Topical corticosteroids minimise the risk of postinflammatory hyper-pigmentation after ablative fractional CO2 laser resurfacing in Asians.
Postinflammatory hyperpigmentation (PIH) is the most common adverse effect of laser treatment in dark-skinned individuals. Little is known whether PIH can be prevented or minimised. The objective of this study was to investigate the effect of short-term application of topical corticosteroids on the incidence of PIH after ablative fractional resurfacing in Asians. Forty subjects with skin phototype IV and atrophic acne scars were treated with a fractional CO2 laser on both sides of the face. Post-operatively, clobetasol propionate 0.05% ointment was applied to one randomly selected side of the face for the first 2 days, followed by an application of petrolatum jelly for the rest of the week (petrolatum was applied to the other side for 7 days). Assessments on the clinical outcome, the wound healing process and the occurrence of PIH were obtained once weekly for the first month and at 2 and 3 months post-treatment. The side of the face treated with petrolatum alone had significantly (p < 0.001) higher incidence of PIH (75%) after laser irradiation than the side of the face treated with topical corticosteroids and petrolatum (40%). The PIH occurring on the petrolatum-treated sides had significantly higher intensity (p < 0.001) and was spread over a significantly larger area (p < 0.001), compared with the corticosteroid- and petrolatum-treated sides. In conclusion, a short-term application of topical corticosteroids postoperatively is associated with a decreased risk of PIH after ablative fractional resurfacing.
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Nutjira
N
Cheyasak
Woraphong
W
Manuskiatti
Pitchaya
P
Maneeprasopchoke
Rungsima
R
Wanitphakdeedecha
D000152:Acne Vulgaris / Q000208:ethnology*; D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D044466:Asian People; D002921:Cicatrix / Q000175:diagnosis / Q000208:ethnology / Q000601:surgery*; D002990:Clobetasol / Q000008:administration & dosage* / Q000009:adverse effects; D003872:Dermatitis / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054020:Lasers, Gas / Q000009:adverse effects; D008297:Male; D016037:Single-Blind Method; D012880:Skin Pigmentation / Q000187:drug effects*; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D002990:Clobetasol