Deep Heating Skin Found to Improve Fractional Resurfacing

CHICAGO — The clinical results of fractional skin resurfacing may be improved by pretreatment with an infrared laser or broadband infrared light source, according to a pilot study presented at the annual meeting of the American Society for Dermatologic Surgery.

"In the treatment of scars and wrinkles, combination deep heating immediately prior to fractional resurfacing gives better results in less time than fractional laser treatment alone," said Dr. Robert Weiss, of the dermatology department at Johns Hopkins University, Baltimore.

For this study, a control group of 20 patients received the usual fractional resurfacing on the face or neck with the Lux 1540 (Palomar Medical Technologies), while 20 others first received deep heating with an infrared pulsed laser using the 1,320-nm CoolTouch 3 (CoolTouch Inc.).

"Using the CoolTouch, we preheated the skin from a typical baseline temperature of 32° up to 40°, and then we applied the fractional resurfacing to the scar or wrinkle with the 1540-nm stamped mode at 50 mJ per little dot," Dr. Weiss said.

The control group received four monthly treatments, while the deep heating plus fractional group received two monthly treatments, he said, adding that the results were evaluated out to 3 months after the last treatment.

Down times caused by erythema ranged from 12 to 24 hours in the control group and increased to 48–96 hours for those receiving the combination treatment. That compares with 48–96 hours for patients who receive CO₂ laser fraction treatment, Dr. Weiss explained.

Pretreatment with heat produced both faster and visually better results, Dr. Weiss said, adding that, in some cases, two combination treatments improved scarring as much as five fractional-only treatments.

The investigators concluded that the combination treatment demonstrated a 30% improvement in scars and rhytids, compared with fractional only, and reduced the number of treatments from four to two.

Dr. Weiss is a consultant for Palomar and CoolTouch and performs research for Palomar, Cynosure, and CoolTouch.