Limits...
Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months.

Borges J, Cuzzi T, Mandarim-de-Lacerda CA, Manela-Azulay M - An Bras Dermatol (2014 Mar-Apr)

Bottom Line: The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization.The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm.It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.

View Article: PubMed Central - PubMed

Affiliation: Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Background: Fractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective.

Objectives: To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium.

Methods: Eighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out.

Results: All patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001).

Conclusions: Three 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.

Show MeSH

Related in: MedlinePlus

New arrangement of elastic fibers. Considerable changes in the elastic fibersbefore tretament, represented by the absence of fibers in the dermo-epidermicaljunction and diminushed density of the fibers in the papillary and highreticular dermis (A). Superficial reconstruction of the oxitalanicand elauninic fibers, and papillary and high reticular dermis with more densefibers were seen after three months of treatment (B); orcein 10xand 40x. The same patterns were observed for both tretments.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4008055&req=5

f06: New arrangement of elastic fibers. Considerable changes in the elastic fibersbefore tretament, represented by the absence of fibers in the dermo-epidermicaljunction and diminushed density of the fibers in the papillary and highreticular dermis (A). Superficial reconstruction of the oxitalanicand elauninic fibers, and papillary and high reticular dermis with more densefibers were seen after three months of treatment (B); orcein 10xand 40x. The same patterns were observed for both tretments.

Mentions: Having examined the elastic fibers before treatment, alterations were observed in all18 cases studied. Elastic fibers (oxytalanic and elauninic) in the superficial systemwere diminished, fragmented or absent. Elastic fibers from the high papillary andreticular dermis were thick and fragmented. After the treatment, there was a clearpresence of thin elastic fibers on the superficial topography of the superficialelastic system for both treatments. These structures followed a pattern very similarto that of normal oxitalanic and elauninic fibers. The oxytalanic-smile fibers werestraight and isolated on the dermal-epidermal junction, perpendicular to its axis,while elauninic-simile fibers were close and parallel to the dermal-epidermaljunction. The elastic fibers from the high papillary and reticular dermis aftertreatment were more numerous and denser in all the cases analyzed (Figure 6).


Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months.

Borges J, Cuzzi T, Mandarim-de-Lacerda CA, Manela-Azulay M - An Bras Dermatol (2014 Mar-Apr)

New arrangement of elastic fibers. Considerable changes in the elastic fibersbefore tretament, represented by the absence of fibers in the dermo-epidermicaljunction and diminushed density of the fibers in the papillary and highreticular dermis (A). Superficial reconstruction of the oxitalanicand elauninic fibers, and papillary and high reticular dermis with more densefibers were seen after three months of treatment (B); orcein 10xand 40x. The same patterns were observed for both tretments.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4008055&req=5

f06: New arrangement of elastic fibers. Considerable changes in the elastic fibersbefore tretament, represented by the absence of fibers in the dermo-epidermicaljunction and diminushed density of the fibers in the papillary and highreticular dermis (A). Superficial reconstruction of the oxitalanicand elauninic fibers, and papillary and high reticular dermis with more densefibers were seen after three months of treatment (B); orcein 10xand 40x. The same patterns were observed for both tretments.
Mentions: Having examined the elastic fibers before treatment, alterations were observed in all18 cases studied. Elastic fibers (oxytalanic and elauninic) in the superficial systemwere diminished, fragmented or absent. Elastic fibers from the high papillary andreticular dermis were thick and fragmented. After the treatment, there was a clearpresence of thin elastic fibers on the superficial topography of the superficialelastic system for both treatments. These structures followed a pattern very similarto that of normal oxitalanic and elauninic fibers. The oxytalanic-smile fibers werestraight and isolated on the dermal-epidermal junction, perpendicular to its axis,while elauninic-simile fibers were close and parallel to the dermal-epidermaljunction. The elastic fibers from the high papillary and reticular dermis aftertreatment were more numerous and denser in all the cases analyzed (Figure 6).

Bottom Line: The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization.The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm.It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.

View Article: PubMed Central - PubMed

Affiliation: Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Background: Fractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective.

Objectives: To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium.

Methods: Eighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out.

Results: All patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001).

Conclusions: Three 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.

Show MeSH
Related in: MedlinePlus