Prospective direct comparison study of fractional resurfacing using different fluences and densities for skin rejuvenation in Asians

Abstract

Fractional resurfacing is a new concept of cutaneous remodeling whereby laser-induced zones of microthermal injury are surrounded by normal untreated tissue. The aim of this study is to compare the efficacy and complications of Fraxel laser treatment when using different fluences and density settings. Thirty female Asian patients were enrolled in the study. Group 1 (n = 10); half of the face was treated with eight passes at 125 MTZ/cm2 at an energy setting of 8 mJ. The other half of the face was treated with eight passes at 250 MTZ/cm2 at an energy setting of 8 mJ. Group 2 (n = 10); half of the face was treated with eight passes at 125 MTZ/cm2 at an energy setting of 8 mJ. The other half of the face was treated with eight passes at 125 MTZ/cm2 at an energy setting of 16 mJ. Group 3 (n = 10); half of the face was treated with eight passes at 125 MTZ/cm2 at an energy setting of 16 mJ. The other half of the face was treated with eight passes at 250 MTZ/cm2 at an energy setting of 8 mJ. Ice pack cooling was used during and after laser treatment. The patients were evaluated for clinical efficacy and treatment-related side effects. Pain, erythema, and swelling were observed to be significantly more evident or persisted longer in patients treated with higher densities and fluences (P<0.01). Patient satisfaction is significantly greater in patients treated with higher fluences (P<0.05), but not in patients treated with higher densities. Hyperpigmentation was observed in two patients. Increased density was more likely to produce swelling, redness, and hyperpigmentation when compared to increased energy. Patient satisfaction is significantly higher when their skin is treated with high fluences, but not when patients' skin is treated with high densities.