Saluja Sandeep S, Walker Matthew L, Summers Erika M, Tristani-Firouzi Payam, Smart David R
Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, 84132.
Lasers Surg Med. 2017 Dec;49(10):886-890. doi: 10.1002/lsm.22711. Epub 2017 Aug 29.
Based on reports of poor wound healing and scarring, it is currently recommended that patients wait 6 months after completion of oral isotretinoin therapy before the safe initiation of laser treatment. Our aim was to evaluate the safety of non-ablative fractional laser (NAFL) treatment for acne scars within 1 month after isotretinoin therapy.
STUDY DESIGN/METHODS: This was a randomized split-face controlled trial involving 10 patients with acne scars who had completed isotretinoin treatment. All patients received three treatments each spaced 4 weeks apart with an erbium-doped 1550 nm NAFL on one side of the face within 1 month after isotretinoin therapy. The untreated side acted as a control. Wound healing and adverse effects as well as acne scar improvement were evaluated by two blinded dermatologists.
All patients demonstrated normal wound healing post NAFL treatments, and neither hypertrophic scars nor keloids were observed. Acne scar improvement was satisfactory.
NAFL treatment for acne scarring appears to be well tolerated within 1 month of completing isotretinoin treatment. Dermatologists should reevaluate the current recommendation to wait 6 months after isotretinoin treatment for acne scar revision with lasers. Other larger studies are necessary to further challenge this dogma. Lasers Surg. Med. 49:886-890, 2017. © 2017 Wiley Periodicals, Inc.
基于伤口愈合不良和瘢痕形成的报道,目前建议患者在口服异维A酸治疗结束后等待6个月,再安全地开始激光治疗。我们的目的是评估异维A酸治疗后1个月内非剥脱性分次激光(NAFL)治疗痤疮瘢痕的安全性。
研究设计/方法:这是一项随机半脸对照试验,纳入10例已完成异维A酸治疗的痤疮瘢痕患者。所有患者在异维A酸治疗后1个月内,于面部一侧接受3次掺铒1550nm非剥脱性分次激光治疗,每次治疗间隔4周。未治疗的一侧作为对照。由两名盲法皮肤科医生评估伤口愈合情况、不良反应以及痤疮瘢痕改善情况。
所有患者在接受非剥脱性分次激光治疗后伤口愈合正常,未观察到增生性瘢痕或瘢痕疙瘩。痤疮瘢痕改善情况令人满意。
在完成异维A酸治疗1个月内,非剥脱性分次激光治疗痤疮瘢痕似乎耐受性良好。皮肤科医生应重新评估目前关于异维A酸治疗后等待6个月再用激光修复痤疮瘢痕的建议。需要其他更大规模的研究来进一步挑战这一教条。《激光外科与医学》49:886 - 890, 2017。©2017威利期刊公司