title: Treatment of actinic keratoses and photodamage with non-contact fractional 1540-nm laser quasi-ablation: an ex vivo and clinical evaluation.
abstract: The main use of non-ablative fractional photothermolysis today is for the improvement of wrinkles and scars. The purpose of this work was to evaluate the effect of a "classic" non-ablative fractional 1540 nm on facial photodamaged skin and actinic keratoses. Seventeen patients with facial actinic keratoses (AKs) and photodamage underwent two or three laser treatments with fractional 1540-nm erbium glass laser at fluences of 75 mJ, 15 ms pulse duration, and 10-mm spot size in non-contact mode. Two blinded assessors and participants evaluated clinical improvement of treatment areas after 3 months, using a quartile grading scale (no improvement = 0, 1-25% improvement = 1, 26-50% = 2, 51-75% = 3, and 76-100% = 4). Three months after the last treatment, the mean level of improvement was 3.4 ± 0.72 for AK and 3.3 ± 0.54 for skin appearance. Adverse events observed after each treatment were moderate erythema, mild edema, erosions (two cases), and mild desquamation. No scarring or post-inflammatory pigmentary changes were observed. The clinical results were supported by histological changes observed in Yucatan pig studies in vivo and ex vivo. The 1540-nm fractional erbium glass laser in the non-contact mode is a safe and effective treatment for facial photodamage and AKs.
authors.affiliation: Laser Unit, Department of Dermatology, Rabin Medical Center, Golda Campus, 7 Keren Kayemet St, Petach Tikva, Israel. alapidot@netvision.net.il
authors.forename: Moshe
authors.initials: M
authors.lastname: Lapidoth
authors.forename: Maurice
authors.initials: M
authors.lastname: Adatto
authors.forename: Shlomit
authors.initials: S
authors.lastname: Halachmi
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000473:pathology / Q000601:surgery; D004487:Edema / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005145:Face / Q000473:pathology / Q000528:radiation effects; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012535:Scalp / Q000473:pathology / Q000528:radiation effects; D012867:Skin / Q000528:radiation effects; D013472:Sunlight / Q000009:adverse effects; D016896:Treatment Outcome