Direct quantitative comparison of molecular responses in photodamaged human skin to fractionated and fully ablative carbon dioxide laser resurfacing.
BACKGROUND
Fractionated ablative laser resurfacing has become a widely used treatment modality. Its clinical results are often found to approach those of traditional fully ablative laser resurfacing.


OBJECTIVE
To directly compare the molecular changes that result from fractionated and fully ablative carbon dioxide (CO(2)) laser resurfacing in photodamaged human skin.


METHODS
Photodamaged skin of 34 adult volunteers was focally treated at distinct sites with a fully ablative CO(2) laser and a fractionated CO(2) laser. Serial skin samples were obtained at baseline and several time points after treatment. Real-time reverse transcriptase polymerase chain reaction technology and immunohistochemistry were used to quantify molecular responses to each type of laser treatment.


RESULTS
Fully ablative and fractionated CO(2) laser resurfacing induced significant dermal remodeling and collagen induction. After a single treatment, fractionated ablative laser resurfacing resulted in collagen induction that was approximately 40% to 50% as pronounced as that induced by fully ablative laser resurfacing.


CONCLUSIONS
The fundamental cutaneous responses that result from fully ablative and fractionated carbon dioxide laser resurfacing are similar but differ in magnitude and duration, with the fully ablative procedure inducing relatively greater changes including more pronounced collagen induction. However, the molecular data reported here provide substantial support for fractionated ablative resurfacing as an effective treatment modality for improving skin texture.
Department of Dermatology, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA. jorringe@umich.edu
Jeffrey S
JS
Orringer
Dana L
DL
Sachs
Yuan
Y
Shao
Craig
C
Hammerberg
Yilei
Y
Cui
John J
JJ
Voorhees
Gary J
GJ
Fisher
D000368:Aged; D023181:Antimicrobial Cationic Peptides / Q000235:genetics / Q000378:metabolism; D024042:Collagen Type I / Q000096:biosynthesis; D024061:Collagen Type III / Q000096:biosynthesis; D003357:Cosmetic Techniques; D062109:Dermatologic Surgical Procedures / Q000379:methods; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D053583:Interleukin-1beta / Q000235:genetics / Q000378:metabolism; D016209:Interleukin-8 / Q000235:genetics / Q000378:metabolism; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008264:Macrophages; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000235:genetics / Q000378:metabolism; D019278:Matrix Metalloproteinase 3 / Q000235:genetics / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000235:genetics / Q000378:metabolism; D008875:Middle Aged; D009504:Neutrophils; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D060888:Real-Time Polymerase Chain Reaction; D012867:Skin / Q000098:blood supply / Q000276:immunology / Q000378:metabolism*; D015595:Skin Aging; D023083:beta-Defensins / Q000235:genetics / Q000378:metabolism; D054804:Cathelicidins
D023181:Antimicrobial Cationic Peptides; D024042:Collagen Type I; D024061:Collagen Type III; C106641:DEFB4A protein, human; D053583:Interleukin-1beta; D016209:Interleukin-8; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D012333:RNA, Messenger; D023083:beta-Defensins; D019278:Matrix Metalloproteinase 3; D020780:Matrix Metalloproteinase 9; D020781:Matrix Metalloproteinase 1; D054804:Cathelicidins