title: Fractional deep dermal ablation induces tissue tightening.
abstract: OBJECTIVE
  Due to the significant risk profile associated with traditional ablative resurfacing, a safer and less invasive treatment approach known as fractional deep dermal ablation (FDDA) was recently developed. We report the results of the first clinical investigation of this modality for treatment of photodamaged skin.
  
  
  METHODS
  Twenty-four subjects received treatments on the inner forearm with a prototype fractional CO(2) laser device (Reliant Technologies Inc., Mountain View, CA) at settings of 5-40 mJ/MTZ and 400 MTZ/cm(2). Clinical and histological effects were assessed by study investigators 1 week, 1 month, and 3 months following treatment. Thirty subjects were then enrolled in a multi-center study for treatment of photodamage using the same device. Subjects received 1-2 treatments on the face and neck, with energies ranging from 10 to 40 mJ/MTZ and densities ranging from 400 to 1,200 MTZ/cm(2). Study investigators assessed severity of post-treatment responses during follow-up visits 48 hours, 1 week, 1 month, and 3 months following treatment. Using a standard quartile improvement scale (0-4), subjects and investigators assessed improvement in rhytides, pigmentation, texture, laxity and overall appearance 1 and 3 months post-treatment.
  
  
  RESULTS
  Clinical and histologic results demonstrated that fractional delivery of a 10,600 nm CO(2) laser source offers an improved safety profile with respect to traditional ablative resurfacing, while still effectively resurfacing epidermal and dermal tissue. Forearm and facial treatments were well-tolerated with no serious adverse events observed. Eighty-three percent of subjects exhibited moderate or better overall improvement (50-100%), according to study investigator quartile scoring.
  
  
  CONCLUSIONS
  FDDA treatment is a safe and promising new approach for resurfacing of epidermal and deep dermal tissue targets.
authors.affiliation: Department of Dermatology, Stanford University, Stanford Medical School, Stanford, California 94305, USA.
authors.forename: Zakia
authors.initials: Z
authors.lastname: Rahman
authors.forename: Heather
authors.initials: H
authors.lastname: MacFalls
authors.forename: Kerrie
authors.initials: K
authors.lastname: Jiang
authors.forename: Kin F
authors.initials: KF
authors.lastname: Chan
authors.forename: Kristen
authors.initials: K
authors.lastname: Kelly
authors.forename: Joshua
authors.initials: J
authors.lastname: Tournas
authors.forename: Oliver F
authors.initials: OF
authors.lastname: Stumpp
authors.forename: Vikramaditya
authors.initials: V
authors.lastname: Bedi
authors.forename: Christopher
authors.initials: C
authors.lastname: Zachary
mesh_terms: D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques; D062109:Dermatologic Surgical Procedures; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D015595:Skin Aging