Wu Douglas C, Goldman Mitchel P
Drs. Wu and Goldman are with Cosmetic Laser Dermatology in San Diego, California.
J Clin Aesthet Dermatol. 2017 Oct;10(10):12-17. Epub 2017 Oct 1.
Fractionated, ablative lasers are usually associated with post-treatment erythema, edema, and crusting, which can last from 5 to 14 days. Conjugated linolenic acid, an omega-5 fatty acid, has significant antioxidant and anti-inflammatory properties, and has been shown to stimulate keratinocyte proliferation and epidermal regeneration. By modulating the early inflammatory milieu and directly affecting skin structure and function, conjugated linolenic acid might therefore shorten downtime following fractionated ablative laser resurfacing of the face. To evaluate the efficacy and subject satisfaction of a topical regimen containing conjugated linolenic acid derived from pomegranate seed extract in accelerating wound healing and improving skin quality following fractionated ablative laser resurfacing of the face. Thirty-four subjects were enrolled and received fractionated CO2 laser resurfacing. Subjects were randomized to use the test healing regimen (n=24) or 1% dimethicone ointment (n=10) post-procedure. The primary endpoint was the degree of erythema, edema, crusting, and exudation evaluated by a blinded clinician at post-treatment Days 1,3,7,10, 14, and 30. Secondary endpoints included a blinded evaluator assessment of the degree of wrinkling and elastosis using the Fitzpatrick-Goldman Wrinkle and Elastosis Scale; subject-assessed degree of pain, itching, tightness, oozing, and crusting; and subject overall satisfaction. Subjects who applied the topical conjugated linolenic acid healing regimen experienced significantly reduced edema on post-procedure Day 3 (=0.04), and itching on Days 1 and 3 (=0.03 and =0.04). Both regimens produced significant improvements in wrinkling and elastosis at Days 14 and 30 post-treatment, with conjugated linolenic acid outperforming placebo in improvements in wrinkling at Day 14. Both regimens were well tolerated with no statistical differences in adverse events or subject satisfaction. The topical conjugated linolenic acid formulation outperformed placebo by decreasing acute pruritus and edema, and enabling a faster positive outcome in wrinkle improvement. Additionally, topical conjugated linolenic acid does not raise any safety or tolerability issues as compared to current standard of care.
分次消融激光通常会导致治疗后出现红斑、水肿和结痂，持续时间为5至14天。共轭亚麻酸是一种ω-5脂肪酸，具有显著的抗氧化和抗炎特性，已被证明能刺激角质形成细胞增殖和表皮再生。因此，通过调节早期炎症环境并直接影响皮肤结构和功能，共轭亚麻酸可能会缩短面部分次消融激光换肤后的恢复时间。为了评估一种含有石榴籽提取物衍生的共轭亚麻酸的局部用药方案在加速面部分次消融激光换肤后的伤口愈合和改善皮肤质量方面的疗效和受试者满意度。招募了34名受试者并接受分次二氧化碳激光换肤。受试者在术后被随机分配使用试验性愈合方案（n = 24）或1%二甲基硅油软膏（n = 10）。主要终点是由一位不知情的临床医生在治疗后第1、3、7、10、14和30天评估的红斑、水肿、结痂和渗出程度。次要终点包括由一位不知情的评估者使用菲茨帕特里克 - 戈德曼皱纹和弹性量表对面部皱纹和弹性组织变性程度进行的评估；受试者自我评估的疼痛、瘙痒、紧绷、渗液和结痂程度；以及受试者的总体满意度。应用局部共轭亚麻酸愈合方案的受试者在术后第3天水肿明显减轻（P = 0.04），在第1天和第3天瘙痒明显减轻（P = 0.03和P = 0.04）。两种方案在治疗后第14天和第30天均使皱纹和弹性组织变性有显著改善，共轭亚麻酸在第14天改善皱纹方面优于安慰剂。两种方案耐受性良好，不良事件或受试者满意度方面无统计学差异。局部共轭亚麻酸制剂通过减少急性瘙痒和水肿，并在改善皱纹方面取得更快的积极效果，优于安慰剂。此外，与当前的护理标准相比，局部共轭亚麻酸不会引发任何安全性或耐受性问题。
