PEER-REVIEW | DERMATOLOGY |
SPLIT-FACE STUDY OF TWO
RANDOMISED LASERS TO TREAT
FRACTIONALISED RESURFACING
PHOTO- AGEING
ABSTRACT
Interventions: UltraPulse® ActiveFX™ CO2 laser (Lumenis Ltd., Yokneam, Israel) or DEKA SmartXide DOT™ CO2
laser (DEKA
S.r.l., Florence, Italy). All participants received regional anaesthetic of lignocaine 2% plus adrenaline, topical anaesthetic of ANEStop® 5 mg statim and Valtrex (valacyclovir) 500mg twice daily for 8 days (i.e. herpectic prophylaxis mandatory for all patients). A post-procedural advice sheet was given to patients, and codeine with paracetemol as required.
Main outcome measures: Participants’ global assessment of improvement (five-point Dover scale) at 2, 4 and 12 weeks. Reduction of rhytides, tactile roughness, pigmentation and blood vessels were recorded along with the re-ephithelialisation rate. The level of prolonged erythema and the presence of other side-effects such as infection were also recorded.
Results: Over 7 months, 23 subjects were randomised into a split-face study to compare the effects of two different fractionalised lasers on photoageing. Histological results initially showed that both lasers had a similar depth of penetration, but a greater thermal penetration effect was noted with the
ActiveFX compared with the SmartXide, with consequential formation of increased neocollagenesis. Twenty-three patients (92%) in the ActiveFX group felt that their split face was completely better or improved compared with 21 (84%) in the SmartXide group (P<0.001). Fourteen patients (60.8%) said they preferred the SmartXide experience compared with nine patients (39.13%) in the ActiveFX group. One patient received full facial herpes. All patients received treatment to the neck.
initially appeared to produce equivalent clinical improvement of lesions and rythides, there was a marked difference noted at 3 months with the Lumenis ActiveFX showing superior new collagen formation.
Discussion: Although the two CO2
Conclusions: The Lumenis ActiveFX gives a superior aesthetic outcome of the two lasers when examined at 3 months. It appears to have a deeper dermal penetrative effect, superior neocollagenesis, and is more suitable for the removal of more difficult lesions, such as large congenital nevi. The DEKA SmartXide is an easy laser to use, but requires a separate plume extractor and re-do within a shorter period. Patients preferred the initial SmartXide effect.
While non-sequential fractionalised 46 ❚
technology is relatively new, its benefits of faster recovery time, more precise control of ablation depth, and reduced risk of post-procedural problems are already clear.
October 2013 |
prime-journal.com lasers
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