A Controlled Evaluation of Dermabrasion versus CO2 Laser Resurfacing for the Treatment of Perioral Wrinkles

Abstract

Facial skin treatments with laser resurfacing, dermabrasion, and chemical peels were responsible for a significant portion of the 2.7 million cosmetic procedures performed in 1998. Perioral wrinkles are a common problem for which plastic surgical consultation is obtained. The aim of this study was to compare and quantify the advantages and disadvantages of laser resurfacing versus dermabrasion in the treatment of perioral wrinkles. Twenty female patients provided informed consent and participated in the study. Half of the perioral area was treated with dermabrasion and half was treated with the UltraPulse CO2 laser. The two procedures were compared using high-quality photographs; a biophysical evaluation of skin color, hydration, and mechanical properties; and patient evaluation of outcomes. Photographs were evaluated by 10 board-certified plastic surgeons who were blinded to the treatment methods. The laser treatment had a significantly higher erythema score at 1 month and a small but significantly greater improvement in perioral wrinkles at 6 months. Thirteen subjects selected the laser treatment as producing the best result, despite the greater intraoperative pain for this procedure. Biomechanical measurements suggest that the laser treatment produced a skin state more similar to skin in younger patients, presumably with higher levels and/or greater organization of the collagen and elastin. Patient preference was inferred from the resurfacing method that they would recommend to a friend. Although the laser was selected as the best result in a majority of cases, patient preference was equally distributed between the two treatments. The authors think that by studying and quantifying the biophysical changes that occur as a result of CO2 laser resurfacing, greater improvements in restoring actinic damage (e.g., wrinkles) can be achieved. Patients consider more than the objective skin changes from a resurfacing technique when making a recommendation to a friend.

Forensic sexual assault examination and genital injury: is skin color a source of health disparity?

“…Curiously, in spite of well-developed science in the area of skin mechanics [51–56], no investigators report differences in skin elasticity among racial/ethnic groups. Investigators have studied skin elasticity in fair/white subjects with regard to their healed wounds [54] and erythema [55] and have studied the mechanobiologic features of scars in individuals with dark skin [56], but no comparisons of skin elasticity based on constitutive (untanned) skin color differences were found in the scientific literature. Because there is no reason to suspect innate differences in skin elasticity based on the science available to us at this time, we suggest that the differences we found in injury prevalence between races/ethnicities are due to problems with injury detection and not differences in skin elasticity related to skin color.…”

Effect of dermal thickness, tissue composition, and body site on skin biomechanical properties

“…T he epidermis , the fibrous collagen and elastin network of the dermis, and the hypodermis give rise to the biomechanical properties of the skin. Measurements of these properties have been used extensively to evaluate treatments for the repair of facial actinic damage and the effects of aging and to assess the effectiveness of facial resurfacing treatments (1–3). Quantitative assessment of the tissue mechanical properties is important in understanding the factors that influence wound healing and scar formation (4).…”

Biomechanical properties of infantile hemangiomas: clinical stage and effect of age

“…Consequently, comparisons to the literature are limited to other skin conditions where dermal architecture may be modified. Overall and net elasticity were higher and residual deformation lower 6 months after perioral resurfacing with a CO 2 laser vs. dermabrasion (18). Graft seam elasticity increased after two treatments with pulsed-dye laser and compression vs. compression alone (27).…”