Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury

Background and Objectives We introduce and clinically examine a new concept of skin treatment called fractional photothermolysis (FP), achieved by applying an array of microscopic treatment zones (MTZ) of thermal injury to the skin. Study Design/Materials and Methods Two prototype devices emitting a...

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Bibliographic Details
Published in:Lasers in surgery and medicine 2004-06, Vol.34 (5), p.426-438
Main Authors: Manstein, Dieter, Herron, G. Scott, Sink, R. Kehl, Tanner, Heather, Anderson, R. Rox
Format: Article
Language:English
Subjects:
Adult
Aged
Face
Female
Forearm
fractional
Humans
laser
Laser Therapy
Male
Middle Aged
MTZ
non-ablative
photoaging
photothermolysis
rejuvenation
remodeling
resurfacing
Skin - pathology
Skin Aging
wrinkles
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Summary:Background and Objectives We introduce and clinically examine a new concept of skin treatment called fractional photothermolysis (FP), achieved by applying an array of microscopic treatment zones (MTZ) of thermal injury to the skin. Study Design/Materials and Methods Two prototype devices emitting at 1.5 μm wavelength provided a pattern of micro‐exposures with variable MTZ density. Effects of different MTZ densities were tested on the forearms of 15 subjects. Clinical effects and histology were assessed up to 3 months after exposure. Treatment of photoaged skin on the periorbital area in an additional 30 subjects receiving four treatments over a period of 2–3 weeks was also tested. Tissue shrinkage and clinical effects were assessed up to 3 months after treatment. Results Pattern densities with spacing of 250 μm or more were well tolerated. Typical MTZ had a diameter of 100 μm and penetrated 300 μm into the skin. Reepithelialization was complete within 1 day. Clinical effects were assessed over a 3‐month period. Histology at 3 months revealed enhanced undulating rete ridges and increased mucin deposition within the superficial dermis. Periorbital treatments were well tolerated with minimal erythema and edema. Linear shrinkage of 2.1% was measured 3 months after the last treatment. The wrinkle score improved 18% (P
ISSN:0196-8092
1096-9101
DOI:10.1002/lsm.20048