Nonablative 1927 nm Fractional Resurfacing Effective for Facial Actinic Keratoses

Lara C. Pullen, PhD

October 29, 2010

October 29, 2010 (Chicago, Illinois) — Fractional 1927 nm resurfacing clears facial actinic keratoses (AK). Clinical improvements observed include skin texture and pigmentation. Moreover, histologic evaluation of skin 30 days after treatment revealed reduced epidermal melanin content, increased dermal collagen matrix, and increased collagen I–expressing fibroblasts.

Elliot Weiss, MD, from the Laser and Skin Surgery Center of New York in Southampton, presented the results of the study here at the American Society for Dermatologic Surgery 2010 Annual Meeting. The purpose of the study was to assess the safety and effectiveness of nonablative 1927 nm fractional resurfacing of facial AK. The fractionated 1927 nm nonablative Thulium laser uses a wavelength with moderate to high water absorption to deliver microscopic thermal zones within treated skin.

AK typically forms on chronically photodamaged skin. Current treatments include cryo/electrosurgery, curettage, and topical therapies. These treatments are not optimal for all patients because the treatments are often prolonged and can result in scarring, pigmentary changes, and irritation.

The researchers looked at 25 subjects with facial AK who received up to 4 treatments, at 2 to 6 week intervals, with a 1927 nm laser (Fraxel Dual, Solta Medical, Hayward, California). Laser settings were 5 to 20 mJ/pulse, with a coverage density of 30% to 70%. Patients were given topical anesthetic and optional intramuscular ketorolac 1 hour before treatment.

AK counts decreased in all patients after treatment. At 2 to 4 weeks after the first treatment, AK clearance was 74% (range, 45% to 100%). At 1 month after the final treatment, patients averaged an AK clearance of 86.5% (range, 63% to 100%). At 3 months after the final treatment, average AK clearance was 79% (range, 63% to 100%). The treatment was well tolerated and represents an effective new option for the treatment of facial AK.

Christopher B. Zachary, MBBS, FRCP, chair of the Department of Dermatology at the University of California at Irvine, spoke with Medscape Medical News about the study: "I concur, from my own experience, that their findings are valid and are going to be of significant use in the future."

Dr. Weiss reports serving as a consultant for Lithera. Dr. Zachary reports serving as a consultant for Solta, Cutera, Alma, DUSA, Zeltiq, Sciton, and Iridex.

American Society for Dermatologic Surgery (ASDS) 2010 Annual Meeting: Late breaking abstract GD413. Presented October 24, 2010.

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