Study Finds That Use of Adequate Treatment Parameters May Increase Safety and Enhance Results of Fractional Laser Resurfacing In Dark-Skinned Patients

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Now, a new study published in Lasers in Surgery and Medicine, the peer-reviewed journal of the American Society for Laser Medicine and Surgery (June 2007 issue), shows that adjusting the density and energy parameters during fractional laser resurfacing procedures can significantly reduce the incidence of skin discoloration in Asians.

Thanks to advances in non-invasive technology, laser skin rejuvenation is one of the most popular cosmetic procedures today. However, laser resurfacing in patients with olive or darker skin complexions has been associated with the potential risk of pigmentation problems, such as temporary skin darkening. Now, a new study published in Lasers in Surgery and Medicine, the peer-reviewed journal of the American Society for Laser Medicine and Surgery (June 2007 issue), shows that adjusting the density and energy parameters during fractional laser resurfacing procedures can significantly reduce the incidence of skin discoloration in Asians.

The article entitled “The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians,” was co-authored by Henry H.L. Chan, MD, laser authority and hon. clinical associate professor of dermatology at the University of Hong Kong and Chinese University of Hong Kong, Hong Kong, China; and Dieter Manstein, MD, laser expert and instructor in dermatology at Harvard Medical School, Boston, Mass.

According to Dr. Chan, “reducing the treatment density of the procedure – that is, decreasing the number of passes made by the laser device over the skin and removing less skin in each treatment session – may be the more important factor in reducing the risk of post-inflammatory hyperpigmentation (PIH) in treating Asian patients. Air cooling was also found to be an important safety factor, especially in small anatomical areas like the peri-oral area. Additional studies are needed to confirm these observations.”

Fractional resurfacing is a novel concept of skin rejuvenation whereby zones of micro-thermal injury are generated in the skin with the use of a 1540-nm laser. This precise technology targets only damaged skin in the treatment area, leaving the surrounding skin intact to aid in the healing process. Until this study, the risk and prevalence of hyperpigmentation using the fractional laser approach in dark-skinned patients have not been studied.

The study was carried out in two parts. One arm was a retrospective study of 37 Chinese patients who received fractional laser resurfacing for acne scarring or skin rejuvenation to correct wrinkles and pigmentation. The second arm was a prospective study using nine different density and energy levels that were applied to the forearms of 18 subjects. In both studies, pre- and post-treatment photographs were assessed by two independent clinicians to evaluate the incidence of PIH.

In the retrospective study, 37 patients who underwent a total of 119 treatment sessions were divided into two groups – the skin rejuvenation group and the acne scarring group. The skin rejuvenation group received a low energy/high density treatment, whereas the acne scarring group received a high energy/low density treatment. All of the patients had full facial treatment.

Drs. Chan and Manstein reported that the patients with acne scarring who received a high energy but low density treatment had a lower generalized PIH rate than the skin rejuvenation group.

Similarly, results of the prospective study also showed that low density sites were associated with a lower incidence of PIH. By comparison, subjects in this group who were treated at a low energy but the highest density treatment experienced the highest incidence of moderate levels of generalized PIH.

“Our findings have several clinical implications for treating dark-skinned patients, notably the importance of reducing treatment density and using a cooling device with fractional resurfacing procedures,” said Dr. Manstein. “In our current practice, rather than performing eight to 12 passes and removing 16 percent to 20 percent of the skin per treatment session, we decrease the number of passes to four to six passes and remove only 8 percent to 10 percent of the skin in an effort to achieve increased safety and enhanced results. By reducing the density of the procedure by half and lengthening the treatment intervals, the risk of post-inflammatory hyperpigmentation in dark-skinned patients can be significantly lowered.”

The authors added that all patients, and particularly those with darker skin types, should see a qualified laser expert who has solid clinical experience and knowledge of various laser devices and skin types.

The American Society for Laser Medicine and Surgery (ASLMS) is the world’s preeminent resource for laser research, safety, education, and clinical knowledge. Founded in 1980, ASLMS promotes excellence in patient care by advancing clinical application of lasers and related technologies. For more information and physician referrals, please log on to the Society’s website: http://www.aslms.org.

Media Contact:

Nadine Tosk, 847.920.9858

Karen Sideris, 219.922.7537

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Nadine Tosk
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