A Chinese experience of fractional Ultrapulsed CO2 laser for skin rejuvenation

Abstract

Background and objectives: The ablative fractional CO₂ laser has been successfully used in treating photoaged skin in the Caucasian population. However, its application in Asian skin has not been widely reported. The purpose of this study is to observe the efficacy and safety of the protocol ‘ActiveFX’ for photodamaged facial skin in Chinese patients. Methods: A non-sequential fractional ultrapulsed CO₂ laser with specific settings is used in addition to a new computer pattern generator (CPG). Twenty patients received a single-session, single-pass, ablative fractional treatment on a split face. The patients were evaluated at baseline, and 1 and 3 months (M1, M3) after the treatment using a quartile grading scale. They were also asked to assess their overall satisfaction using a 4-point scale. The improvement of the coarse wrinkles was also quantitatively analyzed with a 3D in vivo imaging system. Results: At M1 and M3, the blinded investigator rated global improvement as 2.8 ± 0.95 and 3.00 ± 0.73, which was consistent with the patients' assessment (2.55 ± 0.83 at M1 and 3.15 ± 0.88 at M3). The roughness analysis (Rz) demonstrated a significant decrease in periorbital wrinkles (p < 0.0001). Minimal and reversible adverse side effects and rapid healing were noted. Conclusions: Non-sequential fractional ultrapulsed CO₂ laser resurfacing (ActiveFX) is considered an excellent treatment modality for photodamaged Chinese facial skin.     

Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma

Background: Picosecond laser is a novel modality for pigmented skin disorders with extremely short pulse duration. Little is known about the effects of the picosecond laser in melasma. Objective: This study aimed to investigate the efficacy of fractional picosecond 1,064?nm laser in melasma treatment. Study design: A prospective, randomized, assessor-blinded, intra-individual split face comparative study. Methods: Female subjects with melasma were enrolled and received fractional picosecond 1,064?nm laser plus 4% hydroquinone cream on one randomly assigned side of the face; the results were compared to the use of hydroquinone cream only on the contralateral side. The modified melasma area severity index (mMASI) score, melanin index by Mexameter MX18®, participant satisfaction score by quartile rating scale, and the quality of life by the dermatology life quality index (DLQI) were evaluated over 12 weeks. Results: Thirty female subjects completed the protocol. The mean (± standard deviation, SD) mMASI score at the 12-week visit was significantly reduced in the picosecond laser-treated areas compared to controls (3.52 ± 1.4 and 4.18 ± 2.03 respectively; p = 0.035). No differences were observed in the mean Mexameter melanin index, participant satisfaction score, and DLQI score. The observed adverse effects included transient mild erythema and mild skin desquamation. Conclusion: The addition of fractional picosecond 1,064?nm laser to 4% hydroquinone was effective and significantly better than 4% hydroquinone alone for the treatment of melasma.     

Comparative study of ablative fractional photothermolysis versus topical retinoid cream in the treatment of idiopathic guttate hypomelanosis

Background: Despite various treatments attempts, no prospective studies have compared the different therapeutic modalities for treatment of idiopathic guttate hypomelanosis (IGH). This study aimed to compare the efficacy of CO₂ fractional laser (CO?FL), Er:YAG fractional laser (EYFL), and 0.025% topical tretinoin for treating IGH. Materials and Methods: A total of 122 lesions were analyzed from 18 patients (mean age, 70.00 ± 20.00 years). Treatment outcome evaluations included the visual analog scale (VAS) to assess lesion severity, investigator’s global assessment (IGA) to assess the extent of improvement, and patient’s satisfaction score (PSS). Results: Among the 122 lesions, 42, 40, and 40 were assigned to the CO?FL, EYFL, and topical tretinoin treatment groups, respectively. The VAS score was significantly improved after the second treatment. CO?FL and EYFL therapy had superior treatment efficacy compared to topical tretinoin (p < 0.01 in VAS, IGA, and PSS). There was no significant difference between the two types of fractional lasers. Conclusions: Ablative fractional laser (AFL) was an effective treatment with a relatively short treatment time without serious adverse events. We recommended AFL to treat IGH as an active treatment strategy.     

The clinical effectiveness and cost-effectiveness of fractional CO2 laser in acne scars and skin rejuvenation: A meta-analysis and economic evaluation

Introduction: Fractional CO₂ has many indications in medicine including in treatment of acne scars and rejuvenation. The aim of this study was to evaluate the safety, efficacy, and cost-effectiveness of Fractional CO₂ Laser in comparison with other methods of rejuvenation and acne scar treatment. Materials and Methods: Several databases including Medline, OVID, EMBASE, CINHAL, SCOPUS, Web of science, CRD, and Cochrane were searched. After conducting the search and evaluation of selected publications, critical appraisal was done and eligible studies were accepted for inclusion in the systematic review. Results and Discussion: From 2667 identified publications two of the trials were eligible. The effectiveness and complications of Fractional CO₂ laser were comparable with Er:YAG but Fractional CO₂ laser was 14.7% (p = 0.01) more effective than Q-Switched ND:YAG laser. Cost affectivity of this method was the same as other alternative lasers. In conclusion Fractional CO₂ laser is an effective and safe method for curing of several kinds of skin diseases. Nevertheless there was not sufficient evidence to support its advantage. This device has equal or lower price in comparison to competent technologies except for the non- fractional ablative CO₂ laser that has the same or lower price and comparable effects.     

A fractional 2940 nm short-pulsed,erbium-doped yttrium aluminium garnet laser is effective and minimally invasive for the treatment of photodamaged skin in Asians

Abstract

Background: Although ablative fractional laser for the facial photodamaged skin was effective and safe, there have been only limited reports regarding the efficacy and safety of fractional Er:YAG laser treatments for photodamaged facial skin in Asians. Objective: Our objective was to assess the efficacy and safety of the Er:YAG laser (2940 nm) using the ‘‘ablative’’ fractional resurfacing mode to treat photodamaged facial skin. Methods: A total of 29 Korean patients were treated for photodamaged facial skin using a fractional Er:YAG laser. The number of treatments was mean 2.3 sessions at two-week intervals. Independent investigators assessed the efficacy using standardized photographs. The patients’ satisfaction rate was also evaluated. Results: For dyspigmentation, 62.5% of the treated patients showed improvement greater than 26%. Regarding wrinkles, 50% of the treated patients showed improvement greater than 26%. All patients showed various degrees of improvement in skin laxity. Assessing the overall features, 62.5% of the study subjects showed improvement greater than 26%, and most of them (91.7%) reported that their subjective satisfaction rate was above ‘slight satisfaction’. Downtime accounted for approximately one week in most patients. Conclusions: A fractional Er:YAG laser can deliver an effective and minimally invasive treatment for photodamaged facial skin in Asians.     

Correction of nasolabial folds wrinkle using intraoral non-ablative Er:YAG laser

Background: The accentuated nasolabial folds (NLFs) is the most pronounced sign of aging. Non-ablative erbium:yttrium aluminum garnet laser (ER:YAG), Smooth mode was used for the treatment of mucosal tissue. It was reported that it is effective in facial rejuvenation.

Aim: To assess the safety and the effectiveness of intraoral ER:YAG Smooth mode laser in the treatment of NLFs wrinkle. Materials and methods: A total of 20 patients with different grades of NLFs wrinkle treated with 2940 nm Er:YAG laser intraorally. Six sessions were done every 2 weeks. The efficacy was assessed by two blinded dermatologists. Photographs were taken at the baseline, end of treatment and 6 months after the final session to document visible changes in NLFs wrinkle. The assessment was based on Modified Fitzpatrick Wrinkle Scale (MFWS) and by comparing the photographs. Patient’s self-assessment and patient’s satisfaction were used for assessment of final results and any side effects associated to treatment were observed. Results: There was significant reduction of the NLFs wrinkle. The MFWS was significantly improved 6 months after treatment compared to before treatment (p < 0.001). At the end of the follow-up period, there was improvement in overall appearance of the wrinkles. Patient’s self -assessment and satisfaction demonstrated better cosmetic outcomes. Conclusion: Intraoral Er:YAG laser is safe, painless, and effective treatment option for NLFs wrinkle.     

The lamellar peel: A sequential nonablative and ablative laser treatment for facial skin rejuvenation

Objectives. Ablative and nonablative laser treatments have established themselves independently in the rejuvenation of aging skin. This study was designed to determine the effects of sequential nonablative and ablative laser treatments on facial skin.

Materials and methods. Twelve patients, ages 32–56 years, with skin phototypes I‐IV, received three treatments spaced six weeks apart. Each treatment consisted of one pass with 1319‐nm Nd:YAG laser at 16 J/cm², 50 ms pulse duration. This was immediately followed by one pass of 2940‐nm Er:YAG laser at 5 J/cm². Photographs and biopsies were taken prior to the first treatment and following the third treatment.

Results. Clinical improvements in facial skin tone and texture, acne scarring and dyschromia were noted in all patients. Histologic changes included a more compact epidermal granular layer and lamellar collagen formation with decreased solar elastosis in the dermis. Compared to controls, treated skin had a thicker, more homogeneous papillary dermis.

Conclusion. The sequential use of nonablative and superficial ablative laser treatments clinically and histologically improved photodamaged and chronologically aged skin. This occurred with minimal recovery and little morbidity, demonstrating this laser application to be a safe and effective method for facial rejuvenation.     

A randomized,single-blind,study evaluating a 755-nm picosecond pulsed Alexandrite laser vs. a non-ablative 1927-nm fractionated thulium laser for the treatment of facial photopigmentation and aging

Background: Laser toning is one of the most popular strategies to treat facial photopigmentation and aging. Several laser modalities, including fractional non-ablative, Q-switched (QS) lasers and new generation picosecond lasers have been used for this indication. However, there is paucity of head to head comparisons of older generation of lasers with new ones.

Objective: To compare a 755 nm picosecond pulsed alexandrite laser with a non-ablative 1927 nm fractionated thulium laser for the treatment of facial photopigmentation and aging through a randomized, single-blind study.

Materials and methods: 20 subjects (skin types I–IV) were randomized to receive either four 755-nm picosecond alexandrite laser treatments, spaced 3 weeks apart, or two dual wavelength thulium fiber fractionated 1550/1927 nm laser treatments, spaced 6 weeks apart. Follow-up assessment visits occurred 4 and 12 weeks after the last study treatment.

Results: At the 4- and 12-week follow-up, both groups showed significant improvement of photoaging, pigmentation, skin quality according to the investigator and subjects assessments. When comparing the two groups, subjects in 755 nm group had statistically significant greater improvement in investigator assessments of photoaging/skin quality and subject satisfaction than those in the 1927 nm group.

Conclusion: Both the non-ablative 1927 and 755 nm picosecond laser can improve facial photopigmentation, but the latter can yield superior results with less pain and side effects according to patient and investigator assessments.     

Clinical evaluation and in-vivo analysis of the performance of a fractional infrared 1550 nm laser system for skin rejuvenation

Background: This study was done to demonstrate the safety and efficacy of a novel fractional 1550 nm laser device with a rolling mechanism (FRAX1550 Ellipse Medical, Horsholm, Denmark).

Objectives: To evaluated the effectiveness of the 1550 nm device for improvement in wrinkles, pigmentation, and texture on a six point (?1 to 4) global improvement scale.

Methods: Five female subjects between the ages of 44 and 71 years, with visible wrinkles and/or dyspigmentation were enrolled in the study. Two full face treatments were performed four weeks apart Follow-up visits at 1 and 3 months posttreatment were scheduled for photographic assessments. Assessment of improvement were performed by the investigators and two blinded evaluators through use of a six-point scale.

Results: All subjects demonstrated improvement in all monitored parameters. The mean improvement scores were: wrinkles 1.6, skin texture 1.8, and pigmentation 1.7. All score improvements were statistically significant. Biopsy was performed on one patient immediately post-treatment and showed 800 μ penetration depth at a treatment level of 88 mJ and 400 μ at 44 mJ.

Conclusions: The new rolling fractional 1550 nm laser device from this study offers improvement of aging facial skin with short downtime and minimal side effects.     

Treatment of acne scarring with fractional CO2 laser

Abstract

Background: Fractional ablative CO₂ laser therapy is based on the theory of fractional photothermolysis. It can be effective in treating acne scars in a less invasive fashion than conventional ablative CO₂ laser therapy. Objective: In this clinical study, the safety and efficacy of a novel CO₂ fractional ablative laser was investigated for the treatment of facial atrophic acne scarring in Chinese individuals. Materials and methods: A total of 31 patients (11 females, 20 males, Fitzpatrick skin phototypes III–IV) with facial acne scarring received three sequential fractional treatments over a 6-month period. Outcome measurements included blinded evaluations of before and after photographs by two physicians at 3 and 12 months after the final treatment. Global improvement was noted as well as any untoward events. Results: At the 12 months follow-up time period, 12.9% of the patients showed excellent improvement in their acne scars, while 38.71% noted good to fair results. The clinical response at the 12-month follow-up visit tended to be better than at the 3-month follow-up visit, but was not statistically significant. Four patients experienced post-treatment and transient PIH but three patients were noted to have prolonged erythema. There was no evidence hypopigmentation or worsening of the scarring in any of the study patients. Conclusion: This high-energy pulsed and cool-scanned fractional ablative CO₂ laser system is safe and effective for facial atrophic acne scarring. Improvement in scarring was noted in the majority of patients with minimal discomfort and minimal downtime. Continued improvement over time is also an important clinical finding.     

Treatment of atrophic facial acne scars with fractional Er:Yag laser

Background: Acne scars are often a permanent disfiguring sequel of acne vulgaris. Although many treatment modalities are available, they are often non satisfactory for all patients. Objective: To determine the effectiveness and safety of fractional 1540 nm erbium_glass laser treatment of facial acne scars in Iraqi patients. Patients and methods: Twenty one patients were enrolled in this prospective clinical study. Three sessions of the 1540 nm erbium glass laser were applied at 2-week intervals. The patients were assessed at 1, 3, and 6 months after the last session. The effect of treatment was assessed by objective (Sharquie scoring system for grading acne scarring and visual analog scale) and subjective (patient satisfaction) methods. Results: Two patients were defaulted. Eleven patients (57.9%) showed improvement from moderate to mild grade, and no grade changes were detected in eight patients (42.1%). The mean score of the visual analog scale prior to treatment was 8.61 ± 0.86 and decreased to 6.15 ± 1.28 (P = 0.037). Ten patients were satisfied to varying degrees. No significant side effects were noted. Conclusion: Non-ablative fractional 1540 nm erbium glass laser is an effective and safe method to treat acne scars and represent good alternative for patients who cannot use the ablative methods because of its longer downtime.     

A novel fractional micro-plasma radio-frequency technology for the treatment of facial scars and rhytids: A pilot study

Abstract

Introduction: Fractional ablative and non-ablative lasers have gained popularity in the treatment of acne scars and rhytids due to their efficacy and improved tolerability. Plasma and radio frequency (RF) have also emerged as methods for ablative or non-ablative energy delivery. We report preliminary experience with a novel fractional micro-plasma RF device for the treatment of facial acne scars and rhytids. Methods: Sixteen patients with facial acne scars or rhytids were treated at 4-week intervals. Treatment parameters were titrated to an immediate end point of moderate erythema. The clinical end point for cessation of treatment was the attainment of satisfactory clinical results. Results were monitored photographically up to 3 months after treatment. Results: Acne scars showed marked improvement after two to four treatments. Facial rhytids demonstrated reduced depth after two treatments and marked improvement after four treatments. Treatment was well tolerated by all participants, with transient erythema and short downtime. These results provide initial evidence for the safety and effectiveness of fractional micro-plasma RF as a low-downtime and well-tolerated modality for the treatment of acne scars and facial rhytids.     

A new multi-modal fractional ablative CO2 laser for wrinkle reduction and skin resurfacing

Abstract

Background: The concept of fractional delivery modality of the energy with both ablative and non-ablative devices is now well known and accepted as an effective method to attain significant aesthetic improvements on facial aging skin. A new, multi-modal, fractional, ablative CO₂ laser that can create, using same scanner/handpiece, deep columns in addition to superficial ablation has been recently proposed and therefore investigated. Method: Twenty-four patients were enrolled in this evaluation. Each of them received one multi-modal, fractional ablative treatment. Patients were clinically and photographically evaluated at baseline and 6 months after the procedure. The degree of photoaging and the efficacy of treatment were evaluated using a VAS five-point scale of some skin features. A 3D images comparison was furthermore performed to objectify the improvements. Results: For all of the analysed skin features of photodamage a significant, statistical improvement was obtained. The data collected with the 3D system demonstrated an average improvement of 42% of the wrinkles and an average improvement of the melanin variation of 40.1%. Conclusions: The multi-modal approach with a single handpiece allows obtaining good outcomes with a very low incidence of adverse effects and a short downtime.     

The comparison of skin rejuvenation effects of vitamin A,fractional laser,and their combination on rat

Background: Because of long-term exposure of skin, skin aging is an unavoidable natural law with age. Traditional Vitamin A and novel ablative fractional laser technique both have the effects of skin rejuvenation, and studies have demonstrated both of them have apparent clinical efficacy and histology-improving effects on photo-aging skin. Materials and methods: 45 female healthy Wistar rats were selected and the depilation areas of every rat were divided into four regions: control region(Region A), Vitamin A acid region(Region B), combination treatment region(Region C), and fractional laser region(Region D). 0.025% Vitamin A acid cream was applied to Region B and C every day for 3 weeks; Region C and D were irradiated once with 10600nm CO₂ fractional laser on the first day of the trail. The skin tissue was dissected and placed into liquid nitrogen according to the design. The real-time quantitative PCR and western blotting methods were taken to detect the expression changes of miR-29a, Akt, TGF-β, and mRNA of type III pre-collagen. Results: It can be seen from the results of the real-time quantitative PCR that the mRNA expression levels of type III pre-collagen, Akt, and TGF-β in the treatment regions are up-regulated and the expression levels of miR-29a mRNA are down-regulated compared to the Region A. The hybridization tests showed that changes of the expression of type III pre-collagen, Akt gene, miR-29a gene, and TGF-β gene across the experiment regions are all significantly different in the third week, and the expression levels of them all achieve the highest value in the third week, the expression level of miR-29a gene achieves the lowest value in the third week, which are consistent with the results of real-time quantitative PCR. Conclusion: It is indicated that the combination region of Vitamin A acid and fractional laser may lead to low expression of miR-29a, thus the inhibition of downstream Akt activation is loss, Akt activation is enhanced, enhancement of the expression of TGF-β is induced, leading to proliferation of fibroblasts, and promotion of the collagen proteins’ synthesis in skin. Therefore miR-29a/Akt/TGF-β signal pathway may participate in the skin rejuvenation mechanism of action Vitamin A acid and fractional laser. This may provide a new treatment approach for skin rejuvenation.     

Evaluation of changes in skin biophysical parameters and appearance after pneumatic injections of non-cross-linked hyaluronic acid in the face

Background: Pneumatic injections of non-cross-linked hyaluronic acid are effective in skin rejuvenation, however, the associated biophysical parameters and appearance have not been evaluated. Objectives: To determine the changes in skin biophysical parameters after facial pneumatic injections of non-cross-linked hyaluronic acid. Patients and methods: Twenty-eight healthy female volunteers received pneumatic injections of non-cross-linked hyaluronic acid into the face for consecutive 5 weeks. Skin biophysical parameter assessment and clinical evaluation were performed using the CK Multi-Probe Adapter and Visia system. Five of the volunteers also underwent retroauricular skin biopsy before and after the last treatment. The skin tissues were all stained with Masson-trichrome, Verhoeff-van Gieson stain, and hematoxylin-eosin to evaluate the changes in collagen, elastic fibers, and the epidermis, before and after the last treatment. Results: Transepidermal water loss was significantly lower in week 4 (18.46 ± 4.70 g/h/m²) than at the baseline (22.03 ± 7.15 g/h/m², p < 0.05). Skin texture was better in week 4 (599.29 ± 354.32) than at the baseline (668.43 ± 342.55, p < 0.05). Skin pores also improved significantly at week 4 (934.07 ± 458.78) compared to the baseline (1024.57 ± 415.31, p < 0.05). Skin wrinkles were improved at the 3-month follow-up (29.29 ± 11.11) compared to the baseline (35.83 ± 16.05, p < 0.05). Conclusion: Pneumatic injections of non-cross-linked hyaluronic acid improved skin TEWL, texture, pores, and wrinkles.     

Efficacy of platelet‐rich plasma plus fractional carbon dioxide laser in treating posttraumatic scars

The management of posttraumatic scars is a great challenge. Autologous platelet‐rich plasma (APRP) and fractional carbon dioxide (CO2) laser can be applied as innovative treatments for posttraumatic scars. The aim of this study was to evaluate the efficacy, safety and complications of fractional CO2 laser exposure plus APRP injection in treating traumatic scars versus CO2 laser applied as a monotherapy. Twenty participants were treated 3 times at a 4‐week interval with a follow‐up visit. The scars were divided into an upper and lower half‐treated with fractional CO2 laser exposure plus APRP injection and CO2 laser alone, respectively. The scar was evaluated using the Vancouver scar scale (VSS), along with patient satisfaction. Twenty patients completed the 3 month treatment course. The mean VSS score improved significantly from 7.0 ± 3.97 to 3.25 ± 1.55 and 6.75 ± 1.77 to 3.85 ± 1.59 with fractional CO2 laser exposure plus APRP injection and CO2 laser exposure, respectively (p < .001). However, CO2 laser plus APRP was significantly superior to CO2 laser alone (p = .001), with fewer adverse effects. Our study shows that combined treatment with CO2 laser exposure plus APRP injection is safer and more effective for posttraumatic scar management than CO2 laser exposure alone.     

Effect of mesotherapy with nanochip in the treatment of facial rejuvenation

ABSTRACT

Objective: To observe the clinical effect of mesotherapy with nanochip for facial rejuvenation.

Methods: 24 volunteers with aging skin were treated with a polycomponent formulation – NCTF® BOOST 135 HA for 5 times (once weekly for 3 times and successively biweekly for 2 times). Photographs were taken by VISIA at baseline, and after 1, 4, 10 weeks, while global scores for photoaging (GSP), improvement scores, volunteers’ satisfaction, parameters describing the properties of the skin, and adverse effects were assessed during each follow-up period.

Results: Total 20 volunteers completed the treatment. Evaluation of the whole face showed that GSP, skin texture (ophthalmic wrinkles, dermal thickness, and intensity of collagen fibers of skin), and skin brightness (Lab value) significantly improved at 4 weeks compared to baseline, while the difference between 4 and 10 weeks was not statistically significant. No evident improvement was observed in pigmented spots, telangiectasia, skin tightening, trans-epidermal water loss (TEWL), and skin hydration. Slight erythema, pain was the most common side effect.

Conclusion: Mesotherapy with nanochip can improve skin texture and brightness, but the effect is not permanent. It is recommended that the treatment be used as a complementary method for patients with facial rejuvenation needs.     

Silicone gel enhances the efficacy of Er:YAG laser treatment for atrophic acne scars: A randomized,split-face,evaluator-blinded,placebo-controlled,comparative trial

Background: The effect of topical silicone gel has been studied to prevent scars from burn, postoperative wound and to treat hypertrophic scars. No previous studies have been done to evaluate the efficacy of topical silicone gel on atrophic acne scars. Material and methods: Nineteen patients were treated with three sessions of ablative Er:YAG laser with 1-month intervals. Following each laser treatment, the randomlyassigned silicone gel or placebo was applied in split-face manner. Objective assessments, which included roughness, smoothness, hydration, transepidermal water loss were measured at baseline and prior to each treatment. Subjective assessments by dermatologists and subjects were done at baseline and 1 month after last laser treatment. Results: The laser treatments were well tolerated and resulted in clinical improvements. Topical silicone gel treatment resulted in significantly less roughness at weeks 4 and 12 compared with placebo (p < 0.05). Conclusion: Adding topical silicone gel to ablative Er:YAG laser treatment may provide additional benefits in improving acne scars.     

Polydeoxyribonucleotide improves wound healing of fractional laser resurfacing in rat model

Background: Polydeoxyribonucleotide (PDRN) is an active compound that can promote wound healing. PDRN stimulates wound healing by enhancing angiogenesis and increasing fibroblast growth rates. Laser skin resurfacing is a popular cosmetic procedure for skin rejuvenation. Despite excellent improvement of photo-damaged skin and acne scarring, it is accompanied with drawbacks, such as prolonged erythema and crusting. Objective: This study was designed to assess the effect of PDRN on wounds induced by fractional laser resurfacing. Methods: Twelve male rats aged 8 weeks were randomly assigned to the PDRN treatment group and the control group. Wounds were induced using a fractional ablative CO₂ laser. The treatment group received daily injections of PDRN and the control group received injections of the vehicle. Wound healing assessed by clinical features and histopathologic findings. Results: The process of wound healing was faster in the treatment group than in the control group. In the histopathological examination, the granulation tissue thickness score of the treatment group was significantly higher than that of the control group. Results of immunohistochemical staining showed a marked increase of VEGF-positive cells and PECAM-1/CD31-positive microvessels in the treatment group. Conclusion: PDRN may be a beneficial option to promote wound healing after laser treatment.     

Combined treatment for skin laxity of the aging face with monopolar radiofrequency and intense focused ultrasound in Korean subjects

Background: Although various minimal invasive approaches are available for aging skin laxity, they alone may not lead to notably satisfactory results. Objective: To evaluate the effectiveness and safety of combination regimen with monopolar radiofrequency (MRF) and intense-focused ultrasound (IFUS) in facial lifting and tightening. Methods: Twenty-two Korean participants with aging face received a sequential single session of MRF and IFUS treatment. Objective and subjective assessments for improvement were performed at the 20-week post-treatment. Safety profiles were also recorded, and skin biopsies were taken at baseline and follow-up visit. Results: Based on the objective assessment for the overall facial skin tightening and laxity, 19 patients (90%) demonstrated “moderate” or better improvements (more than 25%) compared with baseline. Specifically, improvements of skin laxity and sagging, and droopy jaw line were more noticeable compared with that of superficial skin texture (P < 0.05). Subjective satisfactions were generally consistent with objective findings, and no serious adverse effect was observed. Histologic evaluation showed increased dermal collagen fibers throughout the dermis after treatments (P < 0.05). Conclusion: Combination treatment of MRF and IFUS has cumulative benefits for skin lifting and tightening with satisfactory safety profiles in Asian subjects.