A Randomized, Controlled Trial of Four Ablative Fractionated Lasers for Photoaging: A Quadrant Study

Background Fractionated technology has revolutionized laser therapy. With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients. Materials and Methods Twelve subjects were treated w...

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Veröffentlicht in:Dermatologic surgery 2012-09, Vol.38 (9), p.1477-1489
Hauptverfasser: LaTowsky, Brenda C., Abbasi, Naheed, Dover, Jeffrey S., Arndt, Kenneth A., Kaminer, Michael S., Rohrer, Thomas E., MacGregor, Jennifer L., Wesley, Naissan O., Durfee, Melissa A., Tahan, Steven R.
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container_end_page 1489
container_issue 9
container_start_page 1477
container_title Dermatologic surgery
container_volume 38
creator LaTowsky, Brenda C.
Abbasi, Naheed
Dover, Jeffrey S.
Arndt, Kenneth A.
Kaminer, Michael S.
Rohrer, Thomas E.
MacGregor, Jennifer L.
Wesley, Naissan O.
Durfee, Melissa A.
Tahan, Steven R.
description Background Fractionated technology has revolutionized laser therapy. With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients. Materials and Methods Twelve subjects were treated with fractionated ablative lasers (10,600‐nm carbon dioxide and 2790‐nm yttrium scandium gallium garnet) in this institutional review board–approved trial. Each face was divided into four quadrants, and each quadrant was randomly treated using one of four lasers. Clinical experience was used to optimize settings. Two patients submitted biopsies from each quadrant immediately after treatment. Patients and blinded investigators assessed pain during treatment and post‐treatment improvement in photoaging (measured by rhytides, lentigines, texture, and pore size) using a five‐point scale. Results All devices resulted in statistical improvement in photoaging in all patients, but no device was statistically significantly superior. No statistically significant difference was found in pain scores. All patients reported satisfaction 1 month after treatment. Three patients experienced adverse reactions. Histologically, there were no statistically significant differences between devices. Conclusions Fractionated ablative lasers reliably result in improvement in photoaging. Despite marketing claims, no statistically significant differences were found in outcomes, pain during treatment, or histologic findings. Even with experienced users, significant adverse reactions are possible.
doi_str_mv 10.1111/j.1524-4725.2012.02500.x
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With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients. Materials and Methods Twelve subjects were treated with fractionated ablative lasers (10,600‐nm carbon dioxide and 2790‐nm yttrium scandium gallium garnet) in this institutional review board–approved trial. Each face was divided into four quadrants, and each quadrant was randomly treated using one of four lasers. Clinical experience was used to optimize settings. Two patients submitted biopsies from each quadrant immediately after treatment. Patients and blinded investigators assessed pain during treatment and post‐treatment improvement in photoaging (measured by rhytides, lentigines, texture, and pore size) using a five‐point scale. Results All devices resulted in statistical improvement in photoaging in all patients, but no device was statistically significantly superior. No statistically significant difference was found in pain scores. All patients reported satisfaction 1 month after treatment. Three patients experienced adverse reactions. Histologically, there were no statistically significant differences between devices. Conclusions Fractionated ablative lasers reliably result in improvement in photoaging. Despite marketing claims, no statistically significant differences were found in outcomes, pain during treatment, or histologic findings. Even with experienced users, significant adverse reactions are possible.</description><identifier>ISSN: 1076-0512</identifier><identifier>EISSN: 1524-4725</identifier><identifier>DOI: 10.1111/j.1524-4725.2012.02500.x</identifier><identifier>PMID: 22816441</identifier><language>eng</language><publisher>Malden, MA: Wiley</publisher><subject>Adult ; Analysis of Variance ; Biological and medical sciences ; Dermatology ; Face - surgery ; Female ; Humans ; Laser Therapy - adverse effects ; Laser Therapy - instrumentation ; Lasers, Gas - adverse effects ; Lasers, Gas - therapeutic use ; Lasers, Solid-State - adverse effects ; Lasers, Solid-State - therapeutic use ; Medical sciences ; Middle Aged ; Pain - etiology ; Patient Satisfaction ; Photography ; Single-Blind Method ; Skin Aging - pathology ; Skin plastic surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Treatment Outcome</subject><ispartof>Dermatologic surgery, 2012-09, Vol.38 (9), p.1477-1489</ispartof><rights>2012 by the American Society for Dermatologic Surgery, Inc. 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With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients. Materials and Methods Twelve subjects were treated with fractionated ablative lasers (10,600‐nm carbon dioxide and 2790‐nm yttrium scandium gallium garnet) in this institutional review board–approved trial. Each face was divided into four quadrants, and each quadrant was randomly treated using one of four lasers. Clinical experience was used to optimize settings. Two patients submitted biopsies from each quadrant immediately after treatment. Patients and blinded investigators assessed pain during treatment and post‐treatment improvement in photoaging (measured by rhytides, lentigines, texture, and pore size) using a five‐point scale. Results All devices resulted in statistical improvement in photoaging in all patients, but no device was statistically significantly superior. No statistically significant difference was found in pain scores. All patients reported satisfaction 1 month after treatment. Three patients experienced adverse reactions. Histologically, there were no statistically significant differences between devices. Conclusions Fractionated ablative lasers reliably result in improvement in photoaging. Despite marketing claims, no statistically significant differences were found in outcomes, pain during treatment, or histologic findings. Even with experienced users, significant adverse reactions are possible.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Dermatology</subject><subject>Face - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Laser Therapy - adverse effects</subject><subject>Laser Therapy - instrumentation</subject><subject>Lasers, Gas - adverse effects</subject><subject>Lasers, Gas - therapeutic use</subject><subject>Lasers, Solid-State - adverse effects</subject><subject>Lasers, Solid-State - therapeutic use</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pain - etiology</subject><subject>Patient Satisfaction</subject><subject>Photography</subject><subject>Single-Blind Method</subject><subject>Skin Aging - pathology</subject><subject>Skin plastic surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LaTowsky, Brenda C.</creatorcontrib><creatorcontrib>Abbasi, Naheed</creatorcontrib><creatorcontrib>Dover, Jeffrey S.</creatorcontrib><creatorcontrib>Arndt, Kenneth A.</creatorcontrib><creatorcontrib>Kaminer, Michael S.</creatorcontrib><creatorcontrib>Rohrer, Thomas E.</creatorcontrib><creatorcontrib>MacGregor, Jennifer L.</creatorcontrib><creatorcontrib>Wesley, Naissan O.</creatorcontrib><creatorcontrib>Durfee, Melissa A.</creatorcontrib><creatorcontrib>Tahan, Steven R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Dermatologic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LaTowsky, Brenda C.</au><au>Abbasi, Naheed</au><au>Dover, Jeffrey S.</au><au>Arndt, Kenneth A.</au><au>Kaminer, Michael S.</au><au>Rohrer, Thomas E.</au><au>MacGregor, Jennifer L.</au><au>Wesley, Naissan O.</au><au>Durfee, Melissa A.</au><au>Tahan, Steven R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Randomized, Controlled Trial of Four Ablative Fractionated Lasers for Photoaging: A Quadrant Study</atitle><jtitle>Dermatologic surgery</jtitle><addtitle>Dermatol Surg</addtitle><date>2012-09</date><risdate>2012</risdate><volume>38</volume><issue>9</issue><spage>1477</spage><epage>1489</epage><pages>1477-1489</pages><issn>1076-0512</issn><eissn>1524-4725</eissn><abstract>Background Fractionated technology has revolutionized laser therapy. With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients. Materials and Methods Twelve subjects were treated with fractionated ablative lasers (10,600‐nm carbon dioxide and 2790‐nm yttrium scandium gallium garnet) in this institutional review board–approved trial. Each face was divided into four quadrants, and each quadrant was randomly treated using one of four lasers. Clinical experience was used to optimize settings. Two patients submitted biopsies from each quadrant immediately after treatment. Patients and blinded investigators assessed pain during treatment and post‐treatment improvement in photoaging (measured by rhytides, lentigines, texture, and pore size) using a five‐point scale. Results All devices resulted in statistical improvement in photoaging in all patients, but no device was statistically significantly superior. No statistically significant difference was found in pain scores. All patients reported satisfaction 1 month after treatment. Three patients experienced adverse reactions. Histologically, there were no statistically significant differences between devices. Conclusions Fractionated ablative lasers reliably result in improvement in photoaging. Despite marketing claims, no statistically significant differences were found in outcomes, pain during treatment, or histologic findings. Even with experienced users, significant adverse reactions are possible.</abstract><cop>Malden, MA</cop><pub>Wiley</pub><pmid>22816441</pmid><doi>10.1111/j.1524-4725.2012.02500.x</doi><tpages>13</tpages></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete; Journals@Ovid Complete
subjects Adult
Analysis of Variance
Biological and medical sciences
Dermatology
Face - surgery
Female
Humans
Laser Therapy - adverse effects
Laser Therapy - instrumentation
Lasers, Gas - adverse effects
Lasers, Gas - therapeutic use
Lasers, Solid-State - adverse effects
Lasers, Solid-State - therapeutic use
Medical sciences
Middle Aged
Pain - etiology
Patient Satisfaction
Photography
Single-Blind Method
Skin Aging - pathology
Skin plastic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
title A Randomized, Controlled Trial of Four Ablative Fractionated Lasers for Photoaging: A Quadrant Study
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