Pilot Investigation of the Correlation between Histological and Clinical Effects of Infrared Fractional Resurfacing Lasers

Walgrave, Susan E.; Zelickson, Brian D.; Childs, James J.; Altshuler, Gregory B.; Erofeev, Andrei V.; Yaroslavsky, Ilya V.; Kist, David A.; Counters, Jeff

doi:10.1111/j.1524-4725.2008.34307.x

Cited by 25 publications

(47 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…13,[15][16][17][18][19]23,[25][26][27][28][29][30][31] It has been demonstrated in the literature with FP in clinical-histologic correlation experiments that a greater depth of injury maximizes texture improvement, whereas a higher density of more superficial injuries maximizes improvement in pigmentation. [35][36][37] Recent histologic and ultrasound studies with AFP by our group at the settings reported herein have documented ablation into the mid-reticular dermis with stimulation of neocollagenesis and collagen remodeling. 35,36 Thus, the pattern of deep ablation into the reticular dermis and resultant stimulation of collagen contraction and synthesis likely accounts for its greater efficacy in tissue tightening and skin texture.…”

Section: Discussionmentioning

confidence: 87%

Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature

Tierney

Hanke

Watkins³

2011

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 87%

Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature

Tierney

Hanke

Watkins³

2011

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

“…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. Also, in rhytides,[101215] the periocular area is targeted, which is not the site for acne scars. Some studies employed a two-step procedure where the histology was done on ex vivo animal or ex vivo human model,[101215] and the clinical evaluation was done on the in vivo facial skin.…”

Section: Invasive (Histological) Assessment Of Fractional Lasermentioning

confidence: 99%

“…Also, in rhytides,[101215] the periocular area is targeted, which is not the site for acne scars. Some studies employed a two-step procedure where the histology was done on ex vivo animal or ex vivo human model,[101215] and the clinical evaluation was done on the in vivo facial skin. This is not scientifically replicable as there are differences in the tissue responses in different substrate models.…”

Section: Invasive (Histological) Assessment Of Fractional Lasermentioning

confidence: 99%

See 1 more Smart Citation

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

Sardana¹,

Garg²,

Arora³

et al. 2012

J Cutan Aesthet Surg

View full text Add to dashboard Cite

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.

show abstract

“…An in vivo animal model using pig skin has been used in some previous studies1,2, but porcine skin differs from human skin histologically and physiologically, including thickness, vascularity, and pH3. In addition, recent increases in the awareness of animal welfare and legal issues have raised the need for alternatives to animal models4.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Skin Explants for Histologic Analysis after Fractional Photothermolysis

et al. 2015

View full text Add to dashboard Cite

BackgroundFractional laser resurfacing treatment has been extensively investigated and is widely used. However, the mechanism underlying its effects is poorly understood because of the ethical and cosmetic problems of obtaining skin biopsies required to study the changes after laser treatment.ObjectiveTo evaluate the usefulness of human skin explants for the investigation of fractional photothermolysis.MethodsFull-thickness discarded skin was treated in 4 ways: no treatment (control), fractional carbon dioxide laser, fractional Er:YAG laser, and fractional 1,550-nm erbium-doped fiber laser. Both treated and non-treated skin samples were cultured ex vivo at the air-medium interface for 7 days. Frozen tissue was sectioned and stained with hematoxylin & eosin for histologic examination and nitro blue tetrazolium chloride for viability testing.ResultsSkin explants cultured for up to 3 days exhibited histologic changes similar to those observed in in vivo studies, including microscopic treatment zones surrounded by a thermal coagulation zone, re-epithelialization, and formation of microscopic epidermal necrotic debris. However, the explant structure lost its original form within 7 days of culture. The viability of skin explants was maintained for 3 days of culture but was also lost within 7 days.ConclusionThe skin explant model may be a useful tool for investigating the immediate or early changes following fractional photothermolysis, but further improvements are required to evaluate the long-term and dermal changes.

show abstract

Pilot Investigation of the Correlation between Histological and Clinical Effects of Infrared Fractional Resurfacing Lasers

Cited by 25 publications

References 13 publications

Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature

Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature

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

Usefulness of Skin Explants for Histologic Analysis after Fractional Photothermolysis

Contact Info

Product

Resources

About