Treatment of periorbital wrinkles using thermo‐mechanical fractional injury therapy versus fractional non‐ablative 1565 nm laser: A comparative prospective, randomized, double‐arm, controlled study

Abstract

Background: Non-ablative fractional laser is an effective modality for the treatment of periorbital wrinkling, one of the earliest signs of skin aging. Thermomechanical fractional injury (TMFI) therapy (Tixel ® , Novoxel ® , Israel) is an innovative technology that is now being used for facial skin rejuvenation. Our study compares the clinical results, side effects, and downtime profile between TMFI treatment and non-ablative fractional 1565 nm laser (ResurFX ® , Lumenis, Israel). METHODS: This was a prospective study of 68 patients (64 women, 4 men) with skin types I-VI in two medical centers (34 from Israel, 34 from the USA) that were randomized to receive either TMFI or NAFL treatment for periorbital wrinkling. Patients received 3-5 treatments, 3-5 weeks apart. Six months after the last treatment, the change in Fitzpatrick Wrinkling Classification System (FWCS) was calculated by three non-involved physicians and compared to pretreatment results. Side effects and downtime profiles were assessed in each group (including VAS pain assessment, time required to refrain from work and social activity, and time required for the resolution of redness, edema, and crusts.) RESULTS: A moderate improvement in periorbital wrinkling was demonstrated in both groups, with an average improvement of 1.6 ± 0.6 in FWCS in the TMFI group and an average improvement of 1.7 ± 0.8 in the NAFL group (p < 0.001). Postprocedural VAS score was 5.86 ± 2.3 in the NAFL group and 4.01 ± 2.6 in the Tixel ® group. Approximately 80% of subjects returned to both work and social activities two days postprocedure. Crusts were reported by 52% of patients in the TMFI group, compared to 16% of patients in the NAFL group more than 48 hours postprocedure (p < 0.05). There were no statistically significant differences in the other parameters between the two groups. CONCLUSION: TMFI is an effective and safe modality for the treatment of periorbital wrinkling, with comparable results to the 1565 nm NAFL.

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

“…4 Among the many different energy-based devices, the application of ablative lasers, such as CO 2 lasers, is still considered the most effective treatment for skin rejuvenation. 5 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.…”

“…Among the many different energy‐based devices, the application of ablative lasers, such as CO 2 lasers, is still considered the most effective treatment for skin rejuvenation 5 . An ablative fractional laser (AFL) generates arrays of thermally induced microinjuries, thereby inducing secondary dermal remodeling.…”

Stem cell‐derived exosomes in the treatment of melasma and its percutaneous penetration

“…NAFL, an upgrade from an ablative fractional laser, causes less skin damage, less possibility of pigmentation and greater ability for treating dark spots 52 . NAFL is near‐infrared laser peeling, in the process of its penetration depth, stimulate collagen regeneration and tissue reconstruction, its penetration depth near the basement membrane zone, enhance the basement membrane with cell regeneration and restoration, promotes the skin barrier reconstruction 53 . NAFL divides a laser beam into many tiny laser beams that penetrate the cuticle of the epidermis to the dermis, instantly removing necrotic tissue and creating tiny vertical channels consistent with the laser beam, microscopic treatment zones (MTZs) are formed that are conducive to drug introduction 54 .…”

“…52 NAFL is near-infrared laser peeling, in the process of its penetration depth, stimulate collagen regeneration and tissue reconstruction, its penetration depth near the basement membrane zone, enhance the basement membrane with cell regeneration and restoration, promotes the skin barrier reconstruction. 53 NAFL divides a laser beam into many tiny laser beams that penetrate the cuticle of the epidermis to the dermis, instantly removing necrotic tissue and creating tiny vertical channels consistent with the laser beam, microscopic treatment zones (MTZs) are formed that are conducive to drug introduction. 54 At the same time, some scholars believe that laser induced photomechanical wave can affect the intercellular pathway, some scholars believe it is also related to keratinins that absorb some of the laser energy and then are ablated to form intracellular channels .…”

Introduction to 2022 special dermatology/plastic surgery issue

“…Kauvar and Gershonowitz 3 evaluate the clinical and histological effects of FRF treatment of facial wrinkles and skin texture with novel 1-mm long ultra-thin 0.15mm diameter electrode pins. Salameh et al 1 provide a comparative study evaluating the clinical results and side effects between thermomechanical fractional injury (TMFI) therapy and non-ablative fractional 1565 nm laser therapy. TMFI is a novel non-laser, nonradiofrequency thermomechanical skin treatment device that is being explored for rejuvenation and other applications.…”