Fractional Carbon Dioxide (CO2) Laser Skin Resurfacing
Improve Wrinkle and Acne Scarring Using Fractional Carbon Dioxide (CO2) Laser Skin Resurfacing
A comparison of results between Alastin, Human Stem Cell Protein Cytokines and Platelet Rich Plasma (PRP) versus standard treatments. (As presented to the 2017 American Academy of Cosmetic Surgery annual meeting.)
The purpose of this study was to assess the results of typical aesthetic treatments including:
- The visible outcome use of these treatments had on the skin.
- The varying lengths and severity of the recovery period for each treatment type.
- Determining any possible side effects or complications which may arise from use of treaments.
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Investigation Hypotheses:
- When used as a topical application, will platelet rich plasma obtained from the patient prove beneficial to the overall results from CO2 Facial Skin Resurfacing?
- When compared to other laser energy settings, will platelet rich plasma help shorten the recovery period in terms of both severity and length?
- What is the outcome of adding the human stem cell protein, cytokine, and Alastin as part of the post-treatment skin care regimen? How will this affect the overall result of treatment? Will it alter recovery time or increase possible complications for the patient?
For the past decade, leading cosmetic surgeons have been conducting an in-depth clinical laser study involving more than 250 patients. The purpose of this study was to discover what skin resurfacing devise and which post-treatment skin regimen would work best to provide patients high-quality results with minimal recovery periods and side-effects. He accomplished this by using the DEKA Smartxide Fractional Laser to perform CO2 laser skin resurfacing. He then followed this treatment with a Platelet Rich Plasma topical application, an application of Alastin Tripeptide and a post-treatment application of Hexapeptide.
Study Background
Currently, the best device on the market for reducing wrinkles and acne scars on the facial area is the Carbon Dioxide (CO2) laser. Leading surgeons spent time comparing the CO2 laser against other radiofrequency devices and fractional erbium-YAG lasers. Testing included determining the results of the device alone as well as when a topical platelet rich plasma and when dermal needling was added.
The results of the Carbon Dioxide laser proved to be far superior to results from the other devices when it came to reducing wrinkles and acne scarring. An Erbium: YAG laser (2940 nm) was shown to be the best option to improve hyperpigmentation. The study also showed the laser to provide adequate skin tightening. (Preliminary Observations on Fractional Ablative Resurfacing Devices: Clinical Impressions: J. Waibel, K. Beer, V. Narurkar, T. Alster. J. Drugs Derm, 2009, Vol 8(5), 481-485).
It should be noted that patients with Fitzpatrick Classification types V and VII had better results when treated with a radiofrequency device (Matrix RF, Fractora or Venus Viva). These devised helped to reduce the risk of post-treatment hyperpigmentation in these patients.
Not every CO2 laser is the same. The DEKA, Equinox and Lutronic lasers were compared to see which would provide the best beauty results with the least discomfort not only during the procedure, but also during recovery. Leading surgeons performed the largest clinical study involving over 200 participants. The patients had their wrinkles and acne scarring treated with the DEKA laser. A second study backed the results of the first. He now exclusively uses the DEKA Smartxide CO2 laser.
Results of Current Study
As part of the current study, the topical application of platelet rich plasma taken from the patient was used immediately after treatment. It showed to have an advantageous effect on the outcome of the treatment. The use of platelet rich plasma reduced the amount and severity of skin reddening commonly associated with treatment. It also reduced the amount of skin hyperpigmentation. Utilizing the Enhanced Image Pro system, use of platelet rich plasma at part of the post-treatment process showed a 10-15% reduction in wrinkles and scarring as compared to other post-treatment options.
Another study showed the application of platelet rich plasma after carbon dioxide treatment increased recovery time, decreased reddening and hyperpigmentation, encouraged a larger amount of the formation of blood vessels and increased the production of collagen. (Rapid Healing and Reduced Erythema after Ablative Fractional Carbon Dioxide Laser Resurfacing Combined with the Application of autologous Platelet-Rich Plasma, Jung-IM, NA, Jee-Qoong C, Hye-Ryung C, Jeong-Bok, J, et al. Dermatologic Surgery, 2011)
The addition of Alastin Skin Nectar as an extracellular matrix modulator for the platelet rich plasma used in post-treatment beauty regimen also proved beneficial. Combining these two treatments further enhanced the end results, shortened the period of recovery and lessened redness during recovery. Alastin is a product formed from a tripeptide and hexapeptide that shows the ability to increase the production on both collagen and elastin. In turn, Alastin recycles the extracellular matric (ECM) and helps to support the skin in the production of new collagen and elastin allowing younger collagen fibers to replace older ones, thicken the skin’s epidermis and increases the elastin fibers.
Laser tissue treatment causes trauma to the skin. As a result, fragments of collagen amorphous elastin agglutination occurs as well as abnormal cross-linkages between collagen fibers. This hinders the skin’s normal ECM process. Alastin’s tripeptides and hexapeptides are specifically designed to target the modulation of the ECM.
Stress brought on by the laser treatment causes oxidation, dysfunction of proteasome and non-enzymatic cross linkages involved in glycation end products. These are combated by peptides called ‘matrikines.’ Tripeptide is one such matrikine that stimulates production of anti-proteases and metalloproteinase that are responsible for the removal of the ECM’s damaged proteins. The end result of this process is upregulated neocollagenesis and production of elastin. The hexapeptide involved is a signal transduction cytokine that encourages the production of elastin.
Study Summary
The best procedure to resurface the skin and reduce the damage from acne scarring and wrinkles is the carbon dioxide laser. The best of these lasers appear to be the DEKA CO2 laser. Autologous platelet rich plasma and Alastin, when added as part of the post-treatment skin care regimen, help to speed the recovery process, decreases hyperpigmentation and generally improves the overall result. Continue studies of adding human stem cell protein cytokines such as Stemulation Facial Serum by Stemulation or Regenica Dual Serums by Suneva Medical, Inc. show that an addition of these to the regimen further supports healing and improves the aesthetic outcome.