A Comparative Split-Face Trial of Plant-Based Hypoallergenic Ointment vs Petroleum-Based Ointment Following Fractionated Carbon Dioxide Laser Resurfacing of the Face

November 2018 | Volume 17 | Issue 11 | Original Article | 1178 | Copyright © 2018

Yunyoung C. Chang MD, Jennifer Croix MD PhD, Shannon Hernandez RN, Anne Chapas MD

Union Square Laser Dermatology, New York, NY

Abstract

PURPOSE: Fractionated carbon dioxide (CO2) laser resurfacing uses fractional photothermolysis with an ablative 10,600-nm wavelength for treatment of rhytides and photodamage. Although associated with reduced side effect profile from traditional ablative lasers, fractionated lasers can lead to significant erythema, edema, crusting, and exudation for 14 days. Post-care includes regular distilled water soaks and healing ointment. This study evaluated efficacy and patient satisfaction of a novel plant-based hypoallergenic ointment (Doctor Rogers RESTORE®Healing Balm; Product 1) compared to petroleum-based lanolin-containing ointment (Aquaphor® Healing Ointment; Product 2) to accelerate wound healing post-laser resurfacing of the face. DESIGN: This was a single-center, prospective randomized, double-blinded, split-face comparative study of 10 subjects with photo-aging and rhytids who received treatment with fractionated CO2 laser between September 2017 and January 2018. Product 1 and Product 2 were randomized to each half of the face and applied from days 0 to 7 with an option to continue to day 14. The primary outcome measures were Investigator-rated degree of erythema, edema, crusting, exudation, and percentage healing, with follow-up evaluations performed at days 2, 4, 7, 14, and 30. The secondary outcome measure was patient satisfaction. SUMMARY: Based on investigator post-resurfacing scores, day 4 showed improved erythema (50%), edema (50%), crusting (40%), and percentage healing (60%) on the Product 1-treated side compared to Product 2, with the majority of remaining patients scoring the same as Product 2. On day 14, Product 1 demonstrated improvement in erythema (50%), edema (30%), and percentage healing (30%) compared to Product 2, with all remaining patients scoring the same as Product 2. Crusting was the same between the two products on day 14. Ninety percent of patients preferred Product 1 over Product 2, found it easier to use, and were more likely to use it in the future. CONCLUSION: Product 1 is a plant-based hypoallergenic ointment that is safe and effective post-laser treatment and is associated with high patient satisfaction and preference. J Drugs Dermatol. 2018;17(11):1178-1182.

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INTRODUCTION

Ablative resurfacing of the skin using carbon dioxide (CO2) laser has been the gold standard for treatment of photoaging for more than 20 years.1 Ablative fractional laser (AFL) using CO2 resurfacing applies the concept of fractional photothermolysis with an ablative 10,600 nm wavelength for the treatment of facial rhytids and photoaging. This laser technology delivers columns of thermal injury to a specific fraction of the epidermal and dermal tissue, leaving intervening areas of follicular units and fibroblasts unaffected thereby allowing for more rapid repopulation during the healing phase.2 This leads to decreases in recovery time, side effects, and complications as compared to traditional non-fractionated ablative resurfacing treatments.1-3 Nevertheless, AFL can still be associated with significant erythema, edema, crusting, exudation, secondary infections, and hypertrophic scarring.4,5 The downtime associated with this procedure remains a hindrance to treatment.A post-procedure skincare regimen is important to optimize the wound healing response post-AFL. In our practice, it typically consists of regular application of distilled water soaks and healing ointments during the following week. Many of the healing ointments currently used contain lanolin, which has seen an increased prevalence of contact allergy.6 A novel healing ointment (Doctor Rogers RESTORE® Healing Balm; Product 1) has been developed to help repair sensitive or damaged skin. It is a 100% plant-based, hypoallergenic ointment that is both lanolin and petroleum free, and has also been shown to inhibit the growth of bacteria and fungi.The primary objective of this study was to compare the efficacy of a novel plant-based ointment to a petroleum ointment containing lanolin for wound healing and skin quality following AFL resurfacing of the face. Secondary objectives included

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