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Fractionated nonablative laser effectively, safely treated facial actinic keratoses

Fractionated nonablative thulium laser therapy was effective and safe in treating patients with facial actinic keratoses, according to study results.

In a 6-month prospective clinical trial in New York, researchers studied 24 patients (average age, 60 years; 79% women) with photodamage and actinic keratoses (AK) who received up to four treatments with a fractionated 1927-nm nonablative thulium laser. Forty-two percent of patients had Fitzpatrick skin type I, 54% had type II and 4% had type III. Seven patients consented to two 3-mm punch biopsies taken at initial presentation and 6-month follow-up.

One month after final treatment, the average number of AK lesions decreased 91.3% from a baseline of 14.04 to 1.22. At 3 months, AK counts decreased to 1.78 (87.3% reduction in absolute number of AK from baseline), and at 6 months, AK counts declined to 1.88 (86.6% reduction). On a scale of 0 (none) to 4 (very significant), patients noted marked improvement in overall photodamage with an average score of 3.04, compared with physicians’ average score of 3.54 at 6 months beyond treatment.

Patients showed no evidence of erythema or swelling at 3- and 6-month follow-ups. Consistent histological findings were seen in the initial specimens of clinically appearing AK and normal appearing skin of the seven patients who submitted to biopsies. Six patients (85.7%) displayed histological evidence of AK clearance at 6-month follow-up biopsies.

“No incidents of infection, scarring or pigmentary alteration were observed,” the researchers reported. “Individuals with type I to II skin are generally less prone to developing postinflammatory hyperpigmentation from laser resurfacing, and their preponderance in our study potentially contributed to the observed absence of pigment-related side-effects.

“The clinical and histologic findings [and] reported patient satisfaction and safety, suggest that the treatment of AK and photodamage with a fractionated 1927-nm nonablative thulium laser … is a promising new therapeutic option,” the researchers concluded.