Fractional CO₂laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repair

TLDR

Minimally ablative fractional laser devices are widely accepted for skin resurfacing, with reported improvements in facial rhytides, photodamage, acne scarring, and skin laxity. The study compares how different CO₂ laser fluences modulate cytokine secretion pathways to influence wound healing and clinical outcomes. Eighteen photodamaged patients were treated with a fractional CO₂ laser at 2.07, 2.77, and 4.15 J/cm², and immunocytochemistry assessed cytokine expression at defined time points. Cytokine secretion pathways varied with re‑epithelization and laser fluence, and all three fluences produced significant improvements in wrinkles, texture, and hyperpigmentation, demonstrating the laser’s efficacy, rapid downtime, and safety.

Abstract

Minimally ablative fractional laser devices have gained acceptance as a preferred method for skin resurfacing. Notable improvements in facial rhytides, photodamage, acne scarring, and skin laxity have been reported. The aim of the present work was to compare how different CO2 laser fluences, by modulating the secretory pathway of cytokines, are able to influence the wound-healing process, and how these fluences are associated with different clinical results. Eighteen patients, all with photodamaged skin, were treated using a fractional CO2 laser (SmartXide DOT, Deka M.E.L.A., Florence, Italy) with varying laser fluences (2.07, 2.77, and 4.15 J/cm2). An immunocytochemical study was performed at defined end points in order to obtain information about specific cytokines of the microenvironment before and after treatment. The secretory pathway of cytokines changed depending on the re-epithelization and the different laser fluences. Different but significant improvements in wrinkles, skin texture, and hyperpigmentation were definitely obtained when using 2.07, 2.77, and 4.15 J/cm2, indicating fractional CO2 laser as a valuable tool in photorejuvenation with good clinical results, rapid downtime, and an excellent safety profile.