Fractional photothermolysis for the treatment of surgical scars: A case report

Behroozan, Daniel S.; Goldberg, Leonard Harry; Geronemus, Roy G.; Friedman, Paul M.

doi:10.1080/14764170600607251

Cited by 103 publications

(96 citation statements)

References 31 publications

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“…In another case report a white patient with a surgical scar on the chin was treated with the 1,550 nm Fraxel™ in a single treatment session, using pulse energy of 8 mJ and density of 2,000 MTZs per square centimeter. A greater than 75% clinical improvement of the scar was demonstrated 2 weeks after treatment [27]. Thus, FP seems to be a valuable treatment modality for atrophic and potentially hypopigmented scars as well as for surgical scars.…”

Section: Non-ablative Fractional Photothermolysis Lasermentioning

confidence: 86%

Fractional photothermolysis—an update

Allemann¹,

Kaufman

2009

Lasers Med Sci

135

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The novel concept of non-ablative fractional photothermolysis was introduced to the market in 2003 as an answer to the need for effective, yet low risk, resurfacing techniques. Unlike conventional ablative and non-ablative lasers, fractional ablative and non-ablative photothermolysis treats only a fraction of the skin, leaving up to a maximum of 95% of the skin uninvolved. The undamaged surrounding tissue allows for a reservoir of viable tissue, permitting rapid epidermal repair. Non-ablative fractional photothermolysis is currently approved by the US Food and Drug Administration (FDA) for the treatment of pigmented lesions, periorbital rhytides, skin resurfacing, melasma and soft tissue coagulation, acne and surgical scars, and actinic keratoses. However, its off-label use is clearly more extended. In 2007 the concept was further developed, and ablative fractional photothermolysis was introduced, using an erbium yttrium aluminium garnet (Er: YAG) or carbon dioxide laser. These devices are FDA cleared to treat wrinkles, rhytides, furrows, fine lines, textural irregularities, pigmented lesions and vascular dyschromia. In this review we discuss the two concepts, their technical details and clinical indications, and we describe the current literature available. Abstract The novel concept of non-ablative fractional photothermolysis was introduced to the market in 2003 as an answer to the need for effective, yet low risk, resurfacing techniques. Unlike conventional ablative and non-ablative lasers, fractional ablative and non-ablative photothermolysis treats only a fraction of the skin, leaving up to a maximum of 95% of the skin uninvolved. The undamaged surrounding tissue allows for a reservoir of viable tissue, permitting rapid epidermal repair. Non-ablative fractional photothermolysis is currently approved by the US Food and Drug Administration (FDA) for the treatment of pigmented lesions, periorbital rhytides, skin resurfacing, melasma and soft tissue coagulation, acne and surgical scars, and actinic keratoses. However, its off-label use is clearly more extended. In 2007 the concept was further developed, and ablative fractional photothermolysis was introduced, using an erbium yttrium aluminium garnet (Er: YAG) or carbon dioxide laser. These devices are FDA cleared to treat wrinkles, rhytides, furrows, fine lines, textural irregularities, pigmented lesions and vascular dyschromia. In this review we discuss the two concepts, their technical details and clinical indications, and we describe the current literature available.

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Section: Non-ablative Fractional Photothermolysis Lasermentioning

confidence: 86%

Fractional photothermolysis—an update

Allemann¹,

Kaufman

2009

Lasers Med Sci

135

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“…This approach has changed the light-based treatment paradigm from that of layers of photothermolysis to one of columns of thermal damage. Recently, an erbium-doped fiber laser, emitting light at 1,550 nm, has been shown to be effective in the treatment of photodamaged skin, acne scars, post-surgical scarring, poikiloderma of Civatte, pigmented lesions, striae distensae, as well as melasma [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Histologic and ultrastructural analysis of melasma after fractional resurfacing

2008

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Background and Objective: Fractional photothermolysis is a popular treatment option for photodamaged skin and other cutaneous conditions. Recently, successful improvement in melasma has been achieved with this laser system. We undertook this study to evaluate the ultrastructural changes associated with fractional laser treatment of melasma. Study Design/Materials and Methods: Ten subjects with skin types III and IV and a clinical diagnosis of epidermal melasma were treated with a 1,550-nm erbium:-glass laser delivering light in a fractional manner (Fraxel SR 750, Reliant Technologies, Inc., Mountain View, CA) every 2 weeks for a total of four sessions. Biopsies were obtained from all subjects both before treatment and at 3 months following the final treatment. All biopsies were analyzed by light and electron microscopy for treatmentinduced changes. In addition, a secondary endpoint of the study was to assess for clinical improvement in melasma following fractional resurfacing. This assessment was performed by the investigator using pre-and post-treatment photographs. Results: Light microscopy on post-treatment specimens showed a relative decrease in melanocytes compared to the pre-treatment ones. Post-treatment electron microscopy revealed fewer melanocytes and a relative absence of melanin in the surrounding keratinocytes compared to pre-treatment specimens. In addition, six subjects with skin type III were determined to have good improvement, whereas four subjects with skin type IV had fair improvement, as assessed by the investigator. Conclusion: Post-treatment ultrastructural changes are consistent with an elimination process and may help to explain clinical improvement following laser treatment.

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“…In a case report, Behroozan and colleagues 21 noted 75% overall improvement in a surgical scar on the chin after a single treatment with the 1,550-nm Fraxel SR. In 2007, Glaich and colleagues 22 established the efficacy of the 1,550-nm Fraxel SR in hypopigmented facial scars, whereby after two to four treatments, 51% to 75% improvement in hypopigmentation was observed in six of seven patients.…”

Section: Surgical Scarsmentioning

confidence: 99%

Untitled

2009

Dermatologic Surgery

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BACKGROUND Fractional photothermolysis (FP) is one of the most significant milestones in laser technology and resurfacing.METHODS Review of the Medline English literature and recent international conferences regarding FP technology, applications, and indications.RESULTS Successful conditions treated with nonablative FP reported in the literature include acne scarring; dyschromia and fine wrinkling of photoaging on the face, chest, neck, and hands; melasma; poikiloderma of Civatte; nevus of Ota; scars; minocycline hyperpigmentation; telangiectatic matting; residual hemangioma; granuloma annulare; colloid milium; and disseminated superficial actinic porokeratosis. An advance in 2007 was the introduction of ablative FP (AFP), which results in significantly greater improvement in skin laxity and textural abnormalities. Most recently, AFP has demonstrated significantly greater improvement than nonablative FP in reducing acne scarring and skin redundancy and laxity associated with photoaging.CONCLUSIONS Through the induction of microthermal zones of injury, FP technology stimulates a robust and rapid wound healing response resulting in improvement in a diversity of aesthetic, inflammatory, and preneoplastic skin disorders. Further investigation into the technology and diverse array of cutaneous conditions that can benefit from FP is highly needed. The authors have indicated no significant interest with commercial supporters.

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Fractional photothermolysis for the treatment of surgical scars: A case report

Cited by 103 publications

References 31 publications

Fractional photothermolysis—an update

Fractional photothermolysis—an update

Histologic and ultrastructural analysis of melasma after fractional resurfacing

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