PEER-REVIEW | DERMATOLOGY |
Periorbital rhytides In Figure 4, the patient was a 53-year-old Caucasian male with bilateral periorbital rhytides. He had had a previously poor response to Isolagen fibroblast transplantation in this area. He also had a moderate level of photoageing. The right eye was treated with the ActiveFX: energy
100 mJ, rate 125 Hz, CPG 3/5/2. The left eye was treated with the SmartXide: power 30 W, DOT mode spacing 200 µm, dwell time 500 µs, with two passes under the eye.
Periorbital rhytides In Figure 5, the patient was a 39-year-old Caucasian female with moderate bilateral periorbital rhytides. She had had previous treatment with Dysport bilaterally 2 months prior to this procedure. The right eye area was treated with the ActiveFX:
energy 100 mJ, rate 125 Hz, CPG 3/5/2. The left eye area was treated with the SmartXide: power 30 W, DOT mode spacing 400 µm, dwell time 500 µs with two passes.
Discussion Although the two CO2
Figure 5 (A) Right eye ActiveFX day 1; (B) ActiveFX day 2; (C) ActiveFX day 30; (D) comparison between right and left eyes day 2; (E) comparison between right and left eyes at day 30
lasers initially appeared to produce
equivalent clinical improvement of lesions and rhytides, there was a marked difference in new collagen formation noted at 3 months. Re-epithelialisation after Omnilux 633 nm light occurred in all laser-treated areas at day 5, and this appeared to be similar for both lasers. The mean duration of re-epithelialisation was 5.7 days after resurfacing (range 4–9 days). This appeared to be in keeping with previous studies11
, and was quicker than a spacing 400 µm, dwell time 500 µs with two passes
under the eye. The ActiveFX settings for the neck were: energy 90 mJ, rate 125 Hz, CPG 3/5/1. On the third day post-treatment she developed full
facial herpes and some truncal spots and prescribed Famvir 750 mg three times per day for 7 days.
Perioral rhytides In Figure 3, the patient was a 72-year-old Caucasian female who had moderately severe facial rhytides, especially in the perioral area. She also had a moderate level of photoageing. The left side was treated with the ActiveFX: energy
125 mJ, rate 125 Hz, CPG 3/5/3. The right side was treated with the SmartXide: power 30 W, DOT mode spacing 400 µm, dwell time 1 ms, with two passes over each side. Although her rhytides were equal initially, the patient
and author felt the ActiveFX side responded best with regard to the reduction of coarse lines. Scoring for fine lines dropped from 3 to 1 for both lasers at day 30. Scoring for perioral coarse lines dropped from 4 to 2 for ActiveFX, and 4 to 3 for SmartXide at day 30.
56 ❚ October 2013 |
prime-journal.com
initially appeared to produce
two CO2
equivalent clinical improvement of lesions and
rhytides, there was a marked
difference in new collagen
formation noted at 3 months.
Although the lasers
similar study the author had performed in 2007 without the application of post-procedural phototherapy. No patient reported a crusting effect on their face after 6 days. All patients usually received only one pass with both laser devices. However, in some cases, two or more passes were performed — if deemed necessary — to allow a better overall result for the patient or cover overlap and fill in missed edges. Residual erythema remained in a small group for a
period of 14 days, but this was mostly in the herpetic group. Postoperative erythema was most intense in the areas treated by SmartXide whenever the dwell time was increased to 1 ms. This effect was also noted with the ActiveFX at the energy level above 125 mJ. Most patients said they could use camouflage make up (e.g. GloMinerals®) to cover the erythema on days 4–5. No significant gender differences in the duration of re-epithelialisation, erythema or in the histopathology changes were noted. The global score for photoageing for both devices
improved from 13.8 at baseline to 9.6 at day 30. The score for fine lines was the most significant reduction, dropping from 3.6 at baseline to 1.4 at day 30. The score for sallowness was the most difficult to interpret at day 30 as patients still had some mild erythematous effect. Scores for reduction of coarse wrinkles (3.2 at baseline to 2.2 at day 30) were also difficult to interpret in this heterogeneous age grouping, with older patients
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