非剝離性雷射療法可以有效的改善粉刺疤痕


  Nov. 15, 2004 - 一項刊載於11月份Archives of Dermatology期刊上先期性的研究結果顯示,以非剝離性雷射治療後,皮膚會繼續以膠原作重整,可以安全有效的改善粉刺留在臉上的輕中度疤痕。
  
  德州大學醫學院皮膚學系的Paul Friedman醫師指出,最近有許多方法,如非剝離性雷射法、不同光源及不同放射線波頻等,都被用來對上皮組織傳達能量,以期對傷害處的復原反應作控制,並在不傷害上皮組織的情形下,對上皮凸出及網狀異樣組織作治療。
  
  Friedman醫師表示,雖然許多研究都已證實,新的膠原會在雷射治療後生成,對臉部的皺折及疤痕產生相當程度的改善,但是這些改善的效果卻很難量化。
  
  在最近的一項研究裡,針對11位患有輕中度萎縮性皮膚疤的患者,研究人員以三度空間光學造影系統取得了13處的臉部皮膚形體造影,所有的患者皆經歷過5次的非剝離性雷射療程,每一次療程皆為波長1064nm的Q-switched Nd:YAG雷射;取得對比影像的時間分別為,第三次療程後1個月(治療中點)、及治療後第1、3及第6個月。
  
  皮膚粗糙度分析(Ra)發現,相較於治療初期,於治療中點時有8.9%的中度改善;治療後1個月時,發現有23.3%的改善幅度。
  
  治療後第1個月及第3個月之間,Ra出現最大的改善幅度31.6%;改善的情況於治療後第6個月就出現停止的狀態,但是此時和治療初期仍相差了39.2%。
  
  副作用有輕度到中度的短暫紅斑、疼痛及輕度的瘀斑。
  
  Friedman醫師指出,本研究顯示,1064-nm Q-switched Nd:YAG雷射對於輕中度的臉部粉刺疤痕,提供了一項安全有效的非侵犯性治療,而且療效是持久的,並可維持至後期治療以後;由此看出,於雷射治療後,皮膚會以再生膠原繼續作重整。

Nonablative Laser Therapy Sign

By Yael Waknine
Medscape Medical News

Nov. 15, 2004 — Nonablative laser therapy appears to be safe and significantly improves mild to moderate facial scarring due to acne, with posttreatment continuation of dermal collagen remodeling, according to the results of a prospective study published in the November issue of the Archives of Dermatology.

"Recently, nonablative lasers, light sources, and radiofrequency waves have been used to selectively deliver thermal energy to the upper dermis, inducing a controlled wound healing response in the papillary and upper reticular dermis without epidermal damage," write Paul M. Friedman, MD, from DermSurgery Associates and the Department of Dermatology at the University of Texas Medical School in Houston, and colleagues.

Although studies have confirmed the production and deposition of new collagen after laser therapy as well as the resulting qualitative improvements of facial rhytids and scars, the authors suggest that these effects have been difficult to quantify.

In the current study, the investigators used a three-dimensional optical profiling imaging system to assess skin topography of 13 facial sites in 11 patients with mild to moderate atrophic skin scarring. Each patient underwent five nonablative treatment sessions with the 1064-nm Q-switched Nd:YAG laser. Comparative images were taken one month after the third treatment session (therapy midpoint), and at one, three, and six months posttherapy.

Moderate improvements in roughness analysis (Ra) of 8.9% were observed at therapy midpoint, and significant improvement was observed as early as one month posttreatment (23.3%; P < .001) compared with baseline.

The greatest improvement in Ra occurred between the first and third months posttreatment (P = .03), with a 31.6% change compared with baseline (P < .01). Improvements appeared to reach a plateau by six months posttherapy, although the change from baseline remained significant (39.2%; P < .01).

Adverse events included mild to moderate transient erythema and pain, and mild pinpoint petechiae.

"[T]his study demonstrated that the 1064-nm Q-switched Nd:YAG laser provides a safe and effective noninvasive treatment for mild to moderate facial acne scarring," the authors point out. "The results are long lasting and continue well beyond the last treatment, indicating ongoing collagen remodeling after completion of the laser treatment sessions."

The authors report no pertinent financial conflicts of interest.

Arch Dermatol. 2004;140:1337-1341

Reviewed by Gary D. Vogin, MD

    
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