Efficacy and safety of ultra-pulsed CO2 fractional laser (UP) for the treatment of periorbital static wrinkles.

Abstract

To evaluate the efficacy and safety of ultra-pulsed CO2 fractional laser (UP) in the treatment of periorbital static wrinkles in Asians, and to follow up on its long-term efficacy. This was a prospective, self-controlled study conducted at the Dermatological Cosmetic Center of Xijing Hospital from June 2021 to June 2022. A total of 30 Asian patients aged 30-65 years with periorbital static wrinkles were enrolled (both genders, signed informed consent, and had not received treatment in the previous 6 months. Patients were excluded if they were pregnant or lactating, had facial dermatitis, or had received neuromodulator injections in the treatment area recently). All patients underwent one session of ultra-pulsed CO2 fractional laser treatment. Before treatment, the periorbital area was cleaned and topical anesthesia with compound lidocaine ointment (Beijing Ziguang Pharmaceutical Co., Ltd., lidocaine concentration of 5%, containing prilocaine and lidocaine, 25 mg of each per gram, synergistically enhancing the anesthetic effect with minimal skin irritation) was applied for 1 h. After anesthesia, the treatment area was disinfected, and a metal heat-insulating intraocular shield was placed to protect the cornea. The periorbital area (energy 10 mj, density 10%), forehead, and nasal root (energy 17.5 mj, density 5%) were treated with different energy and density settings. Post-treatment, ice compresses were applied for 20-30 min, and strict sun protection was advised. Photographs were taken before treatment, immediately after treatment, and at 2 weeks, 1 month, 2 months, and 3 months post-treatment to assess efficacy. Skin wrinkle assessment was performed using Think View skin analysis. Pain was assessed using the Visual Analog Scale (VAS) during treatment. Telephone follow-ups were conducted on days 1, 3, and 5 post-treatment to record adverse reactions. The Antera3D skin image analysis system was used to evaluate overall periorbital wrinkle scores, average wrinkle depth, average wrinkle width, and maximum wrinkle depth. All 30 patients tolerated the intraoperative pain, with a VAS pain score of 5.67 ± 1.15. 93% of the subjects were satisfied with the treatment outcomes. The Fitzpatrick wrinkle grading scores decreased after treatment compared to before treatment in all subjects. 3D skin analysis revealed a reduction in overall wrinkle scores post-treatment, with a significant decrease in average wrinkle depth at 3 months post-treatment (p < 0.001). Maximum wrinkle depth improved at 1 month post-treatment (p < 0.05) and decreased significantly at 2 and 3 months post-treatment (p < 0.001). No significant adverse reactions were observed post-treatment.Ultra-pulsed CO2 fractional laser (UP) is effective in improving periorbital static wrinkles in Asians with high safety and tolerability.