Ablative versus non-ablative treatment of perioral rhytides. A randomized controlled trial with long-term blinded clinical evaluations and non-invasive measurements

• Published in: Lasers in surgery and medicine Vol. 38; no. 2; pp. 129 - 136
• Main Authors: Hedelund, L., Bjerring, P., Egekvist, H., Haedersdal, M.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-02-2006
• Subjects: Adult; Aged; Carbon Dioxide; CO2 laser; Erythema - etiology; Female; Humans; intense pulsed light; Laser Therapy; Lip; Middle Aged; Patient Satisfaction; Phototherapy; Skin Aging; skin elasticity; skin reflectance; trans epidermal water loss; Treatment Outcome; ultrasound
• ISSN: 0196-8092; 1096-9101
• DOI: 10.1002/lsm.20216

Background and Objective
To compare efficacy and side effects of CO2 laser resurfacing and intense pulsed light (IPL) rejuvenation for treatment of perioral rhytides.
Methods
Twenty‐seven female subjects with perioral rhytides (class I–III) were randomly treated with either CO2 laser or IPL (three monthly treatments). Efficacy was evaluated by patient self‐assessments and blinded photographs up to 12 months postoperatively. Side effects were assessed clinically. Non‐invasive measurements included: trans epidermal water loss (TEWL), skin reflectance, skin elasticity, and ultrasound.
Results
CO2 laser resurfacing resulted in higher degrees of patient satisfaction and clinical rhytide reduction compared to IPL rejuvenation up to 12 months postoperatively (patient evaluations, P < 0.05) (observer evaluations, P < 0.008). Laser‐induced side effects included erythema, dyspigmentation, and milia whereas no side effects were observed after IPL rejuvenation. Non‐invasive measurements showed a significant higher reduction of the subepidermal low‐echogenic band in CO2 laser treated areas versus IPL treated areas (12 months postoperatively, P < 0.001). Skin elasticity (expressed as Young's modulus) increased in both groups (P = ns). One month postoperatively a significant increase in TEWL values (P < 0.009) and skin redness% (P < 0.02) was found in CO2 laser treated patients versus IPL treated patients. No significant differences were seen in skin pigmentation% during the observation period.
Conclusion
CO2 laser resurfacing induces a significantly higher degree of clinical rhytide reduction followed by considerably more side effects compared to IPL rejuvenation in a homogeneous group of patients. Lasers Surg. Med. 38:129–136, 2006. © 2006 Wiley‐Liss, Inc.