Clinical trial of a laser device called fractional photothermolysis system for acne scars

Hasegawa, Toshio; Matsukura, Tomoyuki; Mizuno, Yuki; Suga, Yasushi; Ogawa, Hideoki; Ikeda, Shigaku

doi:10.1111/j.1346-8138.2006.00143.x

Cited by 125 publications

(96 citation statements)

References 33 publications

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“…Moreover, the undesirable side effects of the very effective original ablative laser resurfacing fostered the use of FP in the treatment of scars, and, so far, various studies have examined its effect on different scar types. For acne scars, ten patients treated with non-ablative FP for up to three times at 2-3 week intervals all showed clinical improvement 4 weeks after treatment [23]. In a larger study by Alster et al 53 patients with atrophic scars were treated with non-ablative FP on a monthly basis for two or more treatments.…”

Section: Non-ablative Fractional Photothermolysis Lasermentioning

confidence: 99%

Fractional photothermolysis—an update

Allemann¹,

Kaufman

2009

Lasers Med Sci

135

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The novel concept of non-ablative fractional photothermolysis was introduced to the market in 2003 as an answer to the need for effective, yet low risk, resurfacing techniques. Unlike conventional ablative and non-ablative lasers, fractional ablative and non-ablative photothermolysis treats only a fraction of the skin, leaving up to a maximum of 95% of the skin uninvolved. The undamaged surrounding tissue allows for a reservoir of viable tissue, permitting rapid epidermal repair. Non-ablative fractional photothermolysis is currently approved by the US Food and Drug Administration (FDA) for the treatment of pigmented lesions, periorbital rhytides, skin resurfacing, melasma and soft tissue coagulation, acne and surgical scars, and actinic keratoses. However, its off-label use is clearly more extended. In 2007 the concept was further developed, and ablative fractional photothermolysis was introduced, using an erbium yttrium aluminium garnet (Er: YAG) or carbon dioxide laser. These devices are FDA cleared to treat wrinkles, rhytides, furrows, fine lines, textural irregularities, pigmented lesions and vascular dyschromia. In this review we discuss the two concepts, their technical details and clinical indications, and we describe the current literature available. Abstract The novel concept of non-ablative fractional photothermolysis was introduced to the market in 2003 as an answer to the need for effective, yet low risk, resurfacing techniques. Unlike conventional ablative and non-ablative lasers, fractional ablative and non-ablative photothermolysis treats only a fraction of the skin, leaving up to a maximum of 95% of the skin uninvolved. The undamaged surrounding tissue allows for a reservoir of viable tissue, permitting rapid epidermal repair. Non-ablative fractional photothermolysis is currently approved by the US Food and Drug Administration (FDA) for the treatment of pigmented lesions, periorbital rhytides, skin resurfacing, melasma and soft tissue coagulation, acne and surgical scars, and actinic keratoses. However, its off-label use is clearly more extended. In 2007 the concept was further developed, and ablative fractional photothermolysis was introduced, using an erbium yttrium aluminium garnet (Er: YAG) or carbon dioxide laser. These devices are FDA cleared to treat wrinkles, rhytides, furrows, fine lines, textural irregularities, pigmented lesions and vascular dyschromia. In this review we discuss the two concepts, their technical details and clinical indications, and we describe the current literature available.

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Section: Non-ablative Fractional Photothermolysis Lasermentioning

confidence: 99%

Fractional photothermolysis—an update

Allemann¹,

Kaufman

2009

Lasers Med Sci

135

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“…Fractional non-ablative treatments have been useful in treating conditions such as mild to moderate rhytides [10], photodamaged skin [11], acne scarring [12,13], leucodermic scars [14], melasma [15,16], and nonfacial skin rejuvenation [17]. Investigators have reported re-epithelization in 24 hours with this procedure [18,19], thereby reducing downtime for the patient.…”

Section: Introductionmentioning

confidence: 99%

Micro‐fractional ablative skin resurfacing with two novel erbium laser systems

et al. 2008

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Background and Objectives: Fractional ablation offers the potential benefits of full-surface ablative skin resurfacing while minimizing adverse effects. The purpose of this study was to evaluate the safety, damage profile, and efficacy of erbium fractional lasers. Materials and Methods: Histology from animal and human skin as well as clinical evaluations were conducted with erbium YAG (2,940 nm) and erbium YSGG (2,790 nm) fractional lasers varying pulse width, microbeam (mb) energy, number of passes, and stacking of pulses. Results: Single-pulse treatment parameters from 1 to 12 mJ per 50-70 mm diameter microbeam and 0.25-5 milliseconds pulse widths produced microcolumns of ablation with border coagulation of up to 100 mm width and 450 mm depth. Stacking of pulses generated deeper microcolumns. Clinical observations and in vivo histology demonstrate rapid re-epithelization and limited adverse side effects. Facial treatments were performed in the periorbital and perioral areas using 1-8 passes of single and stacked pulses. Treatments were well-tolerated and subjects could resume their normal routine in 4 days. A statistically significant reduction in wrinkle scores at 3 months was observed for both periorbital and perioral wrinkles using blinded grading. For periorbital treatments of four passes or more, over 90% had !1 score wrinkle reduction (0-9 scale) and 42% had !2. For perioral wrinkles, over 50% had substantial improvements (!2). Conclusion: The clinical observations and histology findings demonstrate that micro-fractional ablative treatment with 2,790 and 2,940 nm erbium lasers resulted in safe and effective wrinkle reduction with minimal patient downtime. The depth and width of the ablated microcolumns and varying extent of surrounding coagulation can be controlled and used to design new treatment procedures targeted for specific indications and areas such as moderate to severe rhytides and photodamaged skin.

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“…This approach has changed the light-based treatment paradigm from that of layers of photothermolysis to one of columns of thermal damage. Recently, an erbium-doped fiber laser, emitting light at 1,550 nm, has been shown to be effective in the treatment of photodamaged skin, acne scars, post-surgical scarring, poikiloderma of Civatte, pigmented lesions, striae distensae, as well as melasma [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Histologic and ultrastructural analysis of melasma after fractional resurfacing

2008

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Background and Objective: Fractional photothermolysis is a popular treatment option for photodamaged skin and other cutaneous conditions. Recently, successful improvement in melasma has been achieved with this laser system. We undertook this study to evaluate the ultrastructural changes associated with fractional laser treatment of melasma. Study Design/Materials and Methods: Ten subjects with skin types III and IV and a clinical diagnosis of epidermal melasma were treated with a 1,550-nm erbium:-glass laser delivering light in a fractional manner (Fraxel SR 750, Reliant Technologies, Inc., Mountain View, CA) every 2 weeks for a total of four sessions. Biopsies were obtained from all subjects both before treatment and at 3 months following the final treatment. All biopsies were analyzed by light and electron microscopy for treatmentinduced changes. In addition, a secondary endpoint of the study was to assess for clinical improvement in melasma following fractional resurfacing. This assessment was performed by the investigator using pre-and post-treatment photographs. Results: Light microscopy on post-treatment specimens showed a relative decrease in melanocytes compared to the pre-treatment ones. Post-treatment electron microscopy revealed fewer melanocytes and a relative absence of melanin in the surrounding keratinocytes compared to pre-treatment specimens. In addition, six subjects with skin type III were determined to have good improvement, whereas four subjects with skin type IV had fair improvement, as assessed by the investigator. Conclusion: Post-treatment ultrastructural changes are consistent with an elimination process and may help to explain clinical improvement following laser treatment.

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Clinical trial of a laser device called fractional photothermolysis system for acne scars

Cited by 125 publications

References 33 publications

Fractional photothermolysis—an update

Fractional photothermolysis—an update

Micro‐fractional ablative skin resurfacing with two novel erbium laser systems

Histologic and ultrastructural analysis of melasma after fractional resurfacing

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