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Split-face comparison of the erbium micropeel with intense pulsed light . BACKGROUND A variety of photorejuvenative techniques have been utilized to reverse the signs of cutaneous photoaging , including ablative and nonablative laser resurfacing as well as light-based devices . OBJECTIVE The purpose of this split-face randomized prospective open-label trial was to determine the effectiveness of sequential erbium : yttrium-aluminum-garnet ( Er : YAG ) laser versus intense pulsed light ( IPL ) for the treatment of mild to moderate facial photodamage . MATERIALS AND METHODS Ten subjects ( ages 35-63 ) with facial dyschromia and rhytides were enrolled . Study patients were randomized to the two treatment arms , Er : YAG ( 3.8 J/cm ( 2 ) , 30 % pattern overlap , 0 % interpulse overlap , 15 microm per pass with no coagulation ) and IPL ( 560-nm filter , 30 J/cm ( 2 ) , 2.4/4.0-ms pulse with 10-ms delay ) , each receiving three sequential treatments spaced 1 month apart . Subjective and blinded physician evaluations were performed at baseline and 4 , 8 , and 20 weeks posttreatment using a nominal scale from 1 to 4 . Erythema and adverse events were assessed 1 week following each treatment . RESULTS Ten female subjects with mild to moderate facial photodamage were treated with one pass of either IPL or Er : YAG in a split-face fashion . Patients received three treatments each spaced 1 month apart . Nine of 10 patients completed the trial ; 1 withdrew due to pain during the second Er : YAG treatment . Baseline subjective and blinded physician dyschromia and rhytid scores revealed no significant difference between the IPL and Er : YAG randomly assigned sides . Up to three IPL or Er : YAG treatments did not result in a significant improvement in rhytid scores . Subjective and blinded physician dyschromia scores improved 26 and 38 % , respectively , 3 months after the final IPL treatment , but only by 7 and 29 % , respectively , with Er : YAG . Subjective global facial appearance scores worsened by 5 % while blinded physician scores improved by 16 % 3 months after 3 Er : YAG treatments , but by 28 and 20 % for IPL , respectively . The overall incidence of adverse events and subsequent downtime was increased for Er : YAG ( 1/10 patients experienced hyperpigmentation , 3/10 exfoliation , 1/10 blistering , and 5/10 discomfort ) compared to IPL ( 1/10 exfoliation and 1/10 discomfort ) , although no permanent side effects were observed with either treatment arm . CONCLUSIONS While low-fluence erbium resurfacing has a modest effect on facial photodamage , patients preferred IPL because it resulted in less downtime . The authors have indicated no significant interest with commercial supporters .
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Intervention_Physical
erbium micropeel with intense pulsed light .
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Intervention_Physical
sequential erbium : yttrium-aluminum-garnet ( Er : YAG ) laser versus intense pulsed light ( IPL )
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Intervention_Physical
Er : YAG
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Intervention_Physical
pattern overlap
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Intervention_Physical
interpulse overlap
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Intervention_Physical
IPL
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Outcome_Pain
pain
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Outcome_Physical
blinded physician dyschromia and rhytid scores
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Outcome_Physical
Subjective and blinded physician dyschromia scores improved
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Outcome_Physical
Subjective global facial appearance scores
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Outcome_Adverse-effects
overall incidence of adverse events
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Outcome_Physical
subsequent downtime
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Outcome_Adverse-effects
hyperpigmentation
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Outcome_Adverse-effects
exfoliation
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Outcome_Adverse-effects
blistering
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Outcome_Adverse-effects
discomfort
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Participant_Condition
mild to moderate facial photodamage
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Participant_Sample-size
Ten subjects
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Participant_Age
( ages 35-63 )
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Participant_Condition
facial dyschromia and rhytides
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Participant_Sample-size
Ten
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Participant_Sex
female
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Participant_Condition
mild to moderate facial photodamage
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Participant_Sample-size
Nine of 10 patients completed the trial