alexa Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury.


Journal of Cosmetology & Trichology

Author(s): Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR

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Abstract BACKGROUND AND OBJECTIVES: We introduce and clinically examine a new concept of skin treatment called fractional photothermolysis (FP), achieved by applying an array of microscopic treatment zones (MTZ) of thermal injury to the skin. STUDY DESIGN/MATERIALS AND METHODS: Two prototype devices emitting at 1.5 microm wavelength provided a pattern of micro-exposures with variable MTZ density. Effects of different MTZ densities were tested on the forearms of 15 subjects. Clinical effects and histology were assessed up to 3 months after exposure. Treatment of photoaged skin on the periorbital area in an additional 30 subjects receiving four treatments over a period of 2-3 weeks was also tested. Tissue shrinkage and clinical effects were assessed up to 3 months after treatment. RESULTS: Pattern densities with spacing of 250 microm or more were well tolerated. Typical MTZ had a diameter of 100 microm and penetrated 300 microm into the skin. Reepithelialization was complete within 1 day. Clinical effects were assessed over a 3-month period. Histology at 3 months revealed enhanced undulating rete ridges and increased mucin deposition within the superficial dermis. Periorbital treatments were well tolerated with minimal erythema and edema. Linear shrinkage of 2.1\% was measured 3 months after the last treatment. The wrinkle score improved 18\% (P < 0.001) 3 months after the last treatment. CONCLUSIONS: FP is a new concept for skin restoration treatment. Safety and efficacy were demonstrated with a prototype device. Further clinical studies are necessary to refine the optimum parameters and to explore further dermatological applications. Copyright 2004 Wiley-Liss, Inc. This article was published in Lasers Surg Med and referenced in Journal of Cosmetology & Trichology

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