous fat atrophy. Traditional treatment modalities, including topical therapies, dermal fillers, and fat grafting, often yield variable results and present limitations such as invasiveness, temporary effects, or complications. This case report presents a novel therapeutic approach for the treatment of steroid-induced atrophic scars (SIAS) on the face, using fractional CO₂ laser therapy, recognized for its ability to promote dermal remodeling and scar improvement. CASE REPORT A 32-year-old woman presented with a single atrophic scar on her cheek, resulting from an intralesional corticosteroid injection. The patient underwent a preparatory phase involving mono polydioxanone (PDO) threads and dimethylaminoethanol (DMEA) skin booster to enhance dermal remodeling. She then received 2 sessions of fractional 10 600 nm laser therapy spaced 4 months apart, with tailored parameters: initial settings of 15 mJ/dot and 100 dots/cm², adjusted to 175 dots/cm² with Spread Half Fill Mode in the second session. This approach minimized downtime, with erythema resolving in 1-2 days, and avoided post-inflammatory hyperpigmentation (PIH). Clinical evaluations, including the Vancouver Scar Scale (VSS), showed significant improvement. The patient reported high satisfaction and improved quality of life. CONCLUSIONS Fractional CO₂ laser therapy represents a promising, minimally invasive treatment option for SIAS. The dual-session protocol highlighted in this report underscores its safety and efficacy. Future research should include larger trials, comparative studies, and parameter optimization for diverse populations.

Management of Lymphangioma Circumscriptum via Combined Laser Therapy in Pigmented Skin: A Case Report - Article abstract #951370

Introduction: Port-wine stains (PWS), congenital vascular malformations affecting approximately 0.3–0.5% of live births, present as pink to red patches that darken and thicken over time, potentially leading to disfigurement, functional complications, and significant psychosocial distress. While pulsed dye lasers (PDLs) are considered the standard treatment, they often require multiple sessions and exhibit variable clearance rates. Alternative laser modalities, such as the 532-nm potassium titanyl phosphate (KTP) laser, have shown promising results, particularly in PDL-resistant cases. However, managing complex PWS with diverse vessel calibers, hypertrophy, and scarring remains a challenge, highlighting the need for tailored treatment strategies. Case Presentation: A 22-year-old female presented with a complex PWS affecting the V2 dermatome of the left hemiface, including the lower eyelid, inner canthus, and associated lip/gingival hypertrophy and scarring from previous surgical intervention. She underwent five monthly sessions of a novel sequential laser protocol. This protocol combined long-pulsed KTP 532-nm laser treatment with quasi long-pulsed 1,064-nm Nd:YAG laser treatment to target both larger and smaller superficial vascular structures. In the final two sessions, ablative Er:YAG 2,940-nm laser treatment was added to address existing scars. Fluence and pulse duration were dynamically adjusted throughout the treatment course. Post-treatment care consisted of gentle skincare, emollients, and broad-spectrum sunscreen. The patient achieved significant lightening of the lesion, reduced vascular prominence and hypertrophy, improved facial symmetry, and softening of scars, with minimal and transient side effects. Conclusion: This case demonstrates the potential of a tailored, sequential combination of long-pulsed KTP 532-nm, quasi long-pulsed 1,064-nm Nd:YAG, and ablative Er:YAG 2,940-nm lasers for effectively managing complex PWS with associated hypertrophy and scarring. This multimodal approach, adjusting parameters to target specific lesion characteristics, suggests a promising strategy for achieving superior esthetic and functional outcomes in challenging PWS cases and improving patient quality of life.

Background: Accurate prediction of the number of sessions required for laser tattoo removal is essential for effective treatment planning and patient counseling. The Kirby–Desai (KD) scale, developed for Q‐switched nanosecond lasers, overestimates treatment sessions when applied to modern picosecond laser technology. Aims: To develop and validate a novel predictive scoring system specifically calibrated for picosecond laser tattoo removal and to compare its predictive accuracy with the KD scale. Methods: A retrospective cohort of 545 patients treated with picosecond laser tattoo removal between 2019 and 2024 was analyzed. Tattoo characteristics were evaluated using both the KD scale and the newly developed (PT) scale, which incorporates six parameters: tattoo type, pigment density, anatomical location, ink color, scarring, and layering. Multiple regression and machine learning models were trained separately on KD‐ and PTbased variables. Model performance was assessed using mean absolute error (MAE), root mean square error (RMSE), and coefficient of determination ( R ² ) on an independent test set. Model interpretability was evaluated using SHapley Additive exPlanations (SHAP). Results: PT‐based models consistently outperformed KD–based models. The PT Ridge regression model achieved the best predictive performance (MAE = 0.58, RMSE = 0.64, R ² = 0.73), significantly improving accuracy compared with KD‐based approaches ( p < 0.001). SHAP analysis identified tattoo type and pigment density as the most influential predictors. Conclusions: The PT scale provides a more accurate and clinically relevant prediction of treatment sessions for picosecond laser tattoo removal than the KD scale, offering a practical and reliable tool for contemporary clinical practice.