Wanitphakdeedecha R, Phuardchantuk R, Manuskiatti W
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Eur Acad Dermatol Venereol. 2014 Nov;28(11):1522-8. doi: 10.1111/jdv.12332. Epub 2013 Dec 10.
The most common side-effect of ablative fractional skin resurfacing in Asians is post inflammatory hyperpigmentation (PIH). Various attempts have been made to reduce the occurrence of PIH after laser treatment including sun avoidance, the use of preoperative and postoperative treatment regimens, and treatment using conservative energy settings and epidermal protection.
To determine whether the use of broad-spectrum sunscreen with anti-inflammatory agents starting on the first day after fractional CO2 laser skin resurfacing reduces the incidence of post laser PIH.
Thirty patients were treated with ablative fractional CO2 resurfacing on both sides of their faces at 10 mJ and 10% density. Each subject was randomly treated on one side of the face with petrolatum ointment four times a day for the first week after laser treatment and on the other side of the face with petrolatum ointment four times a day plus broad-spectrum sunscreen with anti-inflammatory agents in the morning starting on the first day after laser treatment. Transepidermal water loss was recorded at baseline and every day for 1 week. Melanin and erythema indexes were measured at baseline, 1-, 2-week, 1-, 2- and at 3-month post treatment.
Of the 30 patients involved in the study, 26 received the treatment and attended 1-, 2-week, 1-, 2- and 3-month post-treatment visits. Four patients were withdrawn from the study because they could not attend every follow-up visit. There was no statistically significant difference in transepidermal water loss at baseline, immediately after laser treatment, or at the D1 to D7 follow-up visits. Erythema index had no significantly statistical difference at baseline, 1-, 2- and at 3-month after laser treatment. Furthermore, there was a statistically significant difference in melanin index at 1-week post laser treatment between both sides (P = 0.001). Melanin index at the 1-week follow-up visit on the side treated with broad-spectrum sunscreen with anti-inflammatory agents starting on the first day after laser treatment was significantly less than the control side.
The use of broad-spectrum sunscreen with anti-inflammatory agents starting on the first day after ablative fractional skin resurfacing can decrease the incidence of PIH after laser treatment at 1-week postoperatively.
在亚洲人当中，非剥脱性分次皮肤磨削术最常见的副作用是炎症后色素沉着（PIH）。人们已经进行了各种尝试来减少激光治疗后PIH的发生，包括避免日晒、使用术前和术后治疗方案，以及采用保守的能量设置和表皮保护措施进行治疗。
确定在二氧化碳分次激光皮肤磨削术后第一天开始使用含抗炎剂的广谱防晒霜是否能降低激光后PIH的发生率。
30例患者面部两侧接受非剥脱性二氧化碳分次磨削术，能量为10 mJ，密度为10%。每位受试者在激光治疗后的第一周，一侧面部每天涂抹凡士林软膏4次，另一侧面部从激光治疗后的第一天开始，每天早上涂抹凡士林软膏4次，并使用含抗炎剂的广谱防晒霜。在基线期以及之后的1周内每天记录经表皮水分流失情况。在基线期、治疗后1周、2周、1个月、2个月和3个月测量黑色素和红斑指数。
参与研究的30例患者中，26例接受了治疗，并参加了治疗后1周、2周、1个月、2个月和3个月的随访。4例患者退出研究，因为他们无法参加每次随访。在基线期、激光治疗后即刻或第1至7天的随访中，经表皮水分流失没有统计学上的显著差异。激光治疗后基线期、1周、2周和3个月时，红斑指数没有显著的统计学差异。此外，激光治疗后1周时，两侧的黑色素指数存在统计学上的显著差异（P = 0.001）。在激光治疗后第一天开始使用含抗炎剂的广谱防晒霜的一侧，1周随访时的黑色素指数显著低于对照侧。
在非剥脱性分次皮肤磨削术后第一天开始使用含抗炎剂的广谱防晒霜可降低术后1周激光治疗后PIH的发生率。
