Synergistic Sequential Emission of Fractional 10.600 and 1540 nm Lasers for Skin Resurfacing: An Ex Vivo Histological Evaluation

Abstract

Background: Fractional ablative and non-ablative lasers are useful treatments for skin rejuvenation. A procedure that provides the sequential application of fractional ablative followed by non-ablative laser treatment may reduce patients’ downtime and deliver better cosmetic results than with either laser alone. Objective: The purpose of the current study was to demonstrate the ameliorative and therapeutic effects in skin remodeling of the synergistic use of the two laser wavelengths (fractional ablative CO2 and non-ablative 1540 nm) with three different types of pulse shapes, S-Pulse (SP), D-Pulse (DP) and H-Pulse (HP), through which the CO2 laser can emit, performing an ex vivo histological evaluation. Methods: In this prospective study, ex vivo sheep inner thigh skin was chosen due to its similarity to human skin tissue, and a histological evaluation was performed. Three irradiation conditions, using all of the three CO2 pulse shapes (alone or averaged), were investigated: (1) 10.600 nm alone, the sequential irradiation of the two wavelengths in the same perfectly controlled energy pulses (DOT) for the entire scan area; ((2) 10.600 nm followed immediately by 1540 nm; and (3) 1540 nm followed immediately by 10.600 nm). Results: When comparing ablative to sequential irradiations, the synergy of the two wavelengths did not alter the typical ablative pulse shape of the 10.600 nm laser alone. With the same CO2 pulse shape, the lesion depth did not vary with the synergy of the two wavelengths, while thermal lesion width increased compared to CO2 alone. The ablation rate was achieved, while the total thermal lesion coverage in the scanning area of CO2 − 1540 lasers was greater than when using CO2 alone and then the other sequential irradiation. Conclusions: This study provides important preclinical data for new and early uses of the novel 10.600/1540 nm dual-wavelength non-ablative fractional laser. The synergy of the two wavelengths enhanced all the benefits already available when using CO2 laser systems both in terms of tone strengthening, thanks to a greater shrinking effect, and in terms of stimulation and collagen remodeling thanks to a greater volumetric thermal effect.

A Multimodal Approach to Laser Treatment of Extensive Hypertrophic Burn Scar: A Case Report

“…Specifically, the second wavelength of 1540 nm allows homogeneous and contiguous heating over the entire scan area, reaching significant depths in the dermis in a non-ablative way. Moreover, the sequential action of the CO 2 laser with 1540 nm amplifies and improves the tissue thermal effect, as already demonstrated by previous histological studies [15]; it promotes more effective tissue remodeling, ensuring healing with the timings of a fractional emission.…”

“…These advantages must be considered if considering other surgical procedures, such as diathermocoagulation and traditional surgery, which involves more frequent unaesthetic use, protracted healing, and slower scarring processes, and a higher incidence of keloids and hypertrophic scars [10]. Due to their ablative and thermal effects, CO 2 -based light sources induce skin remodeling and neocollagenesis [10,26,15]. The fractional ablative CO 2 laser has been increasingly used to treat burn scars [18,19].…”

“…The 1540 nm wavelength is known to increase the expression of collagen-related synthesis genes while decreasing matrix protein production in cultured fibroblasts [11][12][13][14]. Recent scientific findings demonstrated that the simultaneous combination of the CO 2 wavelength (10 600 nm) and the wavelength 1540 nm is a valid treatment choice for skin remodeling [15,16].…”

“…With these premises, the purpose of this study was to assess the efficacy of a new laser device (DuoGlide, Deka M.e.l.a Srl, Florence, Italy) in hypertrophic burn scar management using 2 recently developed scanning units. The first unit was the µScan DOT scanner, which combines a CO 2 and 1540 nm with an estimated ablative DOT width of 120 µm @45 mJ of CO 2 and 30 mJ@1540 nm [15]. The second was the Scar3 scanner, which uses a CO 2 laser with an estimated ablative DOT width of 80 µm @45 mJ of CO 2 [26].…”

Synergistic Sequential Emission of Fractional 1540 nm and 10 600 Lasers for Abdominal Postsurgical Scar Management: A Clinical Case Report

“…Recent scientific findings demonstrated that the simultaneous combination of the CO 2 laser wavelengths of 10 600 nm and 1540 nm non-ablative laser is a valid treatment choice for skin remodeling. In addition, to reduce downtime and pain for patients during treatments, the combination of ablative and non-ablative fractional CO 2 lasers produced better skin remodeling results than either laser used alone [13][14][15][16]. Based on the existing literature, the purpose of the current study was to assess the volumetric action of the 1540 wavelength, and the efficacy and safety of the synergistic sequential application of a new fractional ablative 10 600 nm CO 2 and non-ablative 1540 nm lasers on abdominal postsurgical scar management.…”