Fractional Laser Resurfacing Treats Photoaging by Promoting Neocollegenesis and Cutaneous Edema

Juliano Borges; Luciana Araújo; Tullia Cuzzi; Luis Martinez; Yliana Gonzales; Mônica Manela-Azulay

Fractional Laser Resurfacing Treats Photoaging by Promoting Neocollegenesis and Cutaneous Edema

J Clin Aesthet Dermatol. 2020 Jan;13(1):22-27. Epub 2020 Jan 1.

Authors

Juliano Borges^{1

2

3}, Luciana Araújo^{1

2

3}, Tullia Cuzzi^{1

2

3}, Luis Martinez^{1

2

3}, Yliana Gonzales^{1

2

3}, Mônica Manela-Azulay^{1

2

3}

Affiliations

¹ Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil.
² Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil.
³ Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil.

PMID: 32082467
PMCID: PMC7028380

Abstract

BACKGROUND: Laser resurfacing is a common treatment for photoaging. This treatment creates skin incisions that initiate the wound healing cascade, including reorganization of the collagen matrix, in a dermal remodeling process that can last up to 12 months. OBJECTIVE: We compared the effects of nonablative and ablative Erbium fractional laser resurfacing on dermal content and arrangement of Collagen Types I and III, and on fibroblast activation. METHODS: Ten female patients (50-63 years) with Fitzpatrick Skin Types I-IV and clinical signs of photoaging underwent two types of Erbium fractional laser resurfacing (nonablative, 1540nm; ablative, 2940nm) on opposite sides of the face. Skin biopsies were obtained pretreatment and three months post-treatment. Morphometric analysis was performed using Picrosirius staining for overall collagen, and immunohistochemistry for Collagen Types I and III. Finally, hematoxylin and eosin staining was used to identify fibroblast activation. RESULTS: Both laser treatments induced reorganization of Collagen Types I and III and demonstrated signs of fibroblast activation. However, morphometric analysis of Picrosirius staining revealed that, after both treatments, there was a lower density of collagen fibers, which is characteristic of edema. CONCLUSION: At three months after laser resurfacing, skin lifting in photoaged skin likely resulted from new collagen deposition but also from edema.

Keywords: Collagen Type I; Collagen Type III; Erbium fractional laser resurfacing; ablative; aging skin; nonablative; photoaging; rejuvenation; solar elastosis.