What it means for a patient
- CO2 laser resurfacing reduced wrinkles around the mouth and eyes in this study.
- Shallow lines were removed. Deeper wrinkles improved.
- The laser also tightened loose skin, which the authors attribute to heat shrinking collagen.
- Side effects were temporary redness and darkening of the skin after inflammation. There was one raised scar.
- Limits: the abstract gives the number of treated areas but not the number of patients, and follow-up was 1 to 12 months.
Why this paper matters
It reported wrinkle reduction and skin tightening with high-energy pulsed CO2 laser resurfacing, using a set treatment protocol and a blinded 9-point score.
Overview
Demand for treatment of sun-damaged skin led to the use of high-energy, short-pulsed carbon dioxide (CO2) lasers. The authors treated wrinkles around the mouth and around the eyes and measured the improvement with a 9-point score. Four blinded reviewers scored photographs taken before and after treatment, and patients were observed for 1 to 12 months for healing and side effects.
Findings
- Areas treated: around the mouth (n = 73) and around the eyes (n = 38).
- Laser settings: 10,600 nm, 3-mm collimated beam, pulse under 1 millisecond, 450 mJ per pulse, 2 to 5 W.
- Multiple passes were made, and the skin was cleaned and wiped with saline between passes.
- A 9-point clinical scale scored wrinkling and photodamage; 4 blinded reviewers scored the photos.
- Mild, moderate and severe photoaging responded equally well.
- Average wrinkle score reduction: 2.25 around the eyes and 2.34 around the mouth.
- The most superficial wrinkles and photodamage were eliminated; more severe wrinkles improved.
- An unexpected finding was tightening of loose and folded skin.
- Side effects: temporary redness, postinflammatory hyperpigmentation, and 1 hypertrophic scar.
- The authors state heat-induced collagen shrinkage appears to contribute to the tightening.
Terms
- Photoaging: skin aging caused by sun exposure.
- CO2 laser resurfacing: removal of thin outer layers of skin with a carbon dioxide laser so new skin forms.
- Perioral: around the mouth.
- Periorbital: around the eyes.
- Pulsed laser: a laser that fires in very short bursts to limit heat damage.
- Erythema: redness of the skin.
- Postinflammatory hyperpigmentation: darkening of the skin after inflammation or injury.
- Hypertrophic scar: a raised scar that stays within the edges of the wound.
- Collagen: the protein that gives skin its strength.
- Débridement: removal of dead or damaged tissue.