Significant skin‐tightening by closure of fractional ablative laser holes

Abstract

Background and Objective Ablative fractional laser treatment uses thousands of very small laser beam wounds to damage a fraction of the skin, which stimulates tissue remodeling. Each open micro‐wound heals without scarring, but the amount of skin tightening achieved is limited. This animal study was performed to test the hypothesis that immediate temporary closure of fractional laser wounds could increase skin tightening after fractional ablative laser treatment. Materials and Methods Four adult swine were used for the study; 98 square test sites (3 × 3 cm) were tattooed on the abdomen and flanks of each pig. An ablative fractional Erbium:YAG laser (Sciton Profile, Sciton Inc, Palo Alto, CA) was used to treat the test areas. A laser micro‐spot fluence of 375 J/cm2 was delivered in 150–250 microseconds pulses, resulting in an array of ablation channels extending 1.5 mm deep into the skin, with a spot size of 250 µm, with 10% treatment density. Immediately following laser exposure the resulting holes were closed using a stretched elastic adhesive dressing, which, when applied, recoiled and compressed the diameter of the ablation holes. The compressive dressings were removed after 7 days. This procedure was compared to removing the same amount of skin (10%) mechanically by specially designed 19 gauge coring needles, as well as to the same laser and coring methods without compression closure. Area and shape of test sites were measured by digital photography before and 28 days after treatment. Data analysis included compensation for animal growth, as measured by increase in the area of the untreated control sites. Results All treated and control sites healed within a week, without scarring evident at 28 days. Laser treatment combined with compressive wound closure caused significant shrinkage at 28 days compared with untreated control sites. The treated skin area was reduced by 11.5% (P = 0.0001). Needle coring with wound closure produced similar, significant shrinkage (8%, P < 0.0021), whereas laser and needle coring treatment without closure did not result in significant area reduction (P = 0.1289) compared with untreated control sites. Conclusion Significant skin tightening can be achieved by immediate temporary non‐invasive wound closure after short pulse Er:YAG fractional ablative laser treatment, as well as after mechanically removing skin with a coring needle. This approach may improve skin tightening after ablative laser treatments. Further clinical studies are necessary to confirm successful application in humans. Lasers Surg. Med. 50:64–69, 2018. © 2017 Wiley Periodicals, Inc.

Full ablative versus fractional ablative laser therapy for Dowling–Degos disease

“…Both lasers induce tissue tightening secondary to heat‐induced collagen contraction. The skin tightening after fractional ablative laser therapy may be further improved by the application of stretched elastic adhesive dressings . For treatment of patients with DDD, another benefit of using a full ablative Er:YAG laser compared to a fractional CO 2 laser is the reduced thermal damage.…”

Investigation of laser pulsing parameters’ importance in Er:YAG laser skin ablation: a theoretical study conducted via newly developed thermo-mechanical ablation model

“…Consequently, temperature and specific internal energy of tissue's water were obtained from the steam tables utilizing the Engineering Equation Solver software (EES: F-Chart Software, Madison, WI) run on a desktop PC with Intel Core i7 processor (2.66 GHz) and 4 GB DDR3 RAM. Lastly, energy density within the tissue was calculated using Equation (1). Table 1 summarizes the thermo-physical properties of the skin that were utilized in the model.…”

“…The second step was to calculate the maximum energy density (e max ) defined as the energy needed to reach the strain to failure (e max ). e max was calculated using Equation (1). Initially, this step was performed assuming quasi-static loading.…”

“…Lasers are used frequently in the field of dermatology in skin tightening and remodeling [1][2][3], treatment of different skin and mucous disorders [4], treatment of cutaneous lesions [5,6], and recently in drug delivery where micro-craters are made in the skin to enhance transdermal drug delivery [7,8].…”

Quantitative evaluation of collagen and elastic fibers after intense pulsed light treatment of mouse skin

“…Fractional CO2 laser treatment can improve caesarean section scars after 6 months of follow‐up . A study demonstrated significant skin‐tightening after an ablative fractional Erbium:YAG laser treatment that was immediately closed with a medical elastic skin‐adherent dressing for 7 days .…”