Novel Use of Erbium:YAG (2,940-nm) Laser for Fractional Ablative Photothermolysis in the Treatment of Photodamaged Facial Skin: A Pilot Study

Lapidoth, Moshe; Odo, Marina Emiko Yagima; Odo, Lilian Mayumi

doi:10.1111/j.1524-4725.2008.34204.x

Cited by 48 publications

(50 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bodendorf et al [18] found no difference between both modalities based on the published material and their own experience; this conclusion is in complete agreement with our own results. As for ablative fractional methods in general, the efficacy of various laser modalities for rhytide reduction has been demonstrated (e.g., [2,5,12,13,15,17,18]) but the effect of a single treatment session may not be comparable to conventional ablative methods. There is published material opposing this statement; for instance, Trelles et al [14] published very encouraging results about a single treatment with a fractional Er:YAG laser, albeit in a very inhomogeneous sample in terms of treated region and treatment parameters.…”

Section: Discussionmentioning

confidence: 99%

“…The findings about ablative fractional photothermolysis of rhytides that have been published so far are encouraging, but they are inconsistent in detail as far as study design and the respective efficacy of different laser modalities are concerned. Whereas several studies claim encouraging results of erbium lasers (e.g., [12][13][14]), the same holds true for fractional CO 2 ablation [15][16][17]. There is very little evidence on the comparative safety and efficacy of both methods, but the limited scope of the literature to date suggests a roughly equivalent status [18], just as it does for non-fractional applications [4][5][6][7].…”

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

et al. 2010

View full text Add to dashboard Cite

Background and Objective: Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO 2 and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Study Design/Materials and Methods: Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO 2 and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Results: Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO 2 laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. Conclusions: According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO 2 and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Except for one case of hyperpigmentation in a phototype IV patient, no side effects were observed. Two further studies confirmed that microfractional ablative treatment with 2,790 nm and 2,940 nm erbium lasers is a safe and effective treatment for wrinkle reduction and results in only minimal patient downtime [38][39][40]. Supporting data have recently been published by Berlin et al Ten patients, Fitzpatrick skin types I-III, with photodamaged facial skin were given a single-pass superficial full-face ablative treatment using the CO 2 laser at energy levels of 80-100 mJ.…”

Section: Non-ablative Fractional Photothermolysis Lasermentioning

confidence: 99%

Fractional photothermolysis—an update

Allemann¹,

Kaufman

2009

Lasers Med Sci

135

View full text Add to dashboard Cite

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.

show abstract

“…Fractional ablative procedures are available with carbon dioxide laser (CO 2 laser, 10,600 nm) and erbium YAG laser (Er:YAG laser, 2,940 nm) [3][4][5]. The concept of AFR has so far been used for dermal remodeling in the treatment of photodamaged facial skin, rhytides, acneiform scarring, and burn scar remodeling [3,[6][7][8][9][10]. Theoretically, AFR may also facilitate penetration and distribution of topically applied drugs, since the ablated laser holes extend into dermis, thereby possibly acting as channels for drug uptake.…”

Section: Introductionmentioning

confidence: 99%

Fractional CO₂ laser‐assisted drug delivery

et al. 2010

View full text Add to dashboard Cite

Background and Objectives: Ablative fractional resurfacing (AFR) creates vertical channels that might assist the delivery of topically applied drugs into skin. The purpose of this study was to evaluate drug delivery by CO 2 laser AFR using methyl 5-aminolevulinate (MAL), a porphyrin precursor, as a test drug. Materials and Methods: Two Yorkshire swine were treated with single-hole CO 2 laser AFR and subsequent topical application of MAL (Metvix 1 , Photocure ASA, Oslo, Norway), placebo cream and no drug. MAL-induced porphyrin fluorescence was measured by fluorescence microscopy at skin depths down to 1,800 mm. AFR was performed with a 10.6 mm wavelength prototype CO 2 laser, using stacked single pulses of 3 millisecond and 91.6 mJ per pulse. Results: AFR created cone-shaped channels of approximately 300 mm diameter and 1,850 mm depth that were surrounded by a 70 mm thin layer of thermally coagulated dermis. There was no porphyrin fluorescence in placebo cream or untreated skin sites. AFR followed by MAL application enhanced drug delivery with significantly higher porphyrin fluorescence of hair follicles (P<0.0011) and dermis (P<0.0433) versus MAL alone at skin depths of 120, 500, 1,000, 1,500, and 1,800 mm. AFR before MAL application also enhanced skin surface (epidermal) porphyrin fluorescence. Radial diffusion of MAL from the laser-created channels into surrounding dermis was evidenced by uniform porphyrin fluorescence up to 1,500 mm from the holes (1,000, 1,800 mm depths). Skin massage after MAL application did not affect MAL-induced porphyrin fluorescence after AFR. Conclusions: Ablative fractional laser treatment facilitates delivery of topical MAL deeply into the skin. For the conditions of this study, laser channels approximately 3 mm apart followed by MAL application could produce porphyrins throughout essentially the entire skin. AFR appears to be a clinically practical means for enhancing uptake of MAL, a photodynamic therapy drug, and presumably many other topical skin medications. Lasers Surg.

show abstract

Novel Use of Erbium:YAG (2,940-nm) Laser for Fractional Ablative Photothermolysis in the Treatment of Photodamaged Facial Skin: A Pilot Study

Abstract: Fractional ablative photothermolysis using erbium:YAG laser (2,940 nm) is a promising option for skin resurfacing with reduced risk and downtime compared to existing laser methods.

Cited by 48 publications

References 15 publications

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Fractional photothermolysis—an update

Fractional CO₂ laser‐assisted drug delivery

Contact Info

Product

Resources

About

Novel Use of Erbium:YAG (2,940-nm) Laser for Fractional Ablative Photothermolysis in the Treatment of Photodamaged Facial Skin: A Pilot Study

Abstract: Fractional ablative photothermolysis using erbium:YAG laser (2,940 nm) is a promising option for skin resurfacing with reduced risk and downtime compared to existing laser methods.

Cited by 48 publications

References 15 publications

Ablative fractional lasers (CO2 and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Ablative fractional lasers (CO2 and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Fractional photothermolysis—an update

Fractional CO2 laser‐assisted drug delivery

Contact Info

Product

Resources

About

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Fractional CO₂ laser‐assisted drug delivery