BALTIMORE — An erbium-impregnated 2910 nm fluoride The glass fiber laser, approved 2 years ago by the US Food and Drug Administration, has shown a high degree of improvement for facial photoaging and wrinkling along with relatively high patient satisfaction rates — while causing less discomfort and downtime compared to conventional fractional lasers. small single-center study showed.
The study involved 15 patients who had three treatment sessions with the 2910 nm laser. “It’s highly adaptable,” said the study’s lead author, Taryn Murray, MDsaid a dermatologist at the Cleveland Clinic in Cleveland, Ohio Medscape Dermatology. “It has a very fast healing time compared to traditional digestible lasers; the healing time is five to seven days versus several weeks.” Murray presented the results at the annual meeting of the American Society for Laser Medicine and Surgery.
The technology behind the laser
The 2910 nm erbium-doped fluorine glass fiber laser is a mid-infrared ablative fractional device that operates at maximum water absorption. It’s designed to cause minimal residual thermal damage, resulting in less discomfort, less downtime and possibly fewer side effects than conventional ablative lasers, Murray said.
Because of the way the pulses are delivered, “it’s much less painful than traditional fractional ablative lasers, so you can use mainly local numbing, you don’t need nerve blocks, you don’t need to penetrate lidocaineyou don’t have to put the patient under anesthesia,” he said.
“Because of the wavelength, the way the pulses are delivered and how customizable the settings are, it’s safer to use on darker skin,” and the density, depth and amount of coagulation applied to the skin is customizable, added Murray.
The laser also delivers pulses in a different manner than conventional erbium and CO at 2940 nm2 laser, he explained. “Traditional lasers do it all in one pulse. This laser uses micropulses with a relaxation time between pulses, so the body interprets it as less painful and allows pressure and steam to escape the canal, resulting in faster healing. “
Study patients had local anesthetic cream applied to their faces 45-60 minutes before the procedure. Multiple passes were performed using surface and deep laser modes. Mean patient age was 65.7 years, and Fitzpatrick skin types included I (n = 3), II (n = 3), III (n = 7), and IV (n = 2). On a scale of 0-10, the average level of discomfort was 4.9, and average patient satisfaction after three treatments was 4.8, Murray said.
For aesthetic improvement, the study used the 5-point Global Aesthetic Improvement Scale (GAIS). Blinded reviewers evaluated the digital images and determined a mean GAIS score of 3.2 for overall appearance, 2.9 for wrinkles, 3.6 for pigmentation, 3.1 for skin texture, and 2.6 for skin laxity.
When patients themselves reviewed the digital images, the mean GAIS score was 3.8 for overall appearance.
Side effects, Murray said, were transient, with soft tissue swelling and crusting lasting 3-5 days and erythema resolving in 1-2 weeks on average. One case post-inflammatory hyperpigmentation (PIH) emerged, which was linked to allergic contact dermatitis from the healing salve. This patient remained in the study and had complete resolution of PIH.
The study stands out
A number of studies on the 2910-nm fluoride glass fiber laser have emerged in the past six months, Ritu Swali, MD, an American Society for Dermatologic Surgery fellow at a practice in Houston, Texas, said in an interview. at the meeting. But this one stands out because of the evidence surrounding its use.
Most people use this laser for facial resurfacing, “and we want to know that we have a technology…with less downtime and easier wound care and just more comfort,” he said.
He noted that with conventional lasers, most patients get a nerve block and some choose to general anesthesia. “To be able to do the facelift levels [Murray] does without having to do all that pain management is pretty amazing,” added Swali.
The speed of the process and relatively short downtime are also notable, he said. “The huge advantage is that you have a lot less pain from the procedure itself, so you can do it faster because they tolerate it so well and you don’t have to take breaks,” she said.
As for downtime, Swali added, “these patients come in on a Thursday and will be back up and running by Monday,” as opposed to the weeks that are typical with a conventional laser. This laser platform also avoids the pigmentation problems that can occur with continuous and aggressive treatment with conventional lasers, he said.
Murray disclosed his relations with Acclaro Medical, the manufacturer of the laser. Swali has no relationships to disclose.
Richard Mark Kirkner is a medical journalist based in the Philadelphia area.
