An Innovative Device for Fractional CO_2 Laser Resurfacing: A Preliminary Clinical Study

摘要

Background and Objective: Use of CO_2 laser resurfacing is a powerful tool for the treatment of several skin conditions, such as fine and coarse wrinkles, scars of various origin, uneven pigmentation, and dilated pores. Some major drawbacks have progressively limited its use: the need for effective anesthesia, the downtime associated with treatment, the risk of hyperpigmentation and scarring, the need for intensive postoperative care, the long-lasting erythema, and the need to avoid sun exposure for extended periods. Fractional laser resurfacing with a 1540-nm laser can avoid some of these disadvantages, but pain and cost still serve as barriers. A new CO_2 laser system with a fractional modality added to a traditional though potentially very rapid scanner was tested as a tool for skin rejuvenation. It can perform traditional and fractional resurfacing at depths ranging from 20 to 500 mum and treating 20%, 40%, or 100% of the scanned area.Materials and Methods: A series of 24 consecutive patients (Fitzpatrick skin types II-TV) were treated with one pass of the aforementioned fractional CO_2 laser (18 faces, 2 necks, 8 hands). No anesthesia was used. The power used was between 8 and 15 W, with SX index values of 4 to 8, according to patient tolerance. SX index indicates pulse width: the shorter the pulse the higher the SX index value. Postoperative management included a thermal water-based cream and makeup provided free of charge. Digital clinical macrophotography was used to assess the results and a subjective pain and satisfaction evaluation was also done.Results: All patients showed improvement in skin texture and color after one treatment. Undesired postoperative effects were immediate erythema, and swelling that subsided within 24 hours. Fine pinpoint microcrusting occurred in all cases, but it resolved within 1 week on the face and 10 dayson the other body areas. The treatment was well tolerated. With makeup it looked like a tan. No long-term side effects were observed after 6 months of follow-up.Conclusions: The evaluated system is an effective and safe tool for skin rejuvenation by fractional laser resurfacing.