What it means for a patient
- Wrinkles around the eyes responded best; frown lines and the deepest wrinkles responded least.
- Expect redness for about 2 months and possible temporary darkening of the skin, which occurred in 30% of patients.
- No scarring occurred in this series.
- Follow-up was 24 weeks. The authors state that evidence for long-lasting results was preliminary.
Why this paper matters
It reported results by facial area and side effects in a large group treated with a high-energy pulsed CO2 laser. The authors conclude it is safe and effective for facial wrinkles in an outpatient setting.
Overview
Older wrinkle treatments were limited by scarring and pigment changes in delicate facial skin. The authors treated 259 patients with a high-energy pulsed CO2 laser. Two blinded assessors rated results at 1, 4, 8, 12 and 24 weeks.
Findings
- 259 patients with facial wrinkles: 104 around the mouth, 83 around the eyes, 53 between the brows, 17 on the forehead.
- Blinded evaluation by two assessors at 1, 4, 8, 12 and 24 weeks.
- Average improvement across all areas: 90%.
- Best response around the eyes: average 93% improvement.
- Lowest response (86.8%): the most severe wrinkles and those caused by strong muscle movement, such as frown lines between the brows.
- No scarring.
- Redness lasting 1 to 3 months (mean 2.2 months) was typical.
- Temporary postinflammatory hyperpigmentation, averaging 3 months, in 30% of patients, not limited to darker skin.
- Treatment was outpatient without general anesthesia.
Terms
- Rhytides: wrinkles.
- CO2 laser resurfacing: a laser treatment that removes thin layers of skin so new skin grows.
- High-energy pulsed laser: a laser that delivers short, strong bursts to limit heat damage to nearby skin.
- Perioral: around the mouth.
- Periorbital: around the eyes.
- Glabellar: the area between the eyebrows.
- Erythema: redness of the skin.
- Postinflammatory hyperpigmentation: darkening of the skin after injury or inflammation.