The Safety and Efficacy of the 308-nm Excimer Laser for Pigment Correction of Hypopigmented Scars and Striae Alba | Dermatology | JAMA Dermatology | JAMA Network
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Sahl Jr  WJClever  H Cutaneous scars: part I  Int J Dermatol. 1994;33681- 691PubMedGoogle ScholarCrossref
Velangi  SSRees  JL Why are scars pale? an immunohistochemical study indicating preservation of melanocyte number and function in surgical scars  Acta Derm Venereol. 2001;81326- 328PubMedGoogle ScholarCrossref
Grimes  PEBhawan  JKim  JChiu  MLask  G Laser resurfacing–induced hypopigmentation: histologic alterations and pigmentary correction with topical photochemotherapy  Dermatol Surg. 2001;27515- 520PubMedGoogle ScholarCrossref
Alster  TSWest  TB Treatment of scars: a review  Ann Plast Surg. 1997;39418- 432PubMedGoogle ScholarCrossref
Monheit  GD The Jessner's–trichloroacetic acid peel: an enhanced medium-depth chemical peel  Dermatol Clin. 1995;13277- 283PubMedGoogle ScholarCrossref
Acikel  CUlkur  EGuler  MM Treatment of burn scar depigmentation by carbon dioxide laser–assisted dermabrasion and thin skin grafting  Plast Reconstr Surg. 2000;1051973- 1978PubMedGoogle ScholarCrossref
Onur Erol  OAtabay  K The treatment of burn scar hypopigmentation and surface irregularity by dermabrasion and thin skin grafting  Plast Reconstr Surg. 1990;85754- 758PubMedGoogle ScholarCrossref
Holme  SABeattie  PEFleming  CJ Cosmetic camouflage advice improves quality of life  Br J Dermatol. 2002;147946- 949PubMedGoogle ScholarCrossref
Zheng  PLabkar  RMKligman  AM Anatomy of striae  Br J Dermatol. 1985;112185- 193PubMedGoogle ScholarCrossref
Kang  SKim  KJGriffiths  CEM  et al.  Topical tretinoin (retinoic acid) improves early stretch marks  Arch Dermatol. 1996;132519- 526PubMedGoogle ScholarCrossref
Alster  TS Laser treatment of hypertrophic scars, keloids, and striae  Dermatol Clin. 1997;15419- 429PubMedGoogle ScholarCrossref
Pribanich  SSimpson  FGHeld  BYarbrough  CLWhite  SN Low-dose tretinoin does not improve striae distensae: a double-blind, placebo-controlled study  Cutis. 1994;54121- 124PubMedGoogle Scholar
Nouri  KRomagosa  RChartier  TBowes  LSpencer  JM Comparison of the 585 nm pulse dye laser and the short pulsed CO2 laser in the treatment of striae distensae in skin types IV and VI  Dermatol Surg. 1999;25368- 370PubMedGoogle ScholarCrossref
Ortonne  J Psoralen therapy in vitiligo  Clin Dermatol. 1989;7120- 135PubMedGoogle ScholarCrossref
Westerhof  WNieuweboer-Krobotova  L Treatment of vitiligo with UV-B radiation vs topical psoralen plus UV-A  Arch Dermatol. 1997;1331525- 1528PubMedGoogle ScholarCrossref
Njoo  MDBos  JDWesterhof  W Treatment of generalized vitiligo in children with narrow-band (TL-01) UVB radiation therapy  J Am Acad Dermatol. 2000;42 ((pt 1)) 245- 253PubMedGoogle ScholarCrossref
Scherschun  LKim  JJLim  HW Narrow-band ultraviolet B is a useful and well-tolerated treatment for vitiligo  J Am Acad Dermatol. 2001;44999- 1003PubMedGoogle ScholarCrossref
Spencer  JMNossa  RAjmeri  J Treatment of vitiligo with the 308-nm excimer laser: a pilot study  J Am Acad Dermatol. 2002;46727- 731PubMedGoogle ScholarCrossref
Friedman  PMGeronemus  RG Use of the 308-nm excimer laser for postresurfacing leukoderma [letter]  Arch Dermatol. 2001;137824- 825PubMedGoogle Scholar
Takiwaki  H Measurement of skin color: practical application and theoretical considerations  J Med Invest. 1998;44121- 126PubMedGoogle Scholar
Clarys  PAlewaeters  KLambrecht  RBarel  AO Skin color measurements: comparison between three instruments: the Chromameter®, the DermaSpectrometer® and the Mexameter®  Skin Res Technol. 2000;6230- 238PubMedGoogle ScholarCrossref
Baltas  ECsoma  ZIgnacz  FDobozy  AKemeny  L Treatment of vitiligo with the 308-nm xenon chloride excimer laser [letter]  Arch Dermatol. 2002;1381619- 1620PubMedGoogle ScholarCrossref
Alexiades-Armenakas  MRBernstein  LJJacobson  LGChen  JZGeronemus  RG The safety and efficacy of a localized UVB light device for selective cosmetic repigmentation [abstract]  Paper presented at: The 30th Annual Clinical and Scientific Meeting of the American Society for Dermatologic Surgery October 10, 2003 New Orleans, La
de Gruijl  FR p53 Mutations as a marker of skin cancer risk: comparison of UVA and UVB effects  Exp Dermatol. 2002;11(suppl 1)37- 39PubMedGoogle ScholarCrossref
Pasker-de Jong  PCWielink  Gvan der Valk  PGvan der Wilt  GJ Treatment with UV-B for psoriasis and nonmelanoma skin cancer: a systematic review of the literature  Arch Dermatol. 1999;135834- 840PubMedGoogle ScholarCrossref
Bickers  DR The carcinogenicity and mutagenicity of therapeutic coal tar: a perspective  J Invest Dermatol. 1981;77173- 174PubMedGoogle ScholarCrossref
Stern  RS Genital tumors among men with psoriasis exposed to psoralens and ultraviolet A radiation (PUVA) and ultraviolet B radiation: the Photochemotherapy Follow-up Study  N Engl J Med. 1990;3221093- 1097PubMedGoogle ScholarCrossref
Schothorst  AASlaper  HSchouten  RSuurmond  D UVB doses in maintenance psoriasis phototherapy versus solar UVB exposure  Photodermatology. 1985;2213- 240PubMedGoogle Scholar
Studniberg  HMWeller  P PUVA, UVB, psoriasis, and nonmelanoma skin cancer  J Am Acad Dermatol. 1993;291013- 1022PubMedGoogle ScholarCrossref
Elder  DE Skin cancer: melanoma and other specific nonmelanoma skin cancers  Cancer. 1995;75(suppl)245- 256PubMedGoogle ScholarCrossref
Karagas  MRGreenberg  ERSpencer  SKStukel  TAMott  LANew Hampshire Skin Cancer Study Group, Increase in incidence rates of basal cell and squamous cell skin cancer in New Hampshire, USA  Int J Cancer. 1999;81555- 559PubMedGoogle ScholarCrossref
Harris  RBGriffith  KMoon  TE Trends in the incidence of nonmelanoma skin cancers in southeastern Arizona, 1985-1996  J Am Acad Dermatol. 2001;45528- 536PubMedGoogle ScholarCrossref
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.