Histological comparison of two different fractional photothermolysis devices operating at 1,550 nm

Thongsima, Siremon; Zurakowski, David; Manstein, Dieter

doi:10.1002/lsm.20882

Cited by 29 publications

(37 citation statements)

References 22 publications

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“…Such studies mainly involve exposing the excised skin samples to lasers in order to evaluate the histological changes that occur immediately after laser treatment, thereby not requiring organotypic culturing of skin samples. 12,13 The histological changes following laser exposure, as assessed by ex vivo methods, have been found to be nearly the same as those obtained in in vivo tests. Exposure of a skin sample to carbon dioxide fractional laser ex vivo has revealed many microscopic treatment zones and thermal coagulation zones where the epidermis and the dermis were histologically ablated.…”

Section: Advantages Of Using Skin Explants In Laser Studiessupporting

confidence: 54%

Usefulness and Limitations of Skin Explants to Assess Laser Treatment

et al. 2013

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To overcome the ethical issues associated with performing clinical trials or obtaining patient's skin tissues, there have been many attempts to develop appropriate models to study skin physiology, such as the use of skin explants to assess the effects of laser treatment. Skin explants are produced by processing skin tissue obtained from an excision. Con taminants and subcutaneous fat tissue are removed from the tissue, which is then cultured. Such processed tissue lacks blood circulation and nerve innervation, and is difficult to be preserved over a prolonged period of time. However, due to the similarities between skin explants and live skin tissues in terms of structure and physiological factors, such explants are thought to be useful as skin models to study the effects of laser treatment. Our previous studies showed that, following exposure to actual fractional laser, skin explants have very similar histological and molecular biological changes to those seen in the initial in vivo stages. However, with time, the differences between skin explants and live skin tissues become increasingly apparent. Therefore, skin explant models may be improved, such as by optimizing the culture conditions. In our present review, we examined the usefulness and limitations of skin explants to study the effects of laser therapy based on our own previous experience and the existing literature.

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Section: Advantages Of Using Skin Explants In Laser Studiessupporting

confidence: 54%

Usefulness and Limitations of Skin Explants to Assess Laser Treatment

et al. 2013

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“…[65] It has been shown that the use of higher energy settings and multiple laser passes leads to improved clinical results, while use of increased densities results in increased post-treatment erythema, edema, and hyperpigmentation. [66] Similar to NAFLs, AFLs work by achieving collagen contraction and neocollagenesis. Split-face studies have found equal or slightly greater clinical improvement scores with the AFL than with the NAFL, only at the cost of higher chances of post procedural erythema and hyperpigmentation.…”

Section: Laser Therapy For Acne Scarsmentioning

confidence: 99%

What′s new in the management of acne?

Arshdeep¹,

De²

2013

Indian J Dermatol Venereol Leprol

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“…The depth-width ratio (DWR) for most fractional lasers is about 4–5. [6] The higher the DWR, more the dermal volume that can be thermally damaged. As the width of most fractional lasers is almost the same due to the intrinsic quality of the fractional ‘technology’, the depth is the variable factor that may play a predominant role in fractional laser efficacy.…”

Section: Acne Scar Topography and Fractional Lasersmentioning

confidence: 99%

“…Another issue is that the substrates used in studies are ex vivo models[124–68–18] and their replicability on facial skin is doubtful [Figure 2]. Extrapolating data from studies done for rhytides[25–27] are not useful as the dose and depth required are less as compared to acne scars.…”

Section: Invasive (Histological) Assessment Of Fractional Lasermentioning

confidence: 99%

“…[1–3] A secondary effect is the dermal remodelling induced in the dermis beyond the narrow zone of coagulation induced by the fractional lasers. [4–6] The carbon dioxide (CO 2 ) laser has a predominant coagulative and necrotic effect (horizontal effect) as compared to the erbium:yttrium-aluminium-garnet (Er:YAG) laser, which has a dose-dependent increase in depth with less necrosis or coagulative effect (vertical effect). Thus, resurfacing procedures may be thought of as having both horizontal (tightening effect) and vertical (depth) treatment vectors on the tissue.…”

Section: Introductionmentioning

confidence: 99%

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Histological validity and clinical evidence for use of fractional lasers for acne scars

Sardana¹,

Garg²,

Arora³

et al. 2012

J Cutan Aesthet Surg

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Though fractional lasers are widely used for acne scars, very little clinical or histological data based on the objective clinical assessment or the depth of penetration of lasers on in vivo facial tissue are available. The depth probably is the most important aspect that predicts the improvement in acne scars but the studies on histology have little uniformity in terms of substrate (tissue) used, processing and stains used. The variability of the laser setting (dose, pulses and density) makes comparison of the studies difficult. It is easier to compare the end results, histological depth and clinical results. We analysed all the published clinical and histological studies on fractional lasers in acne scars and analysed the data, both clinical and histological, by statistical software to decipher their significance. On statistical analysis, the depth was found to be variable with the 1550-nm lasers achieving a depth of 679 μm versus 10,600 nm (895 μm) and 2940 nm (837 μm) lasers. The mean depth of penetration (in μm) in relation to the energy used, in millijoules (mj), varies depending on the laser studied. This was statistically found to be 12.9–28.5 for Er:glass, 3–54.38 for Er:YAG and 6.28–53.66 for CO2. The subjective clinical improvement was a modest 46%. The lack of objective evaluation of clinical improvement and scar-specific assessment with the lack of appropriate in vivo studies is a case for combining conventional modalities like subcision, punch excision and needling with fractional lasers to achieve optimal results.

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Histological comparison of two different fractional photothermolysis devices operating at 1,550 nm

Cited by 29 publications

References 22 publications

Usefulness and Limitations of Skin Explants to Assess Laser Treatment

Usefulness and Limitations of Skin Explants to Assess Laser Treatment

What′s new in the management of acne?

Histological validity and clinical evidence for use of fractional lasers for acne scars

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