https://pubmed.ncbi.nlm.nih.gov/34996116/
Dario Bertossi, Luca C Carletta, Laetitia Colombo Fink, Marco Bartolucci, Gianfranco Barba, Alessia Montanari, Massimo Alotto, Claudio Brusi, Salvatore Chirumbolo
Affiliations
Unit of Maxillofacial Surgery, Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy.
Sotherga Clinic, Milan, Italy.
Private Dermatologist, Verona, Italy.
Agresti Dermatology Outpatient Clinic, Bologna, Italy.
Private Dermatologist, Rome, Italy.
Dermolaser s. r. l., Florence, Italy.
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
PMID: 34996116
DOI: 10.1055/a-1733-2768
Abstract
Following our survey, we can appreciate that a variety of laser platforms exist to rejuvenate the skin by resurfacing the outer layer of the skin as well as heating the lower layers of the dermis. Based on reliable clinical effectiveness and a limited side effect profile, we can confirm that nonablative fractionated technologies greatly improve the appearance of lentigines, rhytids; eliminate sun damage, attenuate scarring due to acne and other causes; and treat hyperpigmentation. The Fraxel (Solta Medical) laser system delivers pulses across a wide range of density and energy levels. We determined that when increasing the pulse energy this led to an increase in thermolysis microzone depth and width without damaging the surrounding tissue. Due to its performance and various clinical applications, Fraxel laser can be optimally considered to be the gold standard for skin rejuvenation.
Patients signed an informed consent for using clinical data for research purposes, according ethical approvals ruled by the University Hospital Committee for healthcare units
So far, no (or very few) attempts to appraise the use of laser in cosmetic medicine have been made. For a long time, fractional resurfacing has been considered the gold standard for skin restoration and rejuvenation. The term “fractional” refers to the production of thousands of different microscopic laser columns that treat fractions of the skin without affecting the surrounding tissue. Each spot has a ≤400 um diameter and has different energy levels, which are finally adjusted to fit the individual needs of each patient.
The use of fractional laser (or Fraxel) has come to the spotlight as a straightforward technique in cosmetic dermatology. Fractional laser treatment is suitable to stimulate the natural process of healing the skin, allowing the replacement of old and damaged cells with new, healthy skin cells.
Aside from ablative laser technology, the process of skin regeneration is initiated from heat generated by the energy of Fraxel technology, a device developed in the United States by Reliant (Solta Medical, Inc., Hayward, CA). It is known that the principle with which Fraxel laser operates is based on directing an intense concentrated beam of light onto the skin. This results in (a) removal of senescent cells from the most superficial layer of the skin, (b) stimulation of collagen production in the deeper layers of the skin, and (c) a contraction of collagen fibers. These mechanisms altogether lead to a younger looking skin following just one treatment.8-10 The full awareness on its potential and suitability in a surgical-medical unit is yet scanty and, in this report, we tried to elucidate this issue.
Moreover, the risk of herpes simplex virus (HSV) reactivation discourages laser usage. Therefore, patients with a history of HSV infection need to undergo an antiviral prophylactic regimen, often consisting of acyclovir, which has to be initiated 1 day prior to treatment.
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