Girish Munavalli

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Combining confluent and fractionally ablative modalities of a novel 2790nm YSGG laser for facial resurfacing.

Girish S Munavalli; Ayse Turley; Sirunya Silapunt; Brian Biesman (Profiled Author: Girish Munavalli)

Dermatology, Laser, and Vein Specialists of the Carolinas, Charlotte, North Carolina, USA.
Lasers in surgery and medicine 2011;43(4):273-82.

BACKGROUND: Several laser technologies exist for improving rhytides, pigmentation, and skin texture. Recent advances in technology introduced a new wavelength, 2,790 nm, erbium:yttrium-scandium-galium-garnet (Er:YSGG) for treatment of photoaging. 2,790 nm Er:YSGG has a water absorption coefficient between CO(2) laser and Er:YAG laser and has both ablative and fractional-ablative capabilities. OBJECTIVES: To evaluate the efficacy and safety of combining the ablative (confluent) and fractional-ablative modes of 2,790 nm Er:YSGG laser for treatment of photoaging. STUDY DESIGN/MATERIALS AND METHODS: In this uncontrolled, open label, prospective study, 10 subjects were enrolled and had a single treatment of combined confluent and fractional-ablative 2,790 nm lasers for photoaging. The primary clinical end point of the study was the change in Fitzpatrick wrinkle score from baseline at different time points as determined by blinded reviewer assessments. Secondary clinical end points were the improvement in fine lines, tone/texture, and pigmentation; the subjects' self assessment; the incidence of side effects; and the tolerability of treatments. RESULTS: Based on blinded photo-assessments by two independent dermatologists, subjects showed clinically and statistically significant mean improvement of 1.9 (95% CI: 1.1-2.6), 1.6 (95% CI: 0.8-2.3), and 1.2 (95% CI: 0.5-2.0) in Fitzpatrick wrinkle scores at 6 weeks, 3 and 6 months, respectively. Of the 90% of subjects who showed improvement in Fitzpatrick wrinkle scores, 78% continued to have improvement at the 6-month follow-up visit. Mild erythema observed post-treatment was resolved by the 6-week follow-up visit in all subjects. No transient or permanent post-inflammatory hyperpigmentation (PIH); or serious adverse events were reported. CONCLUSION: A combined confluent and fractional-ablative 2,790 nm Er:YSGG laser treatment improves photodamaged skin for at least 6 months. The treatment was well-tolerated and PIH was not found in our study.

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