The authors have no acknowledgments.

All procedures carried out in research involving human participants were in accordance with the approval of the Ethics Review Committee of the First Affiliated Hospital of Chongqing Medical University (Research Ethics in 2023 [2023-119]). Informed consent was obtained from the patients before undergoing the procedure.
1. Pretreatment preparation
<ol>
	<li>Lesion selection and clinical indications
	<ol>
		<li>Patient selection
		<ol>
			<li>Select female patients with Fitzpat...

Minimizing Pigmentation in Laser Treatment Using Salicylic Acid

<ol>
	<li>Ko, A. C., Korn, B. S., Kikkawa, D. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+aging+face.">The aging face.</a> Surv Ophthalmol. 62 (2), 190-202 (2017).</li><li>Khavkin, J., Ellis, D. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aging+skin:+histology,+physiology,+and+pathology.">Aging skin: histology, physiology, and pathology.</a> Facial Plast Surg Clin North Am. 19 (2), 229-234 (2011).</li><li>Horovitz, T., Clementoni, M. T., Artzi, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nonablative+laser+skin+resurfacing+for+periorbital+wrinkling+-+A+case+series+of+16+patients.">Nonablative laser skin resurfacing for periorbital wrinkling - A case series of 16 patients.</a> J Cosmet Dermatol. 20 (1), 99-104 (2021).</li><li>Dou, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fractional+microneedle+radiofrequency+device+and+fractional+erbium-doped+glass+1,565-nm+device+treatment+of+human+facial+photoaging:+a+prospective,+split-face,+random+clinical+trial.">Fractional microneedle radiofrequency device and fractional erbium-doped glass 1,565-nm device treatment of human facial photoaging: a prospective, split-face, random clinical trial.</a> J Cosmet Laser Ther. 23 (5-6), 142-148 (2021).</li><li>Wang, Y., Zheng, Y., Cai, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+safety+of+1565-nm+non-ablative+fractional+laser+versus+long-pulsed+1064-nm+Nd:YAG+laser+in+treating+enlarged+facial+pores.">Efficacy and safety of 1565-nm non-ablative fractional laser versus long-pulsed 1064-nm Nd:YAG laser in treating enlarged facial pores.</a> Lasers Med Sci. 37 (8), 3279-3284 (2022).</li><li>Lin, A. N., Nakatsui, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Salicylic+acid+revisited.">Salicylic acid revisited.</a> Int J Dermatol. 37 (5), 335-342 (1998).</li><li>Arif, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Salicylic+acid+as+a+peeling+agent:+a+comprehensive+review.">Salicylic acid as a peeling agent: a comprehensive review.</a> Clin Cosmet Investig Dermatol. 8, 455-461 (2015).</li><li>Zhang, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=30%+supramolecular+salicylic+acid+peels+effectively+treats+acne+vulgaris+and+reduces+facial+sebum.">30% supramolecular salicylic acid peels effectively treats acne vulgaris and reduces facial sebum.</a> J Cosmet Dermatol. 21 (8), 3398-3405 (2022).</li><li>Zheng, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+safety+of+2%+supramolecular+salicylic+acid+compared+with+5%+benzoyl+peroxide/0.1%+adapalene+in+the+acne+treatment:+a+randomized,+split-face,+open-label,+single-center+study.">Efficacy and safety of 2% supramolecular salicylic acid compared with 5% benzoyl peroxide/0.1% adapalene in the acne treatment: a randomized, split-face, open-label, single-center study.</a> Cutan Ocul Toxicol. 38 (1), 48-54 (2019).</li><li>Han, Q., Zeng, J., Liu, Y., Yin, J., Sun, P., Wu, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+30%+supramolecular+salicylic+acid+followed+by+1565-nm+non-ablative+fractional+laser+on+facial+acne+and+subsequent+enlarged+pores.">Evaluation of 30% supramolecular salicylic acid followed by 1565-nm non-ablative fractional laser on facial acne and subsequent enlarged pores.</a> Lasers Med Sci. 38 (1), 91 (2023).</li><li>Salter, S. A., Kimball, A. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Striae+gravidarum.">Striae gravidarum.</a> Clin Dermatol. 24 (2), 97-100 (2006).</li><li>Li, Y. J. Z., Luo, S., Xu, K. X., Hao, L. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+observation+of+the+injection+of+autologous+concentrated+growth+factors+(CGF)+in+the+improvement+of+facial+inflammaging.">Clinical observation of the injection of autologous concentrated growth factors (CGF) in the improvement of facial inflammaging.</a> Chin J Aesth Plast Surg. 30 (4), 236-239 (2019).</li><li>Munavalli, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Split-face+assessment+of+the+synergistic+potential+of+sequential+Q-switched+Nd:YAG+laser+and+1565+nm+fractional+nonablative+laser+treatment+for+facial+rejuvenation+in+Fitzpatrick+skin+Type+II-V+patients.">A Split-face assessment of the synergistic potential of sequential Q-switched Nd:YAG laser and 1565 nm fractional nonablative laser treatment for facial rejuvenation in Fitzpatrick skin Type II-V patients.</a> J Drugs Dermatol. 15 (11), 1335-1342 (2016).</li><li>Chan, H. H., Manstein, D., Yu, C. S., Shek, S., Kono, T., Wei, W. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+prevalence+and+risk+factors+of+post-inflammatory+hyperpigmentation+after+fractional+resurfacing+in+Asians.">The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians.</a> Lasers Surg Med. 39 (5), 381-385 (2007).</li><li>Gold, M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+future+of+non-invasive+rejuvenation+technology:+Devices.">The future of non-invasive rejuvenation technology: Devices.</a> J Drugs Dermatol. 16 (6), s104-s107 (2017).</li><li>Lu, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Salicylic+acid+treats+acne+vulgaris+by+suppressing+AMPK/SREBP1+pathway+in+sebocytes.">Salicylic acid treats acne vulgaris by suppressing AMPK/SREBP1 pathway in sebocytes.</a> Exp Dermatol. 28 (7), 786-794 (2019).</li></ol>

1565 nm non-ablative fractional laser can effectively stimulate collagen rearrangement, achieving the effect of rejuvenation and anti-aging. It is used in the treatment of facial rejuvenation, stretch marks, and acne scars14. However, after 1565 nm non-ablative fractional laser treatment, there may be obvious pain and redness immediately, and posttreatment inflammation pigmentation easily occurs, which makes it difficult for some patients to accept. In this article, we described an effective metho...

Facial aging usually refers to the changes that occur after aging, such as bone shrinkage and deformation, soft tissue relaxation and sagging, increased skin pigmentation, and wrinkles, among which the aging of the skin is the most obvious1. The causes of facial aging are divided into exogenous and endogenous factors. Exogenous aging is caused by gravity, UV radiation, air pollution, smoking, excessive alcohol consumption, and malnutrition, among other factors2. Endogenous aging is mainly an inevitable aging process caused by genetics and age. With the pursuit of a beautiful image by those seeking beauty, various technologies and treatment concepts have emerged. Among them, photonic beauty treatments have developed rapidly in the treatment of facial aging in recent years. According to statistics from the International Society of Aesthetic Plastic Surgery, the number of patients undergoing photonic beauty treatments in the United States in 2020 increased by 15.2% compared to 20193.
Currently, there are various laser devices available for treating skin aging. These lasers are primarily used to reduce wrinkles and improve enlarged pores and can be categorized as ablative or non-ablative lasers. Non-ablative lasers, such as different wavelengths of erbium-doped glass (Er:Glass) lasers (1540 nm, 1550 nm, 1565 nm), are representative instruments for this purpose, with the ResurFX fiber optic laser being the most commonly used. The 1565 nm laser emitted by ResurFX can stimulate dermal collagen remodeling while maintaining the integrity of the epidermis. It has shown good efficacy and high safety for the treatment of periorbital wrinkles4. A prospective study has confirmed that non-ablative fractional lasers can improve various facial skin concerns, such as laxity, wrinkles, and coarse pores, among Asian patients, and the patients were satisfied with the treatment outcomes5. However, posttreatment complications such as pain, erythema, edema, crust formation, inflammatory hyperpigmentation, and acne eruptions were reported in 100% of cases treated with non-ablative fractional lasers. Currently, in order to alleviate the adverse reactions during and after non-ablative fractional laser treatment, methods include a topical anesthetic ointment that can be applied before treatment to improve treatment tolerance, and an adequate cold compress after laser treatment can shorten the duration of erythema and edema6. However, these treatments have limited effects in reducing pain and erythema edema and still cannot make all patients accept non-ablative fractional laser treatment.
Salicylic acid (SA) is a &#946;-hydroxy acid extracted from willow bark, etc.7, with a concentration of 2% ~ 30%. SA can remove lipids between cells, reduce the adhesion of keratin-forming cells, and cause these cells to loosen and subsequently separate8. In addition, it has antibacterial, antifungal, and some anesthetic effects9. However, SA has poor solubility in water and easily precipitates in low-pH alcohol solutions and irritating solvents to the skin. To solve these limitations, supramolecular SA (SSA) was introduced. It forms water-soluble supramolecular entities in the form of intermolecular complexes through reversible non-covalent bonding and releases slowly during use, reaching maximum efficacy under low-pH conditions and reducing skin irritation10. Zhang et al.9. measured skin hydration, transepidermal water loss (TEWL), pH value of skin barrier-related parameters. After four treatments, TEWL decreased, while skin hydration and pH values increased. These results suggested that 30% of SSA peels did not damage the skin barrier function but improved instead.
Therefore, some scholars advocate the use of non-ablative fractional laser combined with SSA chemical peel treatment to improve problems such as large pores and acne11. However, according to the author's experience, the immediate use of SSA chemical peel treatment after 1565 nm non-ablative fractional laser treatment has not been fully utilized in clinical practice, which may be due to different treatment sequences in previous clinical practice. This article introduces a new treatment method to improve the adverse reactions after 1565 nm non-ablative fractional laser treatment, combined with relevant visual aids, in order to help more patients receive 1565 nm non-ablative fractional laser treatment for facial rejuvenation.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>ResurFX fiber optic laser</td>
			<td>Lumenis, Yokneam, Israel</td>
			<td>M22 system</td>
			<td>1565 nm non-ablative fractional laser</td>
		</tr>
		<tr>
			<td>ISEMECO skin detector&#160;</td>
			<td>Isomeco Biomedical Technology Co., Ltd.,Shanghai, China</td>
			<td>MC-2600</td>
			<td>Skin testing can be conducted under 5 types of spectrum</td>
		</tr>
		<tr>
			<td>Compound lidocaine cream</td>
			<td>Beijing Unigroup Pharmaceutical Co., Ltd., China</td>
			<td>Guo Yao Quan Zi H20063466</td>
			<td>This product is a compound preparation, consisting of prilocaine and lidocaine. Each gram of this product contains 25 mg of prilocaine and 25 mg of lidocaine.</td>
		</tr>
		<tr>
			<td>30% supramolecular salicylic acid</td>
			<td>BRODA, Shanghai Ruizhi Medical Technology Co., Ltd., China</td>
			<td>N/A</td>
			<td>It can be used for anti-inflammatory and repairing the skin barrier.</td>
		</tr>
	</tbody>
</table>

enhancement of facial rejuvenation through a combination of 1565 nm non-ablative fractional laser with 30% supramolecular salicylic acid

The 1565 nm non-ablative fractional laser can effectively stimulate collagen regeneration, achieving the effect of skin rejuvenation and anti-aging. In recent years, it has been widely used in dermatology, especially in facial rejuvenation, treatment of stretch marks, and acne scar treatment, with significant results. However, after the 1565 nm non-ablative fractional laser treatment, patients may experience short-term erythema and edema. The inflammation after treatment may also cause pigmentation, making it difficult for some patients to accept. This article introduces a treatment method of 1565 nm non-ablative fractional laser combined with 30% super molecular salicylic acid for facial rejuvenation, effectively reducing posttreatment erythema and post-inflammatory pigmentation. The method includes specific treatment steps and the respective endpoint reactions of each step. The method starts by selecting appropriate energy parameters for the 1565 nm non-ablative fractional laser treatment, followed immediately by the application of 30% supramolecular salicylic acid. The treatment should be stopped when a frosty reaction occurs. The purpose of this project is to provide patients with a safer new method of facial rejuvenation treatment.

Author Spotlight: Advancing Facial Rejuvenation Therapy with Post-Laser Salicylic Acid Application

Enhancement of Facial Rejuvenation Through a Combination of 1565 nm Non-Ablative Fractional Laser with 30% Supramolecular Salicylic Acid

My research focuses on facial rejuvenation and I want to translate clinical experience into evidence-based medical results through clinical trials. Currently, several clinicians have implemented the use of 30%super molecular salicylic acid immediately following 1, 565 nanometer non-ablative fractional laser treatment, discovering that this combined approach outperforms the sole application of 1565 nanometer non-ablative fractional laser. Our research validates this finding and further demonstrates that the distinct advantage of this combined therapy its effectiveness in resolving pigmented and reddened areas.Our method can reduce the incidence of post laser pigmentation and expedite the fading of post laser erythema. Moreover, the combined treatment also reduces the number of hospital visits for patients.

The 1565 nm non-ablative fractional laser can improve facial aging, such as pores, texture, and brown spots. However, the combination of a 1565 nm non-ablative fractional laser with SSA can effectively reduce adverse reactions such as erythema and pigmentation while improving facial aging. The right side of the patient&#39;s face was treated with a 1565 nm non-ablative fractional laser, while the left side was treated with a 1565 nm non-ablative fractional laser combined with 30% supramolecular salicylic acid. At 14 days...

The purpose of this project is to effectively reduce the occurrence of adverse reactions such as erythema and pigmentation after non-ablative fractional laser treatment by combining 1565 non-ablative fractional laser with 30% super molecular salicylic acid, providing patients with a safer new method of facial rejuvenation treatment.

The 1565 nm non-ablative fractional laser can effectively stimulate collagen regeneration, achieving the effect of skin rejuvenation and anti-aging. In ...