Skip to main content
SpringerLink
Log in

Low-fluence and low-density CO2 laser: histological analysis of collagen fiber changes in skin and its clinical repercussions in photorejuvenation

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

This study refers to clinical and histologic analysis of effects on photorejuvenation after one single treatment of fractional CO2 laser with low fluence and low density. To analyze histologically the quantitative variation of collagen fibers type I and III, elastic fibers, and epidermal thickness on D84, besides clinical evaluation of amount, length, thickness, and depth of periocular wrinkles during the same period. This is an open, prospective, interventional study. There were 40 healthy female with age between 35 and 65 years. Twenty-six participants were randomly selected for D0 and D84 biopsy. A single session of fractional CO2 laser was done in the hole face, using a 800-µm tip, 5% density, and 10 mJ fluence with a single pass. On D0, D42, and D84, a clinical comparative analysis of amount, length, depth, and thickness of periocular wrinkles has been done. On histological analysis, a comparative quantitative evaluation of collagen fibers type I and III, elastic fibers, and epidermal thickness has been done on D0 and D84. The results of this study denoted a significant clinical improvement of amount (− 32.17%; p < 0.0001), thickness (− 33%; p < 0.0001), lenght (− 35.84%; p < 0.0001), and depth of periocular wrinkles (− 32.46%; p < 0.0001). A significant increase in the amount of collagen fibers type III was observed on D84 (+ 60.67%; p = 0.0013). Collagen fibers type I and elastic fibers did not have the same result, with a nonsignificant increase (+ 8.31%; p = 0.3820) and a decrease (− 12.4%; p = 0.0585) respectively. Epidermal thickness has a tendency to significant variation (p = 0.05553). The results demonstrate that fractional CO2 laser with low fluence and low density is a safe and efficient option for photorejuvenation of the face.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Graph 1
Fig. 4

Similar content being viewed by others

References

  1. Khan MH, Sink RK, Manstein D, Eimerl D, Anderson RR (2005) Intradermally focused infrared laser pulses: thermal effects at defined tissue depths. Lasers Surg Med 36(4):270–280. https://doi.org/10.1002/lsm.20142

    Article  PubMed  Google Scholar 

  2. Prignano F, Bonciani D, Campolmi P, Cannarozzo G, Bonan P, Lotti T (2011) A study of fractional CO2 laser resurfacing: the best fluences through a clinical, histological, and ultrastructural evaluation. J Cosmet Dermatol 10:210–216. https://doi.org/10.1111/j.1473-2165.2011.00571.x

    Article  PubMed  Google Scholar 

  3. Thomson PJ (2002) Wylie J (2002) Interventional laser surgery: an effective surgical and diagnostic tool in oral precancer management. Int J Oral Maxillofac Surg 31(2):145–153. https://doi.org/10.1054/ijom.2001.0189

    Article  CAS  PubMed  Google Scholar 

  4. Sharon-Buller A, Sela M (2004) CO2-laser treatment of ulcerative lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97(3):332–334. https://doi.org/10.1016/j.tripleo.2003.11.012

    Article  PubMed  Google Scholar 

  5. Motta MM, Stelini RF, Calderoni DR, Gilioli R, Kharmandayan P (2016) Lower energy and pulse stacking. A safer alternative for skin tightening using fractional CO2 laser. Acta Cir Bras 31(1):28–35. https://doi.org/10.1590/S0102-865020160010000005

    Article  PubMed  Google Scholar 

  6. Saluja R1, Khoury J, Detwiler SP, Goldman MP (2009) Histologic and clinical response to varying density settings with a fractionally scanned carbon dioxide laser. J Drugs Dermatol 8(1):17–20

    PubMed  Google Scholar 

  7. Yuan XH, Zhong SX, Li SS (2014) Comparison study of fractional carbon dioxide laser resurfacing using different fluences and densities for acne scars in Asians: a randomized split-face trial. Dermatol Surg 40(5):545–552. https://doi.org/10.1111/dsu.12467

    Article  CAS  PubMed  Google Scholar 

  8. Bazin R, Doublet E (2007) Skin Aging Atlas. Med`Com, Paris

    Google Scholar 

  9. DeBruler DM, Blackstone BN, Baumann ME et al (2017) Inflammatory responses, matrix remodeling, and re-epithelialization after fractional CO2 laser treatment of scars. Lasers Surg Med 49:675–685. https://doi.org/10.1002/lsm.22666

    Article  PubMed  Google Scholar 

  10. Capon A, Mordon S (2006) Can thermal lasers promote skin wound healing? Am J Clin Dermatol 4(1):1–12. https://doi.org/10.2165/00128071-200304010-00001

    Article  Google Scholar 

  11. Goldberg DJ (2006) Lasers for facial rejuvenation. Am J Clin Dermatol 4(4):225–234. https://doi.org/10.2165/00128071-200304040-00002

    Article  Google Scholar 

  12. Sadick NS (2006) Update on non-ablative light therapy for rejuvenation: a review. Lasers Surg Med 32(2):120–128. https://doi.org/10.1002/lsm.10127

    Article  Google Scholar 

  13. Stadelmann WK, Digenis AG, Tobin GR (1998) Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg 176:26S-38S. https://doi.org/10.1016/S0002-9610(98)00183-4

    Article  CAS  PubMed  Google Scholar 

  14. Helbig D, Paassch U (2011) Molecular changes during skin aging and wound healing after fractional ablative photothermolysis. Skin Res Technol. 17(1):119–28. https://doi.org/10.1111/j.1600-0846.2010.00477.x

    Article  PubMed  Google Scholar 

  15. Longo C, Galimberti M, de Pace B, Pellacani G, Bencini PL (2003) Laser skin rejuvenation: epidermal changes and collagen remodeling evaluated by in vivo confocal microscopy. Lasers Med Sci 28:769–776. https://doi.org/10.1007/s10103-012-1145-9

    Article  Google Scholar 

  16. El-Domyati M, El-Ammawi TS, Medhat W, Moawad O, Mahoney MG, Uitto J (2012) Multiple minimally invasive erbium: yttrium aluminum garnet laser mini-peels for skin rejuvenation: an objective assessment. J Cosmet Dermatol 11(2):122–130. https://doi.org/10.1111/j.1473-2165.2012.00606.x

    Article  PubMed  PubMed Central  Google Scholar 

  17. El-Domyati M, Abd-El-Raheem T, Medhat W, Abdel-Wahab H, Al Anwer M (2014) Multiple fractional erbium: yttrium-aluminum-garnet laser sessions for upper facial rejuvenation: clinical and histological implications and expectations. J Cosmet Dermatol 13(1):30–37. https://doi.org/10.1111/jocd.12079

    Article  PubMed  Google Scholar 

  18. Ross EV, Swann M, Soon S, Izadpanah A, Barnette D, Davenport S (2009) Full-face treatments with the 2790-nm erbium:YSGG laser system. J Drugs Dermatol 8(2):248–252

    PubMed  Google Scholar 

  19. Chen KH, Tam KW, Chen IF, Huang SK, Tzeng PC, Wang HJ, Chen CC (2017) A systematic review of comparative studies of CO2 and erbium:YAG lasers in resurfacing facial rhytides (wrinkles). J Cosmet Laser Ther 19(4):199–204. https://doi.org/10.1080/14764172.2017.1288261

    Article  PubMed  Google Scholar 

  20. Marqa MF, Mordon S (2014) Laser fractional photothermolysis of the skin: numerical simulation of microthermal zones. J Cosmet Laser Ther 16(2):57–65. https://doi.org/10.3109/14764172.2013.854642

    Article  PubMed  Google Scholar 

  21. Schmitt L, Huth S, Amann PM et al (2018) Direct biological effects of fractional ultrapulsed CO2 laser irradiation on keratinocytes and fibroblasts in human organotypic full-thickness 3D skin models. Lasers Med Sci 33(4):765–772. https://doi.org/10.1007/s10103-017-2409-1

    Article  CAS  PubMed  Google Scholar 

  22. Hantash BM, Bedi VP, Kapadia B et al (2007) In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers Surg Med 39(2):96–107. https://doi.org/10.1002/lsm.20468

    Article  PubMed  Google Scholar 

  23. Skovbølling Haak C, Illes M, Paasch U, Hædersdal M (2011) Histological evaluation of vertical laser channels from ablative fractional resurfacing: an ex vivo pig skin model. Lasers Med Sci 26(4):465–471. https://doi.org/10.1007/s10103-010-0829-2

    Article  PubMed  Google Scholar 

  24. Ross EV, Yashar SS, Naseef GS et al (1999) A pilot study of in vivo immediate tissue contraction with CO2 skin laser resurfacing in a live farm pig. Dermatol Surg 25(11):851–856. https://doi.org/10.1046/j.1524-4725.1999.99091.x

    Article  CAS  PubMed  Google Scholar 

  25. T Omi, K Numano. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 23(1):49–60. https://doi.org/10.5978/islsm.14-RE-01

Download references

Acknowledgements

The authors acknowledge Lismary Aparecida de Forville Mesquita, dermopatologist, for her role in the management of the biopsies and for providing relevant information for this study.

Vichy Laboratories, Brazil, provided products for the subjects during the study.

Funding

Dr. Fajgenbaum Feiges Stoliar reports personal fees from L´Oréal Brazil, from null, during the conduct of the study, and personal fees from L´Oréal Brazil, from null, outside the submitted work.

Author information

Authors and Affiliations

  1. Head of Laser Therapy Dermatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil

    Juliana Merheb Jordão

  2. L´Oréal Brazil, Rio de Janeiro, RJ, Brazil

    Mariana Fajgenbaum Feiges Stoliar

  3. Dermatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil

    Sarah Sanches Melo & Giovana Liz Marioto de Campos

  4. Santa Casa de Misericorida de Curitiba, Curitiba, PR, Brazil

    Lismary Aparecida de Forville Mesquita

  5. Rheumatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil

    Thelma Larocca Skare

Authors
  1. Juliana Merheb Jordão
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariana Fajgenbaum Feiges Stoliar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarah Sanches Melo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giovana Liz Marioto de Campos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lismary Aparecida de Forville Mesquita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thelma Larocca Skare
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juliana Merheb Jordão.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Faculdade Evangélica Mackenzie (nº 53058216.6.0000.0103).

Conflict of interest

Dr. Jordão, Dr. Melo, Dr. de Campos, and Dr. Skare have stated explicitly that there are no conflicts of interest in connection with this article.

Dr. Fajgenbaum Feiges Stoliar reports personal fees from L´Oréal Brazil, from null, during the conduct of the study, and personal fees from L´Oréal Brazil, from null, outside the submitted work.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jordão, J.M., Stoliar, M.F.F., Melo, S.S. et al. Low-fluence and low-density CO2 laser: histological analysis of collagen fiber changes in skin and its clinical repercussions in photorejuvenation. Lasers Med Sci 37, 905–911 (2022). https://doi.org/10.1007/s10103-021-03330-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-021-03330-0

Keywords

Search

Navigation