Fractional photothermolysis: Treatment of facial and nonfacial cutaneous photodamage with a 1,550-nm erbium-doped fiber laser

Purpose To evaluate the safety and effectiveness of a novel nonablative 1,550 nm erbium-doped fiber laser in the treatment of facial and non-facial photodamaged skin. Methods 50 patients with mild to moderate cutaneous photodamage, rhytides, and dyspigmentation received 3 successive treatments at 3-4 week intervals with a 1,550 nm erbium-doped fiber laser (Fraxel, Reliant Technologies Inc., San Diego, CA). Clinical improvement of treatment areas was independently determined by two masked assessors' evaluations of comparative photographs at baseline and 3, 6, and 9 months post-treatment using a quartile grading scale. Patient satisfaction surveys were also obtained at each follow-up visit. Results Mean clinical improvement at 3 months for the face was 2.23 and 1.85 for non-facial skin (p < 0.001). Mean improvement at 6 months was 2.10 for the face and 1.81 for non-facial skin (p < 0.001). Mean improvement at 9 months was 1.96 for the face and 1.70 for non-facial skin (p < 0.001). At least 51% to 75% improvement in photodamage at the 9-month follow-up was achieved in 73 and 55% of facial and non-facial treated skin, respectively. Side effects were limited to transient erythema and edema in the majority of patients. No prolonged pigmentary changes or scarring were observed. Patient satisfaction surveys mirrored the observed clinical effects. Conclusions The nonablative 1,550 nm erbium-doped fiber laser is an effective treatment for facial and non-facial photodamage, rhytides, and dyspigmentation with a favorable recovery and side effect profile.