Fractional CO2 Laser Resurfacing Research Articles

Randomized controlled study using autologous fat grafts, hybrid filler, and fractional CO2 laser resurfacing in the treatment of elastosis: analysis of outcomes and satisfaction

Randomized controlled study using autologous fat grafts, hybrid filler, and fractional CO2 laser resurfacing in the treatment of elastosis: analysis of outcomes and satisfaction

Safety and efficacy of human platelet extract in skin recovery after fractional CO2 laser resurfacing of the face: A randomized, controlled, evaluator-blinded pilot study.

Fractional carbon dioxide (CO2 ) laser resurfacing is used successfully for facial rejuvenation. Post procedure skincare is a variable that influences downtime caused by pain/tenderness, erythema, crusting, and bruising. The primary objective of this pilot study was to demonstrate the benefits of human platelet extract (HPE) (plated)™ CALM Serum, a new topical cosmetic product, following fractionated CO2 ablative laser resurfacing treatment to the entire face versus standard of care. In a single-center, randomized, evaluator-blinded pilot study, a total of 18 subjects were randomized into two groups, CO2 facial resurfacing followed by post-procedural standard of care (Stratacel silicone gel) or CO2 facial resurfacing with the addition of HPE renewosomes in the CALM Serum. CALM Serum demonstrated statistically significant less crusting at Day 10 compared to the control group (p = 0.0193) with less downtime in the first 14 days (p = 0.03). Subjects treated with CALM Serum had statistically significant brighter appearing skin at 14 days (p = 0.007) and more youthful looking skin on Days 14 and 30 (p = 0.003 and 0.04, respectively). This study demonstrates that Renewosome™ technology provides statistically significant post-laser clinical recovery over silicone gel for reducing crusting, and downtime. Subjects reported less diary days of symptoms of pain/tenderness, redness, crusting/flaking, bruising, and itching in the first 14 days compared to the control group. CALM also demonstrated statistically significant improvements in brighter and more youthful appearing skin. CALM is safe and well tolerated.

Fractional Laser Resurfacing for Acne Scars: Our Experience at Tertiary Care Hospital of North India.

Acne is very common among adolescents, which may sometimes persist into adulthood, and acne scars continue to have a profoundly negative impact on quality of life. Of all the various modalities available, fractional lasers have shown effective results. The aim of this study was to assess the efficacy and safety of fractional carbon dioxide (CO2) laser resurfacing in atrophic facial acne scars. The study included 104 subjects aged ≥18 years with atrophic acne scars on face of more than 6 months of duration recruited over a period of 1 year. All the patients were treated with fractional CO2 laser (600 W power and wavelength 10,600 nm). Four sessions of fractional CO2 laser resurfacing were done at 6-week intervals in each patient. We compared the improvement rate of scars after every session at 6-week interval, 2 weeks after the last session, and finally 6 months after the last laser session. The difference between the mean baseline score (3.43) and mean final score (1.83) using Goodman and Baron's qualitative scar scale was found to be statistically significant (P = 0.001). Mean improvement increased from first treatment session to the end of the treatment course from 0.56 to 1.62 indicating the role of the number of sessions in the overall improvement of acne scars. With regard to overall satisfaction, maximum number of patients were either very satisfied (55.8%) or satisfied (25%) as compared to those who were only slightly satisfied (11.5%) or completely unsatisfied (7.7%). Fractional ablative laser gives excellent results in the management of acne scars and has emerged as an appealing non-invasive option for this indication. Being a safe and effective option for atrophic acne scar treatment, it can be recommended wherever available.

Fractional CO2 Laser resurfacing treatment of acne scar comparing high and low energy levels

Background : Fractional CO2 laser resurfacing in the treatment of acne scars, attempts to reduce the adverse effect of laser resurfacing by creating microscopic injury zones to the dermis with skipped interval areas. Aim of the study : The purpose of this study is to compare the safety and efficacy of high pulse energy (70 mJ) and low pulse energy (45 mJ) of fractional CO2 laser resurfacing in the treatment of facial acne scars. Patients and Methods : Twenty patients with moderate to severe atrophic acne scars were treated with three sessions of fractional CO2 laser resurfacing at four-week intervals with high and low energy levels applied to each side of the face separately. The severity of acne scars at baseline and after treatment was assessed using Goodman and Baron’s qualitative scar grading system. Patient satisfaction score was obtained using a quartile grading scale. Results : The severity of acne scars on both sides was comparable to each other before the treatment (p = 0.643). At the final assessment, both sides with high and low energy levels demonstrated an excellent response (p = 0.000). However, the difference between the mean final scores of both sides was not significant (p = 0.731). The most frequently reported side effects were crustation and erythema. Crustation lasted longer on the right side (mean = 6.75 days) whereas for the left side (mean = 5.45 days). Erythema was transient and only in four cases persisted beyond a week (right side mean = 10.5 days while left side mean = 8.75 days) Conclusions : Both high energy (70 mJ/pulse) and low energy (45 mJ/pulse) CO2 fractional laser resurfacing of acne scar results in satisfactory outcomes with no statistically significant differences. While the duration of side effects (crustation and erythema) was increased slightly with higher fluence.

Potent Periorbital Fractionated CO 2 Laser Resurfacing.

The aged face results from a culmination of skin changes, gravitational descent, and volume loss. Surgical interventions in the periorbital region are beneficial for addressing these 3 factors. Despite this, studies describing CO2 laser safety settings are lacking. There is no present consensus on ideal periorbital CO2 laser; therefore, this study evaluates the safety of periorbital laser resurfacing as an adjunct to lower blepharoplasty using robust settings. A retrospective review was performed of all patients who underwent bilateral lower blepharoplasty with adjunctive periorbital (upper and lower eyelid) fractionated CO2 laser resurfacing from 2013 to 2018 performed by a single oculoplastic surgeon. Fifty-nine patients were included. Six patients experienced side effects including postinflammatory hyperpigmentation, (3/59, 5.1%), prolonged superficial excoriations (1/59, 1.7%), prolonged hyperemia (1/59, 1.7%), and lower eyelid retraction requiring lower eyelid recession (1/59, 1.7%). None of the patients developed postoperative infection. All patient expressed satisfaction at their final postoperative visit. CO2 laser resurfacing, even with robust settings, is a safe and effective adjunct to lower blepharoplasty.

"Split-Face" Evaluation of Collagen Changes Induced by Periorbital Fractional CO2 Laser Resurfacing.

Periorbital fractional CO2 laser resurfacing has been employed for facial rejuvenation purposes. However, to the best of our knowledge, no study has objectively assessed periorbital neoformation and remodeling of local cutaneous collagen, in a split-face model, from skin samples obtained during upper blepharoplasty. The authors sought to objectively evaluate neoformation and remodeling of local cutaneous collagen after periorbital skin fractional CO2 laser resurfacing. Sixteen female patients presenting with dermatochalasis and periorbital rhytids were evaluated in a prospective and comparative study. All patients underwent unilateral periorbital fractional CO2 laser resurfacing 30 days before upper blepharoplasty. Quantification of types I and III collagen from laser-treated and untreated eyelid skin samples obtained during upper blepharoplasty was assessed with histochemical analysis (Picrosirius Red staining). Laser resurfacing treatment was applied to the untreated side immediately after the upper blepharoplasty. Two blinded, independent physicians evaluated clinical improvement in pretreatment and 1- and 6-month posttreatment digital images. Histochemical analysis showed significantly higher intensity in collagen types I (treated: 158.7 ± 5.3, untreated: 139.2 ± 5.0; P < 0.0001) and III (treated: 105.1 ± 7.7, untreated: 104.1 ± 7.1; P < 0.0001) in the fractional CO2 laser treatment samples; a greater difference was detected in collagen type I. A significant improvement in periorbital rhytidosis was observed 1 month after laser resurfacing (23%); a greater improvement in the periorbital region was observed 6 months after laser resurfacing and upper blepharoplasty (43.67%). Periorbital fractional CO2 laser resurfacing was an effective method to improve palpebral skin, with histochemical evidence of increase in collagen types I and III.

Fractional Carbon Dioxide Laser Versus Carboxytherapy in Treatment of Striae Distensae.

The aim of this study was to compare the efficacy and safety of fractional carbon dioxide (CO2 ) laser versus carboxytherapy in treatment of striae distensae. This study was conducted on forty female patients with striae distensae on the abdomen. Patients were selected and divided randomly into two matched groups; group I was treated with fractional CO2 laser resurfacing and group II with carboxytherapy. Assessment and evaluation of the results were done by comparing photographs and the Global Aesthetic Improvement Scale (GAIS). Pregnancy, obesity, and long-term steroid use were the most common causes of striae in both groups. Both groups showed a statistically significant improvement in both the width and length of striae with no statistically significant difference between them. Patients' satisfaction was comparable in both groups. Pain and post-inflammatory hyperpigmentation were the two most common side effects in group I while bruising at the injection site was the most common in group II. Both modalities could be effective in management of striae distensae.Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

Efficacy of stem cell-conditioned medium vs. platelet-rich plasma as an adjuvant to ablative fractional CO2 laser resurfacing for atrophic post-acne scars: a split-face clinical trial

Objectives To explore the impact of using topical stem cell-conditioned medium (SC-CM) after fractional carbon dioxide laser (FCL) vs. combined FCL and platelet-rich plasma (PRP) or FCL alone in treatment of atrophic acne scars. Methods Thirty-three patients were randomly divided into two split-face groups. Group I (n = 17) received FCL plus topical SC-CM on one side or FCL plus saline on the other. Group II (n = 16) received FCL plus topical PRP or SC-CM. All patients had three monthly sessions. Clinical assessment was done at each visit, with a final assessment after 3 months. Skin biopsies were obtained for histological and quantitative molecular analysis after treatment. Results No significant difference in clinical improvement of acne scars was observed between the FCL/SC-CM and FCL only sides (p = .63), while better and faster improvement was detected on FCL/PRP side compared to FCL/SC-CM side (p = .006). There was no significant difference in downtime or adverse effects between the treated sides in either group. Dermal collagen was increased and procollagen type I gene was upregulated in both FCL/PRP and FCL/SC-CM sides compared to FCL only sides (p = .001 and p = .041, respectively). Conclusions Topical SC-CM could potentially enhance the efficacy of FCL. However, PRP seems to be a better alternative.

Accelerated wound healing with a dexpanthenol-containing ointment after fractional ablative CO2 laser resurfacing of photo-damaged skin in a randomized prospective clinical trial

Background: Laser therapy with an ablative CO2 laser is a prominent treatment option for photo-damaged skin. The healing process and therefore the success of a laser can be supported by an appropriate postoperative treatment of the laser-treated skin.Objective: The effect of a dexpanthenol-containing ointment with petroleum jelly on wound healing after fractional ablative CO2 laser therapy of photo-damaged skin.Methods: A total of 38 patients with photo-damaged skin received fractional ablative CO2 laser treatment. Occlusive wound care was conducted for a period of 7 days. The complete wound area was divided into two sections: one that was treated with a dexpanthenol-containing ointment and a section that was treated with petroleum jelly. This study had three primary outcome measures: (1) Overview images as well as dermatoscopic images of the laser treated skin were taken immediately after laser treatment and on days 1, 2, 5 and 14 (study visits). Dermatoscopic images were analysed to determine changes of the diameter of the individual lesions between the study visits. (2) Wound-healing rate was visually assessed, based on the measure of re-epithelialization. (3) Cosmetic results were evaluated during study visits by patients and physicians applying a visual analogue scale (VAS).Results: Measuring the diameter of laser-generated lesions revealed a significantly faster cure of the lesions in wound sections that were treated with the dexpanthenol-containing ointment on days 1 and 2, in comparison to the lesions that were treated with petroleum jelly. Concordantly, visual evaluation of the wounds revealed significantly better cosmetic results and re-epithelialization on days 1, 2 and 5 after laser treatment in wound sites that were treated with the dexpanthenol-containing ointment. All patients exhibited a completed wound healing on day 14 after laser treatment.Conclusion: In this comparative study, post-operative treatment of laser-treated skin with a dexpanthenol-containing ointment led to a significantly faster wound closure in comparison to petroleum jelly, especially during the early phase of wound healing. Moreover, assessment of the cosmetic result exhibited beneficial effects of the dexpanthenol-containing ointment in the post-operative wound care after laser treatment. These results emphasize that the use of a dexpanthenol-containing ointment in the post-operative phase following CO2 laser therapy could be a promising alternative to the routinely used treatment with petroleum jelly.

Persistent Pixel Stamping Marks: a novel complication of fractional CO2 laser in scar treatment.

Fractional CO2 laser rejuvenation of scars offers a high safety profile. Laser marks usually disappear clinically within 1week. The authors observed occasional persistence of the laser marks on the scar surface. The purpose of this study is to report the incidence and to describe the clinical, dermoscopic, and histological features of a novel observed complication of fractional CO2 laser scar rejuvenation "Persistent Pixel Stamping Marks (PPSM)".One hundred seventy-one cases were consecutively recruited from patients assigned for fractional CO2 laser scar rejuvenation. Patients who developed the phenomenon 1month post laser session were recorded and subjected to clinical photography, dermoscopy, and optical coherence tomography (OCT) as well as a 4-mm punch biopsy from pixelated scars. The evolution of PPSM was followed up for 6months. PPSM developed in 16 patients (9.4%), 15 of which were post burn hypertrophic scars. PPSM was significantly related to darker skin type, darker scar color, and longer scar duration. Histopathological findings included characteristic holes in stratum corneum and superficial dermis, thick collagen bundles perpendicular to the skin surface with loss of elastic tissue, focal interface changes, and triangular focus of fibroblastic proliferation. The marks disappeared in 5 and lasted in 11 patients. Their longevity was significantly related to longer dwell times and lower densities. PPSM represent miniature scarring at the sites of the microscopic thermal zones or a sign of their delayed healing. They tend to follow fractional CO2 laser resurfacing of hyperpigmented, long-standing burn scars. Longer dwell times and lower densities make them last longer.

Fractional Carbon Dioxide Laser Resurfacing in Combination With Potent Topical Corticosteroids for Hypertrophic Burn Scars in the Pediatric Age Group: An Open Label Study.

Lasers and potent topical corticosteroids are used as therapeutic options in hypertrophic burn scars. To assess the therapeutic effect of fractional CO2 laser resurfacing in combination with potent topical corticosteroids on hypertrophic burn scars in pediatric age group. Ten children (5-12 years) with postburn hypertrophic scars were treated with 3 to 5 sessions of fractional CO2 laser resurfacing at 1-month intervals, and triamcinolone suspension was applied immediately after each laser session. Patients were also instructed to apply clobetasol propionate gel for 1 week after each laser session. Response to treatment was assessed using Vancouver Scar Scale (VSS) and Physician Global Assessment (PGA). Tolerability for the procedure and adverse effects were also assessed. Laser sessions were well tolerated under the effect of topical or local anesthesia. At the time of final assessment, there was mean reduction of 4.2 (range: 2.8-7) in VSS. Reduction of VSS by ≥4 points was observed in 8 of 10 cases, whereas PGA revealed excellent response in 6 of 10 cases. No significant adverse effects were reported by any patient. Fractional CO2 laser resurfacing in combination with potent topical steroids leads to significant therapeutic benefits in children with postburn hypertrophic scars.

The Efficacy of Combined Plasma Gel and Fractional CO2 Laser in Treatment of Atrophic Acne Scars

Atrophic post acne scars have a profound psychosocial impact on patients of all ages. The dermatologists usually face the dilemma of choosing the most effective or choosing the safest modality of treatment. The fractional CO2 laser (FCL) resurfacing is the gold standard for treating atrophic scars but is associated with prolonged recovery and many side effects. To address these limitations, newer combined therapies have emerged. The current work aimed to evaluate the safety and efficacy of FCL combined with topical application of plasma gel in the treatment of atrophic acne scars.Twenty patients with facial atrophic post acne scars were enrolled in this study. All of them completed the study. All patients underwent 4 treatment sessions at 4 – weeks intervals. The evaluation was applied by the investigator at the baseline, and one month after final session. Then, the percentage of improvement was calculated. Patients were with Fitzpatrick skin types II-V. They were 8 males and 12 females. According to the qualitative global scarring grading system (GSGS), patients with grade 4 acne scars comprised 50% of the study population, followed by 10% with grade 2 and 40% with grade 3. GSGS scores were decreased from 3.10 ± 0.99 to 2.00 ± 0.47 after 1 month from the last treatment session with P- value <0.001. Reported side effects were mild and transient.The combination of plasma gel and FCL resurfacing was noticeably outstanding in their efficacy and safety.

The efficacy of fractional CO2 laser resurfacing in the treatment of facial acne scars

Background: Acne is a common condition with prevalence as high as 80% among adolescents and often it causes atrophic scars. Laser resurfacing is an effective treatment for acne scars. However, post-treatment adverse effects are often induced. Fractional laser photothermolysis has been designed to create microscopic thermal wounds to achieve skin rejuvenation without significant side effects. Objectives: The aim of this study is to assess the efficacy and safety level of fractional CO2 laser in atrophic acne scars treatment. Materials and Methods: Forty patients between 18 and 40 years of both sexes with atrophic acne scars seen in the Department of Dermatology at Najran University Hospital in Najran, Saudi Arabia, were treated with 4–6 sessions of fractional CO2 laser resurfacing. The result was evaluated objectively at each follow-up visit and 3 months after the last laser session using a quartile grading scale. Patient improvements were classified as excellent when the improvement was >50% in scar outcome and appearance of skin, good if 25–50% response, and poor when the response

Continuous Wave Fractional CO2 Laser for the Treatment of Upper Eyelid Dermatochalasis and Periorbital Rejuvenation.

Fractional continuous wave CO2 laser resurfacing is used to improve photodamage, wrinkles, and acne scarring by surface ablation and by using heat to activate natural collagen production and dermal remodeling. In this study, the author examined the efficacy and safety of nonincisional continuous wave fractional CO2 laser blepharoplasty in the upper lid. Standard lid measurements including marginal reflex distance, palpebral fissure, and upper lid crease were performed preoperatively and at 6 months by the surgeon. All patients underwent full facial MIXTO continuous wave CO2 laser treatment (MIXTO Slim Evolution 2; MIXTOLasering USA, San Ramon, CA), including resurfacing on the upper eyelid from lashes to brow. We evaluated results at 6 months after laser treatment and found that on average, after MIXTO continuous wave laser treatment, marginal reflex distance of the upper lid increased from baseline from 0.7 to 2.2 mm, palpebral fissures increased from 5.6 to 7.4 mm, the upper lid crease was unchanged at 5.7 mm as was the upper lid excursion at 14.7 mm compared with those before treatment. Patients reported postoperative erythema, edema, crusting, and oozing that resolved within 14 days. These data demonstrate the safety and efficacy of noninvasive continuous wave fractional CO2 laser in the treatment of mild and moderate upper eyelid dermatochalasis.

Single Session Treatment of Rolling Acne Scars Using Tumescent Anesthesia, 20% Trichloracetic Acid Extensive Subcision, and Fractional CO2 Laser

Successful treatment of acne scars is challenging. Many modalities have been used with marginal success. The authors describe a combination of a superficial chemical peel, subcision, and fractional carbon dioxide (CO2) laser resurfacing in a single-treatment session as a novel treatment approach for rolling acne scars. A total of 114 patients (75 women and 39 men) with predominantly rolling acne scars were treated with a 20% trichloracetic acid chemical peel, subcision with a novel dissecting instrument, and the CO2 laser under tumescent anesthesia. This was a retrospective, uncontrolled, unblinded study. The mean improvement after a single treatment was 2.9 on a scale of 1 to 4 with few complications. Ninety percent of the patients were satisfied with their final result and desired no additional treatment. The combination of a trichloracetic acid 20% chemical peel, subcision, and fractional CO2 laser resurfacing combined with tumescent anesthesia is both safe and effective in the treatment of rolling acne scars.

Application of regenerative medicine in treatment of acne scars

Aim: The aim of this study is to evaluate the efficacy of the protocol of nanofat and platelet-rich plasma (PRP) infiltration and fractional CO2 laser resurfacing for face atrophic scars by acne and to analyse patient’s satisfaction with the original questionnaire.

Evaluation of efficacy and safety of a focal fractional laser for the treatment of atrophic acne scars

Objective To evaluate the efficacy and safety of focal fractional laser treatment (FFLT) for atrophic acne scars. Methods A randomized, self-controlled study was performed. A total of 20 patients with atrophic facial acne scars were enrolled into this study. Treatments were randomly administered in a split-face manner. Half of each subject's face received FFLT (FFLT side) , and the other half underwent full-face fractional CO2 laser resurfacing (control side) , for one session. All the patients were followed up for 3 months after the treatment. Evaluation was based on the ECCA grading scale (echelle d'evaluation clinique des cicatrices d'acne) and patient satisfaction score. A VISIA skin detector was used to take photographs and evaluate skin texture. Moreover, physical parameters of the skin, including erythema index, melanin index and transepidermal water loss (TEWL) , were measured. Adverse effects were recorded and evaluated. Statistical analysis was carried out by paired t test, Wilcoxon paired rank test, Fisher's exact test and repeated-measure analysis of variance. Results The ECCA score decreased from 51.24 ± 17.61 at the baseline to 34.46 ± 14.99 at 3 months after the treatment at the FFLT side (t= 7.886, P 0.05). Compared with those before the treatment, skin texture scores decreased in both sides (both P 0.05) from 2 weeks to 3 months after the treatment (all P> 0.05). Conclusion FFLT can improve therapeutic outcomes in atrophic acne scars with reduced adverse reactions. Key words: Cicatrix; Acneiform eruptions; Lasers, gas; Treatment outcome; Drug toxicity

Combination Laser Resurfacing with Facial Plastic Surgery is Superior to Lasers Alone

Introduction: This study was designed to demonstrate through validated objective wrinkle scales that the combining of facial plastic surgery with fractionated CO2 lasers in the perioperative setting is superior to CO2 laser only in the treatment of rhytidosis. Materials and Methods: Data were gathered and reviewed from 2 patient groups who were treated with either combined facial plastic surgery with fractionated CO2 lasers or laser-only therapy. Surgeries were performed by the senior author (J.E.B.) at a level 1 trauma center from July 2009 through May 2014. Preoperative and postoperative photographs were gathered for all patients and distributed in random order to a facial plastic surgeon and a dermatologist who objectively rated them. Both raters were blinded to patient data and treatment information. The study included 32 patients (30 females and 2 males). Nineteen patients received adjunctive fractionated CO2 laser resurfacing in the setting of facial plastic surgery; the second group consisting of 13 patients was treated with fractionated CO2 laser only. Surgeries performed included blepharoplasty, deep plane rhytidectomy, forehead rhytidectomy, submental liposuction, and rhinoplasty. Raters used validated scales to objectively assess the 2 patient groups. These included the Glogau, Fitzpatrick, and Modified Fitzpatrick scales. Numerical values were assigned to before and after pictures of patients in the frontal and profile views. Results: Patients treated with the combination of laser plus facial plastic surgery showed a greater decrease in wrinkles than patients treated with laser-only therapy (estimate = −0.78, P = .07) when evaluated with the Glogau scale. In addition, younger patients and patients with darker pigmentation showed a greater reduction in wrinkles compared with their counterparts (estimates negative, P values &lt;.001). Discussion: A combined technique using facial plastic surgery in conjunction with fractional CO2 laser resurfacing is superior in treating rhytidosis in comparison to fractional CO2 laser-only treatment. This technique can be used safely in a wide range of patients and is convenient and cost-effective.

Efficacy of Punch Elevation Combined with Fractional Carbon Dioxide Laser Resurfacing in Facial Atrophic Acne Scarring: A Randomized Split-face Clinical Study.

Background:A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO2) laser resurfacing combined with punch elevation with fractional CO2 laser resurfacing alone in the treatment of atrophic acne scars.Materials and Methods:Forty-two Iranian subjects (age range 18–55) with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO2 laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO2 laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment.Results:The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56). Their evaluation found that fractional CO2 laser treatment combined with punch elevation had greater efficacy than that with fractional CO2 laser treatment alone, assessed 4 months after treatment (P = 0.02). Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO2 laser treatment was significant on both treatment sides (P < 0.05).Conclusion:Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring.

Periorbital Post-Inflammatory Hyperpigmentation after Fractionated CO&amp;lt;sub&amp;gt;2&amp;lt;/sub&amp;gt; Laser Resurfacing in Asians

Background: Most data on laser resurfacing have come from studies of people with Fitzpatrick skin types 1 - 3; however, the world’s population is comprised mostly of Fitzpatrick skin types 4 - 6, which are more susceptible to post-inflammatory hyperpigmentation (PIH). Objective: For the purpose of expanding the expertise of plastic surgeons treating patients with darker skin types, this study examined the incidence of PIH in Asians who underwent laser resurfacing, including a histologic arm on fractional ablative resurfacing. Methods & Materials: The clinical study included six subjects of Vietnamese origin who underwent single-depth fractionated CO2 laser resurfacing. The histologic study involved a seventh subject. The MiXto SX® laser with a new scanning handpiece was used, along with magnifying loupes to assess ablative depth after each of three laser passes performed. Photographs were taken at various postoperative intervals. Results: All six clinical subjects showed cosmetic improvement in skin texture and tone with no post-inflammatory hyperpigmentation. In the histologic study, H&E stained sections revealed uniform diathermy. Conclusion: It is possible to significantly reduce PIH in darker skinned subjects through use of a new scanning handpiece and a technique using loupes to assess the depth of ablative resurfacing. The histologic study confirms these findings.