Fractional Carbon Dioxide Laser for Keratosis Pilaris: A Single-Blind, Randomized, Comparative Study (original) (raw)
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Journal of Cosmetic Dermatology, 2019
Keratosis pilaris (KP), frequently referred to as "chicken skin," by patients, is a common skin disorder that presents as a cosmetic complaint in the vast majority of cases. 1 Clinically, KP presents as multiple small greyish-white, follicular keratotic papules, resembling gooseflesh with variable degrees of perifollicular erythema and these papules usually contain fine-coiled, brittle hairs. Lesions are usually asymptomatic but may be itchy, and the extensor aspects of the arms, thighs, face, buttocks, and eyebrows are the most commonly affected sites. 2 Keratosis pilaris usually starts in childhood or adolescence and affects both sexes and all ethnic groups, with an estimated prevalence of 2 to 12 percent in pediatric populations. 3-5
2021
Background : Fractional Carbon Dioxide ( CO 2 ) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose : To evaluate the efficacy and side effects of fractional CO 2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods : Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO 2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result : A total of 42.9% of patients underwent fractional CO 2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respect...
Light and Laser Treatments for Keratosis Pilaris: A Systematic Review
Dermatologic Surgery, 2020
BACKGROUND Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease. Topical treatments often yield ineffective and temporary results. OBJECTIVE The objective of this article is to review and assess all the studies that used light and laser devices to treat KP and its variants. MATERIAL AND METHODS On January 15, 2017, an online search of the MEDLINE, Embase, and Cochrane databases was performed using the following combination of keywords: “keratosis pilaris” and “treatment.” RESULTS Seventeen studies related to light and laser treatments were retained for analysis. The total number of treated patients was 175. Of which, 22 patients had KP atrophicans faciei, 17 patients had KP rubra, and 136 patients had KP. CONCLUSION Light and laser devices have been emerging as promising therapeutic options for a disfiguring disease that still lacks, until today, an effective long-term treat...
Evaluation of Fractional CO2 Laser Efficacy in Acne Scar
Journal of Lasers in Medical Sciences, 2012
Introduction: Acne scar is formed after severe episodes of acne in teen and early adult years. Several treatment options have been used for depressed acne scars such as punch grafting, punch excision carbon dioxide (CO 2 ) laser etc. Moreover, Studies show that laser skin resurfacing such as CO 2 fractional can effectively treat depressed acne scars. We investigated the efficacy of fractional CO 2 laser in acne scar. Methods: In this clinical trial; we used CO 2 fractional laser (Unit: eCO 2 Lutronic Korea; FDA approved) in 15 female cases with an age range of 20-40 years old. They underwent 3 sessions of laser resurfacing at one month intervals. In the first session we used laser with a density of 150 and fluency of 70 with a 4mm diameter circular spot in static mode on depressed acne scars, and we exerted laser with density of 100 and fluency 70 with 12 mm diameter square spot in static mode on all involved skin in the other sessions. Photographs were taken before every process. The patients and another dermatologist filled the questionnaire concerning the percent of improvement. Finally, we compared photographs and evaluated the efficacy of CO 2 fractional laser in acne scars. Results: Objective and subjective improvement was estimated about 20-70% and 30-70%, respectively, without any erythema, permanent hyperpigmentation and other adverse effects. The important point is that, participants returned back to work after 4-7 days. Conclusion: The Fractional CO 2 laser resurfacing can be used as a safe and efficacious method to treat depressed acne scar.
The Efficacy and Safety of Ablative Fractional Carbon Dioxide Laser for Treatment of Acne Scars
Journal of Sulaimani Medical College, 2012
Background Acne may lead to long term squelae including physical scars. Lasers have been used with variable degree of success but literature pertaining to Asian population is sparse. Objectives To evaluate the efficacy and safety of carbon dioxide (CO 2) fractional laser in the treatment of acne scars in the local population. Patients and methods Twenty patients with mild to moderate atrophic acne scars were registered and subjected to monthly fractional CO 2 laser resurfacing for six sessions and final evaluation was done six months after the last treatment. Results More than 71% patients showed variable degree of improvement. No severe long term complications were noted in any patient. Conclusion Study suggests that CO 2 Fractional laser may prove a useful addition in the management of acne scars in our patients as well.
Treatment of Keratosis Pilaris With 810-nm Diode Laser
JAMA Dermatology, 2014
IMPORTANCE Keratosis pilaris (KP) is a common skin disorder of follicular prominence and erythema that typically affects the proximal extremities, can be disfiguring, and is often resistant to treatment. Shorter-wavelength vascular lasers have been used to reduce the associated erythema but not the textural irregularity. OBJECTIVE To determine whether the longer-wavelength 810-nm diode laser may be effective for treatment of KP, particularly the associated skin roughness/bumpiness and textural irregularity. DESIGN, SETTING, AND PARTICIPANTS We performed a split-body, rater-blinded, parallel-group, balanced (1:1), placebo-controlled randomized clinical trial at a dermatology outpatient practice of an urban academic medical center from March 1 to October 1, 2011. We included all patients diagnosed as having KP on both arms and Fitzpatrick skin types I through III. Of the 26 patients who underwent screening, 23 met our enrollment criteria. Of these, 18 patients completed the study, 3 were lost to or unavailable for follow-up, and 2 withdrew owing to inflammatory hyperpigmentation after the laser treatment. INTERVENTIONS Patients were randomized to receive laser treatment on the right or left arm. Each patient received treatment with the 810-nm pulsed diode laser to the arm randomized to be the treatment site. Treatments were repeated twice, for a total of 3 treatment visits spaced 4 to 5 weeks apart. MAIN OUTCOMES AND MEASURES The primary outcome measure was the difference in disease severity score, including redness and roughness/bumpiness, with each graded on a scale of 0 (least severe) to 3 (most severe), between the treated and control sites. Two blinded dermatologists rated the sites at 12 weeks after the initial visit. RESULTS At follow-up, the median redness score reported by the 2 blinded raters for the treatment and control sides was 2.0 (interquartile range [IQR], 1-2; P = .11). The median roughness/bumpiness score was 1.0 (IQR, 1-2) for the treatment sides and 2.0 (IQR, 1-2) for the control sides, a difference of 1 (P = .004). The median overall score combining erythema and roughness/bumpiness was 3.0 (IQR, 2-4) for the treatment sides and 4.0 (IQR, 3-5) for the control sides, a difference of 1 (P = .005). CONCLUSIONS AND RELEVANCE Three treatments with the 810-nm diode laser may induce significant improvements in skin texture and roughness/bumpiness in KP patients with Fitzpatrick skin types I through III, but baseline erythema is not improved. Complete treatment of erythema and texture in KP may require diode laser treatment combined with other laser or medical modalities that address redness. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01281644
Efficacy and safety of ablative fractional carbon dioxide laser for acne scars
Journal of Pakistan Association of Dermatology, 2017
Background Acne may lead to long term squelae including physical scars. Lasers have been used with variable degree of success but literature pertaining to Asian population is sparse. Objectives To evaluate the efficacy and safety of carbon dioxide (CO 2) fractional laser in the treatment of acne scars in the local population. Patients and methods Twenty patients with mild to moderate atrophic acne scars were registered and subjected to monthly fractional CO 2 laser resurfacing for six sessions and final evaluation was done six months after the last treatment. Results More than 71% patients showed variable degree of improvement. No severe long term complications were noted in any patient. Conclusion Study suggests that CO 2 Fractional laser may prove a useful addition in the management of acne scars in our patients as well.
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.1\_Jan2022/IJRR-Abstract05.html, 2022
Introduction: Acne vulgaris is a common disease affecting pilosebaceous unit that can lead to significant scarring. Fractional CO2 Laser and microdermabrasion are effective nonsurgical treatment modalities for acne scars. Aims and objectives: To study and compare the efficacy of fractional CO2 Laser and microdermabrasion therapy in acne scars. Material and methods: Total 100 patients were selected in our study. 50 patients were allotted into each group. Scar grading assessment was done by Goodman and Baron qualitative scar grading system. Result: 50 patients were taken in each group. There was a significant improvement in grading of acne scars at the end of 6months of treatment. On comparison of fractional CO2 Laser with microdermabrasion, p-value was <0.05 that is significant. Conclusion: Fractional CO2 Laser showed better improvement in grading of acne scars then microdermabrasion, though none of these treatments are 100% effective in treating acne scars.
IP innovative publication pvt. ltd, 2019
Introduction: Isotretinoin is an approved drug from the United States (US) Food and Drug Administration (FDA) for the treatment of severe recalcitrant nodular acne. Based on reports of poor wound healing and scarring, many practitioners believe that the majority of cutaneous laser treatments should be delayed at least six to 12 months after a patient discontinues isotretinoin treatment. The purpose of this study was to investigate the safety and the efficacy of fractional carbon dioxide laser combined with the low (6mg/day), medium (18mg/day) or high dose (30mg/day) of isotretinoin for the treatment of acne and acne scars and, investigation of the factor associated with the synchronous use of isotretinoin and fractional CO2 laser. Settings and Design: The study was retrospective, non- randomized, single-centre, open case series performed in our private clinic. A retrospective chart review was conducted for all patients registered at our private clinic for assessment of acne from April 2016 through March 2018. Materials and Methods: In this study, 80 patients with acne scarring were treated with 10,600nm fractional CO2 laser. Out of eighty, 60 patients in three experimental groups received different dose of isotretinoin (n=20, low dose: 6mg/day; n=20, medium dose: 18mg/day; n=20, high-dose: 30mg/day) prior to the initial fractional CO2 laser treatment. 20 patients with acne scarring who was treated only with the fractional CO2 laser served as control. Acne scars improvement, healing period and presence of keloids formation was taken in account as outcome measured after 6 months follow-up. Statistical analysis: Comparisons of differences in the demographic profile, efficacy and healing period among four groups was done by Kruskal–Wallis test. Multiple comparisons were performed using Kruskal-Wallis test followed by the p-value was adjusted using the Holm-Bonferroni sequential correction “P” to identify independent factors associated with synchronous use. Results: In the fractional CO2 laser with medium-dose isotretinoin group, all patients demonstrated normal wound healing also satisfactory acne scar improvement. Moreover, no hypertrophic scars or keloids were observed in patients from this group. Grade of acne, doses of isotretinoin, No of the treatment session, % of MTZ applied during the session, level of MTZ and passes per session were an independent factor that significantly correlated synchronous use of with isotretinoin and fractional CO2 laser. Conclusion: Based on findings the author concluded that synchronous use of a medium dose of isotretinoin and the fractional CO2 laser was an excellent choice for the future treatment regime.
Fractional CO2 laser in the treatment of atrophic scars
Scientific Journal of October 6 University, 2016
A variety of treatment modalities have been used depending on the scar type. Treatment methods may be invasive /or conservative. To assess the efficacy of fractional CO 2 laser in the treatment of atrophic scars. This is an observational study of 30 patients (skin types III-IV, aged 18-44 years) with atrophic acne and post traumatic depressed scars who underwent three sessions with a fractional CO2 laser at 1-month interval. Side effects as well as improvements in texture, atrophy and overall satisfaction with appearance were graded on a quartile scale by the patients and investigators after each treatment and 4 weeks after the final treatment. Before-after scores were compared using the student t-test, with significance assigned to P values less than 0.05. All patients showed clinical improvement. There was a significant difference in the overall scar appearance between both scar groups according to all dermatologists. The acne scar group improved more than the depressed scar group. There was no statistically significant difference in the assessment of the three dermatologists. In terms of patient satisfaction for the acne scars group, 5 patients were slightly satisfied, 2 patients were satisfied, 4 patients were very satisfied and 3 patients were extremely satisfied. The depressed scar group, 3 patients were not satisfied with the outcome, 6 patients were slightly satisfied, 6 patients were satisfied and only 1 patient was extremely satisfied. Side effects were minimal and transient. Fractional CO 2 laser treatment is a safe, well-tolerated and effective treatment modality for atrophic scars, with minimal downtime and fewer side effects.