Ablative versus non‐ablative treatment of perioral rhytides. A randomized controlled trial with long‐term blinded clinical evaluations and non‐invasive measurements

Background and Objective To compare efficacy and side effects of CO 2 laser resurfacing and intense pulsed light (IPL) rejuvenation for treatment of perioral rhytides. Methods Twenty‐seven female subjects with perioral rhytides (class I–III) were randomly treated with either CO 2 laser or IPL (three monthly treatments). Efficacy was evaluated by patient self‐assessments and blinded photographs up to 12 months postoperatively. Side effects were assessed clinically. Non‐invasive measurements included: trans epidermal water loss (TEWL), skin reflectance, skin elasticity, and ultrasound. Results CO 2 laser resurfacing resulted in higher degrees of patient satisfaction and clinical rhytide reduction compared to IPL rejuvenation up to 12 months postoperatively (patient evaluations, P  < 0.05) (observer evaluations, P  < 0.008). Laser‐induced side effects included erythema, dyspigmentation, and milia whereas no side effects were observed after IPL rejuvenation. Non‐invasive measurements showed a significant higher reduction of the subepidermal low‐echogenic band in CO 2 laser treated areas versus IPL treated areas (12 months postoperatively, P  < 0.001). Skin elasticity (expressed as Young's modulus) increased in both groups ( P  = ns). One month postoperatively a significant increase in TEWL values ( P  < 0.009) and skin redness% ( P  < 0.02) was found in CO 2 laser treated patients versus IPL treated patients. No significant differences were seen in skin pigmentation% during the observation period. Conclusion CO 2 laser resurfacing induces a significantly higher degree of clinical rhytide reduction followed by considerably more side effects compared to IPL rejuvenation in a homogeneous group of patients. Lasers Surg. Med. 38:129–136, 2006. © 2006 Wiley‐Liss, Inc.