| DERMATOLOGY | PEER-REVIEW
Patrick Treacy presents the results of a study which compared two different fractional CO2
lasers to treat the signs of photoageing in 23 patients F
RACTIONALISED LASER SKIN RESURFACING HAS become an important component of facial rejuvenation surgery as patients continue to seek less invasive procedures with a low downtime and low risk1
. This
change in attitude has also been prompted by a realisation of both doctors and patients that the much hyped
Until this time, CO2
for the treatment of rhytides and photodamaged facial skin5–10 practitioners went further and stated that the ultrapulsed CO2
non-ablative methods are not comparable with ablative skin resurfacing and were often subject to extravagant claims with regard to efficacy2–4 laser resurfacing was considered the ‘gold standard’ . Many
. laser was
the most effective modality for repairing photodamaged skin as a result of years of exposure to harmful ultraviolet light11, 12
. This photoageing
effect is demonstrated clinically as a gradual deterioration of cutaneous structure and function. It manifests in the epidermis and upper papillary dermis by giving skin a roughened surface texture, as well as laxity, telangiectasia, wrinkles and varying degrees of pigmentation13, 14 laser skin resurfacing was largely
. Although, ultrapulsed CO2
considered the best option for treatment of this type of photoaged facial skin, it also had certain post-procedural problems15–17
. These included
prolonged postoperative recovery, pigmentary changes and a high incidence of adverse side-effects, including acne flares and herpes simplex virus (HSV) infection18–20
made many patients reluctant to accept this method of treatment23, 24
. Fractional CO2 lasers
While non-sequential fractionalised 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 clear1
. Many patients also complained of
oedema, burning, and erythema that sometimes lasted for a number of months21, 22
. The delayed healing, implied risks and long downtime also
. These lasers also reduce the
consistently high levels of non-responders often seen with quite expensive non-ablative treatments that require many painful sessions25
. The obvious benefits of
these lasers have led to many new fractional resurfacing devices entering the market at the same time26
. CO2
The adoption of the newer fractionalised lasers by many physicians also
appears to have reduced the morbidity associated with this type of treatment1
.
Damage to the epithelium is less apparent because unlike conventional ablation, some of the stratum corneum remains intact during treatment and acts as a
DR PATRICK TREACY is Medical Director of Ailesbury Clinics Ltd and Ailesbury Hair Clinics Ltd; Chairman of the Irish Association of Cosmetic Doctors and Irish Regional Representative of the British Association of Cosmetic Doctors; European Medical Advisor to Network Lipolysis and the UK’s largest cosmetic website Consulting Rooms. He practices cosmetic medicine in his clinics in Dublin, Cork, London and the Middle East
email:
ptreacy@gmail.com
KEYWORDS facial rejuvenation, photo ageing, fractional resurfacing, CO2
laser, rhytides, pigmentation
prime-journal.com | October 2013 ❚ 47
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