Background and Objectives To evaluate the safety and effectiveness of combined fractional radiofrequency microneedling (FRM) and fractional carbon dioxide (FCO2) laser treatment for striae distensae and to compare the results to those of FRM alone and those of FCO2 alone. Study Design/Materials and Methods Adult women (Fitzpatrick skin types III–IV) with striae distensae on the abdomen or calf were enrolled in this study. Each lesion was divided into three regions, with each region assigned to one of the three treatments (FCO2, FRM, or combined FCO2 and FRM). Global photographic assessments were performed by three dermatologists and by patients using a scored visual analog scale (VAS). Additionally, each lesion was evaluated using a skin imaging analyzer and a diagnostic ultrasound system. Results All 19 female subjects had an average body mass index of 23.85 kg/m2. The global assessment by dermatologists indicated a significant improvement in the combined treatment group (6.1) compared with the other groups (4.3 and 5.1 in the FRM and FCO2 groups, respectively; P < 0.05), and that by the patients indicated a significant improvement in the combined treatment group (6.3) compared with the FRM group (5.1; P = 0.02). Ultrasound results showed significantly increased skin thickness and dermal density (204.9 μm and 8.8%; both P < 0.05) in the combined treatment group. However, results of the skin imaging analysis showed a higher average level of melanin and redness indices in the combined treatment group than in the FRM group (P < 0.001, P < 0.01, respectively), but not in the FCO2 group (P = 0.15, P = 0.11, respectively). Conclusion Combined FRM and FCO2 treatments resulted in slightly better clinical outcomes than single treatments, and the side effects of the treatment, such as pigmentation and persistent erythema, did not result in more serious events to a level similar to that of FCO2 alone. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

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Background/purpose Ultraviolet B (UVB) laser irradiation in a targeted manner is a reasonable treatment option for localized vitiligo. Recently, narrow‐band UVB gain‐switched 311‐nm titanium:sapphire lasers (TSL) were developed for the treatment of localized vitiligo. We aimed to compare efficacy, patient satisfaction, and safety between the conventional 308‐nm excimer laser (EL) and gain‐switched 311‐nm TSL in patients with vitiligo. Methods The 13‐paired lesions from 10 patients who had small vitiligo patches were included in this prospective intra‐patient comparison trial. Each pair was randomly assigned to each laser treatment group and treated twice weekly for 12 weeks. The global photographic assessments by dermatologists, objective numerical assessments by imaging analyzer, and patient's satisfaction were used to evaluate the effectiveness. Adverse effects were also investigated at every visit. Results All treated lesions showed improvement of about 50% after 12 weeks. There was no significant difference between EL‐ and TSL‐treated groups. Patient satisfaction and preference among the groups were also similar. Regarding safety, there were no serious adverse effects requiring cessation of the treatments; however, the severity score for persistent erythema (lasting >24 hours) was significantly lower in the TSL group than in the EL group. Conclusions The gain‐switched 311‐nm TSL exhibited similar efficacy to the 308‐nm EL in treating vitiligo as well as improved safety. Therefore, the 311‐nm TSL is considered as a candidate device to replace the EL as a new and promising treatment option for localized vitiligo.

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