1540-nm Nonablative Fractional Laser Safely Treats Actinic Keratosis

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Investigators evaluated the therapeutic effect of a 1540-nm nonablative fractional laser on actinic keratosis, which can be treated by various treatment modalities.

Therapy with a 1540-nm nonablative fractional laser could be considered as a safe and effective alternative therapeutic option for the treatment of actinic keratosis (AK) according to recent study results published in the Journal of Cosmetic Dermatology.

Therapeutic approaches for the treatment of AK include modalities such as ablative lasers; however, ablative lasers have adverse effects (AEs), including oozing, crusting, edema, and burning discomfort during the first week of treatment and long-term erythema, which is disagreeable for most patients. Consequently, in this study, researchers investigated the therapeutic effect of noncontact 1540-nm nonablative fractional laser for the treatment of AK.

The study included 10 patients [7 men and 3 women; average age, 60 (range, 53-80) years] with a total of 31 AK lesions. Exclusion criteria included the history of keloid and scar, nonhealing ulcer, using ablative methods such as cryotherapy, curettage a month before the study, and pregnancy or lactation. The patients were treated with nonablative fractional laser (1540 nm) 3× at 4-week intervals in a noncontact mode.

A dermatologist assessed treatment response and AEs at each session and 3 months after the last session; severity of skin lesions was rated from 0 to 4 (0 = no damage; 4 = most damage) according to the thickness, coarseness, and scaling by clinical and dermoscopical evaluation and palpation. The dermatologist also assessed patients for signs of improvement.

Overall, the results demonstrated that 3-session laser therapy significantly reduced the number and severity of AK lesions (P <.001). Compared with number of baseline AK lesions, counts reduced from 31 to 17, and the severity of AK lesions 1 month after the first treatment, 1 month after the second session, and 3 months after the last session reduced 33%, 72%, and 79%, respectively. The patient scoring data revealed a significant reduction in AK severity: Mean severity of AK lesions at the beginning of treatment was 3.5±0.52, whereas 3 months after the last session, the severity of AK reduced to 1.1±0.1 (P <.01). Patients reported satisfaction with the level of improvement and reported no serious AEs.

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Limitations of the study include the small sample size, short follow-up period, lack of control group, and nonblinded experimental design.

The researchers concluded that “fractional 1540-nm nonablative laser is a safe and effective method for the treatment of AK and it can be used as a new and alternative therapeutic method; however, more studies with greater number of participants are needed to introduce this method as a definite therapeutic approach.”

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Pour PN, Esmaili N, Ehsani A, Hamzelou S, Nasimi M. Nonablative fractional laser therapy for treatment of actinic keratosis with 3-months follow-up [published online March 1, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13350