Aesthetic Dermatology

Single Treatment With Fractional Laser Reduces Perioral Wrinkles


 

KISSIMMEE, FLA. — A single treatment with a microfractional 2940-nm erbium:YAG laser resulted in perioral wrinkle reduction of greater than 40% and an improvement of 2–3 grades on the Fitzpatrick wrinkle assessment scale in a recent study.

In all, 23 patients with a score of 5–9 on the 9-point Fitzpatrick scale underwent full-face laser treatment. The improvements from baseline were noted after the first treatment, Dr. E. Victor Ross reported at the annual meeting of the American Society for Laser Medicine and Surgery.

The patients, who had skin types ranging from I to III, were treated with a 6- to 10-mm spot size and energy ranging from 400 to 920 microbeams/cm

Between one and three passes were used in less photodamaged areas, and three to eight passes were used in more severely damaged areas. Additionally, small areas were treated with a traditional short-pulse erbium:YAG laser at four passes and 5 J/cm

Preliminary findings suggest that the microfractional erbium:YAG treatments resulted in a similar wrinkle response to that observed with traditional short-pulse erbium:YAG laser treatments; however, healing times were reduced with the microfractional erbium:YAG, said Dr. Ross of the Scripps Clinic in San Diego.

Dr. Ross acknowledged that he has received equipment, consulting fees, and a research grant from Palomar Medical Technologies Inc.

"There was very rapid recovery, both histologically and clinically," he said, noting that the average full-face treatment time was 48 minutes. Re-epithelialization of the basal layer of the epidermis occurred within 12–24 hours, and complete re-epithelialization occurred within 4–5 days.

Bronzed skin was noted immediately after the treatments, and some patients experienced focal pinpoint hemorrhage. At 2 weeks, however, only mild erythema remained, he said.

On microscopic examination, separated columns of ablation were noted, typically with a depth of 200 microns and 20–30 microns of residual thermal damage at the periphery of the conical microwounds.

Not only did the treatment lead to smoothing of the skin and reduction of perioral wrinkles, but improvements in dyschromia were also noted, Dr. Ross said.

Although optimal treatment parameters for wrinkle reduction remain to be defined, these findings suggest that microfractional 2940-nm laser treatment is superior to traditional short-pulse erbium:YAG laser treatment for this purpose, he concluded.

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