title: A randomized, controlled trial of four ablative fractionated lasers for photoaging: a quadrant study.
abstract: BACKGROUND
  Fractionated technology has revolutionized laser therapy. With the success of initial devices, several fractionated lasers have appeared on the market. Claims of superiority have made device choice difficult for physicians and patients.
  
  
  METHODS
  Twelve subjects were treated with fractionated ablative lasers (10,600-nm carbon dioxide and 2790-nm yttrium scandium gallium garnet) in this institutional review board-approved trial. Each face was divided into four quadrants, and each quadrant was randomly treated using one of four lasers. Clinical experience was used to optimize settings. Two patients submitted biopsies from each quadrant immediately after treatment. Patients and blinded investigators assessed pain during treatment and post-treatment improvement in photoaging (measured by rhytides, lentigines, texture, and pore size) using a five-point scale.
  
  
  RESULTS
  All devices resulted in statistical improvement in photoaging in all patients, but no device was statistically significantly superior. No statistically significant difference was found in pain scores. All patients reported satisfaction 1 month after treatment. Three patients experienced adverse reactions. Histologically, there were no statistically significant differences between devices.
  
  
  CONCLUSIONS
  Fractionated ablative lasers reliably result in improvement in photoaging. Despite marketing claims, no statistically significant differences were found in outcomes, pain during treatment, or histologic findings. Even with experienced users, significant adverse reactions are possible.
authors: SkinCare Physicians, Chestnut Hill, MA, USA. blatowsky@yahoo.com
authors: Brenda C
authors: BC
authors: Latowsky
authors: Naheed
authors: N
authors: Abbasi
authors: Jeffrey S
authors: JS
authors: Dover
authors: Kenneth A
authors: KA
authors: Arndt
authors: Michael S
authors: MS
authors: Kaminer
authors: Thomas E
authors: TE
authors: Rohrer
authors: Jennifer L
authors: JL
authors: Macgregor
authors: Naissan O
authors: NO
authors: Wesley
authors: Melissa A
authors: MA
authors: Durfee
authors: Steven R
authors: SR
authors: Tahan
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010781:Photography; D016037:Single-Blind Method; D015595:Skin Aging / Q000473:pathology*; D016896:Treatment Outcome