J Drugs Dermatol. 2021 Nov 1;20(11):1174-1179. doi: 10.36849/jdd.6182.
Dyspigmentation and photodamage are common concerns in patients who seek aesthetic consultation. A number of treatment modalities have been utilized to address this issue. 1927 nm thulium fiber laser is a fractionated non-ablative laser that has been shown to be safe and effective in treatment of photoaging. Topical retinoids have been used for over two decades for photoaging to promote epidermal hyperplasia and collagen synthesis and to decrease melanin production. There has been lack of data to support the combination of topical retinoids with laser treatments in the management of facial dyspigmentation and photodamage.
The primary objective of this study is to evaluate the benefits and subject satisfaction resulting from use of a 1927 nm thulium fiber laser with and without 0.05% tretinoin lotion for facial dyspigmentation and photodamage.
Both groups showed a significant change in Investigator Assessed Overall Hyperpigmentation and Investigator Assessed Overall Photodamage over time (P<0.001). No statistically significant differences were seen between groups at any time point as measured by investigator reported and subject reported efficacy scales except for Subject Global Aesthetic Improvement Scale and Subject Satisfaction at 30 days after laser treatment, at which patients who received 0.05% tretinoin lotion reported a lower level of improvement (2.8 ± 0.86 in the treatment group vs 2 ± 0.85 in the vehicle group, P=0.009) and lower patient satisfaction when compared to the vehicle group (2.87 ± 1.55 in the treatment groups vs 1.53 ± 0.64 in the vehicle group, P=0.001).
In our study, patients tolerated the combination of 1927 nm thulium fiber laser and 0.05% tretinoin lotion well. Both groups resulted in significant reduction of hyperpigmentation and photodamage. Subject satisfaction and perceived improvement were temporarily lower at 30 days only when, combining 0.05% tretinoin lotion with 1927 nm thulium fiber laser. Future studies are needed to investigate the impact on efficacy when combining laser procedures with a longer duration of use or a higher concentration of topical tretinoin. J Drugs Dermatol. 2021;20(11):1174-1179. doi:10.36849/JDD.6182.
色素沉着和光损伤是寻求美容咨询的患者常见的关注点。已经使用了多种治疗方法来解决这个问题。1927nm 铥光纤激光是一种分束非剥脱性激光,已被证明在治疗光老化方面是安全有效的。维 A 酸类药物已被用于光老化治疗超过二十年,以促进表皮增生和胶原合成,并减少黑色素生成。在面部色素沉着和光损伤的管理中,将外用维 A 酸类药物与激光治疗相结合的数据支持不足。
本研究的主要目的是评估使用 1927nm 铥光纤激光联合和不联合 0.05%维 A 酸乳膏治疗面部色素沉着和光损伤的益处和患者满意度。
两组患者的研究者评估的整体色素沉着和研究者评估的整体光损伤均随时间显著改善(P<0.001)。在任何时间点,除激光治疗后 30 天时的患者自我报告和研究者报告的疗效量表外,两组之间均无统计学差异,包括患者整体美学改善量表和患者满意度,接受 0.05%维 A 酸乳膏的患者报告的改善水平较低(治疗组为 2.8±0.86,对照组为 2±0.85,P=0.009),与对照组相比,患者满意度较低(治疗组为 2.87±1.55,对照组为 1.53±0.64,P=0.001)。
在我们的研究中,患者对 1927nm 铥光纤激光联合 0.05%维 A 酸乳膏的治疗耐受良好。两组均显著减少了色素沉着和光损伤。仅当 0.05%维 A 酸乳膏与 1927nm 铥光纤激光联合使用时,在 30 天时,患者满意度和感知改善暂时较低。需要进一步研究当将激光程序与更长时间的使用或更高浓度的外用维 A 酸类药物联合使用时对疗效的影响。J 皮肤病药物杂志。2021;20(11):1174-1179。doi:10.36849/JDD.6182.