Skip to main content
SpringerLink
Log in

Application of reflectance confocal microscopy to investigate the non-ablative, micro-ablative, and ablative effects of CO2 fractional laser irradiation on skin

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

CO2 fractional laser, as an ablative fractional laser, is commonly used in cosmetic treatment. We applied CO2 fractional laser irradiation to skin in vitro and used reflectance confocal microscopy (RCM) to image and detect the presence of any non-ablative, micro-ablative and ablative effects, in order to better understand the features of a CO2 fractional laser. In vitro irradiation of foreskin was performed using a CO2 fractional laser. Foreskin specimens were divided into 4 groups that received different amounts of irradiation energy, based on the number of irradiation passes they received: 5, 10, 15, and 20 passes, respectively. This corresponds to fluence energy of 16.3, 32.6, 48.9, 65.3 J/cm2. Immediately after irradiation, digital microscopy (DM), RCM, and histopathology were performed to observe whether the non-ablative, micro-ablative, and ablative phenomenon occurred, and the injury features of MTZs. Immediately after CO2 fractional laser irradiation, RCM and DM showed that when the numbers of passes were 5 and 10, a micro-ablative column (MAC) could not be observed or was very small. We mainly observed a thicker thermal coagulation zone (TCZ), representing non-ablative or micro-ablative effects. When the number of passes were increased to 15 and 20, the MAC was significantly enlarged and surrounded by a TCZ of medium thickness, representing ablative effects. For the first time, this study used RCM and DM to demonstrate that a CO2 fractional laser could achieve non-ablative, micro-ablative, and ablative effects on irradiated skin via different energy levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 220(4596):524–527. https://doi.org/10.1126/science.6836297

    Article  CAS  PubMed  Google Scholar 

  2. Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34(5):426–438. https://doi.org/10.1002/lsm.20048

    Article  PubMed  Google Scholar 

  3. Omi T, Numano K (2014) The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther 23(1):49–60. https://doi.org/10.5978/islsm.14-RE-01

    Article  PubMed  PubMed Central  Google Scholar 

  4. Beasley K, Lii JMD, Brown P, Lenz B, Hivnor CM (2013) Ablative fractional versus nonablative fractional lasers-where are we and how do we compare differing products? Curr Derm Rep 2(2):135–143. https://doi.org/10.1007/s13671-013-0043-0

    Article  Google Scholar 

  5. Hantash BM, Bedi VP, Kapadia B, Rahman Z, Jiang K, Tanner H, Chan KF, Zachary CB (2007) In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers Surg Med 39(2):96–107. https://doi.org/10.1002/lsm.20468

    Article  PubMed  Google Scholar 

  6. Hantash BH, Bedi VP, Chan KF, Zachary CB (2007) Ex vivo histological characterization of a novel ablative fractional resurfacing device. Lasers Surg Med 39(2):87–95. https://doi.org/10.1002/lsm.20405

    Article  PubMed  Google Scholar 

  7. Haak CS, Illes M, Paasch U, Hædersdal M (2011) Histological evaluation of vertical laser channels from ablative fractional resurfacing: an ex vivo pig skin model. Lasers Med Sci 26(4):465–471. https://doi.org/10.1007/s10103-010-0829-2

    Article  Google Scholar 

  8. Uwe P, Merete H (2011) Laser systems for ablative fractional resurfacing. Expert Review of Medical Devices 8(1):67–83. https://doi.org/10.1586/erd.10.74

    Article  Google Scholar 

  9. Xu XG, Luo YJ, Wu Y, Chen JZ, Xu TH, Gao XH, He CD, Geng L, Xiao T, Zhang YQ, Chen HD, Li YH (2011) Immunohistological evaluation of skin responses after treatment using a fractional ultrapulse carbon dioxide laser on back skin. Dermatol Surg 37(8):1141–1149. https://doi.org/10.1111/j.1524-4725.2011.02062.x

    Article  CAS  PubMed  Google Scholar 

  10. Shin MK, Choi JH, Ahn SB, Lee MH (2014) Histologic comparison of microscopic treatment zones induced by fractional lasers and radiofrequency. J Cosmet Laser Ther 16(6):317–323. https://doi.org/10.3109/14764172.2014.957216

    Article  PubMed  Google Scholar 

  11. Yue X, Wang H, Li Q, Li L (2017) Application of reflectance confocal microscopy to evaluate skin damage after irradiation with an yttrium-scandium-gallium-garnet (YSGG) laser. Lasers Med Sci 32(2):255–262. https://doi.org/10.1007/s10103-016-2106-5

    Article  PubMed  Google Scholar 

  12. Richters RJH, Hoogedoorn L, Uzunbajakava NE et al (2016) Clinical, biophysical, immunohistochemical, and in vivo reflectance confocal microscopy evaluation of the response of subjects with sensitive skin to home-use fractional non-ablative photothermolysis device. Lasers Surg Med 48(5):474–482. https://doi.org/10.1002/lsm.22486

    Article  PubMed  Google Scholar 

  13. Laubach HJ, Tannous Z, Anderson RR, Manstein D (2010) Skin responses to fractional photothermolysis. Lasers Surg Med 38(2):142–149. https://doi.org/10.1002/lsm.20254

    Article  Google Scholar 

  14. Ross EV, Barnette DJ, Glatter RD, Grevelink JM (1999) Effects of overlap and pass number in CO2 laser skin resurfacing: a study of residual thermal damage, cell death, and wound healing. Lasers Surg Med 24(2):103–112. https://doi.org/10.1002/(sici)1096-9101(1999)24:2<103::aid-lsm5>3.0.co;2-b

    Article  CAS  PubMed  Google Scholar 

  15. Longo C, Galimberti M, De Pace B, Pellacani G, Bencini PL (2013) Laser skin rejuvenation: epidermal changes and collagen remodeling evaluated by in vivo confocal microscopy. Lasers Med Sci 28(3):769–776. https://doi.org/10.1007/s10103-012-1145-9

    Article  PubMed  Google Scholar 

  16. Banzhaf CA, Wind BS, Mogensen M, Meesters AA, Paasch U, Wolkerstorfer A, Haedersdal M (2016) Spatiotemporal closure of fractional laser-ablated channels imaged by optical coherence tomography and reflectance confocal microscopy. Lasers Surg Med 48(2):157–165. https://doi.org/10.1002/lsm.22386

    Article  PubMed  Google Scholar 

  17. Sattler ECE, Poloczek K, Kästle R, Welzel J (2013) Confocal laser scanning microscopy and optical coherence tomography for the evaluation of the kinetics and quantification of wound healing after fractional laser therapy. J Am Acad Dermatol 69(4):e165–e173. https://doi.org/10.1016/j.jaad.2013.04.052

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Thanks for the China Medical Laser (Beijing) Technology Co., Ltd., for supplying the laser device.

Funding

This study was supported by the Open Research Fund Program of Beijing Key Lab of Plant Resource Research and Development, Beijing Technology and Business University.

Author information

Authors and Affiliations

  1. Department of Dermatology, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Beijing, 100730, People’s Republic of China

    Xueping Yue & Hongwei Wang

  2. Department of Dermatology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100070, People’s Republic of China

    Xueping Yue

Authors
  1. Xueping Yue
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hongwei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hongwei Wang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Beijing Tian Tan Hospital, Capital Medical University research committee and with the declaration of Helsinki.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yue, X., Wang, H. Application of reflectance confocal microscopy to investigate the non-ablative, micro-ablative, and ablative effects of CO2 fractional laser irradiation on skin. Lasers Med Sci 35, 957–964 (2020). https://doi.org/10.1007/s10103-019-02910-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-019-02910-5

Keywords

Search

Navigation