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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61 JCAD journal of clinical and aesthetic dermatology June 2017 • volume 10 • Number 6 r E v I E w variable square pulsed 2940nm er:YaG laser in a randomized open label trial. although no difference was noted in efficacy, less downtime with fractional laser correlated positively with higher patient satisfaction. in conclusion, there is strong evidence that nonablative fractional laser is a safe and effective modality for skin rejuvenation in skin of color. SCAR RESURFACING Keloids and hypertrophic scars are more prevalent in racial/ethnic populations with sPt iv–vi. Multiple treatment modalities such as intralesional steroid injections, silicone sheets, cryotherapy, excision and laser surgery are currently used to treat scars or improve their appearance. However, the response to these treatments is often unsatisfactory and unpredictable. the following studies assess the effectiveness of nonablative fractional laser for treating keloids, hypertrophic and surgical scars (table 7). 50–55 a randomized blinded study was performed by lin et al 50 wherein linear surgical hypertrophic scars were divided into halves. one half of the scar was further randomized to receive either high density (40mJ/26% coverage) or low density (40mJ/14% coverage) treatment whereas the other half served as control. No significant difference was observed in the efficacy of high density and low density groups. Moreover, high density group reported high incidence of side effects such as erythema, pain, swelling and scabbing. this study also emphasized the importance of treating scars at an earlier stage as younger scars respond better to treatment. Cervelli et al 51 performed a randomized blinded study analyzing the combined effects of fractional resurfacing, fat grafting and use of PrP in t able 8: nonablative fractional lasers for striae distensae in spt iv–vi autHors, yEar sKin t ypEs no. oF patiEnts spt Hiv, v, vii trEatmEnt modalit y postinFlammatory HypErpigmEntation HpiH %i Yang et al, 2011 56 IV 24 24,0,0 One side of abdomen: 1550nm fractional laser Other side: 10600nm ablative fractional CO 2 laser 36.4 81.8 Kim et al, 2008 57 III–IV 6 Not mentioned 1550nm erbium doped fractional laser 50 De Angelis et al, 2010 58 I–IV 51 10,0,0 1540nm Er:Glass laser 15.6 Stotland et al, 2008 59 I–IV 20 3,0,0 1550 Erbium doped fiber laser No PIH observed Malekzad et al, 2014 60 III–V 10 3,1,0 1540nm erbium fractional laser 10 Alves et al, 2015 61 IV 4 4,0,0 Nonablative 1540nm fractional laser No PIH observed Wang et al, 2016 62 I–IV 10 Not mentioned One side of abdomen: 1540nm fractional laser Other side: 1410nm fractional laser Transient PIH observed in all patients SPT: Fitzpatrick skin photo type

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