What it means for a patient
- Scar improvement was the same with or without the gel.
- The gel shortened scabbing and redness after the laser.
- The gel side showed less skin darkening in the first 2 months after treatment.
- Patients felt the two sides differently for burning, dryness and scabbing, and the authors report better comfort on the gel side.
- Limits: 27 patients completed the study, with 60 days of follow-up.
Why this paper matters
It tested rhGM-CSF gel as wound care after fractional thulium laser treatment of atrophic acne scars, using a split-face, evaluator-blinded design.
Overview
Fractional lasers treat depressed (atrophic) acne scars, but there is no accepted standard for wound care after laser resurfacing. GM-CSF, a growth factor, has helped healing in other acute wounds. The authors applied a recombinant human GM-CSF gel to one side of the face for 7 days after laser treatment and left the other side untreated.
Findings
- 30 patients enrolled and treated with a 1927-nm fractional thulium fiber laser; 27 completed the study.
- Each patient's face was split: rhGM-CSF gel for 7 days on one side, no intervention on the other, assigned at random.
- Measures: photos, melanin index, erythema index, hydration, transepidermal water loss and lesion improvement at days 0, 3, 7, 14, 30 and 60.
- The gel side had significantly shorter scabbing and shorter skin redness.
- The gel side had a milder erythema index 1 week after laser.
- The melanin index fell more on the gel side at the first and second months after laser.
- Patients reported significant differences between sides in burning, dryness and scabbing.
- Both sides improved in acne scars from baseline, with no difference between sides.
- The authors conclude the gel sped wound healing, improved comfort after laser and reduced post-laser pigmentation.
- The journal assigned Level of Evidence I.
Terms
- Atrophic acne scar: a depressed scar left by acne.
- Fractional thulium fiber laser: a laser at a 1927-nm wavelength that treats tiny columns of the upper skin.
- GM-CSF (granulocyte-macrophage colony-stimulating factor): a natural growth factor that supports wound healing.
- rhGM-CSF: GM-CSF made in the laboratory in the human form (recombinant human).
- Split-face trial: a study that treats each side of the face differently in the same patient.
- Evaluator-blinded: the people rating results did not know which side had which treatment.
- Melanin index: a measurement of skin pigment.
- Erythema index: a measurement of skin redness.
- Transepidermal water loss: the amount of water that escapes through the skin; a measure of skin barrier health.