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Objective:To investigate the clinical effect of 5-aminolevulinic acid (ALA) photodynamic therapy (PDT) combined with CO 2 fractional laser on hypertrophic scars. Methods:From 2017 to 2019, 20 patients [17 males, 3 females, aged (24.4±4.24) years] with mandibular acne keloid in the Department of Dermatology of Air Force Medical Center, were treated with ALA-PDT combined with CO 2 fractional laser treatment, once a month, 3 times in total, and were followed up for 6 months. The efficacy, safety, and recurrence were evaluated by the Vancouver scar scale (VSS) score. Results:The effective rate was 100% after three treatments. The VSS score decreased significantly after the first treatment, and as the number of treatments increased, the VSS score further decreased. The first improvement after treatment was thickness and hardness. There was no recurrence during the 6-month follow-up. The main adverse reactions were pain, erythema and pigmentation.Conclusions:ALA-PDT combined with CO 2 fractional laser can be used as a new treatment for hypertrophic scars.
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OBJECTIVE@#To observe and compare the clinical efficacy of CO₂ fractional laser in the early control of scar post-secondary repair in patients with a cleft lip.@*METHODS@#In the treatment group, 43 patients with secondary repair of cleft lip were treated via CO₂ fractional laser. The control group covered 70 patients post-cheiloplasty. The effect in the two groups after six months was compared. The duration from the beginning of the laser treatment to surgery and patient gender were analyzed to determine if they affected the efficacy of the laser treatment for scars.@*RESULTS@#1) The curative effect in the treatment group was better than that in the control group (P<0.000 1), the total effectiveness rate was 90.7% in the treatment group. 2) No significant statistical difference in efficacy was observed between men and women (P=0.487). Moreover, no significant statistical difference in efficacy (P=0.055) was observed among patients one year after surgery, within the duration of <3 months, and within the duration of ≥3 months.@*CONCLUSIONS@#CO₂ fractional laser had a definite effect on the treatment of scar post-secondary repair in patients with a cleft lip. No significant correlation was observed between treatment effect and patient gender, and no difference was noted among patients one year after surgery. In the beginning of the laser treatment, no difference was observed between the durations of <3 months and ≥3 months after the reconstruction, Therefore, early intervention of scars a year after secondary repair of a cleft lip can achieve good results.
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Female , Humans , Male , Carbon Dioxide , Cicatrix/pathology , Cleft Lip/surgery , Lasers , Treatment OutcomeABSTRACT
Objective To study the therapeutic effect of ultra pulsed carbon dioxide fractional laser on treating hypertrophic scar after burn.Methods Forty-five patients with hypertrophic scar after burn were selected.Each laser treatment included an ultra-pulse mode and a Scaar FX mode scan irradiation,and the treatment wasconducted once a month for 4 to 6 times.In the ultra-pulse irradiation,the energy was 150～175 mJ,frequency was40 Hz,hole spacing was about 4～5 mm,and irradiation time per hole was 2～3 s,and in Scaar FX mode energy was60～150 mJ,frequency 250 Hz,and density 1％ to 3％.Before the first treatment and 6 months after the end of thetreatment,the Vancouver scar scale (VSS) was used to score the scar morphology,and the visual analog scale (VAS)was used to score the scar pain and itching.The effect of the treatment was classified as significant,effective andinvalid.In addition,adverse reactions occurred during the treatment were recorded.Results After six months of thetreatments,the VSS score,VAS pain score,and VAS pruritus score of the patients were 4.16±1.72,1.58±0.62,and1.24±0.74,respectively,while the pre-treatment values were 10.17±1.96,2.98±0.89,and 2.31±0.97,respectively.The differences were statistically significant (all P＜0.01).The treatment was effective in all patients,and the effectwas significant in 35 cases,effective in 10 cases,and no recurrence occurred within 6 months after treatment.In 3patients,blisters appeared on the scar after the first treatment,and the blister collapsed to form a wound.After thedressing change,the blisters healed after 7 to 10 days.Conclusion Ultra pulsed carbon dioxide fractional laser iseffective in treating hypertrophic scar after burn,with mild adverse reactions and no relapse,which is worthy ofclinical promotion.
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Objective To explore the effects of wound healing and histological changes by utilizing ultrapulse CO2 fractional laser for the treatment of superficial scar in dermal-epidermal junction (DEJ) in rabbit ears.Methods We adopted traditional iodophor treatment and moist exposed burn ointment treatment repairing the wound and utilizing ultra pulse CO2 fractional laser for the treatment of rabbit ears superficial scar.The superficial scars in rabbit ear were induced with ultra pulse CO2 fractional laser.In 1,2,4,8 weeks tissue samples would be taken.Using electron microscopy we observed DEJ ultrastructure and light microscopy to observe the histological changes of the dermal papilla and PAS staining for epidermis basement membrane.Results The wound healing time of moist exposed burn ointment group was shorter than that of iodophor group (P＜0.05).The number of hemidesmosomes and anchoring fibers in the moist exposed burn ointment group on the 8th week was more than the 1th week,The number of hemidesmosomes and anchoring fibers in the iodophor group on 8th week was more than 1th week (P ＜0.05).The number of hemidesmosomes and anchoring fibers in the iodophor group was less than the moist exposed burn ointment group (P＜0.05).Conclusions U1trapulse CO2 fractional laser can cause ultra structural changes in scarring dermal-epidermal junction area,wet wound healing environment promotes the reconstruction of DEJ district organization,and rebuilding the function of the scar skin has the positive significance.
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Objective To investigate the efficacy and side effects of carbon dioxide (CO2) fractional laser for the treatment of suborbital wrinkles.Methods Twenty-one female patients with suborbital wrinkles received a single treatment of CO2 fractional laser at fluences of 20-30 mJ with density of 10 ％-15 ％.Patients were photographed standardly and evaluated at baseline,one and six months after the treatment.Wrinkle improvements were graded in 5 levels:1 (no improvement or worse),2 (1％ 25％ improvement),3 (26％-50％ improvement),4 (51％-75％ improvement),and 5 (76％-100％ improvement).Patients rated the pain intensity by a visual analog scale (VAS,0 10).The side effects,such as hyperpigmentation,were observed and recorded.Results After one month follow-up,3-level improvement was observed in 7 patients (33.3％),2-level in 9 patients (42.9％);and after six months,3-level improvement was observed in 9 patients (42.9％),2-level in 8 patients (38.1％),but there was no statistically significant difference between one month and six months (P ＞0.05).The overall patient satisfactory rate was 81.0％.The average pain of VAS was 4.24± 1.73,7 patients (33.3％) had hyperpigmentation which faded within three months,and no patients had scars.Conclusions Single CO2 fractional laser treatment can improve the suborbital wrinkles in a cerrain extent with few side effects.
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Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group (40 cases) and control group (40 cases).The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0％ (36/40) and 72.5％ (29/40) for the control group,the difference was statistically significant (P＜0.05).There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.
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Objective To investigate the therapeutic efficacy and safety of carbon dioxide (CO2) fractional laser in treating periorbital syringoma.Methods Twenty-eight patients with syringoma were treated with ultrapulse CO2 fractional laser.Digital photos were taken before the treatment,1 month and 3 months after the treatment to evaluate the efficacy.The recovery process and side effects were also recorded to assess the safety.Dermatologists rated the efficacy in 0-4 points scales.The patients assessed overall satisfaction in 0-4 point scales.Results One month after the treatment,74.99 ％ of the patients had improvement rate of over 50 ％ and 67.85 ％ of the patients were satisfied or very satisfied with the overall efficacy.Three months after treatment,78.57 ％ of the patients had improvement rate of over 50 ％ and 71.42 ％ of the patients were satisfied or very satisfied with the overall efficacy.There was no statistically significant difference between 1 month and 3 months (P＞0.05).Conclusions Carbon dioxide fractional laser is an effective and safe approach to treat syringoma with minimized side effects.
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BACKGROUND: Striae distensae are atrophic dermal scars with overlying epidermal atrophy causing significant cosmetic concern. Although a variety of laser and light sources have been used for the treatment of striae distensae, to date no definite 'gold standard' treatment modality has been determined. OBJECTIVE: To assess and compare the efficacy and safety of nonablative fractional photothermolysis and ablative CO2 fractional laser resurfacing in the treatment of striae distensae. METHODS: Twenty-four ethnic South Korean patients with varying degrees of atrophic striae alba in the abdomen were enrolled in a randomized blind split study. The patients were treated with 1,550 nm fractional Er:Glass laser and ablative fractional CO2 laser resurfacing. Each half of the abdominal lesion was randomly selected and treated three times at intervals of 4-weeks using the same parameters. Digital photography was conducted and skin elasticity and the width of the widest striae in each subject were measured at the baseline and 4 weeks after the final treatment. Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs by two blinded physicians and participant satisfaction rates were evaluated. Skin biopsies were taken from three participants. All adverse effects were reported during the study. RESULTS: Although they do not statistically differ, both treatments with nonablative fractional laser and ablative CO2 fractional laser showed a significant clinical and histopathologic improvement of striae distensae over pretreatment sites. CONCLUSION: These results support the use of nonablative fractional laser and ablative CO2 fractional laser as effective and safe treatment modalities for striae distensae of Asian skin. However, neither treatment showed any greater clinical improvement than the other treatment.