A Comparative Study of Efficacy of Fractional CO2 Laser vs Microdermabrasion in Treatment of Acne Scars (Total 100 Patients)

Introduction: Acne vulgaris is a common disease affecting pilosebaceous unit that can lead to significant scarring. Fractional CO2 Laser and microdermabrasion are effective non-surgical treatment modalities for acne scars. Aims and objectives: To study and compare the efficacy of fractional CO2 Laser and microdermabrasion therapy in acne scars. Material and methods: Total 100 patients were selected in our study. 50 patients were allotted into each group. Scar grading assessment was done by Goodman and Baron qualitative scar grading system. Result: 50 patients were taken in each group. There was a significant improvement in grading of acne scars at the end of 6months of treatment. On comparison of fractional CO2 Laser with microdermabrasion, p-value was <0.05 that is significant. Conclusion: Fractional CO2 Laser showed better improvement in grading of acne scars then microdermabrasion, though none of these treatments are 100% effective in treating acne scars. Keywords: Acne scars, fractional CO2 laser, microdermabrasion, Goodman and baron grading.

Fractional CO2 Laser Treatment after Transvaginal Polypropilene Mesh for Urinary Incontinence and Pelvic Organ Prolapse Treatment as an Alternative to Improove Mesh Erosion Rates

The support advantages of synthetic mesh in vaginal reconstructive surgery and stress urinary incontinence are significant. However, erosion of the mesh may occur as a complication, Four sessions of fractional CO2 Laser treatment protocol (Mona Lisa Touch Deka M.E.L.A Florence Italy protocol, were performed in the study group to 96 patients, beginning at 30 days, after mesh insertion, important improvement regarding erosion rates was found inside our study group, thanks to the trophic effects of fractional CO2 laser protocol. The use of alternative technologies that provide bio -stimulation of vaginal epithelium by increasing its thickness, and trophic changes that may be related to the very low erosion rate was found in our group of patients

“Split-Face” Evaluation of Collagen Changes Induced By Periorbital Fractional CO2 Laser Resurfacing

Background Periorbital fractional CO2 laser resurfacing has been used for facial rejuvenation purposes. However, to the best of our knowledge, no study objectively assessed periorbital neoformation and remodeling of local cutaneous collagen, in a split-face model, from skin samples obtained during upper blepharoplasty. Objectives To objectively evaluate neoformation and remodeling of local cutaneous collagen after periorbital skin fractional CO2 laser resurfacing. Methods Prospective and comparative study in which 16 female subjects presenting with dermatochalasis and periorbital rhytids were evaluated. All subjects underwent unilateral periorbital fractional CO2 laser resurfacing 30 days prior to upper blepharoplasty. Quantification of types I and III collagen from laser treated and untreated eyelid skin samples obtained during upper blepharoplasty was assessed with histochemical analysis (Picrosirius Red staining). Laser resurfacing treatment was applied to the untreated side immediately after the upper blepharoplasty. Two blinded, independent physicians evaluated clinical improvement in pretreatment, 1 and 6-month post-treatment digital images. Results Histochemical analysis showed significant higher intensity in collagen types I (treated: 158.7 ± 5.3, untreated: 139.2 ± 5.0; p&lt;0.0001) and III (treated: 105.1 ± 7.7, untreated: 104.1 ± 7.1; p&lt; 0.0001) in the samples submitted to fractional CO2 laser treatment; a greater difference was detected in collagen type I. A significant improvement in periorbital rhytidosis was observed one month after laser resurfacing (23%); a greater improvement in the periorbital region was observed 6 months after laser resurfacing and upper blepharoplasty (43.67%). Conclusions Periorbital fractional CO2 laser resurfacing demonstrated to be an effective method to improve palpebral skin, with histochemical evidence of increase in collagen types I and III.

Split face comparative study of microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars

Background Acne scars, is a challenge for dermatologists, despite having multiple treatment modalities like microneedling, dermabrasion, Fractional CO2 Laser, dermal fillers, etc. However, monotherapy has been hardly satisfactory because of the polymorphism seen with the scars. Objective Comparison between microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars. Patients and methods This study was carried out in department of dermatology, venereology and andrology, in Kobry El-Kobba Military complex during the period (from September 2018 to July 2020 ) on 20 patients of both sexes aged from 20 to 60 years old presenting with Goodman and Baron Grade II, III, IV acne scars . Results The study revealed a statistically significant difference (p = 0.017) between Goodman and Baron scar grades on the right side of the face before and after treatment indicating that microneedling with platelet rich plasma was effective in improving acne scars. Also, there is a statistically significant difference (p = 0.010) between Goodman and Baron scar grades on the left side of the face before and after treatment, indicating that fractional CO2 laser with platelet rich plasma was effective in improving acne scars. Conclusion and recommendation Further controlled and randomized studies are needed to validate our findings in a larger cohort of patients and longer follow up. Also, number of sessions might be more than 3 sessions.

Efficacy of Fractional Co2 Laser and Human Lyophilized Growth Factors in the Treatment of Stretch Marks: A Clinical and Histopathological Study

Background Striae distensae are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The natural evolution of striae is from red or purple, raised wavy lesions (striae rubra) to white atrophic lesions with wrinkly surface (striae alba). Objectives The present study was designed to compare the efficacy of fractional CO2 laser alone or combined with lyophilized growth factors or to its efficacy alone in the treatment of striae distensae. Patients and Methods The present study included 20 female patients with SD; they were all recruited from Dermatology Outpatient Clinic, Ain Shams University from may 2017 to march 2018. An informed consent for treatment, photography and punch biopsy was taken before enrollment and the study was approved by Dermatology Research Ethical Committee. Results The present study showed statistically significant clinical and histopathological improvement in areas A and B after treatment. This impronment was in rubra more than alba. Area C showed no clinical and histopathological improvement. Area B showed better results than area A.We propose that LGF alone did not show clinical or histopathologiacl improvement. Treatment was tolerated well by all patients where side effects were minimal in the form of transient PIH that resolved after using bleaching creams. There was no statistically sgnificant difference in the incidence of PIH between areas A& B. Conclusion We concluded that fractional CO2 alone is effective in treatment of SD especially stria rubra in skin type III and IV.

A comparative study of Fractional co2 laser combined with topical methotrexate versus Fractional co2 laser combined with topical [Calcipotriol + Betamethasone] in the treatment of nail psoriasis

Background Nail psoriasis is a distressing clinical condition as it is known that psoriasis on visible areas of the skin, such as the face, hands and nails, may have a substantial negative impact on physical, psychological, and social dimensions of quality of life. The additional negative consequences of nail involvement in psoriasis are pain, inability to grasp small objects, tie shoe laces or button clothes, and cause an altered sense of fine touch. Objective To evaluate and compare the efficacy, safety and side effects of co2 laser combined with topical methotrexate in one side and topical (calcipotriol +betamethasone) in the other side of the patient for the treatment of nail psoriasis. Patients and Methods This comparative pilot study included 20 patients with nail psoriasis. They were recruited from the dermatology out-patient clinic of Ain–Shams University Hospitals, during the period from March 2019 till October 2019. The study was approved by Research Ethical Committee of Ain Shams University (FMASU M S 71/2019) and fulfilled all the ethical aspects required for a human research. Results Our study revealed that both medications showed marked statistical and clinical improvement of the nail condition in a period of 2 months when applied topically after nail exposure to fractional co2 laser which facilitated the delivery of both medications through the nail plates to the site of the psoriasis inflammation in therapeutic concentrations by creating pores through the nails. There was no statistical or clinical difference between both medications regarding the improvement of the NAPSI scores or the level of patient satisfaction. However, there were some nail symptoms that didn’t show any improvement as (sub-ungual hyperkeratosis and nail ridging). Conclusion Our treatment protocol’s side effects based mainly on the action of fractional co2 laser which caused pain and nail bleeding during sessions for some of the patients in each group, while topical methotrexate caused nail yellowish discoloration for the all involved group. However, these side effects lasted for very short time and didn’t have any impact on the level of the patient satisfaction. There was no statistical difference in the level of the patient satisfaction between both groups.