Treatment of periorbital wrinkles using thermo-mechanical fractional injury therapy versus fractional non-ablative 1565 nm laser: A comparative prospective, randomized, double-arm, controlled study

Fares Salameh; Danny Daniely; Arielle Kauvar; Rafael L Carasso; Joseph N Mehrabi; Ofir Artzi

doi:10.1002/lsm.23494

Treatment of periorbital wrinkles using thermo-mechanical fractional injury therapy versus fractional non-ablative 1565 nm laser: A comparative prospective, randomized, double-arm, controlled study

Lasers Surg Med. 2022 Jan;54(1):46-53. doi: 10.1002/lsm.23494. Epub 2021 Nov 17.

Authors

Fares Salameh^{1

2}, Danny Daniely^{1

2}, Arielle Kauvar^{3

4}, Rafael L Carasso⁵, Joseph N Mehrabi², Ofir Artzi^{1

2

6}

Affiliations

¹ Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
² Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
³ New York Laser & Skin Care, New York, New York, USA.
⁴ Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA.
⁵ Department of Neurology and Pain Clinic, Hillel Yaffe Medical Center, Hadera, Israel.
⁶ Dr. Artzi and Associates Treatment and Research Center, Tel Aviv, Israel.

PMID: 34787919
DOI: 10.1002/lsm.23494

Abstract

Background: Non-ablative fractional laser is an effective modality for the treatment of periorbital wrinkling, one of the earliest signs of skin aging. Thermo-mechanical fractional injury (TMFI) therapy (Tixel®, Novoxel®, Israel) is an innovative technology that is now being used for facial skin rejuvenation. Our study compares the clinical results, side effects, and downtime profile between TMFI treatment and non-ablative fractional 1565 nm laser (ResurFX®, Lumenis, Israel).

Methods: This was a prospective study of 68 patients (64 women, 4 men) with skin types I-VI in two medical centers (34 from Israel, 34 from the USA) that were randomized to receive either TMFI or NAFL treatment for periorbital wrinkling. Patients received 3-5 treatments, 3-5 weeks apart. Six months after the last treatment, the change in Fitzpatrick Wrinkling Classification System (FWCS) was calculated by three non-involved physicians and compared to pretreatment results. Side effects and downtime profiles were assessed in each group (including VAS pain assessment, time required to refrain from work and social activity, and time required for the resolution of redness, edema, and crusts.) RESULTS: A moderate improvement in periorbital wrinkling was demonstrated in both groups, with an average improvement of 1.6 ± 0.6 in FWCS in the TMFI group and an average improvement of 1.7 ± 0.8 in the NAFL group (p < 0.001). Postprocedural VAS score was 5.86 ± 2.3 in the NAFL group and 4.01 ± 2.6 in the Tixel® group. Approximately 80% of subjects returned to both work and social activities two days postprocedure. Crusts were reported by 52% of patients in the TMFI group, compared to 16% of patients in the NAFL group more than 48 hours postprocedure (p < 0.05). There were no statistically significant differences in the other parameters between the two groups.

Conclusion: TMFI is an effective and safe modality for the treatment of periorbital wrinkling, with comparable results to the 1565 nm NAFL.

Keywords: non-ablative fractional laser; periorbital rejuvenation; periorbital rhytides; periorbital wrinkling; thermomechanical fractional injury.

Publication types

Case Reports
Randomized Controlled Trial

MeSH terms

Female
Humans
Laser Therapy*
Lasers, Solid-State* / therapeutic use
Male
Prospective Studies
Rejuvenation
Skin Aging*
Treatment Outcome