Fractionated Carbon Dioxide Laser Treatment of Photoaging: Prospective Study in 45 Patients and Review of the Literature

BACKGROUND Ablative fractional photothermolysis (AFP) has been reported to be effective for photoaging. OBJECTIVE To perform a clinical trial in 45 patients with moderate to severe skin photoaging to quantify improvement with AFP. MATERIALS AND METHODS A prospective, single-blind study in 45 patients who presented for desired treatment of photoaging. Patients received a series of two to three treatments with AFP. RESULTS Thirty-nine women (86.7%) and six men (13.3%) were enrolled. Patients received two or three treatment sessions (mean 2.4). There were no incidence of adverse events of scarring, prolonged erythema (lasting more than 7 days), postinflammatory hyper- or hypopigmentation, or infection in the 108 treatment sessions given during this study. Mean improvement was 48.5% (95% confidence interval (CI) = 44.6-52.4%) for skin texture, 50.3% (95% CI = 46.1-54.5%) for skin laxity, 53.9% (95% CI = 49.5-58.5%) for dyschromia, and 52.4% (95% CI = 47.9-56.9%) for overall cosmetic outcome (all p<.05). CONCLUSIONS Significant improvement in photoaging of the face can be achieved using an AFP device with skin types I to III after a series of two to three treatments. The authors have indicated no significant interest with commercial supporters.