Effects Of Fractional CO2 Laser Research Articles

Effects of Fractional CO2 Laser Combined with Timolol versus Oxymetazoline in Treatment of Striae Rubra Distensae

Effects of Fractional CO2 Laser Combined with Timolol versus Oxymetazoline in Treatment of Striae Rubra Distensae

Fractional CO2 Laser vs. Microneedling with PRP in Striae Distensae Treatment: A Comparative Analysis on Asian Skin

Background: Stretch marks, or striae distensae (SD), are a common dermatological issue caused by skin stretching and subsequent dermal damage. Various treatments, including laser therapy and microneedling, have been explored for SD. This study evaluates and compares the effectiveness of Fractional CO2 laser and microneedling with platelet-rich plasma (PRP) for treating SD. Method: A randomized controlled trial was conducted over a year at Rohilkhand Medical College and Hospital. Ninety-eight patients aged 18-40 were enrolled and divided into two groups: Group A (Fractional CO2 laser) and Group B (microneedling with PRP), each receiving four sessions at three-week intervals. Patients' histories, including demographics and striae characteristics, were documented. The effectiveness of treatments was assessed using the Visual Analogue Score (VAS) and Patient Satisfaction Scale (PSS) at multiple follow-ups. Side effects were also recorded. Result: Group A (Fractional CO2 laser) had 49 patients with a mean age of 25.9 years, and Group B (microneedling with PRP) had 49 patients with a mean age of 26.4 years. Group A showed a significant reduction in striae width and length compared to Group B. By Week 12, 48.80% of Group A reported Excellent Improvement in VAS scores, compared to 12.80% in Group B. Patient satisfaction was significantly higher in Group A, with more patients reporting Very Satisfied and Extremely Satisfied outcomes. Side effects such as erythema and hyperpigmentation were more common in Group A. Conclusion: Fractional CO2 laser therapy is more effective than micro needling with PRP in reducing the appearance of stretch marks, with higher patient satisfaction and significant improvements in VAS scores. Despite a higher incidence of side effects, the CO2 laser provides better overall outcomes.

Comparison of promestriene with vaginal fractional CO2 laser and radiofrequency treatments of genitourinary syndrome of menopause

ObjectiveTo compare the effects of fractional CO2 laser and microablative fractional radiofrequency treatment with promestriene topical estrogen on sexual function and genitourinary syndrome of menopause symptoms. MethodsThis was a prospective randomized open-label clinical trial conducted with 62 postmenopausal women assigned to three intervention groups: a) topical promestriene for 90 days (n = 17); b) fractional CO2 laser treatment (n = 24); and c) microablative fractional radiofrequency treatment (n = 21). Each of the latter two groups underwent three treatment sessions at 4-week intervals. At baseline and at the end of the study, all participants had a gynecological examination that included vaginal pH measurement, and the completion of the Vaginal Symptom Score, the Vaginal Health Index, and the Female Sexual Function Index. For the energy treatment groups, adverse effects were evaluated after each session. Group homogeneity was assessed at baseline, and results were evaluated over time (from baseline to the end of treatment) and between groups over time. ResultsAll baseline parameters were similar among studied groups. At the end of the study, all 3 treatments had produced similar effects: a reduction of vaginal pH, and an improvement of vulvovaginal symptoms (Vaginal Symptom Score and Vaginal Health Index scores) as well as sexual function (higher total Female Sexual Function Index scores, and in the desire, arousal, lubrication and pain domain scores), with no differences observed between groups. Side-effects were slight for both energy treatment groups, mainly represented by vaginal discharge. ConclusionThe present study suggests that the two energy treatments were efficient along with promestriene at improving postmenopausal genitourinary and sexuality symptoms.Clinical trial identification numberNCT04717245.

THE EFFECTIVENESS OF FRACTIONATED CARBON DIOXIDE (CO2) LASER IN THE TREATMENT OF RED STREAKS AND STREAK STREAKS

The research developed consisted of analyzing the effectiveness of fractional CO2 laser in the treatment of stretch marks. Among the main aesthetic changes in the body, this one is like stars. The stretch mark is an atrophic aesthetic lesion, caused by ahuge stretch and a consequent rupture of the collagen and elastin fibers, responsible for theelasticity of the skin. They affect a large portion of the population, being more frequent inadolescent and pregnant women, although it can also present in obese people, patients withhormonal imbalances, users of medications and patients with a genetic history. The treatmentsfor stretch marks vary according to the stage of evolution of the stretch and the phototype ofthe patient's skin. Among the most sought after is the fractional CO2 laser, its practiceconsists of promoting tissue damage through thermal damage and vaporization of cells,leading to the stimulation of neocolagenesis, with the main target being the water present inthe tissues. The purpose of the study was to evaluate the effectiveness of using fractional CO2laser in the treatment of red and white streaks, identifying its benefits, describing itsmechanism of action and analyzing the results obtained by the scientific literature. To thisend, a bibliographic search was carried out in the main databases, a virtual health library(bvs); online electronic scientific library (scielo), academic Google and lilacs. Therefore,concluding that fractional CO2 laser is effective for the treatment of stretch marks, however,attention is needed with the patient's phototype due to complications that may occur, such aspost-inflammatory hyperpigmentation, persistent hyperpigmentation, scarring, burns andKoebner syndrome.

THE EFFECTIVENESS OF FRACTIONATED CARBON DIOXIDE (CO2) LASER IN THE TREATMENT OF RED STREAKS AND STREAK STREAKS

The research developed consisted of analyzing the effectiveness of fractional CO2 laser in the treatment of stretch marks. Among the main aesthetic changes in the body, this one is like stars. The stretch mark is an atrophic aesthetic lesion, caused by ahuge stretch and a consequent rupture of the collagen and elastin fibers, responsible for theelasticity of the skin. They affect a large portion of the population, being more frequent inadolescent and pregnant women, although it can also present in obese people, patients withhormonal imbalances, users of medications and patients with a genetic history. The treatmentsfor stretch marks vary according to the stage of evolution of the stretch and the phototype ofthe patient's skin. Among the most sought after is the fractional CO2 laser, its practiceconsists of promoting tissue damage through thermal damage and vaporization of cells,leading to the stimulation of neocolagenesis, with the main target being the water present inthe tissues. The purpose of the study was to evaluate the effectiveness of using fractional CO2laser in the treatment of red and white streaks, identifying its benefits, describing itsmechanism of action and analyzing the results obtained by the scientific literature. To thisend, a bibliographic search was carried out in the main databases, a virtual health library(bvs); online electronic scientific library (scielo), academic Google and lilacs. Therefore,concluding that fractional CO2 laser is effective for the treatment of stretch marks, however,attention is needed with the patient's phototype due to complications that may occur, such aspost-inflammatory hyperpigmentation, persistent hyperpigmentation, scarring, burns andKoebner syndrome.

Effect of fractional CO2 laser combined with 5-Fluorouracil injection in the treatment of Hypertrophic Scars and Keloids..

Effect of fractional CO2 laser combined with 5-Fluorouracil injection in the treatment of Hypertrophic Scars and Keloids..

Comparative Study of Polydioxanone Monofilament (PDO) Threads Combined with Scar Subcision versus Fractional CO2 Laser Combined with Scar Subcision in Management of Atrophic Post Acne Scars

Abstract Background Acne is an inflammatory disorder of the pilosebaceous unit characterized by comedones, inflammatory papules, pustules, and nodules of the face, chest, and back. The inflammatory response in some acne patients results in permanent, disfiguring scars from either increased tissue formation or due to loss or damage of tissue. Many treatments have been attempted in order to improve acne scarring such as: chemical peels, surgical excision, subcision, punch grafting, dermabrasion, fillers and laser have been used to ameliorate atrophic acne scars with varying degrees of success Objectives The aim of this work was to study the efficacy of polydioxanone (PDO) monofilament threads combined with scar subcision versus fractional Co2 laser combined with scar subcision in management of atrophic acne scars. Patients and Methods This is a split-face pilot study included 10 patients with atrophic acne scars. The patients recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals. Fractional CO2 laser sessions were done for the right side of the face (2 sessions - one month apart), and Polydioxanone (PDO) threads were inserted to the left side of the face (2 sessions - one month apart), each treatment modality was preceded by scar subcision. The patients were followed up for 3 months. The response of treatment was evaluated by Antera 3D camera. Results Our study revealed that treatment of the right side of the face with fractional CO2 Laser led to statistically significant improvement more than what was achieved by PDO threads on the left side. It was also found that both PDO monofilament threads and Fractional Co2 laser improved the skin texture. Conclusion .The current study confirmed the superiority of fractional CO2 laser for the management of atrophic post acne scars. Polydioxanone threads had an effect in improving the skin texture but their overall effect is not comparable to the effect of fractional CO2 laser. To the best of our knowledge, we were the first to compare between Fractional Co2 laser and poydioxanone threads regarding there efficacy in management of atrophic acne scars and to evaluate the response using Antera 3D camera.

Efficacy of Fractional CO2 Laser Treatment for Genitourinary Syndrome of Menopause in Short-Term Evaluation-Preliminary Study.

The postmenopausal state covers 40% of modern women's lives and 50-70% of postmenopausal women report GSM symptoms such as vaginal dryness, itching, frequent inflammations, lack of elasticity, or dyspareunia. Consequently, a safe and effective method of treatment is crucial. In a group of 125 patients, a prospective observational study was performed. The aim was to evaluate the clinical effectiveness of fractional CO2 laser in the treatment of GSM symptoms using a protocol of three procedures in 6-week intervals. The vaginal pH, VHIS, VMI, FSFI, and treatment satisfaction questionnaire were used. The fractional CO2 laser treatment was effective in improving all the objective forms of evaluation: vaginal pH (from 5.61 ± 0.50 at the baseline up to 4.69 ± 0.21 in the 6-week follow-up after the third procedure); VHIS (12.02 ± 1.89 at the baseline vs. 21.50 ± 1.76); VMI (21.5 ± 5.66 vs. 48.4 ± 4.46). Similar results were obtained for FSFI: 12.79 ± 5.351 vs. 24.39 ± 2.733, where 79.77% of patients were highly satisfied. Fractional CO2 laser therapy increases the quality of life by having a beneficial effect on the sexual function of women with GSM symptoms. This effect is obtained by restoring the correct structure and proportions of the cellular composition of the vaginal epithelium. This positive effect was confirmed by both objective and subjective forms of evaluating GSM symptom severity.

Effect of Fractional CO2 Laser vs Sham Treatment on Symptom Severity of Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial

<h3>Study Objective</h3> To determine the efficacy of fractional CO₂ laser for treatment of vaginal symptoms associated with menopause. <h3>Design</h3> This study is a double-blind, randomized, sham-controlled trial with 12-month follow-up. Enrollment commenced September 19, 2016, with final follow-up June 30, 2020. <h3>Setting</h3> Outpatient clinic in a single, tertiary referral hospital. <h3>Patients or Participants</h3> Participants were postmenopausal women with vaginal symptoms substantive enough to seek medical treatment. Of 232 participants approached, 90 were recruited. <h3>Interventions</h3> Three treatments using a fractional micro-ablative CO₂ laser system performed 4-8 weeks apart, with 43 women randomized to the laser group and 42 to the sham group. <h3>Measurements and Main Results</h3> The coprimary outcomes were symptom severity assessed by Visual Analog Scale (VAS and Vulvovaginal Symptom Questionnaire (VSQ) at 12 months. Secondary outcomes including quality of life, Vaginal Health Index (VHI) and vaginal histology were assessed. From 85 participants randomized (mean age 57 (SD 8) years), 78 (91.7%) completed 12-month follow-up. From baseline to 12 months between CO₂ laser and sham groups, there was no significant difference in symptom severity (VAS score for overall vaginal symptoms: laser -17.2 vs sham -26.6 (difference 9.4 [95%CI -28.6, 47.5]); VAS score for single most severe symptom: laser -24.5 vs sham -20.4 (difference -4.1 [95%CI -32.5, 24.3]); or VSQ score: laser -3.1 vs sham -1.6 (difference -1.5 [95%CI -5.9, 3.0]). There were no significant differences in quality of life, VHI or histological comparisons between laser and sham treatment. There were 16 adverse events in the laser group and 17 in the sham group including vaginal pain/discomfort (44% vs. 68%), spotting, discharge or lower urinary symptoms. No severe adverse events were reported in either group. <h3>Conclusion</h3> Among women with postmenopausal vaginal symptoms, treatment with fractional CO₂ laser vs sham treatment did not significantly improve vaginal symptoms after 12 months.

Evaluation of combination use of phenytoin cream 1% and fractional CO2 laser in treatment of stable nonsegmental vitiligo: A pilot study.

Vitiligo is an autoimmune disorder of melanocyte characterized by macular and depigmented patches. There are several treatment modalities for this disease, including the use of corticosteroids, calcineurin inhibitors, vitamin D analogous and topical phenytoin. Combination therapy utilizing fractional CO2 laser with different topical agents has been used to enhance treatment response with promising results. In this study, we aimed to evaluate the effect of fractional CO2 laser in combination with topical phenytoin. In this study, 25 patients (11 females and 14 males) with age of 18-59 (mean age of 31.12) with nonsegmental stable vitiligo were recruited with insufficient response to at least 1-year treatment with a monotherapy using topical corticosteroids, calcineurin inhibitors, and/or NB-UVB phototherapy. Patients were treated with a combination of fractional CO2 laser (10,600 nm, pulse energy 30-50 mJ, MIXEL, South Korea, Rating: 220VAC, 3A, 50/60 Hz) with monthly intervals for six sessions and application of phenytoin 1% cream twice daily. Photography was done before and after treatment with Wood's lamp. The severity of disease using VASI score was calculated and compared before and after treatment. The mean VASI score before treatment was 0.55, and sixth month after treatment increased to 1.97 (p-value < 0.001). Patients were divided into three groups based on the vitiligo subtype: acral, upper extremities, and trunk. VASI score was measured in each group: VASI score before and after treatment was 0.50 and 1.48 in acral areas, 0.45 and 2.04 in upper extremities and 0.79 and 3.39 in trunk, respectively. This study revealed that combination therapy with phenytoin and fractional CO2 laser is effective in treatment of vitiligo not only in the upper extremities and trunk, but also interestingly in the acral areas.

Experimental comparative study of the effect of fractional CO2 laser combined with pulsed dye laser versus each laser alone on the treatment of hypertrophic scar of rabbit ears.

The use of fractional CO2 laser and pulsed dye laser (PDL) therapy to treat and/or prevent scarring following burn injury is becoming more widespread with a number of studies reporting reduction in scar erythema and pruritus following treatment with lasers. The objective of this study was to directly compare the efficacy of PDL, fractional CO2 , and PDL and fractional CO2 laser therapy in immature red hypertrophic scars in a standardized animal model. Ten New Zealand big-eared rabbits were used to make rabbit ear hypertrophic scar models. A total of 80hypertrophic scar models were obtained and randomly divided into groups: control (Group A), Fractional CO2 laser (Group B), pulse dye laser (Group C), combined (Group D), 20 in each group. Wound sites were treated with PDL, Fractional CO2 laser, or both at 28days post-grafting. Grafts receiving no laser therapy served as controls. Hypertrophic scar appearance, morphology, size, and erythema were assessed, and punch biopsies were collected. At days 7 and 28, additional tissue was collected for biomechanical analyses and markers for HE staining, Masson staining, immunohistochemical method to determine the CD31 content in the scar; Western blot to detect the expression of VEGF protein in scars. After the day 7 and 28, the scars were collected. Histomorphological change in scars was observed by hematoxylin-eosin staining, Masson staining. The expression of CD31, VEGF protein, and the cell apoptosis rate was detected by immunohistochemical method. (i) In morphological observation, HE staining and Masson staining, both the number of fibroblasts and amount of collagen fibrils in the experimental group were significantly reduced compared with those in control group. (ii) Micro-vessel Density (MVD) value can be found much smaller in the experimental groups than the control (p<0.05). Among the four experimental groups, there was a significant difference among 14d, 21d, and 28d groups (p<0.05). (iii) On days 7 and 28 after treatment, expression of VEGF could be regulated in experimental group (p<0.05). Among the three experimental groups, the decrease of VEGF in the combined group was significantly stronger than that of the other two. The effect of Fractional CO2 laser combined with pulsed dye laser treatment was shown to be better than that of Fractional CO2 laser or pulsed dye laser alone and inhibits the early hypertrophic scar in rabbit ears.

Evaluation of fractional carbon dioxide laser in the treatment of hypertrophic scars

Background Scars affect millions of patients and can significantly influence the physical and psychological functions of patients. Hypertrophic scars are raised nodules or plaques that develop as a result of an excessive collagen deposition during the wound healing process. There are several medical and surgical treatments available. Fractional carbon dioxide (CO2) laser is currently emerging as a minimally invasive therapeutic alternative. Aim The aim was to evaluate the effect of fractional CO2 laser in the treatment of hypertrophic scars. Patients and methods This study included 11 patients with hypertrophic scars (skin type III–IV), and their age ranged from 5 to 25 years old, with a mean of 18.27±7.43 years. Each patient received four sessions of treatment with 1-month interval. Final evaluation was performed 1 month after the last session by the opinion of three dermatologists blinded to the study protocol. The Vancouver scar scale and patient satisfaction before and after treatment were assessed. Skin biopsies were obtained before and 1 month after treatment for light microscopic studies. Results All patients showed clinical improvement. There was a statistically significant difference in the Vancouver scar scale between before and after treatment, where P=0.003. Response to treatment was excellent in 18.2%, good in 27.3%, fair in 36.4%, and poor improvement in 18.2% of patients according to dermatologists’ assessments. Overall, 27.3% of patients were highly satisfied, 54.5% were satisfied, and 18.2% were slightly satisfied. Patients tolerated the procedure well with minimal adverse effects. Conclusion Fractional CO2 can be an effective modality in the treatment of hypertrophic scars, without serious adverse events.

Efficacy and Side Effects of Fractional Carbon Dioxide Laser for Acne Scars, Keloids, and Striae Albae in the Dermatovenereology Clinic of Tertiary Hospital: A Retrospective Study

Background: Fractional Carbon Dioxide (CO2) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose: To evaluate the efficacy and side effects of fractional CO2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods: Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result: A total of 42.9% of patients underwent fractional CO2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respectively. There was a statistically significant decrease in the degree of acne scar (2.72 ± 0.83), keloid height (2.2 ± 0.405), and striae width (0.39 ± 0.02). The statistically significant side effects were hyperpigmentation (59.5%), crustae (26.2%), erythema ≥ for 4 days (19%), and new acne (19%). Conclusion: Fractional CO2 LASER was effective for treating scar tissue (acne scars, keloids, and striae albae) with a higher incidence of side effects in population with darker skin and post-inflammatory hyperpigmentation.

Effects of Different Laser Treatments on Some Properties of the Zirconia-Porcelain Interface.

Introduction: This study was performed to compare the effect of Fractional CO2 laser or Q switched Nd:YAG laser of surface treatment on the shear bond strength of zirconia-porcelain interface. Methods: Fractional CO2 laser at 30 W, 2 ms, time interval 1 ms, distance between spots 0.3 mm, and number of scans is (4) or Q switched Nd:YAG laser at 30 J/mm2 and 10 Hz were used to assess the shear bond strength of zirconia to porcelain. Pre-sintered zirconia specimens were divided into three groups (n = 10) according to the surface treatment technique used: (a) untreated (Control) group; (b) CO2 group; (c) Nd:YAG group. All samples were then sintered and veneered with porcelain according to the manufacturer's instructions. Surface morphology was examined using a light microscope, the surface roughness test was done by the atomic force microscope (AFM), and the shear bond strength (SBS) test was done by a universal testing machine. After debonding following shear bond test, zirconia surfaces were examined under a light microscope to determine their fracture mode. Results: The Results of this study showed that the lowest SBS was recorded in the control group, and the highest SBS recorded in the Fractional CO2 group, followed by the Q switched Nd:YAG laser group, as well as an increase in surface roughness and change in the morphology and mode of failure in the experimental groups. Conclusion: This study shows that Fractional CO2 laser and Q switched Nd:YAG laser treatments significantly increase the bond strength than untreated zirconia.

Effect of carbon dioxide laser with botulinum toxin compared with carbon dioxide alone in treatment of periorbital syringoma

Background Periorbital syringoma is a benign adnexal tumor of eccrine origin that mostly affects middle-aged women. It consists of bilateral, multiple, yellow to flesh colored to brown firm papules. Aim To assess the effect of fractional CO2 laser with topical botulinum toxin compared with fractional CO2 laser alone in the treatment of periorbital syringomas. Patients and methods This split-face prospective study was carried out on 30 patients presented with periorbital syringomas. All patients were subjected to history taking, clinical examination, examination for site, number of syringomas, and photographic documentation. The patients were treated by fractional CO2 laser and immediately followed by 0.1 cm of diluted Botox (by gentle hand massage) in the right eyelid, whereas the left eyelid was treated by fractional CO2 laser only. The patients were subjected to two sessions with 4–6-week interval. Results There was a statistically significant increase in the response to treatment by fractional CO2 laser followed by topical Botox (P=0.039). The percentage of improvement was 95.5%. Conclusion The use of fractional CO2 laser combined with topical botulinum toxin in treatment of periorbital syringomas has better results than the use of fractional CO2 laser only.

Effects of Fractional CO2 Laser Treatment on Subglottic Scar in a Rabbit Model.

The objective of this study was to investigate the effects of fractional CO2 laser on subglottic scar. Randomized controlled animal study. Academic medical center. Subglottic scar was induced in 12 New Zealand white rabbits via an endoscopic brush technique. This was followed by an open airway surgery that included vertical division of the cricoid and proximal trachea. Eight rabbits underwent fractional CO2 laser treatment of the scar via a Lumenis Ultrapulse Deep FX handpiece. Four rabbits underwent the open surgical approach without laser treatment. Bronchoscopy was performed at weeks 1, 2, 4, and 8. The animals were euthanized and laryngotracheal complexes harvested 12 weeks postsurgery. Immunohistochemistry was performed to determine the collagen composition of treated and untreated scars. All 12 subjects survived to the study endpoint with no significant respiratory complications, despite 10 of 12 developing some degree of lateral tracheal narrowing. The median ratio of type I collagen to type III collagen in the laser group (1.57) was significantly more favorable than that of the untreated group (2.84; P = .03). Treatment with fractional CO2 laser appears to have similar effects on subglottic scars as with cutaneous scars, improving the ratio of type I to type III collagen. Additionally, we developed an open airway approach in the rabbit model to deliver fractional CO2 laser treatment to the subglottis without introducing respiratory complications or compromising survival.

The efficacy of fractional CO2 laser in acne scar treatment: A meta-analysis.

Fractional CO2 laser is a good option for treating acne scars. However, the clinical efficacy of this treatment modality requires further evidence. To perform a meta-analysis to assess clinical improvements in acne scars with fractional CO2 laser and non-CO2 laser therapies. Databases (PubMed, Embase, Cochrane Library) were searched using the search strategy to identify eligible studies. All statistical analyses were performed using the Review Manager 5.0, and a meta-analysis was conducted to assess the effects of fractional CO2 laser used as a treatment for acne scars. Eight studies were included for further analysis. There was no significant difference between fractional CO2 laser and non-CO2 laser therapies in terms of clinical improvement, observer assessment (P = .19), patient assessment (P = .91), and incidence of post-inflammatory hyperpigmentation (P = .69). The subgroup analyses showed that the duration of follow-up had little effect on the evaluation of treatment effect. The efficacy of fractional CO2 laser therapy in acne scars appeared to be equal to that of non-CO2 laser therapies. More well designed randomized controlled trials and more credible and standard evaluation criteria are needed, and the efficiency of combination therapy requires further analysis.

The effects of CO2 fractional laser on improving the scar of alar base incision in rhinoplasty patients

Objectivepost-surgical complications of rhinoplasty such as scars may alter the success rate of the operation. The aim of this study was to investigate the effects of fractional CO2 laser on the scars of alar base region in rhinoplasty patients. Materials and methodsTwenty six patients who had subsequent scar in the alar base region after open rhinoplasty were enrolled to this clinical study. Their skin type was recorded using Fitzpatrick scale, and then patients were randomly allocated into the control and the laser groups. Patients in the control group received no treatment, in the laser group, one session of fractional CO2 laser therapy with a 0.05 mm spot diameter, 4 ms pulse duration, 12−14 W power and 48_56 mJ energy in each pulse was completed. The scar score was evaluated using Vancouver Scar Scale before and 6 months after the treatment. The Scar score was calculated in a descriptive manner. Paired t-test and (Wilcoxon test) were employed to compare the results before and after the treatment. Data were analyzed using SPSS software version 22, and the level of significance was P < 0.05. ResultsNo difference was observed regarding the demographic information and the skin type between the two groups. After 6 months, reduction in the scar score was observed in both groups, however, the difference was not statistically significant. ConclusionThis study concluded that fractional CO2 laser did not affect the scar of alar base incision after rhinoplasty.

Fractional Carbon Dioxide Laser is Effective in Amelioration of Pruritus in Primary Cutaneous Amyloidosis: A Clinical and Biochemical Study.

Primary cutaneous amyloidosis (PCA) is a pruritic disease characterized by amyloid deposition in the skin. Interleukin-31 (IL-31) is a pruritus-mediating cytokine. Fractional carbon dioxide (CO2 ) laser has shown efficacy in the treatment of PCA regarding the clinical appearance, histological pattern, and pruritus. The aim of this study is to assess the effect of fractional CO2 laser on pruritus associated with PCA, and analyze whether this effect is related to IL-31 and IL-31 receptor (R) expression. The study included 24 patients with PCA and 24 healthy controls. Each patient received four fractional CO2 laser sessions, 4 weeks apart, using the superficial ablative mode. Skin biopsies were taken from patients before and after treatment, as well as controls, for assessment of IL-31 and IL-31R by real-time polymerase chain reaction. Treatment resulted in significant improvement of all clinical parameters, including pruritus (P < 0.001). Patients before treatment had significantly higher IL-31 and IL-31R than controls (P = 0.000 for both). In addition, there was a statistically significant decrease in IL-31 and IL-31R after treatment than their values before treatment (P = 0.000 for both). This study confirms the therapeutic efficacy of fractional CO2 laser in treatment of PCA. Reduction of IL-31 and its receptor seems to be one of the involved mechanisms; however, its relation to improvement of pruritus is still not clear. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

The efficacy of fractional carbon dioxide laser combined with narrow-band ultraviolet B phototherapy for non-segmental vitiligo: a systematic review and meta-analysis.

Fractional carbon dioxide (CO2) laser has been used with conventional treatments for vitiligo, demonstrating more effectiveness compared with conventional treatments alone. Especially, fractional CO2 laser combined with narrow-band ultraviolet B (NB-UVB) was shown to induce more improvement compared with NB-UVB monotherapy for treating stable non-segmental vitiligo. However, the effectiveness of fractional CO2 laser plus NB-UVB for the treatment of non-segmental vitiligo remains controversial. Therefore, this study aimed to confirm the safety and efficacy of fractional CO2 laser combined with NB-UVB compared with NB-UVB monotherapy in stable non-segmental vitiligo. We searched the data from different databases, including Cochrane, Embase, and PubMed up to January 2020. Four randomized controlled trials (RCTs) for comparison between fractional CO2 laser plus NB-UVB and NB-UVB monotherapy in patients with stable non-segmental vitiligo were included. We performed meta-analyses for repigmentation improvement and patient satisfaction as well as subgroup analyses based on acral or non-acral vitiligo, according to the PRISMA guidelines. The combination treatment showed more superior results than NB-UVB monotherapy (≥ 75% repigmentation, RR 4.60, 95% CI 1.19-17.74; ≥ 50% repigmentation, RR 2.24, 95% CI 0.45-11.17; < 25% repigmentation, RR 0.81, 95% CI 0.60-1.08). Also, fractional CO2 laser plus NB-UVB significantly improved acral and non-acral vitiligo compared with NB-UVB monotherapy (standard mean difference (SMD) 1.24, 95% CI 0.66-1.82; SMD 1.14, 95% CI 0.67-1.60, respectively), while it increased markedly patient satisfaction compared with NB-UVB monotherapy (SMD 1.12, 95% CI 0.66-1.58). Collectively, this meta-analysis suggested that fractional CO2 laser combined with NB-UVB might be more effective for treating non-segmental vitiligo than NB-UVB monotherapy.