Short-Pulse Carbon Dioxide Laser Resurfacing in the Treatment of Rhytides and Scars

Abstract

Histopathological studies suggest improvement of rhytides and scars by CO2 laser resurfacing may be attributed to new collagen formation following treatment.

Evaluating the efficacy of using a short‐pulsed erbium:YAG laser for intraoperative resurfacing of surgical wounds

“…As had been seen with dermabrasion, elevated scars responded better than depressed scars. Shim et al reported similar improvement of scars treated with carbon dioxide resurfacing lasers and showed an increase in collagen layer thickness histologically that was sustained for the one year follow up of the study [11]. In a split scar study, Nehal et.…”

Collagen thermal damage and collagen synthesis after cutaneous laser resurfacing

“…Several reports confirm that new collagen synthesis after cutaneous resurfacing accounts for improvements of fine wrinkles on the face [1,2,5,11,12]. Given that the scanned laser works deeper in the dermis and affects a greater depth of new collagen synthesis, one might expect that the scanned laser would be more efficacious than the short-pulsed laser in removing deeper wrinkles.…”

“…While comparisons between the thermal damage depth created by the scanned and short-pulsed lasers has been done in human skin [5,11,12], we believe that our in vivo experiments with piglets have clinical relevance. Porcine skin has been shown to be very similar to human skin in such parameters as hair growth, thickness, and sweat glands [13,14].…”

“…The organized collagen synthesis that oc-curs after the dermis is damaged is widely accepted to be responsible for the clinical improvement of fine wrinkling [1,2]. Histologically, resurfaced skin demonstrates a thicker dermis with more parallel bands of collagen and less elastosis and perivascular inflammation [3,5]. However, if the ablation extends too deeply into the reticular dermis, unwanted excessive scarring with disorganized collagen bands and lasting postoperative erythema occurs [6].…”

Variable pulse erbium:YAG laser skin resurfacing of perioral rhytides and side-by-side comparison with carbon dioxide laser

“…Based on currently available systems, some general observations can be made: CO 2 by using current techniques generally remove up to 220 m of tissue, leaving a residual zone of irreversible thermal necrosis of 50-100 m [9,24,25]. An additional zone of reversible thermal injury also remains, which represents the "repairable injury" zone that triggers wound remodeling and in which collagen fibril "shrinkage" occurs [3,26,27].…”