title: Fractional treatment of aging skin with Tixel, a clinical and histological evaluation.
abstract: OBJECTIVE
  This study presents clinical results of Tixel, a new fractional skin resurfacing system based on thermo-mechanical ablation technology. Tixel employs a hot (400°C) metallic tip consisting of 81 pyramids. Treatment is performed by rapidly advancing the tip to the skin for a preset tip-skin contact duration. Thermal energy transfer to the skin creates micro-craters by evaporation.
  
  
  METHODS
  Treatment results with tip types, D and S, with high and low thermal conductivity, were evaluated. Twenty-six subjects received three facial treatments, with 4-5-week intervals between treatments, without analgesia or cooling. In addition, histopathologies of Tixel and CO2 laser were performed.
  
  
  RESULTS
  Crater properties are related to contact duration and to thermal conductivity. The D tip created char-free ablative craters 100-320 μm wide with a thermal zone 100-170 μm deep. The S tip created non-ablative coagulation preserving the epidermis. Skin complexion improvement was achieved in all subjects; average treatment pain of 3.1/10, downtime of 0-1 days, and erythema clearance of 3.5 days. Subject's satisfaction was 75% and wrinkle attenuation was achieved in 75% of the cases. There was no incidence of bleeding, scarring, or post-inflammatory hyperpigmentation.
  
  
  CONCLUSIONS
  Tixel may be used safely for ablative and non-ablative resurfacing with low pain, low downtime, and quick healing.
authors.affiliation: a Elman Laser Clinic , Rishon Le-Zion , Israel.
authors.forename: Monica
authors.initials: M
authors.lastname: Elman
authors.affiliation: b CLDP , Clapiers , France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fournier
authors.affiliation: c Centre Pathology , Montpellier , France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Barnéon
authors.affiliation: d Main Line Center for Laser Surgery , Ardmore , PA , USA.
authors.forename: Eric F
authors.initials: EF
authors.lastname: Bernstein
authors.affiliation: e UCLA Medical School , Los Angeles , CA , USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Lask
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D000368:Aged; D000818:Animals; D004735:Energy Transfer; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D015595:Skin Aging / Q000473:pathology; D013552:Swine; D014945:Wound Healing
keywords: ablation; fractional; resurfacing; skin rejuvenation; thermal model