ABSTRACT
BACKGROUND: Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application. OBJECTIVE: To determine the effectiveness and safety of fractional photothermolysis treatment of various atrophic scars in Korean patients. METHODS: Fifty-nine patients with atrophic scars (caused by acne, trauma, herpes zoster, and burns) were treated with fractional photothermolysis using either Fraxel™ SR 750 or Fraxel™ SR 1500 instruments. Each patient underwent one to three treatment sessions 3-4 weeks apart. The assessment of treatment response was conducted by three dermatologists, who independently evaluated a series of photographs using a quartile grading scale. Skin biopsies were taken before treatment and 4 weeks after the final treatment, and were examined for procollagen-1, matrix metalloproteinase-1 (MMP-1), and elastin by immunofluorescence staining. RESULTS: Four weeks after the final treatment, the mean overall improvement in objective grade was 2.0 when the Fraxel SR 750 was employed and 2.9 when the Fraxel SR 1500 was used. Confocal microscopy revealed an increase in procollagen-1 in dermis, with no difference or a slight increase in the levels of elastin and MMP-1. Side effects were minimal. CONCLUSIONS: After short-term follow-up, fractional photothermolysis appeared to be a safe and effective option for atrophic scar treatment of Asian skin.
Subject(s)
Cicatrix/therapy , Laser Therapy/instrumentation , Laser Therapy/methods , Adolescent , Adult , Asian People , Child , Child, Preschool , Cicatrix/metabolism , Collagen Type I/metabolism , Elastin/metabolism , Female , Fluorescent Antibody Technique , Humans , Male , Matrix Metalloproteinase 1/metabolism , Microscopy, Confocal , Middle Aged , Skin/metabolism , Skin/pathology , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Striae distensae are dermal scars characterized by flattening and atrophy of the epidermis. Although many treatment modalities have been tried with variable results, most have been disappointing. OBJECTIVE: To determine whether striae distensae might respond to fractional photothermolysis. METHODS: Twenty-two women with striae distensae were treated with two sessions each of fractional photothermolysis at a pulse energy of 30 mJ, a density level of 6, and eight passes at intervals of 4 weeks. Response to treatment was assessed by comparing pre- and post-treatment clinical photography and skin biopsy samples. RESULTS: Six of the 22 patients (27%) showed good to excellent clinical improvement from baseline, whereas the other 16 (63%) showed various degrees of improvement. Most of the lesions with excellent results were white in color and of long duration. Skin biopsy revealed that average epidermal thickness and dermal thickness were greater than at baseline. The immunoreactivity of procollagen type 1 increased after treatment. There were no significant side effects except erythema and mild pigmentation. CONCLUSION: Fractional photothermolysis may be effective in treating striae distensae, without significant side effects. Treatment outcomes were better in patients with white rather than red striae.
