The primary function of a high-power fractional CO2 laser system is to utilize the principle of focal photothermolysis to generate numerous Microscopic Treatment Zones (MTZs) directly on thickened plaques. By creating these controlled micro-injuries, the system physically disrupts the hardened outer layer of skin (hyperkeratotic stratum corneum) to create pathways for treatment.
By vaporizing pathological tissue layer-by-layer, this technology creates precise skin micro-channels. These channels not only improve local microcirculation but also act as conduits for topical medications, accelerating the resolution of inflammation and restoring skin barrier function.
The Mechanism of Action: Focal Photothermolysis
Creating Microscopic Treatment Zones (MTZs)
The core operating principle is focal photothermolysis. The laser emits an array of microscopic beams that vaporize tissue to create specific zones of thermal injury, rather than treating the entire skin surface at once.
Disrupting the Hyperkeratotic Barrier
Psoriasis plaques are characterized by a thickened stratum corneum. The high-energy beam scanning performs micro-ablation, effectively removing this superficial keratin and hyperplastic tissue layer-by-layer.
Establishing Micro-Channels
The ablation process creates physical micro-channels that penetrate through the epidermis. These vertical channels bypass the skin's natural barrier, significantly facilitating the deep penetration of topical medications or biological agents applied after the procedure.
Physiological Response and Healing
Improving Local Microcirculation
Beyond physical ablation, the thermal energy delivered by the laser stimulates the underlying tissue. This results in improved local microcirculation, which is essential for reducing the stagnation often associated with chronic plaques.
Accelerating Barrier Restoration
The controlled injury triggers the body's natural healing response. This accelerates the resolution of inflammation within the plaque and promotes the biological restoration of the skin barrier function.
Inducing Tissue Remodeling
While primarily used here for plaque disruption, the thermal energy also reaches the dermis. This induces fibroblasts to synthesize new collagen, aiding in the structural remodeling of the affected skin.
Critical Trade-offs: Precision and Safety
Balancing Depth and Safety
Success depends on the precise adjustment of pulse energy and spot density. These parameters determine the depth and diameter of the micro-channels, ensuring they reach the dermis for effective drug delivery without causing excessive damage.
Preserving Healthy Tissue Bridges
A key advantage of the fractional approach is the preservation of bridges of healthy tissue between the micro-channels. These untreated areas act as a reservoir for rapid re-epithelialization, which minimizes recovery time.
Managing Thermal Damage
While thermal energy is beneficial for remodeling, the extent of lateral thermal damage must be controlled. Proper calibration ensures the procedure stimulates repair and clears pathological tissue without increasing the risk of scarring.
Making the Right Choice for Your Goal
To maximize the efficacy of fractional CO2 laser treatment for psoriasis, align your approach with your specific clinical objectives:
- If your primary focus is enhancing drug delivery: Prioritize the creation of deep, clear micro-channels to bypass the hyperkeratotic barrier and maximize the absorption of topical agents.
- If your primary focus is safety and rapid recovery: Ensure parameter controls preserve sufficient bridges of healthy tissue to facilitate quick healing and minimize the risk of adverse scarring.
This technology transforms a physical barrier into a therapeutic gateway, leveraging controlled ablation to accelerate the biological resolution of psoriasis plaques.
Summary Table:
| Feature | Mechanism of Action | Clinical Benefit |
|---|---|---|
| Microscopic Treatment Zones (MTZs) | Focal photothermolysis creating vertical channels | Precise ablation of pathological tissue with rapid healing |
| Barrier Disruption | Vaporization of hyperkeratotic stratum corneum | Creates pathways for deep penetration of topical medications |
| Thermal Stimulation | Controlled heat delivery to the dermis | Improves microcirculation and stimulates tissue remodeling |
| Fractional Delivery | Preserving bridges of healthy tissue between beams | Minimizes downtime and reduces the risk of scarring |
Elevate Your Clinic's Dermatological Capabilities with BELIS
Are you looking to provide advanced solutions for chronic skin conditions like thick psoriasis? BELIS specializes in professional-grade medical aesthetic equipment designed exclusively for clinics and premium salons. Our advanced CO2 Fractional Laser systems offer the precision needed to create therapeutic micro-channels while ensuring maximum patient safety and rapid recovery.
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References
- Hui Ye, Xibao Zhang. Fractional Carbon Dioxide Laser Combined with Secukinumab in the Treatment of Refractory Psoriasis Lesions on the Lower Legs. DOI: 10.2147/ccid.s493967
This article is also based on technical information from Belislaser Knowledge Base .
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