Prospective direct comparison study of fractional resurfacing using different fluences and densities for skin rejuvenation in Asians

Abstract

Increased density was more likely to produce swelling, redness, and hyperpigmentation when compared to increased energy. Patient satisfaction is significantly higher when their skin is treated with high fluences, but not when patients' skin is treated with high densities.

Fractional photothermolysis—an update

“…Those more 'obligatory' side-effects (pain, erythema, edema) are stronger and persist longer with higher densities. Increased density seems to be more likely to produce edema, erythema, and even post-inflammatory hyperpigmentation than does increased energy [10]. However, patient satisfaction was shown to be significantly greater for patients treated with higher fluences, but not for patients treated with higher densities [10].…”

“…However, the possibility of post-inflammatory pigment alterations in darker skin types should not be neglected and should thus be accounted for by adjustment of treatment settings accordingly. Further, unlike traditional ablative resurfacing, non-ablative fractional photothermolysis (NAFP) has been shown to be safe to use on locations other than the face, and no side-effects such as scarring have been reported so far [10]. For ablative fractional photothermolysis (AFP) however, first reports of side-effects and complications when used off-face or in locations with thin skin, such as the eyelids, have recently been published.…”

“…Increased density seems to be more likely to produce edema, erythema, and even post-inflammatory hyperpigmentation than does increased energy [10]. However, patient satisfaction was shown to be significantly greater for patients treated with higher fluences, but not for patients treated with higher densities [10]. Graber et al retrospectively evaluated 961 treatments with a 1,550 nm erbium-doped laser for sideeffects and complications [15].…”

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

“…3,21 Higher fluences have been associated with higher procedural pain scores. 39,40 Small case series reporting scarring located on the neck or ectropion, preceded by infection or nonhealing ulcers, have been described. 21,41 PIH is a substantial risk when treating darkly pigmented patients, as multiple studies performed in Asian patients conclude.…”

“…73 Similar to AFLs, lower densities and fewer treatment passes have been associated with a lower risk for hyperpigmentation at the expense of more treatment sessions, 43 whereas higher densities result in more side effects without improved results. 40 Pre-and posttreatment with hydroquinone 4% may help decrease the incidence of PIH, even in darker patients. 74 Quality-switched lasers While the technology for QS lasers and the more recent picosecond lasers is primarily being used for endogenous and exogenous pigmentation correction, its use naturally expanded to the broader and sought-after goal of skin rejuvenation and tightening.…”