The Safety and Efficacy of the 308-nm Excimer Laser for Pigment Correction of Hypopigmented Scars and Striae Alba

Abstract

To assess the safety and efficacy of the 308-nm excimer laser in pigment correction of hypopigmented scars and striae alba.Design: Institutional review board-approved randomized controlled trial.Setting: Private research center.Patients: Volunteer sample of 31 adult subjects with hypopigmented scars or striae alba distributed on the face, torso, or extremities.Interventions: Lesions were randomized to receive treatment or not, with site-matched normal control areas. Treatments were initiated with a minimal erythema dose minus 50 mJ/cm 2 to affected areas. Subsequent treatments were performed biweekly until 50% to 75% pigment correction, then every 2 weeks thereafter until a maximum of 10 treatments, 75% increase in colorimetric measurements, or 100% visual pigment correction.Main Outcome Measures: Pigment correction by visual and colorimetric assessments compared with untreated control lesions and site-matched normal skin before each treatment and at 1-, 2-, 4-, and 6-month follow-up intervals. Occurrence of erythema, blistering, dyspigmentation, or other adverse effects was monitored. Results:The percentage pigment correction by both assessments increased in direct proportion to the number of treatments. The mean percentage pigment correction by visual assessment relative to control of 61% (95% confidence interval [CI], 55%-67%) for scars and 68% (95% CI, 62%-74%) for striae was achieved after 9 treatments. The mean percentage pigmentation by colorimetric measurements relative to control of 101% (95% CI, 99%-103%) for scars and 102% (95% CI, 99%-104%) for striae was achieved after 9 treatments. Both sets of values gradually declined toward baseline levels during the 6-month follow-up. No blistering or dyspigmentation occurred.Conclusions: Therapy with the 308-nm excimer laser is safe and effective in pigment correction of hypopigmented scars and striae alba. Mean final pigment correction rates relative to control sites of approximately 60% to 70% by visual assessment and 100% by colorimetric analysis were observed after 9 treatments administered biweekly. Maintenance treatment every 1 to 4 months is required to sustain the cosmetic benefit.

Fractionated CO2 Laser in the Treatment of Striae Alba in Darker Skinned Patients - A Prospective Study

“…34 AlexiadesArmenakas et al also indicated that following treatment with the 308-nm excimer laser, the percentage of pigment correction increased in direct correlation with the number of treatment sessions. 35 In a recent study, Wang et al compared the safety and efficacy of a 1540-nm and 1410-nm non-ablative fractional laser in treatment of striae, histologically and clinically. Both methods resulted in clinical and histological improvement.…”

Obesity and the skin: Skin physiology and skin manifestations of obesity

“…The 585-nm flash-pumped laser decreases erythema of early-stage lesions, 86 and the 308-nm excimer laser improves hypopigmentation associated with late-stage striae. 87,88 Striae rubra and alba have been treated with a pulsed dye laser with marginal success. 38 Laser therapy should be avoided for striae in individuals having Fitzpatrick skin types IV through VI because of the resultant hyperpigmentation.…”

Targeted UV therapy in the treatment of psoriasis

“…A randomized controlled trial demonstrated pigment correction of hypopigmented scars and striae alba following 308-nm excimer laser therapy, with pigment increases correlating directly with the number of treatments (23). In addition, two case reports of excimer laser therapy have shown promise in the treatment of alopecia areata (24).…”