title: The use of sunscreen starting on the first day after ablative fractional skin resurfacing.
abstract: BACKGROUND
  The most common side-effect of ablative fractional skin resurfacing in Asians is post inflammatory hyperpigmentation (PIH). Various attempts have been made to reduce the occurrence of PIH after laser treatment including sun avoidance, the use of preoperative and postoperative treatment regimens, and treatment using conservative energy settings and epidermal protection.
  
  
  OBJECTIVE
  To determine whether the use of broad-spectrum sunscreen with anti-inflammatory agents starting on the first day after fractional CO2 laser skin resurfacing reduces the incidence of post laser PIH.
  
  
  METHODS
  Thirty patients were treated with ablative fractional CO2 resurfacing on both sides of their faces at 10 mJ and 10% density. Each subject was randomly treated on one side of the face with petrolatum ointment four times a day for the first week after laser treatment and on the other side of the face with petrolatum ointment four times a day plus broad-spectrum sunscreen with anti-inflammatory agents in the morning starting on the first day after laser treatment. Transepidermal water loss was recorded at baseline and every day for 1 week. Melanin and erythema indexes were measured at baseline, 1-, 2-week, 1-, 2- and at 3-month post treatment.
  
  
  RESULTS
  Of the 30 patients involved in the study, 26 received the treatment and attended 1-, 2-week, 1-, 2- and 3-month post-treatment visits. Four patients were withdrawn from the study because they could not attend every follow-up visit. There was no statistically significant difference in transepidermal water loss at baseline, immediately after laser treatment, or at the D1 to D7 follow-up visits. Erythema index had no significantly statistical difference at baseline, 1-, 2- and at 3-month after laser treatment. Furthermore, there was a statistically significant difference in melanin index at 1-week post laser treatment between both sides (P = 0.001). Melanin index at the 1-week follow-up visit on the side treated with broad-spectrum sunscreen with anti-inflammatory agents starting on the first day after laser treatment was significantly less than the control side.
  
  
  CONCLUSIONS
  The use of broad-spectrum sunscreen with anti-inflammatory agents starting on the first day after ablative fractional skin resurfacing can decrease the incidence of PIH after laser treatment at 1-week postoperatively.
authors: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors: R
authors: R
authors: Wanitphakdeedecha
authors: R
authors: R
authors: Phuardchantuk
authors: W
authors: W
authors: Manuskiatti
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002921:Cicatrix / Q000601:surgery; D003131:Combined Modality Therapy; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects; D004817:Epidermis / Q000601:surgery*; D004890:Erythema / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017495:Hyperpigmentation / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D053685:Laser Therapy / Q000009:adverse effects*; D054020:Lasers, Gas / Q000009:adverse effects*; D008297:Male; D008543:Melanins / Q000378:metabolism; D008875:Middle Aged; D010577:Petrolatum / Q000494:pharmacology / Q000627:therapeutic use; D015995:Prevalence; D012867:Skin / Q000187:drug effects / Q000378:metabolism; D013473:Sunscreening Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D008543:Melanins; D013473:Sunscreening Agents; D010577:Petrolatum