Abstract
Introduction:
Laser resurfacing with the 950-μs pulsed CO2 laser (UPCO2) is an effective treatment for photodamage and acne scarring. Adverse sequelae such as prolonged erythema and delayed would healing are not uncommon after resurfacing. Less adverse sequelae are seen with the use of erbium lasers alone; however, the same degree of improvement cannot be achieved as with the CO2 laser. New long-pulse erbium:YAG lasers (LP Er:Yag) have been developed to deliver increased thermal effects to tissue. It is hypothesized that, with use of these lasers, improved clinical outcomes may be achieved while still allowing for diminished erythema and improved wound healing.
Materials and Methods:
Nineteen patients were randomized to receive laser resurfacing with the UPCO2 followed by short-pulse erbium:YAG ablation on one half of the face and LP Er:YAG followed by traditional short-pulse erbium laser on the other half. Patients were evaluated clinically before resurfacing and at 1, 2, 4, 8, and 12 weeks postoperatively. Histologic samples taken at various time periods before and after resurfacing were also evaluated.
Results:
Overall clinical improvement was equal for both UPCO2 and LP Er:YAG treated sides, with an average improvement in photoaging scores of 53%. In 5 patients, greater clinical improvement in periorbital lines, perioral lines, or both was noted on the UPCO2 side, but overall average photoaging scores were equal. There was a tendency toward faster healing and less edema on the LP Er:YAG-treated side. Histologic examination of tissue taken after resurfacing revealed greater thermal damage on the UPCO2-treated side, and both sides showed evidence of new collagen formation 3 months after the procedure.
Conclusion:
The LP Er:YAG laser can achieve a similar degree of improvement as seen with short-pulse CO2 laser resurfacing, with decreased thermal tissue effects and decreased risk for adverse sequelae.
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