Split‐Sided Chest Study of Skin Rejuvenation Comparing Low‐Energy, 1,927‐nm Thulium Fractional Laser Treatment Prior to Photodynamic Therapy Versus Photodynamic Therapy Alone

Abstract

Background and Objectives: Treatment of photoaging and intrinsic aging of the chest, with the associated concerns of skin roughness, uneven pigmentation, laxity, atrophy, and telangiectasias, can be problematic because of the potential for worsened esthetic outcomes with existing treatments. This study assessed the efficacy and safety of using nonablative fractional laser therapy (FLT) pretreatment with photodynamic therapy (PDT) versus PDT alone for chest rejuvenation. Study Design/Materials and Methods: In a randomized, evaluator-blinded, split-sided study, adult female patients with photodamage to the chest received three treatment courses over an 8-week period with follow-up visits at Weeks 12 and 20. FLT was applied to one side of the chest, randomly assigned at baseline, followed by aminolevulinic acid-based PDT, delivered using a thermal, short incubation, broad area technique, to both sides of the chest. In-person and photographic assessments were conducted using fivepoint scales to evaluate outcomes including rhytides, pigmentation, skin texture, and telangiectasias. Results: Eleven adults completed the study, of whom 11 had improved scores for rhytides and 10 had improved scores for skin texture at Week 20. There was no significant difference in any efficacy outcome between FLT and PDT and standard PDT alone. The severity of adverse events was rated significantly greater with the combined FLT-PDT treatment vs PDT alone. Conclusions: Significant improvements were observed vs baseline for both sides of the chest treated with FLT-PDT or standard PDT following three treatment sessions. No significant difference in efficacy was observed between treatment approaches, although adverse events were more severe on the FLT-pretreated side. This study was not registered as it qualified as a nonsignificant risk study. Lasers Surg. Med.

Low‐fluence treatment with a novel fractionated 2,910‐nm fiber laser improves photodamage

“…Fractionated lasers deliver treatment to only a portion of the skin surface area, limiting laser treatment zones to reduce side effects, downtime and discomfort, while still inducing inflammation across the entire treated area. Along with a high safety profile and a rapid healing time, good cosmetic results have been achieved from fractionated nonablative and semi‐ablative lasers treating fine lines and wrinkles, and unwanted pigmentation, as well as being used to enhance penetration of topicals 9–16 . Water absorption in the skin is highest between 2,900 and 3,100 nm, resulting in tissue ablation with very little residual thermal damage, 17–19 thus resulting in less side effects and downtime than nonfractionated or ablative fractionated lasers.…”

“…Along with a high safety profile and a rapid healing time, good cosmetic results have been achieved from fractionated nonablative and semiablative lasers treating fine lines and wrinkles, and unwanted pigmentation, as well as being used to enhance penetration of topicals. [9][10][11][12][13][14][15][16] Water absorption in the skin is highest between 2,900 and 3,100 nm, resulting in tissue ablation with very little residual thermal damage, [17][18][19] thus resulting in less side effects and downtime than nonfractionated or ablative fractionated lasers. Here, we investigate a new, fractionated, 2,910 nm, Er:glass fiber laser, with a unique beam profile and small beam diameter, using the superficial treatment mode for its effect on mildly photodamaged skin.…”

Evidence-Based Clinical Practice Guidelines for Laser-Assisted Drug Delivery

“…In total, 48 published studies of AF LADD met inclusion criteria (eFigure in the Supplement): 4 cosmetic studies,, 21 oncologic, and 23 medical (not cosmetic/oncologic) . In addition, 6 publications of NAF LADD were included at the request of the expert panel, for a total of 54 studies.…”

The photosensitizer-based therapies enhance the repairing of skin wounds

“…As a new treatment option for inflammatory and infectious diseases, it has been successfully used in skin diseases, such as acne, viral warts, and leishmaniasis (14,17). Topical PDT is widely used in skin diseases, and it is also an effective method for skin rejuvenation due to the immunomodulatory and antimicrobial effects (17)(18)(19)(20)(21)(22).…”