Fractional Erbium Laser in the Treatment of Photoaging: Randomized Comparative, Clinical and Histopathological Study of Ablative (2940nm) Vs. Non-ablative (1540nm) Methods After 3 Months

Overview

Journal An Bras Dermatol

Specialty Dermatology

Date 2014 Apr 29

PMID 24770501

Citations 7

Authors

Juliano Borges

Tullia Cuzzi

Carlos Alberto Mandarim-de-Lacerda

Monica Manela-Azulay

Affiliations

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Abstract

Background: Fractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective.

Objectives: To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium.

Methods: Eighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out.

Results: All patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001).

Conclusions: Three 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.

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References

Gotkin R, Sarnoff D, Cannarozzo G, Sadick N, Alexiades-Armenakas M . Ablative skin resurfacing with a novel microablative CO2 laser. J Drugs Dermatol. 2009; 8(2):138-44. View

Hantash B, Bedi V, Chan K, Zachary C . Ex vivo histological characterization of a novel ablative fractional resurfacing device. Lasers Surg Med. 2006; 39(2):87-95. DOI: 10.1002/lsm.20405. View

Naouri M, Atlan M, Perrodeau E, Georgesco G, Khallouf R, Martin L . High-resolution ultrasound imaging to demonstrate and predict efficacy of carbon dioxide fractional resurfacing laser treatment. Dermatol Surg. 2011; 37(5):596-603. DOI: 10.1111/j.1524-4725.2011.01943.x. View

Tretti Clementoni M, Gilardino P, Muti G, Beretta D, Schianchi R . Non-sequential fractional ultrapulsed CO2 resurfacing of photoaged facial skin: preliminary clinical report. J Cosmet Laser Ther. 2007; 9(4):218-25. DOI: 10.1080/14764170701632901. View

Derstine P . Implementing goals for non-cognitive outcomes within a basic science course. Acad Med. 2002; 77(9):931-2. DOI: 10.1097/00001888-200209000-00035. View

Wheeland R, McBurney E, Geronemus R . The role of dermatologists in the evolution of laser surgery. Dermatol Surg. 2000; 26(9):815-22. DOI: 10.1046/j.1524-4725.2000.00509.x. View

Alam M, Hsu T, Dover J, Wrone D, Arndt K . Nonablative laser and light treatments: histology and tissue effects--a review. Lasers Surg Med. 2003; 33(1):30-9. DOI: 10.1002/lsm.10195. View

Brightman L, Brauer J, Anolik R, Weiss E, Karen J, Chapas A . Ablative and fractional ablative lasers. Dermatol Clin. 2009; 27(4):479-89, vi-vii. DOI: 10.1016/j.det.2009.08.009. View

Manstein D, Herron G, Sink R, Tanner H, Anderson R . Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004; 34(5):426-38. DOI: 10.1002/lsm.20048. View

10.

Chan N, Ho S, Yeung C, Shek S, Chan H . The use of non-ablative fractional resurfacing in Asian acne scar patients. Lasers Surg Med. 2011; 42(10):710-5. DOI: 10.1002/lsm.20976. View

11.

Hantash B, Bedi V, Kapadia B, Rahman Z, Jiang K, Tanner H . In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers Surg Med. 2007; 39(2):96-107. DOI: 10.1002/lsm.20468. View

12.

Varani J, Warner R, Gharaee-Kermani M, Phan S, Kang S, Chung J . Vitamin A antagonizes decreased cell growth and elevated collagen-degrading matrix metalloproteinases and stimulates collagen accumulation in naturally aged human skin. J Invest Dermatol. 2000; 114(3):480-6. DOI: 10.1046/j.1523-1747.2000.00902.x. View

13.

Oh J, Kim Y, Jung J, Shin J, Kim K, Cho K . Intrinsic aging- and photoaging-dependent level changes of glycosaminoglycans and their correlation with water content in human skin. J Dermatol Sci. 2011; 62(3):192-201. DOI: 10.1016/j.jdermsci.2011.02.007. View

14.

Manela-Azulay M, Cuzzi T, Pinheiro J, Azulay D, Rangel G . [Objective methods for analyzing outcomes in research studies on cosmetic dermatology]. An Bras Dermatol. 2010; 85(1):65-71. DOI: 10.1590/s0365-05962010000100009. View

15.

Alster T . Cutaneous resurfacing with CO2 and erbium: YAG lasers: preoperative, intraoperative, and postoperative considerations. Plast Reconstr Surg. 1999; 103(2):619-32; discussion 633-4. DOI: 10.1097/00006534-199902000-00040. View

16.

Prignano F, Bonciani D, Campolmi P, Cannarozzo G, Bonan P, Lotti T . A study of fractional CO₂ laser resurfacing: the best fluences through a clinical, histological, and ultrastructural evaluation. J Cosmet Dermatol. 2011; 10(3):210-6. DOI: 10.1111/j.1473-2165.2011.00571.x. View

17.

Dainichi T, Ueda S, Fumimori T, Kiryu H, Hashimoto T . Skin tightening effect using fractional laser treatment II: A pilot animal study on skin remodeling. Dermatol Surg. 2010; 36(1):71-5. DOI: 10.1111/j.1524-4725.2009.01382.x. View

18.

Helbig D, Paasch U . Molecular changes during skin aging and wound healing after fractional ablative photothermolysis. Skin Res Technol. 2011; 17(1):119-28. DOI: 10.1111/j.1600-0846.2010.00477.x. View

19.

Ciocon D, Engelman D, Hussain M, Goldberg D . A split-face comparison of two ablative fractional carbon dioxide lasers for the treatment of photodamaged facial skin. Dermatol Surg. 2011; 37(6):784-90. DOI: 10.1111/j.1524-4725.2011.01964..x. View

20.

MAIMAN T . Biomedical lasers evolve toward clinical applications. Hosp Manage. 1966; 101(4):39-41. View