Wat Heidi, Wu Douglas C, Chan Henry Hin Lee
Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada, T6G 2G3.
Goldman, Butterwick, Groff, Fabi, and Wu Cosmetic Laser Dermatology, San Diego, California, 92121.
Lasers Surg Med. 2017 Jan;49(1):45-59. doi: 10.1002/lsm.22579. Epub 2016 Sep 8.
BACKGROUND AND OBJECTIVE: Fractionated photothermolysis (FP) has revolutionized modern laser technology. By creating selective columns of microthermal damage, fractionated devices allows for greater treatment depths to be achieved without the prolonged downtime and risk of complications seen in traditional fully ablative laser resurfacing. Fractional resurfacing is a proven method to treat a variety of cutaneous conditions. In the Caucasian patient, a wide range of devices and treatment settings can be utilized safely and effectively. However, ethnic skin requires special consideration due to its unique pigmentary characteristics and clinical presentations. In this review article, we detail the current indications and strategies to optimize results and mitigate complications when utilizing fractional resurfacing for the Asian patient. METHODS: A review of the MEDLINE English literature was conducted on fractionated laser devices studied in the Asian population. Articles included describe non-ablative devices including fractionated erbium glass, thulium fiber, diode, and radiofrequency devices; and ablative devices including fractionated carbon dioxide (CO ) laser, erbium yttrium aluminum garnet and yttrium scandium gallium garnet (YSGG) laser. These data were integrated with the expert opinion of the authors. CONCLUSION: Taking into account the unique characteristics and cosmetic concerns of the Asian population, fractional resurfacing can be considered a safe and effective option for the treatment of atrophic and hypertrophic scarring, and photorejuvenation in ethnic skin types. Select cases of melasma may be treated with fractionated non-ablative devices, but utilized with caution. The predominant complication associated with fractional resurfacing for these conditions is post-inflammatory hyperpigmentation (PIH) and rebound worsening of melasma. A greater number of treatments at lower density settings and wider treatment intervals typically produce the lowest risks of PIH without compromising treatment efficacy. Lasers Surg. Med. 49:45-59, 2017. © 2016 Wiley Periodicals, Inc.
背景与目的：分次光热解（FP）彻底改变了现代激光技术。通过创建选择性的微热损伤柱，分次光热解设备能够实现更大的治疗深度，同时避免了传统完全剥脱性激光换肤术所带来的长时间停机和并发症风险。分次换肤是一种治疗多种皮肤疾病的成熟方法。在白种人患者中，可以安全有效地使用多种设备和治疗参数。然而，由于亚洲人种皮肤独特的色素沉着特征和临床表现，在治疗时需要特别考虑。在这篇综述文章中，我们详细阐述了在为亚洲患者进行分次换肤时，当前的适应症、优化治疗效果及减少并发症的策略。 方法：对MEDLINE英文文献中关于在亚洲人群中研究的分次激光设备进行了综述。所纳入的文章描述了非剥脱性设备，包括分次铒玻璃激光、掺铥光纤激光、二极管激光和射频设备；以及剥脱性设备，包括分次二氧化碳（CO₂）激光、铒钇铝石榴石激光和钇钪镓石榴石（YSGG）激光。这些数据与作者的专家意见相结合。 结论：考虑到亚洲人群的独特特征和美容需求，分次换肤可被视为治疗萎缩性和增生性瘢痕以及改善亚洲人种皮肤光老化的一种安全有效的选择。部分黄褐斑病例可用非剥脱性分次激光设备治疗，但需谨慎使用。这些情况下，与分次换肤相关的主要并发症是炎症后色素沉着（PIH）和黄褐斑的反弹加重。在较低密度设置下进行更多次治疗以及延长治疗间隔通常能在不影响治疗效果的情况下使PIH风险降至最低。《激光外科与医学》49:45 - 59, 2017。© 2016威利期刊公司
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