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August 2004

The Safety and Efficacy of the 308-nm Excimer Laser for Pigment Correction of Hypopigmented Scars and Striae Alba

Author Affiliations

From the Laser & Skin Surgery Center of New York, NY. Dr Alexiades-Armenakas is now with the Department of Dermatology, Yale University School of Medicine, New Haven, Conn, and is in private practice in New York City; Dr Friedman is now with DermSurgery Laser Center, Houston, Tex. Dr Geronemus received funding to support the research from Photomedex, Radnor, Pa.

Arch Dermatol. 2004;140(8):955-960. doi:10.1001/archderm.140.8.955

Objective  To assess the safety and efficacy of the 308-nm excimer laser in pigment correction of hypopigmented scars and striae alba.

Design  Institutional review board–approved randomized controlled trial.

Setting  Private research center.

Patients  Volunteer sample of 31 adult subjects with hypopigmented scars or striae alba distributed on the face, torso, or extremities.

Interventions  Lesions were randomized to receive treatment or not, with site-matched normal control areas. Treatments were initiated with a minimal erythema dose minus 50 mJ/cm2 to affected areas. Subsequent treatments were performed biweekly until 50% to 75% pigment correction, then every 2 weeks thereafter until a maximum of 10 treatments, 75% increase in colorimetric measurements, or 100% visual pigment correction.

Main Outcome Measures  Pigment correction by visual and colorimetric assessments compared with untreated control lesions and site-matched normal skin before each treatment and at 1-, 2-, 4-, and 6-month follow-up intervals. Occurrence of erythema, blistering, dyspigmentation, or other adverse effects was monitored.

Results  The percentage pigment correction by both assessments increased in direct proportion to the number of treatments. The mean percentage pigment correction by visual assessment relative to control of 61% (95% confidence interval [CI], 55%-67%) for scars and 68% (95% CI, 62%-74%) for striae was achieved after 9 treatments. The mean percentage pigmentation by colorimetric measurements relative to control of 101% (95% CI, 99%-103%) for scars and 102% (95% CI, 99%-104%) for striae was achieved after 9 treatments. Both sets of values gradually declined toward baseline levels during the 6-month follow-up. No blistering or dyspigmentation occurred.

Conclusions  Therapy with the 308-nm excimer laser is safe and effective in pigment correction of hypopigmented scars and striae alba. Mean final pigment correction rates relative to control sites of approximately 60% to 70% by visual assessment and 100% by colorimetric analysis were observed after 9 treatments administered biweekly. Maintenance treatment every 1 to 4 months is required to sustain the cosmetic benefit.