Hybrid fractional laser treatment for photodamaged facial skin rejuvenation 6 years following fractional CO₂: Comparison of clinical outcome and patients' satisfaction

Abstract

Objectives Fractional carbon dioxide (CO2) laser resurfacing is considered an effective treatment for skin rejuvenation. The request for clinical effectiveness with shorter downtime has led to the development of new hybrid technologies, including a traditional Er:YAG (erbium‐doped yttrium aluminium garnet) fractional laser 2940 nm combined with a simultaneous nonablative 1470 nm wavelength. The aim of this study is to compare clinical outcomes and patients' satisfaction with face resurfacing performed with both the CO2 laser and the hybrid laser. Methods Nineteen women underwent ultrapulsed CO2 fractional resurfacing for photodamaged facial skin; the same patients underwent the hybrid laser after almost 6 years. Clinical outcomes and patients' satisfaction were evaluated 6 months after the treatment and compared between the two technologies. Results After both CO2 and hybrid treatment a significant improvement was found in terms of fine lines (p < 0.001 and p = 0.004, respectively), tactile roughness (p < 0.001 and p = 0.002, respectively), and mottled pigmentation (both p < 0.001). Healing times and complications were greater with the CO2 laser. Comparing the two technologies, patients showed better results with the CO2 laser for each score's item, but greater satisfaction with the hybrid laser (p = 0.012). Conclusions The present study confirms CO2 laser as the most effective treatment; however, the new hybrid technology revealed good results associated with faster healing and less discomfort.

Hybrid fractional laser facial resurfacing: A comparison between a single treatment at high settings versus multiple treatments at low to moderate settings

“…Table 3 presents the adverse effects of different AFLs, NAFLs, and hybrid lasers. [8][9][10]12,14,18 In the lower-setting treatments, the side effect profile was similar to other hybrid devices, including short-term post-procedural erythema (resolution within a week to 90.9% of patients) without risk of PIH.…”

“…The significantly greater patients' satisfaction might be explained by the shorter downtime, easier recovery and milder expected adverse effects posttreatment in Group B. Table 3 presents the adverse effects of different AFLs, NAFLs, and hybrid lasers 8–10,12,14,18 . In the lower‐setting treatments, the side effect profile was similar to other hybrid devices, including short‐term post‐procedural erythema (resolution within a week to 90.9% of patients) without risk of PIH.…”

“…13 Furthermore, in a study that compared clinical outcomes and patients' satisfaction following CO 2 laser treatment to hybrid laser treatment in the same patients 6 years apart for facial rejuvenation, better results were accomplished after CO 2 laser, but higher patients' satisfaction and safety, and faster healing time were achieved after the hybrid laser. 14 Regarding the safety of the combined emission, a recent study that evaluated histological biopsies from a porcine model, concluded that a dual treatment of fractional 10,600 and 1570 nm lasers had no additional risk compared to the risk of treating with each laser alone. 15 The beams of different hybrid systems can be emitted sequentially in the same pixel in different orders (AFL → NAFL or NAFL → AFL) or, successively, side by side (different pixels) in various AFL: NAFL ratios.…”

“…A split‐face trial that compared the combination of AFL and NAFL resurfacing to AFL resurfacing alone for the treatment of acne scars, found that the combined treatment yielded the best clinical results with fewer complications 13 . Furthermore, in a study that compared clinical outcomes and patients' satisfaction following CO 2 laser treatment to hybrid laser treatment in the same patients 6 years apart for facial rejuvenation, better results were accomplished after CO 2 laser, but higher patients' satisfaction and safety, and faster healing time were achieved after the hybrid laser 14 . Regarding the safety of the combined emission, a recent study that evaluated histological biopsies from a porcine model, concluded that a dual treatment of fractional 10,600 and 1570 nm lasers had no additional risk compared to the risk of treating with each laser alone 15 …”

The Safety and Efficacy of a Dual CO2 and 1570-nm Hybrid Laser for Periorbital Rejuvenation

“…3 There are several available hybrid lasers on the market, as described in Table 3. [16][17][18] Several studies have reported that this combination laser can maximize each individual laser's benefits in facial rejuvenation. A possible explanation for the resultant optimization is the greater amount of energy delivered to different stratifications of the skin due to different wavelengths being delivered simultaneously.…”