Treatment of perioral rhytides - A comparison of dermabrasion and superpulsed carbon dioxide laser

Objective: To directly compare the cosmetic outcome and adverse effects of dermabrasion and superpulsed carbon dioxide laser for the treatment of peri oral rhytides. Design: Subjects were randomly assigned to receive treatment with carbon di oxide laser resurfacing to one side of the perioral area and dermabrasion t o the other side in a prospective, comparative clinical study. The duration of follow-up by blinded observers was 4 months. Setting: University hospital-based dermatologic surgery clinic. Patients: Fifteen healthy fair-skinned volunteers with moderate to severe p erioral rhytides and no history of prior cosmetic surgical procedures to th e same anatomic area. Interventions: One half of the perioral area was treated with the LX-20SP N ovapulse carbon dioxide laser (Luxar Corp, Bothell, Wash), and the other ha lf was treated with dermabrasion using either a hand engine-driven diamond fraise or a medium-grade drywall sanding screen (3M Corp, St Paul, Minn). Main Outcome Measures: Improvement in rhytides, patients' subjective report s of postoperative pain, time to reepithelialization, degree of postoperati ve crusting, and duration of postoperative erythema were observed for both methods. Standardized scoring systems were used to quantify outcome measure s. Paired t tests were used for statistical comparisons of the 2 resurfacin g methods. Results: The difference in rhytide scores for the 2 methods was not statist ically significant (P =.35) at 4 months. Less postoperative crusting and mo re rapid reepithelialization were noted with the dermabrasion-treated skin. Postoperative erythema was of longer duration on laser-treated skin. Patie nts reported less pain with dermabrasion treatment. Subtle differences that were difficult to quantify were also noted between the methods. Conclusions: Both dermabrasion and carbon dioxide laser resurfacing are eff ective in the treatment of perioral rhytides. Both methods have unique adva ntages and disadvantages.