A Case of acne scarring treated with Fractional Photothermolysis
- Author:
Ko Chung Beng
;
Chua Sak Eng
;
Seah Keh Seng
;
Chu Kooi Yen
;
Ko Chung Yee
- Publication Type:Case Reports
- From:Malaysian Journal of Dermatology
2007;19(-):105-106
- CountryMalaysia
- Language:English
-
Abstract:
Acne scarring affects 30% of patients with moderate to
severe acne vulgaris. It is particularly common in acne
conglobata and acne fulminans. To reduce the incidence of
scarring, acne is best treated early. There are various
treatments available for acne scars, such as chemical peel,
dermabrasion, laser (resurfacing), dermal fillers, punch
grafting and subcision therapy.
Fractional photothermolysis is a novel technology designed
to create a network of microscopic intradermal zones of
thermal injury in the dermis and overlying epidermis with
islands of spared, normal tissue, using focused beams
of infrared laser energy (1550nm). Fractional
photothermolysis (Fraxel laser treatment; Reliant
Technologies; Palo Alto; California) is currently approved
by the US Food and Drug Administration for the treatment
of periorbital rhytids and dyspigmentation. The Fraxel laser is a 30watt, diode pumped, 1,550nm erbium fiber laser that targets water as its chromophore. It is a safe and gradual laser procedure that stimulates the body to replace aged and photo-damaged skin, even on delicate skin areas, such as the neck, chest and hands.
Utilizing the concept of fractional treatment, 70-100um
wide and 250-800um deep, microthermal zones of tissue
coagulation are produced. Tissue is not vaporized and the
stratum corneum remains intact. The epidermal coagulated
tissue is expelled and replaced by keratinocyte migration.When there is a significant damage to the basement membrane zone, the dermal contents are also expelled as microscopic epidermal and dermal necrotic debris. Zone of collagen denaturation in the dermis cause upregulation of the inflammatory cascade, which leads to collagen remodeling and new collagen formation.
The mid-infrared wavelength of the Fraxel laser allows
deeper penetration into the tissue without the injury
observed with traditional ablative laser (such as lengthy
downtime, severe pain and prolonged edema). The reported
complications are post-inflammatory hyperpigmentation
(up to 20%), hypopigmentation, infection and scarring.
