Chan Nicola P Y, Ho Stephanie G Y, Yeung Chi K, Shek Samantha Y N, Chan Henry H
Division of Dermatology, Department of Medicine, University of Hong Kong, Hong Kong SAR, China.
Lasers Surg Med. 2010 Dec;42(10):710-5. doi: 10.1002/lsm.20976.
Non-ablative fractional resurfacing (NA FR) has been shown to be effective for photorejuvenation and acne scarring. Previous studies indicated that density, more than pulse energy, was associated with post-inflammatory hyperpigmentation (PIH) in Asians. The objective of this retrospective study was to assess the efficacy and complications of eight passes of NA FR ('full-NA FR') with the 1,550 nm erbium-doped fibre fractional laser (Fraxel SR laser system, Solta Medical, Hayward, CA) versus four passes ('mini-NA FR') with comparable pulse energy and treatment level as 'full-NA FR', but double the number of treatment sessions in Asian acne scar patients.
Forty-seven Asian atrophic facial acne scar patients who received full-face full-NA FR or mini-NA FR treatments between December 2005 and February 2009 were included. All photographic images captured with the Canfield Visia CR system at baseline and follow-ups were assessed for clinical efficacy and complications by an independent, non-treating and blinded physician.
The total treatment densities for full-NA FR and mini-NA FR were 442.5 and 210.5 MTZ/cm(2), respectively. For full-NA FR, the PIH risk was 18.2% with cross-polarized images compared to 6.0% for mini-NA FR. This difference was statistically significant (P < 0.001). Improvement in skin texture, acne scarring, enlarged pores and overall pigmentation irregularity all reached statistical significance at last follow-up compared to baseline. There was no statistically significant difference in clinical efficacy between three full-NA FR and six mini-NA FR treatments.
NA FR was effective and safe in Asians. By reducing the number of passes and the total treatment density, the risk of PIH could be reduced. Meanwhile, clinical efficacy could be maintained by increasing the total number of treatment sessions.
非剥脱性分次激光皮肤再生术(NA FR)已被证明对皮肤年轻化和痤疮瘢痕治疗有效。既往研究表明,在亚洲人群中,与脉冲能量相比,密度与炎症后色素沉着(PIH)的发生更为相关。本回顾性研究的目的是评估使用1550nm掺铒光纤分次激光(飞梭SR激光系统,Solta Medical公司,美国加利福尼亚州海沃德市)进行8次照射的NA FR(“全剂量NA FR”)与4次照射(“小剂量NA FR”)治疗亚洲痤疮瘢痕患者的疗效及并发症,其中“小剂量NA FR”的脉冲能量和治疗水平与“全剂量NA FR”相当,但治疗次数翻倍。
纳入2005年12月至2009年2月期间接受全脸全剂量NA FR或小剂量NA FR治疗的47例亚洲萎缩性面部痤疮瘢痕患者。由一名独立的、未参与治疗且不知情的医生使用Canfield Visia CR系统在基线和随访时采集的所有照片图像,评估临床疗效和并发症。
全剂量NA FR和小剂量NA FR的总治疗密度分别为442.5和210.5 MTZ/cm²。对于全剂量NA FR,交叉偏振图像显示PIH风险为18.2%,而小剂量NA FR为6.0%。这种差异具有统计学意义(P < 0.001)。与基线相比,在最后一次随访时,皮肤质地、痤疮瘢痕、毛孔粗大和整体色素沉着不均的改善均达到统计学意义。三次全剂量NA FR治疗和六次小剂量NA FR治疗之间的临床疗效无统计学显著差异。
NA FR在亚洲人中有效且安全。通过减少照射次数和总治疗密度,可以降低PIH的风险。同时,通过增加治疗总次数可以维持临床疗效。