Prospective, uncontrolled examination of ablative fractional photothermolysis on Asian and Caucasian skin

Abstract

Background and objectives

Ablative fractional carbon dioxide (CO₂) laser treatment has gained popularity for several clinical indications due to its superiority in the treatment of rhytides, scars and photodamaged skin. The concept of ablative fractional photothermolysis (AFP) enables the induction of dermal coagulative injury without confluent epidermal damage, reduces side effects and shortens downtime. To date, less is known about its safety and efficacy on Asian skin where dyspigmentation is suspected to be one of the most challenging adverse events.

Materials and methods

78 Asian and 7 Caucasian subjects underwent 1–3 AFP treatments using a scanned 250 μm CO₂ laser beam for the indications of scar reduction (n = 42), skin tightening (n = 32), enlarged pores (n = 6) and others (n = 5). Two patients were treated for both acneiform scars of the face and atrophic scars on the neck so that in summary, 87 treatment sites received laser therapy. Post-treatment erythema (redness) and edema (swelling) as well as overall satisfaction were graded on a quartile scale with scores from 0 to 3. All designated and observed side effects were noted by blinded observers.

Results

The patient satisfaction (scored by a blinded observer) after AFP for scar reduction, skin tightening, and enlarged pores ranged from minimal to marked clinical improvement with a tendency for a better outcome after repeated treatments. Erythema and edema lasted for 1–4 days in all patients and only one patient developed post inflammatory hyperpigmentation (PIH) after the first treatment.

Conclusion

The presented results allow the conclusion that AFP performed by a scanned CO₂ laser is a safe and effective treatment modality for the improvement of rhytides and photodamaged skin, scarring, enlarged pores and hyperpigmentation in both Asian and Caucasian people, with a minor risk of dyspigmentation. Potential refinement of the number of sessions and treatment parameters need further evaluation to maximize the therapeutic efficacy for the different indications.