Results of fractional ablative facial skin resurfacing with the erbium:yttrium-aluminium-garnet laser 1 week and 2 months after one single treatment in 30 patients

Abstract

The erbium:yttrium-aluminium-garnet (Er:YAG) laser has recently been used in the fractional resurfacing of photo-aged skin. Our study evaluated the results after one single session of fractional resurfacing with Er:YAG. Thirty women participated in the study, with an average age of 46 years, skin types from II to IV, and wrinkle grades I to III. The 2,940 nm Er:YAG system used (Pixel, Alma Laser, Israel) had variable pulse durations (1 ms to 2 ms) and energy densities (800 mJ/cm(2) to 1,400 mJ/cm(2)) which, together with the number of passes (four to eight), were selected as a function of wrinkle severity. All patients received only one treatment. Postoperative side effects were evaluated. The number of wrinkles was documented with clinical photography and was scored. Histological assessment was carried out on two patients before and 2 months after treatment. All patients completed the study. Of the patients, 93% reported good or very good improvement of the degree of their wrinkles, with a satisfaction index of 83%. Pain was not a problem during treatment, and there were no side effects except for in one phototype IV patient, who had hyperpigmentation. Histology 2 months after the single treatment demonstrated younger morphology of both the epidermis and dermis, with improvement of the pretreatment typical elastotic appearance. At the parameters used in our study, only one treatment session of Er:YAG laser could achieve effective skin rejuvenation, with effects recognized in both the dermis and, more importantly, the epidermis. This regimen offers an interesting alternative to the conventional approach of multi-session fractional resurfacing.

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

“…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. Another major shortcoming is illustrated in Figure 3 of the article under discussion: The photographs showing the pre-and post-treatment findings are different both in dimension (distance from camera to skin) and lighting, making it virtually impossible to objectively assess the degree of improvement [40].…”

“…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].…”

“…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]. However, claims that the fractional CO 2 laser is superior to fractional Er:YAG [19] call for evidence-based scrutiny, as do the extremely encouraging results of fractional erbium lasers [14,20]. No systematic comparative studies of both fractional modalities have been published, according to a recent MEDLINE research.…”

Comparison of clinical outcome parameters, the Patient Benefit Index (PBI‐k) and patient satisfaction after ablative fractional laser treatment of peri‐orbital rhytides

“…Treatment parameters were chosen according to the manufacturers' recommendation, the published evidence [11][12][13][14][15][16][17][18], and an estimated downtime of 4-5 days for both methods. Both procedures were limited to a single treatment session.…”

Fractional photothermolysis—an update

“…Another recent study reported on this new technology, using a 2,940 nm Er:YAG laser (Pixel, Alma Lasers, Buffalo Grove, IL, USA) for fractional resurfacing of photoaged skin [6]. They treated 30 women, Fitzpatrick skin types II-IV with one single session of fractional resurfacing, and 93% of the patients showed a good or very good improvement of the wrinkles.…”