Correlation of histological findings of single session Er:YAG skin fractional resurfacing with various passes and energies and the possible clinical implications

Trelles, Mario A.; Vélez, Mariano; Mordon, Serge

doi:10.1002/lsm.20607

Cited by 32 publications

(33 citation statements)

References 6 publications

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“…The CO 2 laser penetrates approximately 20 mm, and the Er:YAG laser penetrates approximately 2 mm into tissue. Deep tissue holes are created by a dynamic laser tissue interaction in which water absorption coefficients and pulse widths are responsible for the formation of MTZ with different dimensions of ablation and thermal coagulation zones (TCZ) [5,6,37]. In our study, the TCZ surrounding each laser hole was about 70 mm thick.…”

Section: Discussionmentioning

confidence: 88%

Fractional CO₂ laser‐assisted drug delivery

et al. 2010

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Background and Objectives: Ablative fractional resurfacing (AFR) creates vertical channels that might assist the delivery of topically applied drugs into skin. The purpose of this study was to evaluate drug delivery by CO 2 laser AFR using methyl 5-aminolevulinate (MAL), a porphyrin precursor, as a test drug. Materials and Methods: Two Yorkshire swine were treated with single-hole CO 2 laser AFR and subsequent topical application of MAL (Metvix 1 , Photocure ASA, Oslo, Norway), placebo cream and no drug. MAL-induced porphyrin fluorescence was measured by fluorescence microscopy at skin depths down to 1,800 mm. AFR was performed with a 10.6 mm wavelength prototype CO 2 laser, using stacked single pulses of 3 millisecond and 91.6 mJ per pulse. Results: AFR created cone-shaped channels of approximately 300 mm diameter and 1,850 mm depth that were surrounded by a 70 mm thin layer of thermally coagulated dermis. There was no porphyrin fluorescence in placebo cream or untreated skin sites. AFR followed by MAL application enhanced drug delivery with significantly higher porphyrin fluorescence of hair follicles (P<0.0011) and dermis (P<0.0433) versus MAL alone at skin depths of 120, 500, 1,000, 1,500, and 1,800 mm. AFR before MAL application also enhanced skin surface (epidermal) porphyrin fluorescence. Radial diffusion of MAL from the laser-created channels into surrounding dermis was evidenced by uniform porphyrin fluorescence up to 1,500 mm from the holes (1,000, 1,800 mm depths). Skin massage after MAL application did not affect MAL-induced porphyrin fluorescence after AFR. Conclusions: Ablative fractional laser treatment facilitates delivery of topical MAL deeply into the skin. For the conditions of this study, laser channels approximately 3 mm apart followed by MAL application could produce porphyrins throughout essentially the entire skin. AFR appears to be a clinically practical means for enhancing uptake of MAL, a photodynamic therapy drug, and presumably many other topical skin medications. Lasers Surg.

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Section: Discussionmentioning

confidence: 88%

Fractional CO₂ laser‐assisted drug delivery

et al. 2010

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“…Indeed, histological examination of specimens is very valuable in basic research on laser effects (e.g., [16]); in a clinical longitudinal study setting where tissue is sampled several times during follow-up (e.g., [41]), its utility is limited because by definition a given specimen can only be obtained and examined once, and adjacent tissue is not necessarily comparable.…”

Section: Discussionmentioning

confidence: 99%

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

et al. 2010

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Background and Objective: Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO 2 and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Study Design/Materials and Methods: Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO 2 and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Results: Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO 2 laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. Conclusions: According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO 2 and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

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“…Fractional-ablative lasers achieve decreased downtime and risk, compared to wavelengthequivalent ablative laser treatments, by only treating microscopic areas of tissue with large areas of untreated tissue surrounding each lesion [7,8]. Typically only performed once, fractional-ablative resurfacing has improved efficacy with respect to rhytides [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. However, a single fractional-ablative treatment without full coverage limits the ability of these devices to improve texture imperfections and large areas of pigmentation.…”

Section: Background and Objectivementioning

confidence: 99%

Combining confluent and fractionally ablative modalities of a novel 2790nm YSGG laser for facial resurfacing

Turley¹,

Silapunt

Biesman

2011

Lasers Surg Med

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Correlation of histological findings of single session Er:YAG skin fractional resurfacing with various passes and energies and the possible clinical implications

Cited by 32 publications

References 6 publications

Fractional CO₂ laser‐assisted drug delivery

Fractional CO₂ laser‐assisted drug delivery

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Combining confluent and fractionally ablative modalities of a novel 2790nm YSGG laser for facial resurfacing

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Correlation of histological findings of single session Er:YAG skin fractional resurfacing with various passes and energies and the possible clinical implications

Cited by 32 publications

References 6 publications

Fractional CO2 laser‐assisted drug delivery

Fractional CO2 laser‐assisted drug delivery

Ablative fractional lasers (CO2 and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

Combining confluent and fractionally ablative modalities of a novel 2790nm YSGG laser for facial resurfacing

Contact Info

Product

Resources

About

Fractional CO₂ laser‐assisted drug delivery

Fractional CO₂ laser‐assisted drug delivery

Ablative fractional lasers (CO₂ and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides