Accelerated wound healing with a dexpanthenol-containing ointment after fractional ablative CO2 laser resurfacing of photo-damaged skin in a randomized prospective clinical trial

Abstract Background: Laser therapy with an ablative CO2 laser is a prominent treatment option for photo-damaged skin. The healing process and therefore the success of a laser can be supported by an appropriate postoperative treatment of the laser-treated skin. Objective: The effect of a dexpanthenol-containing ointment with petroleum jelly on wound healing after fractional ablative CO2 laser therapy of photo-damaged skin. Methods: A total of 38 patients with photo-damaged skin received fractional ablative CO2 laser treatment. Occlusive wound care was conducted for a period of 7 days. The complete wound area was divided into two sections: one that was treated with a dexpanthenol-containing ointment and a section that was treated with petroleum jelly. This study had three primary outcome measures: (1) Overview images as well as dermatoscopic images of the laser treated skin were taken immediately after laser treatment and on days 1, 2, 5 and 14 (study visits). Dermatoscopic images were analysed to determine changes of the diameter of the individual lesions between the study visits. (2) Wound-healing rate was visually assessed, based on the measure of re-epithelialization. (3) Cosmetic results were evaluated during study visits by patients and physicians applying a visual analogue scale (VAS). Results: Measuring the diameter of laser-generated lesions revealed a significantly faster cure of the lesions in wound sections that were treated with the dexpanthenol-containing ointment on days 1 and 2, in comparison to the lesions that were treated with petroleum jelly. Concordantly, visual evaluation of the wounds revealed significantly better cosmetic results and re-epithelialization on days 1, 2 and 5 after laser treatment in wound sites that were treated with the dexpanthenol-containing ointment. All patients exhibited a completed wound healing on day 14 after laser treatment. Conclusion: In this comparative study, post-operative treatment of laser-treated skin with a dexpanthenol-containing ointment led to a significantly faster wound closure in comparison to petroleum jelly, especially during the early phase of wound healing. Moreover, assessment of the cosmetic result exhibited beneficial effects of the dexpanthenol-containing ointment in the post-operative wound care after laser treatment. These results emphasize that the use of a dexpanthenol-containing ointment in the post-operative phase following CO2 laser therapy could be a promising alternative to the routinely used treatment with petroleum jelly.

[1]  L. Schmitt,et al.  Direct biological effects of fractional ultrapulsed CO2 laser irradiation on keratinocytes and fibroblasts in human organotypic full-thickness 3D skin models , 2018, Lasers in Medical Science.

[2]  Sonja Trapp,et al.  Topical use of dexpanthenol: a 70th anniversary article , 2017, The Journal of dermatological treatment.

[3]  D. Chauveau,et al.  Improvement of Microstomia in Scleroderma after Carbon Dioxide Laser Treatment , 2016, Case Reports in Dermatology.

[4]  T. Steiner,et al.  Characterization of a novel standardized human three‐dimensional skin wound healing model using non‐sequential fractional ultrapulsed CO2 laser treatments , 2015, Lasers in surgery and medicine.

[5]  E. Prens,et al.  Laser treatment and its implications for photodamaged skin and actinic keratosis. , 2015, Current problems in dermatology.

[6]  T. Omi,et al.  The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology. , 2014, Laser therapy.

[7]  O. Celik,et al.  Efficacy of Dexpanthenol for Pediatric Post-Tonsillectomy Pain and Wound Healing , 2013, The Annals of otology, rhinology, and laryngology.

[8]  K. Wilhelm,et al.  Dexpanthenol Modulates Gene Expression in Skin Wound Healing in vivo , 2012, Skin Pharmacology and Physiology.

[9]  L. R. Gaspar,et al.  Skin moisturizing effects of panthenol-based formulations. , 2011, Journal of cosmetic science.

[10]  W. Wigger‐Alberti,et al.  Using a novel wound model to investigate the healing properties of products for superficial wounds. , 2009, Journal of wound care.

[11]  W. Parks,et al.  Metalloproteinases and their inhibitors: regulators of wound healing. , 2008, The international journal of biochemistry & cell biology.

[12]  Tomi L Wall.  Current concepts: laser treatment of adult vascular lesions. , 2007, Seminars in plastic surgery.

[13]  W. Boehncke,et al.  Efficacy of dexpanthenol in skin protection against irritation: a double‐blind, placebo‐controlled study , 2003, Contact dermatitis.

[14]  E. Proksch,et al.  Dexapanthenol enhances skin barrier repair and reduces inflammation after sodium lauryl sulphate-induced irritation , 2002, The Journal of dermatological treatment.

[15]  F. Rippke,et al.  Topical Use of Dexpanthenol in Skin Disorders , 2002, American journal of clinical dermatology.

[16]  M. Gloor,et al.  Effect of Topically Applied Dexpanthenol on Epidermal Barrier Function and Stratum Corneum Hydration , 2000, Arzneimittelforschung.

[17]  T. K. Hunt,et al.  Impaired wound contraction in stromelysin-1-deficient mice. , 1999, Annals of surgery.

[18]  T. K. Hunt,et al.  Stromelysin-1-deficient fibroblasts display impaired contraction in vitro. , 1999, The Journal of surgical research.