Fractional resurfacing affords unique therapeutic outcomes
|Roy G. Geronemus, M.D.
An early adopter of laser technology, Roy Geronemus, M.D., director of the Laser & Skin Surgery Center of New York, has become a champion of the many medical and cosmetic treatments afforded to patients by laser devices.
One novel concept — fractional resurfacing — was developed in response to complications and prolonged healing associated with non-fractional resurfacing for cosmetic conditions. During the Plenary Session Friday, he discussed how the technique provides unique therapeutic outcomes for a variety of clinical conditions, giving attendees a better understanding of the indications and benefits of ablative and non-ablative fractional resurfacing.
Results of fractional resurfacing studies show promise
In his talk, "Non-Ablative and Ablative Fractional Resurfacing: Cosmetic and Medical Indications," Dr. Geronemus examined several research studies. In one study of 961 patients receiving fractional laser photothermolysis, 7.6 percent developed complications, of which 1.87 percent of cases were acneiform eruptions and 1.77 percent were herpes simplex virus outbreaks.
In another study, investigators looked at the influence of non-ablative fractional resurfacing in eyelid tightening and eyelid aperture. The degree of improvement was up to 25 percent for 28 percent of patients; 25-50 percent for 26.9 percent of patients; 50-75 percent for 25.8 percent of patients, and 75-100 percent for 19.4 percent of patients.
Study confirms success of a non-invasive treatment
A longtime researcher, Dr. Geronemus, clinical professor of dermatology at New York University Medical Center, has conducted research on the non-invasive treatment of actinic keratoseswith a 1927nm fractionated thulium laser. He treated 25 subjects with multiple facial AKs with up to four treatments every two to six weeks. Patients were given a topical anesthesia lasting one hour. The percentage of AK clearance was 62.7 percent, 84.3 percent and 88.5 percent after the first, second, and third treatment, respectively. At the time of follow-up, AK clearance was 90.6 percent, 84 percent, and 85.1 percent after one month, three months and six months, respectively.
The treatment of actinic keratoses is unique because of the sustained benefit, minimal downtime, and high patient acceptance. He noted that the procedure was well tolerated by patients, leaving no incidents of scarring or infections. Erythema and peeling lasted between four and five days, and patients on average reported pain scores at 2.71 (on a scale of 10).
Fractional resurfacing an effective option
"Ablative fractional and non-ablative fractional resurfacing provide safe and effective treatment for a variety of scars, including acne, surgical and traumatic scars, as well as for wrinkles, skin laxity, photodamage and enhancement of tattoo removal in conjunction with q-switched lasers," Dr. Geronemus said.
"The treatment of scarring is as good or better than other non-fractional techniques with good therapeutic outcomes and minimal risks of additional scarring or pigmentary change," said Dr. Geronemus, who also described the differences in wavelength, lesion depth, spot size, delivery system, and density coverage of a number of fractional ablative devices.