TREATMENT OF PERIORBITAL WRINKLES - A COMPARISON OF THE SILKTOUCH CARBON-DIOXIDE LASER WITH A MEDIUM-DEPTH CHEMICAL PEEL

BACKGROUND. Chemical peels are an effective treatment for wrinkles, bu t their use is limited because of the associated risk of scarring, hyp opigmentation, and the inability to accurately control the depth of ti ssue injury. High energy, pulsed, or computer scanned continuous wave carbon dioxide (CO2) lasers cause minimal thermal injury, decrease the risk of scarring, and allow for precise control of tissue vaporizatio n to predictable depths. OBJECTIVE. To compare the effectiveness and s ide effect profile of a medium-depth chemical peel to that of the Silk Touch CO2 laser in the treatment of periorbital wrinkles. METHODS. Twe nty-four subjects (nine male, 15 female) with moderate to severe perio orbital wrinkles were assigned a wrinkle score (1 = mild through 5 = s evere) before treatment and 6 months after treatment. Each subject was treated with Jessner's solutin and 35% trichloroacetic acid on one si de and the Silk-Touch CO2 laser on the other side. RESULTS. The averag e periorbital wrinkle score decreased from 4.00 +/- 0.78 before laser treatment to 1.75 +/- 0.68 6 months after treatment. The chemical peel wrinkle score decreased from 4.13 +/- 0.85 to 3.29 +/- 0.99. The degr ee in which the wrinkle score improved after laser treatment compared with after chemical peel treatment was statistically significant. Post treatment erythema lasted an average of 4.5 months for the laser-treat ed areas and 2.5 months for the chemical peel-treated areas. CONCLUSIO N. Treatment of periorbital wrinkles with the Silk-Touch CO2 laser res ulted in a greater degree of improvement than treatment with a medium- depth chemical peel but had longer lasting posttreatment erythema. (C) 1997 by the American Society for Dermatologic Surgery, Inc.