NATIONAL HARBOR, MD. Fractional laser resurfacing produced long-term results in a small study of patients treated for acne scarring or photodamage.
Fractional deep dermal ablation is a newer modality that produces clinical improvement in photodamaged skin and acne scarring but with reduced downtime and a lower risk of complications, compared with traditional carbon dioxide resurfacing. However, the long-term outcomes of patients treated with fractional resurfacing have not been previously reported, Dr. Arisa Ortiz said at the annual meeting of the American Society for Laser Medicine and Surgery.
In the current study, results at 12 years were somewhat diminished, compared with those seen at 3 months, but were still better than at baseline and patient satisfaction was maintained, said Dr. Ortiz of the University of California, Irvine.
The single-center study involved six patients with acne scarring and four with photodamage. All had been previously enrolled in studies of fractional resurfacing for those two conditions. They were aged 2463 years, with skin types I-V. There were no serious adverse events associated with the treatment, she said.
All 10 patients returned at 3 months for assessments of improvement in skin texture, rhytids, pigmentation, skin laxity, acne scarring, and overall appearance, compared with baseline.
The patients with acne scarring were then reassessed at 1 year and the patients with photodamage, at 2 years. Three investigators clinically rated improvement on a quartile scale: 0% (no improvement), less than 25% (minor), 25%-50% (minor to moderate), 51%-75% (moderate), and greater than 75% (marked).
Among the acne scarring patients, at 1 year there was 83% maintenance of the initial overall improvement seen at 3 months. For those treated for photoaging, 50% of the 3-month improvement was maintained at 2 years. Overall, there was a 74% improvement from 3 months to the 1- or 2-year follow-up assessment. No patient returned to baseline levels, Dr. Ortiz reported.
Possible explanations for the difference in results between 3 months and the long-term visit include relaxation of tightening, progression of normal aging, or persistent inflammatory changes present at 3 months, as evidenced by heat shock protein activity and ongoing collagen remodeling seen in previous histologic studies.
These results suggest that additional treatments may be necessary to enhance long-term results. It also appeared that acne scarring requires more treatments at higher energies, compared with photodamaged skin, and that performing more frequent treatments early on may result in less bleeding and less downtime for all patients, Dr. Ortiz said.
The original study was funded by Reliant Technologies Inc., but this long-term follow-up study was departmentally funded, she said.
As demonstrated above, results at 1 year (far right) were somewhat diminishedcompared with those seen at 3 months (center)but were still better than at baseline (left), and patient satisfaction was maintained, according to Dr. Arisa Ortiz. Photos courtesy Dr. Arisa Ortiz
