Skin Resurfacing of Fine to Deep Rhytides Using a Char-free Carbon Dioxide Laser in 47 Patients

Waldorf, Heidi A.; Kauvar, Arielle N. B.; Geronemus, Roy G.

doi:10.1111/j.1524-4725.1995.tb00530.x

Cited by 167 publications

(187 citation statements)

References 19 publications

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“…Additional benefits arise from the long-term wound healing response, which leads to replacement of photoaged dermal tissue with newly deposited collagen. Thus, in contrast to ablative skin resurfacing with devices such as the pulsed CO 2 or Er:YAG lasers [2][3][4][5][6][7][8][9][10], nonablative fractional resurfacing by a pulsed mid-infrared laser is able to achieve photorejuvinative effects in the absence of significant side effects and downtime [1].…”

Section: The Fraxelmentioning

confidence: 99%

The effects of pulse energy variations on the dimensions of microscopic thermal treatment zones in nonablative fractional resurfacing

et al. 2006

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Background and Objectives:We examined the effects of pulse energy variations on the dimensions of microscopic thermal injury zones (MTZs) created on human skin ex vivo and in vivo using nonablative fractional resurfacing. Materials and Methods: A Fraxel 1 SR laser system emitting at 1,550 nm provided an array of microscopic spots at variable densities. Pulse energies ranging from 4.5 to 40 mJ were tested on human abdominal skin ex vivo and in vivo. Tissue sections were stained with hematoxylin and eosin (H&E) or nitro blue tetrazolium chloride (NBTC) and MTZ dimensions were determined. Ex vivo and in vivo results were compared. Dosimetry analyses were made for the surface treatment coverage calculation as a function of pulse energy and collagen coagulation based on H&E stain or cell necrotic zone based on NBTC stain. Results: Each MTZ was identified by histological detection of a distinct region of loss of tissue birefringence and hyalinization, representing collagen denaturation and cell necrosis within the irradiated field immediately, 1, 3, and 7 days after treatment. At high pulse energies, the MTZ depth could exceed 1 mm and width approached 200 mm as assessed by H&E. NBTC staining revealed viable interlesional tissue. In general, no statistically significant difference was found between in vivo and ex vivo depth and width measurements. Conclusions: The Fraxel 1 SR laser system delivers pulses across a wide range of density and energy levels. We determined that increases in pulse energy led to increases in MTZ depth and width without compromising the structure or viability of interlesional tissue. Lasers Surg.

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Section: The Fraxelmentioning

confidence: 99%

The effects of pulse energy variations on the dimensions of microscopic thermal treatment zones in nonablative fractional resurfacing

et al. 2006

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“…The persistence of erythema is related to the number of passes and the energy and density settings chosen. More persistent erythema has rarely been reported [30]. The clinical perception of erythema may persist for longer periods in those with partial-face resurfacing [31].…”

Section: Postoperative Carementioning

confidence: 99%

“…One study documented 45%-60% improvement in wrinkles [29]. The glabellar area appears to respond least whereas peri-orbital and -oral responses are much better and similar [30].…”

Section: Patient Consultationmentioning

confidence: 99%

“…The re-epithelialisation is followed in all patients by a dry erythema that generally clears in 2-16 weeks [6,30] with an average of 3.5 months [31]. The persistence of erythema is related to the number of passes and the energy and density settings chosen.…”

Section: Postoperative Carementioning

confidence: 99%

“…These may be adequately controlled with emollients, a low potency topical steroid [30] such as Desowen (Galderma, Fort Worth, TX) and antihistamines. Figures 1-4 illustrate some of the results that can be achieved using CO 2 laser surgery.…”

Section: Dermablendmentioning

confidence: 99%

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Carbon Dioxide Laser Resurfacing of Rhytides and Photodamaged Skin

Kelly

Nelson

1998

Lasers Med Sci

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Abstract. Carbon dioxide (CO 2 ) laser resurfacing has been used as a method to treat rhytides and photodamaged skin. This laser o#ers several advantages over previously utilised modalities but its use has several inherent risks. This article will review important aspects of CO 2 laser resurfacing including laser-skin interactions, patient selection, e#ective pre-and post-operative regimens and potential complications.

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Optimizing Fluence and Debridement Effects on Cutaneous Resurfacing Carbon Dioxide Laser Surgery

Weisberg¹,

Kuo²,

Torkian³

et al. 1998

Arch Dermatol

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To develop methods to compare carbon dioxide (CO 2) resurfacing lasers, fluence, and debridement effects on tissue shrinkage and histological thermal denaturation. Design: In vitro human or in vivo porcine skin samples received up to 5 passes with scanner or shortpulsed CO 2 resurfacing lasers. Fluences ranging from 2.19 to 17.58 J/cm 2 (scanner) and 1.11 to 5.56 J/cm 2 (short pulsed) were used to determine each laser's threshold energy for clinical effect. Variable amounts of débridement were also studied. Main Outcome Measures: Tissue shrinkage was evaluated by using digital photography to measure linear distance change of the treated tissue. Tissue histological studies were evaluated using quantitative computer image analysis. Results: Fluence-independent in vitro tissue shrinkage was seen with the scanned and short-pulsed lasers above threshold fluence levels of 5.9 and 2.5 J/cm 2 , respectively. Histologically, fluence-independent thermal depths of damage of 77 µm (scanner) and 25 µm (pulsed) were observed. Aggressive debridement of the tissue increased the shrinkage per pass of the laser, and decreased the fluence required for the threshold effect. In vivo experiments confirmed the in vitro results, although the in vivo threshold fluence level was slightly higher and the shrinkage obtained was slightly lower per pass.

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Skin Resurfacing of Fine to Deep Rhytides Using a Char-free Carbon Dioxide Laser in 47 Patients

Abstract: A CO2 laser system with a scanning beam can effectively and safely improve or remove glabellar, perioral, and periorbital rhytides.

Cited by 167 publications

References 19 publications

The effects of pulse energy variations on the dimensions of microscopic thermal treatment zones in nonablative fractional resurfacing

The effects of pulse energy variations on the dimensions of microscopic thermal treatment zones in nonablative fractional resurfacing

Carbon Dioxide Laser Resurfacing of Rhytides and Photodamaged Skin

Optimizing Fluence and Debridement Effects on Cutaneous Resurfacing Carbon Dioxide Laser Surgery

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