Fractional photothermolysis (FP), a recently developed method of laser resurfacing, creates microscopic thermal wounds at specific depths in the dermis. Each of these microscopic wounds stimulate a therapeutic response and trigger dermal collagen production, while remaining surrounded by areas of uninjured tissue. These regions, known as microscopic treatment zones (MTZs), are characterized by small wound sizes and short migratory paths for kerotinocytes, thereby facilitating the healing process. Given the mechanism of action of FP, we believe that topical drug penetration may be enhanced following the creation of microscopic holes in the epithelium that occurs during FP treatment. Specifically, this study examines the effect of FP in combination with topical application of drugs known to stimulate collagen production, including the synthetic retinoic acid stereoisomer, tazarotene and transforming growth factor β (TGF-β). The efficacy of these agents alone and in combination with FP treatment was determined by staining tissue samples for collagen and elastin from patients treated with the laser, the topical agents, and both treatments. Based on our preliminary studies, which demonstrate systemic absorption of topical anesthetic following FP, we expect enhanced collagen production for those regions treated with the combination of both fractional photothermolysis and topical agents. The results of this study bear significance for a variety of skin disorders, which may be more efficaciously treated with enhanced drug penetration following FP.
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