An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial

Abstract Introduction Ablative carbon dioxide fractional laser (CO2 AFL) can alleviate static wrinkles; however, its use in East Asian populations can predispose them to postinflammatory hyperpigmentation (PIH). We aimed to explore the optimum energy and coverage parameters of CO2 AFL for treating s...

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Main Authors: Xianglei Wu, Qingqing Cen, Jian Jin, Wei Gao, Ying Shang, Linting Huang, Xiaoxi Lin
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Dermatology and Therapy
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Online Access:https://doi.org/10.1007/s13555-025-01404-3
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author Xianglei Wu
Qingqing Cen
Jian Jin
Wei Gao
Ying Shang
Linting Huang
Xiaoxi Lin
author_facet Xianglei Wu
Qingqing Cen
Jian Jin
Wei Gao
Ying Shang
Linting Huang
Xiaoxi Lin
author_sort Xianglei Wu
collection DOAJ
description Abstract Introduction Ablative carbon dioxide fractional laser (CO2 AFL) can alleviate static wrinkles; however, its use in East Asian populations can predispose them to postinflammatory hyperpigmentation (PIH). We aimed to explore the optimum energy and coverage parameters of CO2 AFL for treating static periorbital wrinkles in a Chinese population and to minimize PIH incidence. Methods In total, 30 patients with static periorbital wrinkles were recruited. The PIH intervention side (1% hydroquinone cream every night on one periorbital area for each patient 1 month before and from the 8th day to 1 month after each treatment) and group (group A: 15‒20 mJ, 5%; group B: 10‒12.5 mJ, 15%; and group C: 12.5‒15 mJ, 10%) were determined randomly. The patients underwent two sessions of CO2 AFL at 3-month intervals. Follow-ups were conducted until 6 months after the last treatment. Results Overall, 20 participants (48.1 ± 13.1 years) completed all follow-ups without any serious complications. The application of hydroquinone significantly reduced PIH (p = 0.02). Both the investigators’ and patients’ visual evaluations demonstrated a consistent efficacy rate of 68.2% without differences between groups. The Fitzpatrick wrinkle score significantly decreased compared with pre-treatment (p < 0.01); however, a significant reduction only in group B at 3 months (p = 0.016) and 6 months (p = 0.001) post-treatment was observed. Groups B and C demonstrated significant reductions in superficial and deep wrinkles and pigmentation (p < 0.01). Conclusions CO2 AFL effectively reduced static periorbital wrinkles in the Chinese population. Low energy combined with high-density coverage was the most efficacious. The application of hydroquinone significantly reduced PIH incidence. Trial Registration Chinese Clinical Trial Registration no. ChiCTR2400087320 (date of trial registration: 25 July 2024).
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spelling doaj-art-198bb89e859a46b1b7278963faac6b792025-08-20T03:08:40ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722025-04-011561307131710.1007/s13555-025-01404-3An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face TrialXianglei Wu0Qingqing Cen1Jian Jin2Wei Gao3Ying Shang4Linting Huang5Xiaoxi Lin6Department of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Dermatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Drug Clinical Trial Institutions, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineAbstract Introduction Ablative carbon dioxide fractional laser (CO2 AFL) can alleviate static wrinkles; however, its use in East Asian populations can predispose them to postinflammatory hyperpigmentation (PIH). We aimed to explore the optimum energy and coverage parameters of CO2 AFL for treating static periorbital wrinkles in a Chinese population and to minimize PIH incidence. Methods In total, 30 patients with static periorbital wrinkles were recruited. The PIH intervention side (1% hydroquinone cream every night on one periorbital area for each patient 1 month before and from the 8th day to 1 month after each treatment) and group (group A: 15‒20 mJ, 5%; group B: 10‒12.5 mJ, 15%; and group C: 12.5‒15 mJ, 10%) were determined randomly. The patients underwent two sessions of CO2 AFL at 3-month intervals. Follow-ups were conducted until 6 months after the last treatment. Results Overall, 20 participants (48.1 ± 13.1 years) completed all follow-ups without any serious complications. The application of hydroquinone significantly reduced PIH (p = 0.02). Both the investigators’ and patients’ visual evaluations demonstrated a consistent efficacy rate of 68.2% without differences between groups. The Fitzpatrick wrinkle score significantly decreased compared with pre-treatment (p < 0.01); however, a significant reduction only in group B at 3 months (p = 0.016) and 6 months (p = 0.001) post-treatment was observed. Groups B and C demonstrated significant reductions in superficial and deep wrinkles and pigmentation (p < 0.01). Conclusions CO2 AFL effectively reduced static periorbital wrinkles in the Chinese population. Low energy combined with high-density coverage was the most efficacious. The application of hydroquinone significantly reduced PIH incidence. Trial Registration Chinese Clinical Trial Registration no. ChiCTR2400087320 (date of trial registration: 25 July 2024).https://doi.org/10.1007/s13555-025-01404-3Carbon dioxide fractional laserStatic wrinklesChinesePostinflammatory hyperpigmentation
spellingShingle Xianglei Wu
Qingqing Cen
Jian Jin
Wei Gao
Ying Shang
Linting Huang
Xiaoxi Lin
An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial
Dermatology and Therapy
Carbon dioxide fractional laser
Static wrinkles
Chinese
Postinflammatory hyperpigmentation
title An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial
title_full An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial
title_fullStr An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial
title_full_unstemmed An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial
title_short An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial
title_sort effective and safe laser treatment strategy of fractional carbon dioxide laser for chinese populations with periorbital wrinkles a randomized split face trial
topic Carbon dioxide fractional laser
Static wrinkles
Chinese
Postinflammatory hyperpigmentation
url https://doi.org/10.1007/s13555-025-01404-3
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