Stephanie G Y Ho

The University of Hong Kong, Hong Kong, Hong Kong

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Publications (4)7.61 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Background: A new fractional photothermolysis device is used in our retrospective study to treat melasma in Chinese patients. Objectives: To evaluate the efficacy and safety of the 1927 nm fractional thulium fiber laser in the treatment of melasma in Chinese patients. Methods: Eleven melasma patients who received treatment between November 2009 and May 2010 were included. Photographic images at baseline and follow-up were assessed for clinical efficacy and complications by two independent and blinded physicians. Questionnaires were also completed by patients. Results: Significant MASI improvements were seen at 1 week, 1 month and 2 months, but not at 3 months. Patients' degree of satisfaction was high. Significant improvement in skin texture and pore size was seen for up to 2 months and improvement in wrinkles for up to a month. There was no change in skin laxity. Main adverse effects seen were erythema, edema, and crusting in the early days. One patient developed PIH. Conclusion: The novel 1927 nm fractional thulium fiber laser is safe and effective in the management of melasma in Chinese patients for up to 2 months. It is also useful in photo-rejuvenation. Complications were limited to erythema and edema in the early days, and transient PIH.
    Journal of Cosmetic and Laser Therapy 02/2013; · 0.86 Impact Factor
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    ABSTRACT: Transcutaneous intense focused ultrasound has emerged as a novel technology for non-invasive skin tightening. The objective of this study was to evaluate the safety profile of a transcutaneous focused ultrasound device for the treatment of facial skin laxity in Asians. The patients received one to three full-face treatments with the transcutaneous focused ultrasound device. Three transducers (7.0 MHz, 3.0 mm focal depth; 7.0 MHz, 4.5 mm focal depth; 4.0 MHz, 4.5 mm focal depth) were used to deliver a single pass of microthermal coagulation zones without any topical anesthetics. Standardized photos were taken at baseline and at each follow-up with the Canfield Visia CR system® and were assessed by two independent physicians. Adverse effects were assessed up to 6 months post treatment. Subjective assessments in terms of pain and tolerability were also evaluated with patient questionnaires. Forty nine Chinese patients (skin types III-IV, mean age 53.3) completed a total of 68 treatment sessions. Transient erythema and edema were seen in the majority of patients. Focal bruising was present in up to 25% of treatment sessions. Two cases of post-inflammatory hyperpigmentation were seen on the forehead at 1-month post-treatment. One patient experienced focal twitching over the lower eyelid at 1-month follow-up, which was clinically consistent with hemifacial spasm and was unrelated to the ultrasound device. The degree of pain during treatment was recorded as severe in 54.4% of treatment sessions. Transcutaneous intense focused ultrasound appeared to be safe for non-invasive facial skin tightening in Asians. Adverse events were mild and transient. Pain control during treatment should be optimized. No serious permanent or delayed side effects were noted up to 6 months post treatment.
    Lasers in Surgery and Medicine 07/2011; 43(5):366-75. · 2.46 Impact Factor
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    ABSTRACT: Non-ablative fractional resurfacing (NA FR) has been shown to be effective for photorejuvenation and acne scarring. Previous studies indicated that density, more than pulse energy, was associated with post-inflammatory hyperpigmentation (PIH) in Asians. The objective of this retrospective study was to assess the efficacy and complications of eight passes of NA FR ('full-NA FR') with the 1,550 nm erbium-doped fibre fractional laser (Fraxel SR laser system, Solta Medical, Hayward, CA) versus four passes ('mini-NA FR') with comparable pulse energy and treatment level as 'full-NA FR', but double the number of treatment sessions in Asian acne scar patients. Forty-seven Asian atrophic facial acne scar patients who received full-face full-NA FR or mini-NA FR treatments between December 2005 and February 2009 were included. All photographic images captured with the Canfield Visia CR system at baseline and follow-ups were assessed for clinical efficacy and complications by an independent, non-treating and blinded physician. The total treatment densities for full-NA FR and mini-NA FR were 442.5 and 210.5 MTZ/cm(2), respectively. For full-NA FR, the PIH risk was 18.2% with cross-polarized images compared to 6.0% for mini-NA FR. This difference was statistically significant (P < 0.001). Improvement in skin texture, acne scarring, enlarged pores and overall pigmentation irregularity all reached statistical significance at last follow-up compared to baseline. There was no statistically significant difference in clinical efficacy between three full-NA FR and six mini-NA FR treatments. NA FR was effective and safe in Asians. By reducing the number of passes and the total treatment density, the risk of PIH could be reduced. Meanwhile, clinical efficacy could be maintained by increasing the total number of treatment sessions.
    Lasers in Surgery and Medicine 12/2010; 42(10):710-5. · 2.46 Impact Factor
  • Stephanie G Y Ho, Henry H L Chan
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    ABSTRACT: The Asian patient with Fitzpatrick skin types III-V is rarely highlighted in publications on cutaneous disorders or cutaneous laser surgery. However, with changing demographics, Asians will become an increasingly important group in this context. Although high melanin content confers better photoprotection, photodamage in the form of pigmentary disorders is common. Melasma, freckles, and lentigines are the epidermal disorders commonly seen, whilst nevus of Ota and acquired bilateral nevus of Ota-like macules are common dermal pigmentary disorders. Post-inflammatory hyperpigmentation (PIH) occurring after cutaneous injury remains a hallmark of skin of color. With increasing use of lasers and light sources in Asians, prevention and management of PIH is of great research interest. Bleaching agents, chemical peels, intense pulsed light (IPL) treatments, and fractional skin resurfacing have all been used with some success for the management of melasma. Q-switched (QS) lasers are effective for the management of epidermal pigmentation but are associated with a high risk of PIH. Long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers and IPL sources pose less of a PIH risk but require a greater number of treatment sessions. Dermal pigmentary disorders are better targeted by QS ruby, QS alexandrite, and QS 1064-nm Nd:YAG lasers, but hyper- and hypopigmentation may occur. Non-ablative skin rejuvenation using a combination approach with different lasers and light sources in conjunction with cooling devices allows different skin chromophores to be targeted and optimal results to be achieved, even in skin of color. Deep-tissue heating using radiofrequency and infra-red light sources affects the deep dermis and achieves enhanced skin tightening, resulting in eyebrow elevation, rhytide reduction, and contouring of the lower face and jawline. For management of severe degrees of photoaging, fractional resurfacing is useful for wrinkle and pigment reduction, as well as acne scarring. Acne, which is common in Asians, can be treated with topical and oral antibacterials, hormonal treatments, and isotretinoin. Infra-red diode lasers used with a low-fluence, multiple-pass approach have also been shown to be effective with few complications. Fractional skin resurfacing is very useful for improving the appearance of acne scarring. Hypertrophic and keloid scarring, another common condition seen in Asians, can be treated with the combined used of intralesional triamcinolone and fluorouracil, followed by pulsed-dye laser. Esthetic enhancement procedures such as botulinum toxin type A and fillers are becoming increasingly popular. These are effective for rhytide improvement and facial or body contouring. We highlight the differences between Asian skin and other skin types and review conditions common in skin of color together with treatment strategies.
    American Journal of Clinical Dermatology 02/2009; 10(3):153-68. · 1.84 Impact Factor