Comparison of Outcome Parameters in Laser Rhytide Treatment

• Quantitative measurement of wrinkle depth [ Time Frame: Before and after treatment (3 months) ] [ Designated as safety issue: No ]
• Fitzpatrick wrinkle score [ Time Frame: Before and after treatment (3 months) ] [ Designated as safety issue: No ]

• Patient benefit index (PBI) [ Time Frame: Before and after treatment (3 months) ] [ Designated as safety issue: No ]
• Patient satisfaction [ Time Frame: 1, 3, 6 days and 3 months after treatment ] [ Designated as safety issue: No ]

We previously published a comparative split-face study which has shown a significant, albeit moderate, effect of ablative fractional laser treatment. While indicating that a single session with fractional ablative lasers can be effective in the treatment of peri-orbital wrinkles, the trial also revealed substantial disagreement between the different end points (profilometry, Fitzpatrick wrinkle score, patient satisfaction). Since the PBI is a patient-related index it could not be included in the aforementioned split-face trial; the present study therefore attempts to further elucidate the patient-related benefit of a single fractional ablative laser treatment session as well as carefully analyse the respective correlations between the outcome parameters employed.

• Procedure: Fractional carbon dioxide laser treatment
  With the CO2 laser (Fraxel Re:pair, Solta Medical Inc., Hayward, CA), patients received two passes at 15 mJ (1st pass) and 20 mJ (2nd pass), respectively, with a total density of 20 %. We employed 'pin-point bleeding' and serosanguinous exudate as a clinical end point. The pulse duration was 10 msec.
• Procedure: Fractional Er:YAG laser treatment
  The Er:YAG laser (MCL 30 Dermablate, Asclepion Laser Technologies GmbH, Jena, Germany) was used in 4 passes with a total fluence of 60 J/cm² and pulse stacking (6 stacked pulses); the pulse duration was 400 μsec.

• Active Comparator: Fractional carbon dioxide laser treatment
  Intervention: Procedure: Fractional carbon dioxide laser treatment
• Active Comparator: Fractional Er:YAG laser treatment
  Intervention: Procedure: Fractional Er:YAG laser treatment

Inclusion Criteria:

• mild to moderate peri-orbital rhytides ('crow's feet') at rest (Class II according to Fitzpatrick)

Exclusion Criteria:

• unrealistic expectations
• inability to meet follow-up criteria
• Fitzpatrick skin phototype >III
• coagulation disorders or anti-coagulant treatment
• allergy to lidocaine or tetracaine
• oral isotretinoin within the last 6 months
• any active skin disease within the treatment areas (e.g., psoriasis, cancer, or autoimmune disease)
• synthetic implants in the treatment area
• facial cosmetic procedures affecting the treatment area within the last 6 months
• photosensitizing medications (e.g., tetracycline, gold)
• history of keloid formation
• pregnancy