Journal of Clinical and Aesthetic Dermatology

JUN 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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52 JCAD journal of clinical and aesthetic dermatology June 2017 • volume 10 • Number 6 r E v I E w practice. 8–15 Melanin-rich skin types are more susceptible to pigmentary alterations post laser resurfacing due to direct (e.g., melanosome disruption) and indirect (e.g., postinflammatory) effects of treatment. a higher risk of keloid or hypertrophic scarring in patients of african or asian ancestry is also a safety consideration in laser resurfacing involving dermal injury. Nonablative fractional lasers are mid infra-red lasers that target water instead of melanin and hence these lasers are safe for use in darker skin types. 8,16 METHODS the primary objective of this comprehensive review is to provide evidence-based recommendations for the use of nonablative fractional lasers in sPts iv–vi. the authors sought to obtain all the published articles that studied nonablative fractional lasers in skin of color patients. a broad literature search of PubMed/Medline database was conducted in april 2016 using the term fractional lasers. an extensive PubMed search was conducted using the following search combinations: fractional lasers and acne vulgaris, [abstract continued] Findings: The available e vidence strongly suggests that fractional lasers are a favorable treatment option for a variety of dermatological diseases in Fitzpatrick skin phototypes Iv to vI. Level 1 evidence was found for the use of fractional lasers for treating acne, striae and skin rejuvenation. Level 2 evidence was found for their use in acne scars, melasma, and surgical/traumatic scars. Conclusion: Fractional resurfacing is a safe and efficacious treatment option for various dermatological disorders in darker skin types; however, there is a paucity of high-quality studies involving skin types v and vI. J Clin Aesthet Dermatol. 2017;10(6):51–67 table 1: types of fractional lasers 8–15 ablativE Fractional lasErs nonablativE Fractional lasErs 10,600nm fractional CO 2 laser 1410nm laser 2940nm fractional Er:YAG 1440nm Nd:YAG laser 1790nm fractional Er:YSGG 1540nm laser 1550nm Erbium laser 1927nm thulium fiber laser 1927nm Diode laser table 2: inclusion and exclusion criteria inclusion critEria Exclusion critEria 1. Studies limited to human subjects and English language 1. Traditional lasers and ablative fractional devices 2. Articles assessing the use of nonablative fractional lasers for any dermatologic indication 2. Studies limited to SPT I–III 3. SPT IV or more 3. Studies that did not mention SPT 4. Review articles, non-therapy studies, guidelines SPT: Fitzpatrick skin photo type

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