Laser‐Assisted Hyaluronic Acid Delivery by Fractional Carbon Dioxide Laser in Facial Skin Remodeling: A Prospective Randomized Split‐Face Study in France

Benzaquen, Michael; Fongue, J.; Pauly, Vanessa; Collet-Villette, A.-M.

doi:10.1002/lsm.23403

Cited by 11 publications

(13 citation statements)

References 30 publications

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“…Dermal remodeling induced by AFL is characterized by increased vascularity, a reduced senescent fibroblast population, and synthesis and remodeling of the extracellular matrix. 6 In a recent prospective randomized clinical trial, AFL resurfacing on aged skin resulted in a sustained reduction in the number of actinic keratosis and a decreased rate of non-melanoma skin cancers. 7 Despite strong clinical evidence of AFL efficacy with a variety of dermatological conditions, the mechanism by which AFL asserts its dermal remodeling effects is still largely unknown.…”

Section: Introductionmentioning

confidence: 99%

“…An ablative fractional laser (AFL) generates arrays of thermally induced microinjuries, thereby inducing secondary dermal remodeling. Dermal remodeling induced by AFL is characterized by increased vascularity, a reduced senescent fibroblast population, and synthesis and remodeling of the extracellular matrix 6 . In a recent prospective randomized clinical trial, AFL resurfacing on aged skin resulted in a sustained reduction in the number of actinic keratosis and a decreased rate of non‐melanoma skin cancers 7 .…”

Section: Introductionmentioning

confidence: 99%

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Neutrophils and their extracellular traps impair ablative fractional carbon dioxide laser‐induced dermal remolding in mice

et al. 2022

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Objectives: Ablative fractional CO 2 laser (AFL) therapy is an effective intervention to induce dermal remodeling. AFL treatment of the skin triggers the recruitment of immune cells, with neutrophils dominating the early phase. However, the role of recruited neutrophils in AFL-induced microinjuries and their subsequent dermal remodeling capacity remains elusive. Materials and Methods: A mouse model of AFL-induced dermal remodeling was established. RNA sequencing was used to identify the prominent features of AFL-treated tissues. Histological analysis, including H&E and Masson staining, ultrastructure observation by transmission microscopy, immunofluorescence, and quantitative real-time polymerase chain reaction were used for dermal remodeling analysis. Moreover, AFL-treated mice were intraperitoneally injected with antimouse Ly6G antibodies to deplete neutrophils. Neutrophil extracellular traps (NETs) were explored using immunofluorescence, transmission microscopy, and in vitro coculture experiments. Results: Dermal remodeling, characterized by an increased number of CD31-positve vessels and elevated messenger RNA (mRNA) expression of genes encoding transforming growth factor-β (TGF-β), collagen I, and collagen III, was observed at 15 days after AFL treatment. In the AFL-induced inflammation phase, RNA sequencing identified neutrophil chemotaxis, and degranulation genes were significantly enriched. Histology and immunofluorescence staining of human and mouse tissues harvested at Day 1 after AFL treatment revealed significant neutrophil infiltration surrounding thermal-induced microinjuries. Neutrophil depletion decreased the expression of stressrelated genes such as S100A8 and S100A9 in the early phase following AFL treatment. Importantly, neutrophil depletion enhanced dermal remodeling at Day 15, as reflected by enrichment of the extracellular matrix and collagen biosynthesis genes based on RNA sequencing. Moreover, increased collagen I, collagen III, and TGF-β mRNA expression, increased cell proliferation, and vascularity were observed. Interestingly, NETs, which could be induced by AFL-treated fibroblasts in vitro, were identified in both human and mouse tissues on Day 1 after AFL treatment. Conclusions: AFL-treated human and mouse skin recruited a large number of neutrophils. The neutrophil surge impaired dermal remodeling in mice. The microenvironment and fibroblast functional modulation mediated by neutrophil degranulation and NET formation were determined to be the underlying mechanisms. Our results indicate that modification of infiltrated neutrophil activity might be a potential therapeutic target for AFL-induced dermal remodeling.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neutrophils and their extracellular traps impair ablative fractional carbon dioxide laser‐induced dermal remolding in mice

et al. 2022

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“…Although the authors suggested that the microneedles of the FRMN can enable physical transdermal delivery of macromolecules with high molecular masses, they also questioned if the energy delivered by FRMN could potentially lead to early destruction of the PLA in the protocol of topical PLA followed by FRMN. Finally, Benzaquen and colleagues 9 used another modified method of fractional CO 2 laser-assisted topical hyaluronic acid (instead of PLLA) delivery for rejuvenation. Immediately after treatment with fractional CO 2 laser (MiXto SX; Lasering s.r.l, Moderna, Italy; spot size 300 μm, power 10 W, density 5%, index 8), 1 mL hyaluronic acid gel (Restylane Skinboosters Vital; Galderma, La Tour-de-Peilz, Switzerland) without lidocaine, 100 to 500 μm) was applied on one hemiface and saline was applied on the other hemiface.…”

Section: Discussionmentioning

confidence: 99%

“…8 A separate study used topical hyaluronic acid application after fractional CO 2 laser, resulting in facial rejuvenation. 9 Based on these preliminary reports, some clinicians have modified the method by using other physical modalities, such as FRMN, fractional nonablative laser, and microneedling to deliver various fillers. Despite the proliferation of use of these devices to assist in filler delivery, little is known about the optimal settings for laser-assisted or device-assisted filler delivery, especially regarding the type of devices and fillers and how effective these techniques are.…”

mentioning

confidence: 99%

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Laser-Assisted and Device-Assisted Filler Delivery: A Histologic Evaluation

et al. 2023

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BACKGROUND Lasers and devices are used to enhance transcutaneous delivery of fillers. However, little has been published on the histologic findings of this form of laser/device-assisted delivery to determine the optimal devices and fillers. OBJECTIVE To objectively evaluate the histological effects of laser-assisted and device-assisted filler delivery. METHODS Ex vivo human abdominoplasty skin samples were treated with fractional CO2 laser (ECO2, 120 μm tip, 120 mJ), fractional radiofrequency microneedling (FRMN, Genius, 1.5 mm, 20 mJ/pin), and microneedling (2.0 mm). Immediately after poly-l-lactic acid (PLLA), hyaluronic acid gel, calcium hydroxylapatite, and black tissue marking dye were topically applied. After treatment, biopsies were collected for histologic evaluation. RESULTS Histology revealed that PLLA and black dye were found in greatest abundance, hyaluronic acid was found to a lesser extent, and calcium hydroxylapatite was least found within channels created by fractional CO2 laser. Microneedling was effective only at delivering black dye, whereas FRMN failed to show significant channel formation or delivery of the studied products. CONCLUSION Among the devices and fillers studied, fractional CO2 laser and PLLA proved to be the most effective combination for laser/device-assisted filler delivery. Neither microneedling nor FRMN was effective as devices to enhance filler delivery.

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Intradermal Delivery of Calcium Hydroxylapatite With Fractionated Ablation

Driscoll,

Golbari,

Vallmitjana

et al. 2024

Lasers Surg Med

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ObjectivesThe absorption of biostimulatory particulate matter following its application to fractional skin defects remains poorly understood, and even less is known about its in vivo impact in terms of tissue integration. The objectives of this study are twofold: (1) to evaluate the potential of calcium hydroxylapatite (CaHA) to penetrate through skin treated with a fractional laser; and (2) to assess the effectiveness of clinical laser scanning microscopy technologies in monitoring the effects of such treatment over time.MethodsOne area on a volunteer's arm was treated with a fractional erbium laser (Sciton Inc., Palo Alto, CA), while a second area received the same laser treatment followed by CaHA topical application. We used reflectance confocal microscopy (RCM) and multiphoton microscopy (MPM) to noninvasively image beneath the surface of the treated skin to study and monitor the effects of these treatments within 1 h of treatment and at four additional time points over a 6‐week period.ResultsOne hour posttreatment, at different depths beneath the skin surface, MPM and RCM provided similar visualizations of laser‐induced channels. In skin treated by both laser and CaHA, these two imaging methods provided complementary information. RCM captured the lateral and depth distribution of CaHA microspheres and were seen as bright spheres as they became incorporated into the healing tissue. MPM, meanwhile, visualized the CaHA microparticles as dark shadow spheres within the laser‐induced channels and encroaching healing tissue. Furthermore, MPM provided critical information about collagen regeneration around the microspheres, with the collagen visually marked by its distinct second harmonic generation (SHG) signal.ConclusionsThis observational pilot study demonstrates that CaHA, a collagen stimulator used as a dermal filler, can not only be inserted into the dermis after fractional laser treatment but remains in the healing skin for at least 6 weeks posttreatment. The noninvasive imaging techniques RCM and MPM successfully captured the presence of CaHA microspheres mid‐dermis during the healing phase. They also demonstrated new collagen production around the microspheres, highlighting the effectiveness of these imaging approaches in monitoring such treatment over time.

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Laser‐Assisted Hyaluronic Acid Delivery by Fractional Carbon Dioxide Laser in Facial Skin Remodeling: A Prospective Randomized Split‐Face Study in France

Cited by 11 publications

References 30 publications

Neutrophils and their extracellular traps impair ablative fractional carbon dioxide laser‐induced dermal remolding in mice

Neutrophils and their extracellular traps impair ablative fractional carbon dioxide laser‐induced dermal remolding in mice

Laser-Assisted and Device-Assisted Filler Delivery: A Histologic Evaluation

Intradermal Delivery of Calcium Hydroxylapatite With Fractionated Ablation

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