Effects of skin cleaning modes on the condition of collagen and elastin after laser resurfacing

BACKGROUND : Laser resurfacing is now widely used for the treatment of facial wrinkles, photoaging and acne scars and is usually combined with comparatively methods of cleaning detritus off the treated area after each laser pass. OBJECTIVE : This study aims to evaluate two different methods (damp gauze or damp large-tip cotton buds) in order to elucidate their influence on the healing process, if any. The left or right preauricular area, chosen at random on 10 patients undergoing periocular and perioral resurfacing with the same laser system, was cleaned after each laser pass with damp gauze (Group G) and the contralateral side with the large-tip cotton buds (Group C). Post-resurfacing oedema and erythema were observed in the preauricular areas and rated by the same experienced observer immediately after treatment and aggressive cleaning at 14, 30, 45, 60 and 90 days. RESULTS : Oedema was slightly more noticeable initially in Group G patients, but the erythema was more intense and lasted longer in the gauze-cleaned tissue. The sites were biopsied at 90 days and the samples sent for blinded histological evaluation to assess the degree of collagen and elastin fibre compaction. The histology demonstrated that the tissue from Group G achieved, at 90 days, better compaction of collagen and elastin fibres than that from Group C. CONCLUSIONS : It is suggested that the abrasive action caused by the gauze adds to the existing stimulative inflammatory reaction following CO 2 laser resurfacing, which augments the collagen and fibre compaction response in the tissue. Comparatively aggressive cleaning with damp gauze may therefore be preferable to other methods when performing laser resurfacing.