Biophysical Evaluation of Fractional Laser Skin Resurfacing With an Er:YSGG Laser Device in Japanese Skin

May 2012 | Volume 11 | Issue 5 | Original Article | 637 | Copyright © May 2012


Background: Ablative fractional laser skin resurfacing (FLSR) has recently been used for the amelioration of acne scars, and previous studies have shown clinical effectiveness. Despite its extensive use, few studies have focused on the associated changes in biophysical properties of the epidermis. Herein, we evaluate transepidermal water loss, sebum levels, skin hydration, and skin elasticity, following FLSR treatments with an Er:YSGG laser device (Pearl FractionalTM , Cutera Inc., Brisbane, CA), employing non-invasive measurements.
Methods: Five Japanese patients with facial acne scars underwent one FLSR session. Some acne scars appeared to become less obvious as a consequence of the treatment. All patients were aware of a feeling of skin tightness in treated areas.
Results: Objective measurements on the lower lateral angle of the eye and on the inner cheeks were evaluated at baseline and at 3 days, 1 week, and 4 weeks after FLSR. Transepidermal water loss showed a significant two-fold (100%) increase at day 3, but had returned to almost the baseline level at week 4 in both areas. Sebum secretion showed a 50% increase at day 3, but had returned to the baseline level after day 7. Skin hydration showed a significant decrease at day 3, but had returned to the baseline level by day 7, and showed significant improvement at the end of the study. Skin elasticity (R2) was still at baseline on day 3, but showed some improvement—an increase of at least 30%—at the end of the study.
Conclusions: Based on our findings, we believe that FLSR should be performed no more than once a month to allow sufficient time for the damaged skin to recover its barrier function in most areas of the face.

J Drugs Dermatol. 2012;11(5):637-642.


The fractional laser skin resurfacing (FLSR) system is a new skin treatment concept using multiple microscopic laser beams.1,2 The two main types of FLSR systems currently available are ablative and non-ablative. At present, the mainstays of FLSR are the carbon dioxide (CO2) and the erbium:yttrium-aluminium-garnet (Er:YAG) laser devices. The FLSR using the Er:YAG laser is non-ablative and is gentler than ablative FLSR, but less effective for dermal collagen remodeling.2 Among the ablative FLSR systems, the 2,790 nm Er:YSGG laser targets intracellular water and is a novel laser that is thought to provide clinical results comparable to those of the CO2 laser.2,3
FLSR is effective for both epidermal and dermal disorders and produces minimal side effects. It was previously reported that epidermal defects treated with FLSR are repaired by keratinocytes, which can be seen on the lateral margins of the microscopic zones within several days after the treatment. It also damages dermal tissue, inducing a wound healing response that stimulates prolonged synthesis of new collagen and dermal remodeling.4-6
While a growing body of evidence indicates aesthetic with improvements FLSR, the associated changes in biophysical properties of the skin following these treatments have not been fully elucidated.