Skin rejuvenation through topical application of indocyanine green with diffractive optical element mode of 785 nm picosecond laser in Asian females

J Cosmet Dermatol. 2024 Mar 18. doi: 10.1111/jocd.16275. Online ahead of print.

Abstract

Background: Indocyanine green (ICG) exhibits robust absorption near 800 nm.

Aims: To examine the clinical effects of combining ICG with a 785 nm picosecond laser for treating photo-aged skin.

Patient/methods: A 785 nm 600 picosecond laser was used on the facial area of 16 female patients with Fitzpatrick skin type III and IV (mean age: 58.44 ± 5.24 years) after applying 0.0125% ICG cream. A total of 3000 shots were administered in diffractive optical element mode at a pulse energy of 200 mJ and frequency of 10 Hz. Hyperpigmented lesions were treated using the Zoom handpiece set at a spot size of 3-4 mm, pulse energy of 60-120 mJ, and frequency of 3-7 Hz. Patients underwent five sessions of treatment at intervals of 1-2 weeks. Wrinkles, pores and pigmented lesions were assessed at the initial assessment and 4 weeks after the final treatment using the Modified Fitzpatrick Wrinkle Scale and 10-point visual analog scale, respectively. Skin biopsy of the postauricular area was performed on two consenting patients.

Results: Significant improvements in wrinkles (p = 0.02), pores (p = 0.034), and hyperpigmentation (p = 0.036) were observed, along with increased patient subjective improvement. Adverse effects were transient and well-tolerated. Hematoxylin and eosin and Masson's trichrome staining revealed increased and thickened dermal collagen fibers. Immunohistochemical staining revealed increased expression of collagen I and III throughout the papillary and upper reticular dermis, along with diffuse increase of STRO-1 in the dermis.

Conclusions: The combined application of a 785 nm picosecond laser and ICG yielded promising clinical outcomes for treating photo-aged skin in Asian patients with Fitzpatrick skin type III and IV.

Keywords: collagen; laser treatment; photo-aging.