Treatment of periorbital wrinkles. A comparison of the SilkTouch carbon dioxide laser with a medium-depth chemical peel.

BACKGROUND: Chemical peels are an effective treatment for wrinkles, but their use is limited because of the associated risk of scarring, hypopigmentation, and the inability to accurately control the depth of tissue injury. High energy, pulsed, or computer scanned continuous wave carbon dioxide (CO2) lasers cause minimal thermal injury, decrease the risk of scarring, and allow for precise control of tissue vaporization to predictable depths.

OBJECTIVE: To compare the effectiveness and side effect profile of a medium-depth chemical peel to that of the SilkTouch CO2 laser in the treatment of periorbital wrinkles.

METHODS: Twenty-four subjects (nine male, 15 female) with moderate to severe periorbital wrinkles were assigned a wrinkle score (1 = mild through 5 = severe) before treatment and 6 months after treatment. Each subject was treated with Jessner's solution and 35% trichloroacetic acid on one side and the SilkTouch CO2 laser on the other side.

RESULTS: The average periorbital wrinkle score decreased from 4.00 +/- 0.78 before laser treatment to 1.75 +/- 0.68 6 months after treatment. The chemical peel wrinkle score decreased from 4.13 +/- 0.85 to 3.29 +/- 0.99. The degree in which the wrinkle score improved after laser treatment compared with after chemical peel treatment was statistically significant. Posttreatment erythema lasted an average of 4.5 months for the laser-treated areas and 2.5 months for the chemical peel-treated areas.

CONCLUSION: Treatment of periorbital wrinkles with the SilkTouch CO2 laser resulted in a greater degree of improvement than treatment with a medium-depth chemical peel but had longer lasting posttreatment erythema.