Thulium Laser as Effective as Combination TL-PDT for Photodamaged Décolleté Skin

Treating AKs and Photodamage on the Decollete

A side‐by‐side randomized controlled trial by Kristoffer Hendel, MD, et al, revealed that treatment with a 1,927nm Thulium laser (TL) is as effective at reducing photodamage on the décolleté as combination treatment with TL and photodynamic therapy (PDT).

The study included 12 women with moderate-to-severe photodamage on the décolleté and a cumulative total of 184 thin grade I AKs. All AKs were treated with lesion-directed curettage. Subjects décolletés were then divided into four treatment areas and randomized to receive one single treatment with TL, PDT, combination TL and PDT or only lesion-directed curettage (control).

Six patients underwent eight passes with the TL (20 mJ/mb, 500 mJ/cm22. Follow-up at 12 weeks included clinical assessment of overall photodamage and specific subcomponents, assisted by optical coherence tomography (OCT) imaging.

The areas treated with TL and combination TL‐PDT showed equal improvement in overall photodamage, mottled pigmentation and rhytides compared with lesion‐directed control. Areas treated with combination TL-PDT showed greater improvement in skin texture compared to TL alone. Complete median AK responses were similar for all interventions and control. No scarring or adverse events were observed, but skin response following treatment was more pronounced in areas that received combined TL-PDT.

The study was published in Lasers in Surgery and Medicine (January 2020).

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