Fractional Laser Photothermolysis in the Treatment of Skin Defects: Possibilities and Effectiveness (Review)
For skin defect treatment and rejuvenation the ablative laser skin resurfacing with a CO2 laser is widely applied in cosmetology and dermatology. However this treatment can result in the risk of undesirable side effects and requires a long-term recovery after the procedure. When non-ablative laser skin rejuvenation is used as an alternative, the level of safety is increased, however the efficacy of the procedure is considerably reduced.
The use of fractional laser photothermolysis is a particularly important step in the development of laser technology for cosmetology and dermatology. Due to the creation of only microscopic areas of thermal damage under the laser exposure, this method results in safe, quick healing and complete recovery of the skin without any undesirable side effects. The review presented here illustrate the high efficacy of the application of both ablative and non-ablative fractional laser photothermolysis for wrinkles reduction, for general improvement of the skin appearance, for the abnormal pigmentation treatment, and the removal or appearance improvement of atrophic scars from acne as well as in areas of skin stretching (striae).
- Hsiao F.C., Bock G.N., Eisen D.B. Recent advances in fractional laser resurfacing: new paradigm in optimal parameters and post-treatment wound care. Adv Wound Care (New Rochelle) 2012; 1(5): 207–212, http://dx.doi.org/10.1089/wound.2011.0323.
- Baitinger V.F., Paityan K.G. Morphologic and functional characteristics of pathologic skin scars: state of the art. Voprosy rekonstruktivnoy i plasticheskoy khirurgii 2013; 1(44): 28–34.
- Scar revision — procedures in cosmetic dermatology. Arndt K.A. (editor). Elsevier Inc.; 2006.
- Goodman G.J., Baron J.A. Postacne scarring — a quantitative global scarring grading system. J Cosmet Dermatol 2006; 5(1): 48–52, http://dx.doi.org/10.1111/j.1473-2165.2006.00222.x.
- Naein F.F., Soghrati M. Fractional CO2 laser as an effective modality in treatment of striae alba in skin types III and IV. J Res Med Sci 2012; 17(10): 928–933.
- Zorin V., Cherkasov V. Skin aging and SPRS-therapy. Kosmetika i meditsina 2011; 4: 60–68.
- Tatuzyan E.G., Belovol A.N., Tkachenko S.G. Rational therapy of age-related changes of skin. Dermatologiya i venerologiya 2014; 4(66): 100–108.
- Makrantonaki E., Zouboulis C.C. Molecular mechanisms of skin aging: state of the art. Ann N Y Acad Sci 2007; 1119: 40–50, http://dx.doi.org/10.1196/annals.1404.027.
- Ganceviciene R., Liakou A.I., Theodoridis A., Makrantonaki E., Zouboulis C.C. Skin anti-aging strategies. Dermatoendocrinol 2012; 4(3): 308–319, http://dx.doi.org/10.4161/derm.22804.
- Molecular mechanisms of skin aging and age-related diseases. Quan T. (editor). CRC Press; 2016, http://dx.doi.org/10.1201/b21370.
- Geynits A.V., Moskvin S.V. Lazernaya terapiya v kosmetologii i dermatologii [Laser therapy in dermatology and cosmetology]. Moscow–Tver: Izdatel’stvo “Triada”; 2010; 400 p.
- Patrushev A.V., Khairutdinov V.R., Belousova I.E., Samtsov A.V. Clinical and morphological features of elastolytic granulomas. Vestnik dermatologii i venerologii 2014; 4: 58–67.
- Snarskaya YE.S. Skin photoaging: current aspects. Vestnik dermatologii i venerologii 2011; 2: 98–103.
- Kubanov A.A., Zhilova M.B., Kubanova A.A. Skin photoageing: mechanisms of development and particular features of clinical manifestations. Vestnik dermatologii i venerologii 2014; 5: 53–59.
- Fistarol S.K., Itin P.H. Disorders of pigmentation. J Dtsch Dermatol Ges 2010; 8(3): 187–202, http://dx.doi.org/10.1111/j.1610-0387.2009.07137.x.
- Kang H.Y., Valerio L., Bahadoran P., Ortonne J.P. The role of topical retinoids in the treatment of pigmentary disorders: an evidence-based review. Am J Clin Dermatol 2009; 10(4): 251–260, http://dx.doi.org/10.2165/00128071-200910040-00005.
- Pandya A.G., Guevara I.L. Disorders of pigmentation. Dermatol Clin 2000; 18(1): 91–98, http://dx.doi.org/10.1016/s0733-8635(05)70150-9.
- Shah D., Desai N., Dhanak R. Lasers in facial aesthetics — a review. Adv Hum Biol 2014; 4(3): 1–6.
- Rinaldi F. Laser: a review. Clin Dermatol 2008; 26(6): 590–601, http://dx.doi.org/10.1016/j.clindermatol.2007.09.014.
- Karabut M.M., Gladkova N.D., Feldstein F.I., Kiselyova E.B., Fomina Yu.V., Muraev A.A. Use of a fractional laser photothermolysis in clinical practice. Sovremennye tehnologii v medicine 2010; 4: 115–121.
- Belikov A.V., Pushkareva A.E., Skripnik A.V. Teoreticheskie i eksperimental’nye osnovy lazernoy ablyatsii biomaterialov [Theoretical and experimental bases of laser ablation of biomaterials]. Saint Petersburg: SPbGU ITMO; 2011.
- Roberts T.L. 3rd, Pozner J.N. Lasers, facelifting, and the future. Clin Plast Surg 2000; 27(2): 293–299.
- Manuskiatti W., Fitzpatrick R.E., Goldman M.P. Long-term effectiveness and side effects of carbon dioxide laser resurfacing for photoaged facial skin. J Am Acad Dermatol 1999; 40(3): 401–411, http://dx.doi.org/10.1016/S0190-9622(99)70489-5.
- Schwartz R.J., Burns A.J., Rohrich R.J., Barton F.E., Byrd H.S. Long-term assessment of CO2 facial laser resurfacing: aesthetic results and complications. Plast Reconstr Surg 1999; 103(2): 592–601, http://dx.doi.org/10.1097/00006534-199902000-00037.
- Weinstein C. Carbon dioxide laser resurfacing: long-term follow up in 2,123 patients. Clin Plast Surg 1998; 25(1): 109–130, http://dx.doi.org/10.1016/s0278-2391(98)90789-3.
- Berlin A.L., Hussain M., Phelps R., Goldberg D.J. A prospective study of fractional scanned nonsequential carbon dioxide laser resurfacing: a clinical and histopathologic evaluation. Dermatol Surg 2009; 35(2): 222–228, http://dx.doi.org/10.1111/j.1524-4725.2008.34413.x.
- Bernstein L.J., Kauvar A.N., Grossman M.C., Geronemus R.G. The short- and long-term side effects of carbon dioxide laser resurfacing. Dermatol Surg 1997; 23(7): 519–525, http://dx.doi.org/10.1111/j.1524-4725.1997.tb00677.x.
- Nanni C.A., Alster T.S. Complications of carbon dioxide laser resurfacing. An evaluation of 500 patients. Dermatol Surg 1998; 24(3): 315–320, http://dx.doi.org/10.1111/j.1524-4725.1998.tb04161.x.
- Alexiades-Armenakas M.R., Dover J.S., Arndt K.A. The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. J Am Acad Dermatol 2008; 58(5): 719–740, http://dx.doi.org/10.1016/j.jaad.2008.01.003.
- Lasers and energy devices for the skin. Goldman M.P., Fitzpatrick R.E., Ross V., Kilmer S.L., Weiss R.A. (editors). CRC Press; 2013, http://dx.doi.org/10.3109/9781841849348.
- Goldman M.P., Marchell N., Fitzpatrick R.E. Laser skin resurfacing of the face with a combined CO2/Er:YAG laser. Dermatol Surg 2000; 26(2): 102–104, http://dx.doi.org/10.1046/j.1524-4725.2000.98208.x.
- Goldman M.P., Weiss R.A., Weiss M.A. Intense pulsed light as a nonablative approach to photoaging. Dermatol Surg 2005; 31(9 Pt 2): 1179–1187.
- Geronemus R.G. Fractional photothermolysis: current and future applications. Lasers Surg Med 2006; 38(3): 169–176, http://dx.doi.org/10.1002/lsm.20310.
- Manstein D., Herron G.S., Sink R.K., Tanner H., Anderson R.R. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004; 34(5): 426–438, http://dx.doi.org/10.1002/lsm.20048.
- Wanner M., Tanzi E.L., Alster T.S. Fractional photothermolysis: treatment of facial and nonfacial cutaneous photodamage with a 1,550-nm erbium-doped fiber laser. Dermatol Surg 2007; 33(1): 23–28, http://dx.doi.org/10.1111/j.1524-4725.2007.33003.x.
- Kono T., Chan H.H., Groff W.F., Manstein D., Sakurai H., Takeuchi M., Yamaki T., Soejima K., Nozaki M. Prospective direct comparison study of fractional resurfacing using different fluences and densities for skin rejuvenation in Asians. Lasers Surg Med 2007; 39(4): 311–314, http://dx.doi.org/10.1002/lsm.20484.
- Tierney E.P., Kouba D.J., Hanke C.W. Review of fractional photothermolysis: treatment indications and efficacy. Dermatol Surg 2009; 35(10): 1445–1461, http://dx.doi.org/10.1111/j.1524-4725.2009.01258.x.
- Helbig D., Paasch U. Molecular changes during skin aging and wound healing after fractional ablative photothermolysis. Skin Res Technol 2011; 17(1): 119–129, http://dx.doi.org/10.1111/j.1600-0846.2010.00477.x.
- Arany P.R., Nayak R.S., Hallikerimath S., Limaye A.M., Kale A.D., Kondaiah P. Activation of latent TGF-beta1 by low-power laser in vitro correlates with increased TGF-beta1 levels in laser-enhanced oral wound healing. Wound Repair Regen 2007; 15(6): 866–874, http://dx.doi.org/10.1111/j.1524-475X.2007.00306.x.
- Hantash B.M., Bedi V.P., Kapadia B., Rahman Z., Jiang K., Tanner H., Chan K.F., Zachary C.B. In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers Surg Med 2007; 39(2): 96–107, http://dx.doi.org/10.1002/lsm.20468.
- Ravanti L., Kähäri V.M. Matrix metalloproteinases in wound repair (review). Int J Mol Med 2000; 6(4): 391–407, http://dx.doi.org/10.3892/ijmm.6.4.391.
- Souil E., Capon A., Mordon S., Dinh-Xuan A.T., Polla B.S., Bachelet M. Treatment with 815-nm diode laser induces long-lasting expression of 72-kDa heat shock protein in normal rat skin. Br J Dermatol 2001; 144(2): 260–266, http://dx.doi.org/10.1046/j.1365-2133.2001.04010.x.
- Wilmink G.J., Opalenik S.R., Beckham J.T., Abraham A.A., Nanney L.B., Mahadevan-Jansen A., Davidson J.M., Jansen E.D. Molecular imaging-assisted optimization of hsp70 expression during laser-induced thermal preconditioning for wound repair enhancement. J Invest Dermatol 2009; 129(1): 205–216, http://dx.doi.org/10.1038/jid.2008.175.
- Atalay M., Oksala N., Lappalainen J., Laaksonen D.E., Sen C.K., Roy S. Heat shock proteins in diabetes and wound healing. Curr Protein Pept Sci 2009; 10(1): 85–95, http://dx.doi.org/10.2174/138920309787315202.
- Laplante A.F., Moulin V., Auger F.A., Landry J., Li H., Morrow G., Tanguay R.M., Germain L. Expression of heat shock proteins in mouse skin during wound healing. J Histochem Cytochem 1998; 46(11): 1291–1301, http://dx.doi.org/10.1177/002215549804601109.
- Laubach H.J., Tannous Z., Anderson R.R., Manstein D. Skin responses to fractional photothermolysis. Lasers Surg Med 2006; 38(2): 142–149, http://dx.doi.org/10.1002/lsm.20254.
- Helbig D., Bodendorf M., Anderegg U., Simon J.C., Paasch U. Human skin explant model to study molecular chances in response to fractional photothermolysis: spatio-temporal expression of HSP70. Medical Laser Application 2010; 25: 173–180.
- Helbig D., Moebius A., Simon J.C., Paasch U. Nonablative skin rejuvenation devices and the role of heat shock protein 70: results of a human skin explant model. J Biomed Opt 2010; 15(3): 038002, http://dx.doi.org/10.1117/1.3449736.
- Kurkinen M., Vaheri A., Roberts P.J., Stenman S. Sequential appearance of fibronectin and collagen in experimental granulation tissue. Lab Invest 1980; 43(1): 47–51.
- Bailey A.J., Bazin S., Delaunay A. Changes in the nature of the collagen during development and resorption of granulatin tissue. Biochim Biophys Acta 1973; 328(2): 383–390, http://dx.doi.org/10.1016/0005-2795(73)90272-9.
- Liu H., Dang Y., Wang Z., Chai X., Ren Q. Laser induced collagen remodeling: a comparative study in vivo on mouse model. Lasers Surg Med 2008; 40(1): 13–19, http://dx.doi.org/10.1002/lsm.20587.
- Orringer J.S., Kang S., Johnson T.M., Karimipour D.J., Hamilton T., Hammerberg C., Voorhees J.J., Fisher G.J. Connective tissue remodeling induced by carbon dioxide laser resurfacing of photodamaged human skin. Arch Dermatol 2004; 140(11): 1326–1332, http://dx.doi.org/10.1001/archderm.140.11.1326.
- Gallucci R.M., Lee E.G., Tomasek J.J. IL-6 modulates alpha-smooth muscle actin expression in dermal fibroblasts from IL-6-deficient mice. J Invest Dermatol 2006; 126(3): 561–568, http://dx.doi.org/10.1038/sj.jid.5700109.
- Haisa M., Okochi H., Grotendorst G.R. Elevated levels of PDGF alpha receptors in keloid fibroblasts contribute to an enhanced response to PDGF. J Invest Dermatol 1994; 103(4): 560–563, http://dx.doi.org/10.1111/1523-1747.ep12396856.
- Kumar S., Millis A.J., Baglioni C. Expression of interleukin 1-inducible genes and production of interleukin 1 by aging human fibroblasts. Proc Natl Acad Sci USA 1992; 89(10): 4683–4687, http://dx.doi.org/10.1073/pnas.89.10.4683.
- Roth D., Piekarek M., Paulsson M., Christ H., Bloch W., Krieg T., Davidson J.M., Eming S.A. Plasmin modulates vascular endothelial growth factor-A-mediated angiogenesis during wound repair. Am J Pathol 2006; 168(2): 670–684, http://dx.doi.org/10.2353/ajpath.2006.050372.
- Vaalamo M., Mattila L., Johansson N., Kariniemi A.L., Karjalainen-Lindsberg M.L., Kähäri V.M., Saarialho-Kere U. Distinct populations of stromal cells express collagenase-3 (MMP-13) and collagenase-1 (MMP-1) in chronic ulcers but not in normally healing wounds. J Invest Dermatol 1997; 109(1): 96–101, http://dx.doi.org/10.1111/1523-1747.ep12276722.
- Hantash B.M., Bedi V.P., Struck S.K., Herron G.S., Chan K.F. Laser-induced transepidermal elimination of dermal content by fractional photothermolysis. J Biomed Opt 2006; 11(4): 041115, http://dx.doi.org/10.1117/1.2241745.
- Karsai S., Czarnecka A., Jünger M., Raulin C. Ablative fractional lasers (CO2 and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides. Lasers Surg Med 2010; 42(2): 160–167, http://dx.doi.org/10.1002/lsm.20879.
- Chitvanich S., Rerknimitr P., Panchaprateep R., Pongprutthipan M., Asawanonda P. Combination of non-ablative fractional photothermolysis and 0.1% tacrolimus ointment is efficacious for treating idiopathic guttate hypomelanosis. J Dermatolog Treat 2016; 10: 1–5, http://dx.doi.org/10.3109/09546634.2015.1133883. [Epub ahead of print].
- Glaich A.S., Rahman Z., Goldberg L.H., Friedman P.M. Fractional resurfacing for the treatment of hypopigmented scars: a pilot study. Dermatol Surg 2007; 33(3): 289–294, http://dx.doi.org/10.1111/j.1524-4725.2007.33058.x.
- Goldberg D.J., Berlin A.L., Phelps R. Histologic and ultrastructural analysis of melasma after fractional resurfacing. Lasers Surg Med 2008; 40(2): 134–138, http://dx.doi.org/10.1002/lsm.20591.
- Kouba D.J., Fincher E.F., Moy R.L. Nevus of Ota successfully treated by fractional photothermolysis using a fractionated 1440-nm Nd:YAG laser. Arch Dermatol 2008; 144(2): 156–158, http://dx.doi.org/10.1001/archdermatol.2007.49.
- Allemann I.B., Kaufman J. Fractional photothermolysis — an update. Lasers Med Sci 2010; 25(1): 137–144, http://dx.doi.org/10.1007/s10103-009-0734-8.
- Jih M.H., Kimyai-Asadi A. Fractional photothermolysis: a review and update. Semin Cutan Med Surg 2008; 27(1): 63–71, http://dx.doi.org/10.1016/j.sder.2008.01.002.
- Katz T.M., Glaich A.S., Goldberg L.H., Firoz B.F., Dai T., Friedman P.M. Treatment of melasma using fractional photothermolysis: a report of eight cases with long-term follow-up. Dermatol Surg 2010; 36(8): 1273–1278, http://dx.doi.org/10.1111/j.1524-4725.2010.01621.x.
- Katz T.M., Goldberg L.H., Firoz B.F., Friedman P.M. Fractional photothermolysis for the treatment of postinflammatory hyperpigmentation. Dermatol Surg 2009; 35(11): 1844–1888, http://dx.doi.org/10.1111/j.1524-4725.2009.01303.x.
- Lin J.Y., Warger W.C., Izikson L., Anderson R.R., Tannous Z. A prospective, randomized controlled trial on the efficacy of fractional photothermolysis on scar remodeling. Lasers Surg Med 2011; 43(4): 265–272, http://dx.doi.org/10.1002/lsm.21061.
- Yang Y.J., Lee G.Y. Treatment of striae distensae with nonablative fractional laser versus ablative CO2 fractional laser: a randomized controlled trial. Ann Dermatol 2011; 23(4): 481–489, http://dx.doi.org/10.5021/ad.2011.23.4.481.
- Bencini P.L., Tourlaki A., Galimberti M., Longo C., Pellacani G., De Giorgi V., Guerriero G. Nonablative fractional photothermolysis for acne scars: clinical and in vivo microscopic documentation of treatment efficacy. Dermatol Ther 2012; 25(5): 463–467, http://dx.doi.org/10.1111/j.1529-8019.2012.01478.x.
- Rerknimitr P., Chitvanich S., Pongprutthipan M., Panchaprateep R., Asawanonda P. Non-ablative fractional photothermolysis in treatment of idiopathic guttate hypomelanosis. J Eur Acad Dermatol Venereol 2015; 29(11): 2238–2242, http://dx.doi.org/10.1111/jdv.12763.
- Karsai S., Fischer T., Pohl L., Schmitt L., Buhck H., Jünger M., Raulin C. Is non-ablative 1550-nm fractional photothermolysis an effective modality to treat melasma? Results from a prospective controlled single-blinded trial in 51 patients. J Eur Acad Dermatol Venereol 2012; 26(4): 470–476, http://dx.doi.org/10.1111/j.1468-3083.2011.04100.x.
- Wanitphakdeedecha R., Keoprasom N., Eimpunth S., Manuskiatti W. The efficacy in melasma treatment using a 1410 nm fractional photothermolysis laser. J Eur Acad Dermatol Venereol 2014; 28(3): 293–297, http://dx.doi.org/10.1111/jdv.12100.
- Liu Y., Zeng W., Hu D., Jha S., Ge Q., Geng S., Xiao S., Hu G., Wang X. The long-term effect of 1550 nm erbium: glass fractional laser in acne vulgaris. Lasers Med Sci 2016; 31(3): 453–457, http://dx.doi.org/10.1007/s10103-016-1871-5.
- Dahan S., Lagarde J.M., Turlier V., Courrech L., Mordon S. Treatment of neck lines and forehead rhytids with a nonablative 1540-nm Er: glass laser: a controlled clinical study combined with the measurement of the thickness and the mechanical properties of the skin. Dermatol Surg 2004; 30(6): 872–880, http://dx.doi.org/10.1111/j.1524-4725.2004.30256.x.
- Kim B.J., Lee D.H., Kim M.N., Song K.Y., Cho W.I., Lee C.K., Kim J.Y., Kwon O.S. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol 2008; 9(1): 33–37, http://dx.doi.org/10.2165/00128071-2 00809010-00003.
- Lee S.M., Kim M.S., Kim Y.J., Won C.H., Lee M.W., Choi J.H., Moon K.C., Chang S.E. Adverse events of non-ablative fractional laser photothermolysis: a retrospective study of 856 treatments in 362 patients. J Dermatolog Treat 2014; 25(4): 304–307, http://dx.doi.org/10.3109/09546634.2013.777151.
- Dierickx C.C., Khatri K.A., Tannous Z.S., Childs J.J., Cohen R.H., Erofeev A., Tabatadze D., Yaroslavsky I.V., Altshuler G.B. Micro-fractional ablative skin resurfacing with two novel erbium laser systems. Lasers Surg Med 2008; 40(2): 113–123, http://dx.doi.org/10.1002/lsm.20601.
- Lloyd J., Tanghetti E. Comparison of Affirm 1320/1440 nm versus 1320 nm for the treatment of acne scars — clinical and histologic study. Lasers Surg Med 2008; 66: 27.
- Walgrave S.E., Ortiz A.E., MacFalls H.T., Elkeeb L., Truitt A.K., Tournas J.A., Zelickson B.D., Zachary C.B. Evaluation of a novel fractional resurfacing device for treatment of acne scarring. Lasers Surg Med 2009; 41(2): 122–127, http://dx.doi.org/10.1002/lsm.20725.
- Chapas A.M., Brightman L., Sukal S., Hale E., Daniel D., Bernstein L.J., Geronemus R.G. Successful treatment of acneiform scarring with CO2 ablative fractional resurfacing. Lasers Surg Med 2008; 40(6): 381–386, http://dx.doi.org/10.1002/lsm.20659.
- Qian H., Lu Z., Ding H., Yan S., Xiang L., Gold M.H. Treatment of acne scarring with fractional CO2 laser. J Cosmet Laser Ther 2012; 14(4): 162–165, http://dx.doi.org/10.3109/14764172.2012.699679.
- Singh S., Peterson J.D., Friedman P.M. Management of mild to moderate rhinophyma using ablative fractional photothermolysis. Dermatol Surg 2013; 39(7): 1110–1113, http://dx.doi.org/10.1111/dsu.12222.
- Kim S. Clinical trial of a pinpoint irradiation technique with the CO2 laser for the treatment of atrophic acne scars. J Cosmet Laser Ther 2008; 10(3): 177–180, http://dx.doi.org/10.1080/14764170801930080.
- Aldahan A.S., Shah V.V., Mlacker S., Samarkandy S., Alsaidan M., Nouri K. Laser and light treatments for striae distensae: a comprehensive review of the literature. Am J Clin Dermatol 2016; 17(3): 239–256, http://dx.doi.org/10.1007/s40257-016-0182-8.
- Alexis A.F., Coley M.K., Nijhawan R.I., Luke J.D., Shah S.K., Argobi Y.A., Nodzenski M., Veledar E., Alam M. Nonablative fractional laser resurfacing for acne scarring in patients with fitzpatrick skin phototypes IV–VI. Dermatol Surg 2016; 42(3): 392–402, http://dx.doi.org/10.1097/DSS.0000000000000640.
- Augustyniak A., Rotsztejn H. Fractional non-ablative laser treatment 1410 nm for periorbital wrinkles — reviscometrical and clinical evaluation. J Cosmet Laser Ther 2016; 10: 1–14, http://dx.doi.org/10.3109/14764172.2016.1157370.
- Cachafeiro T., Escobar G., Maldonado G., Cestari T., Corleta O. Comparison of nonablative fractional erbium laser 1,340 nm and microneedling for the treatment of atrophic acne scars: a randomized clinical trial. Dermatol Surg 2016; 42(2): 232–241, http://dx.doi.org/10.1097/DSS.0000000000000597.
- Finney R., Torbeck R., Saedi N. Non-ablative fractional resurfacing in the treatment of scar contracture. Lasers Surg Med 2016; 48(2): 170–173, http://dx.doi.org/10.1002/lsm.22400.
- Friedmann D.P., Tzu J.E., Kauvar A.N., Goldman M.P. Treatment of facial photodamage and rhytides using a novel 1,565 nm non-ablative fractional erbium-doped fiber laser. Lasers Surg Med 2016; 48(2): 174–180, http://dx.doi.org/10.1002/lsm.22461.
- Taudorf E.H., Danielsen P.L., Paulsen I.F., Togsverd-Bo K., Dierickx C., Paasch U., Haedersdal M. Non-ablative fractional laser provides long-term improvement of mature burn scars — a randomized controlled trial with histological assessment. Lasers Surg Med 2015; 47(2): 141–147, http://dx.doi.org/10.1002/lsm.22289.
- Azzam O.A., Bassiouny D.A., El-Hawary M.S., El Maadawi Z.M., Sobhi R.M., El-Mesidy M.S. Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser: a clinical, histological, and immunohistochemical study. Lasers Med Sci 2016; 31(1): 9–18, http://dx.doi.org/10.1007/s10103-015-1824-4.
- Banihashemi M., Nahidi Y., Maleki M., Esmaily H., Moghimi H.R. Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis. Lasers Med Sci 2016; 31(4): 733–739, http://dx.doi.org/10.1007/s10103-016-1919-6.
- Firooz A., Rajabi-Estarabadi A., Nassiri-Kashani M.H. Treatment of atrophic facial acne scars with fractional Er:YAG laser in skin phototype III–IV: a pilot study. J Cosmet Laser Ther 2016, http://dx.doi.org/10.3109/14764172.2016.1157354. [Epub ahead of print].
- Gan S.D., Hsu S.H., Chuang G., Konnikov N., Liang C.A. Ablative fractional laser therapy for the treatment of actinic keratosis: a split-face study. J Am Acad Dermatol 2016; 74(2): 387–389, http://dx.doi.org/10.1016/j.jaad.2015.08.035.
- Kositratna G., Hibert M.L., Jaspan M., Welford D., Manstein D. Effects of deviation from focal plane on lesion geometry for ablative fractional photothermolysis. Lasers Surg Med 2016, http://dx.doi.org/10.1002/lsm.22481. [Epub ahead of print].
- Lee D., Park E.S., Tak M.S., Nam S.M. The effectiveness of ablative fractional carbon dioxide laser with autologous platelet rich plasma combined resurfacing for hypertrophic scar of the shoulder. Arch Aesthetic Plast Surg 2016; 22(1): 40, http://dx.doi.org/10.14730/aaps.2016.22.1.40.
- Schoenewolf N.L., Hafner J., Dummer R., Allemann I.B. Laser treatment of solar lentigines on dorsum of hands: QS Ruby laser versus ablative CO2 fractional laser — a randomized controlled trial. Eur J Dermatol 2015; 25(2): 122–126, http://dx.doi.org/10.1684/ejd.2014.2513.