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MedNext Journal of Medical and Health Sciences
Review
DOI: 10.54448/mdnt23301
Submitted: 07-21-2023
Published: 07-23-2023

Major clinical evidence of the optimization of the use of CO2 fractional ablative laser with cells and molecules: a systematic review

UNIOFTAL- Ophthalmology And Eye Plastic, São José do Rio Preto, São Paulo, Brazil
Chairman, National Authority on Tobacco and Alcohol, Colombo, Sri Lanka
Type 1 diabetes mellitus Working Animals Hypoglycemia

Abstract

Introduction: Ablative fractional CO2 laser skin resurfacing describes the process of removing the superficial epidermal and dermal layers of the skin to reduce the cutaneous signs of photoaging. The clinical efficacy and safety of exosomes, adipose tissue stem cells, platelet-rich plasma, and resveratrol as adjuvant therapy after ablative fractional CO2 laser application are evidenced by the world literature. Objective: It was to carry out a systematic review to list the main clinical outcomes of the use of fractional ablative CO2 laser, with or without associated techniques, for facial aesthetic treatment. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from April to May 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 86 articles were found. A total of 32 articles were fully evaluated and 17 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies at high risk of bias and 37 studies that did not meet the GRADE. It was concluded that ablative fractional CO2 laser offers a safe and effective treatment for disfiguring facial scars. It was shown that the improvement in the appearance and quality of the scar was significant for the patient, with a significant impact on the patient's quality of life. Based on these findings, we suggest including ablative fractional CO2 laser in the concept of facial scar treatment. The results demonstrate that the ablative fractional CO2 laser of low fluence and low density is a safe and efficient option for the photorejuvenation of the face. Repeated application of ablative fractional CO2 laser to skin with melasma can result in lasting improvement due to its destructive effect on melanocytes. Furthermore, the combined use of exosome gel with CO2 laser resurfacing would provide synergistic effects on both the efficacy and safety of atrophic acne scarring treatments. ADSC-CM with CO2 resurfacing is a good combination therapy for the treatment of atrophic acne scars and skin rejuvenation. The combined use of ablative fractional CO2 laser and PRP obtained better results. Resveratrol can improve photoaging alone and add efficacy to fractional ablative laser treatment and decrease the adverse effects induced by fractional ablative laser.

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References

  1. Verma N, Yumeen S, Raggio BS. Ablative Laser Resurfacing. 2023 Apr 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491406.
  2. Omi T, Numano K. The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology. Laser Ther. 2014 Mar 27;23(1):49-60. doi: 10.5978/islsm.14-RE-01.
  3. Ziai K, Wright HV. Carbon Dioxide Laser Rejuvenation of the Facial Skin. Clin Plast Surg. 2023 Jul;50(3):421-436. doi: 10.1016/j.cps.2022.12.007.
  4. Ziai K, Wright HV. Carbon Dioxide Laser Rejuvenation of the Facial Skin. Facial Plast Surg Clin North Am. 2022 Aug;30(3):331-346. doi: 10.1016/j.fsc.2022.03.007.
  5. Zou B, Zheng W, Pan H, Yang B, Liu Z. Research trends and hotspot analysis of fractional carbon dioxide laser: A bibliometric and visualized analysis via Citespace. J Cosmet Dermatol. 2022 Nov;21(11):5484-5499. doi: 10.1111/jocd.15267.
  6. Prohaska J, Hohman MH. Laser Complications. 2023 Mar 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30335281.
  7. Jordão JM, Stoliar MFF, Melo SS, de Campos GLM, de Forville Mesquita LA, Skare TL. Low-fluence and low-density CO2 laser: histological analysis of collagen fiber changes in skin and its clinical repercussions in photorejuvenation. Lasers Med Sci. 2022 Mar;37(2):905-911. doi: 10.1007/s10103-021-03330-0.
  8. Meynköhn A, Fischer S, Neuss C, Willkomm LM, Kneser U, Kotsougiani-Fischer D. Fractional ablative carbon dioxide laser treatment of facial scars: Improvement of patients' quality of life, scar quality, and cosmesis. J Cosmet Dermatol. 2021 Jul;20(7):2132-2140. doi: 10.1111/jocd.13850.
  9. El-Sinbawy ZG, Abdelnabi NM, Sarhan NE, Elgarhy LH. Clinical & ultrastructural evaluation of the effect of fractional CO2 laser on facial melasma. Ultrastruct Pathol. 2019;43(4-5):135-144. doi: 10.1080/01913123.2019.1673861.
  10. Köse O. Efficacy of the carbon dioxide fractional laser in the treatment of compound and dermal facial nevi using with dermatoscopic follow-up. J Dermatolog Treat. 2019 Aug;30(5):498-502. doi: 10.1080/09546634.2018.1529384.
  11. Kwon HH, Yang SH, Lee J, Park BC, Park KY, Jung JY, Bae Y, Park GH. Combination Treatment with Human Adipose Tissue Stem Cell-derived Exosomes and Fractional CO2 Laser for Acne Scars: A 12-week Prospective, Double-blind, Randomized, Split-face Study. Acta Derm Venereol. 2020 Nov 4;100(18):adv00310. doi: 10.2340/00015555-3666.
  12. Duplechain JK. Fractional CO2 resurfacing: has it replaced ablative resurfacing techniques? Facial Plast Surg Clin North Am. 2013 May;21(2):213-27. doi: 10.1016/j.fsc.2013.02.006.
  13. Zhou BR, Zhang T, Bin Jameel AA, Xu Y, Xu Y, Guo SL, Wang Y, Permatasari F, Luo D. The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation. J Cosmet Laser Ther. 2016 Jun;18(3):138-48. doi: 10.3109/14764172.2015.1114638.
  14. Galal O, Tawfik AA, Abdalla N, Soliman M. Fractional CO2 laser versus combined platelet-rich plasma and fractional CO2 laser in treatment of acne scars: Image analysis system evaluation. J Cosmet Dermatol. 2019 Dec;18(6):1665-1671. doi: 10.1111/jocd.12909.
  15. Abdel-Maguid EM, Awad SM, Hassan YS, El-Mokhtar MA, El-Deek HE, Mekkawy MM. Efficacy of stem cell-conditioned medium vs. platelet-rich plasma as an adjuvant to ablative fractional CO2 laser resurfacing for atrophic post-acne scars: a split-face clinical trial. J Dermatolog Treat. 2021 Mar;32(2):242-249. doi: 10.1080/09546634.2019.1630701.
  16. Kadry M, Tawfik A, Abdallah N, Badawi A, Shokeir H. Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study. Clin Cosmet Investig Dermatol. 2018 Nov 8;11:551-559. doi: 10.2147/CCID.S178817.
  17. Du YM, Zeng J, Li M, Wang YB, Wu Y, Qi RQ, Gao XH, Chen HD. Efficacy and safety of Resveratrol combined with Ablative Fractional CO2 laser system in the treatment of skin photoaging. J Cosmet Dermatol. 2021 Dec;20(12):3880-3888. doi: 10.1111/jocd.14569.

How to Cite

Liedtke, F. S., & Rajapaksa, S. W. (2023). Major clinical evidence of the optimization of the use of CO2 fractional ablative laser with cells and molecules: a systematic review. MedNEXT Journal of Medical and Health Sciences, 4(3). https://doi.org/10.54448/mdnt23301