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Erasing the Lines of Time

WebMD Health News

Dec. 20, 2000 -- It's an all-too-common sign of age in women -- wrinkles around the mouth. In trying to erase these time lines, women try various facial skin treatments, including laser resurfacing, dermabrasion, and chemical peels, to the tune of 2.7 million procedures in one year alone.

A recent study in the journal Plastic and Reconstructive Surgery looked at the benefits and risks of two of the procedures. "There have been a lot of advertising claims of miraculous improvements and little downtime in healing," says study author W. John Kitzmiller, MD, associate professor of plastic surgery at the University of Cincinnati in Ohio. "We wanted to provide a side-by-side comparison of laser resurfacing and dermabrasion, the two most effective procedures available for this condition."

Chemical peels were not included in his study, he tells WebMD, "because those that have gone deep enough to treat this condition cause hypopigmentation, or whitening of the skin. Especially when we're treating just one area of the face, this is objectionable to women."

In the study, 20 women between the ages of 44 and 74 were treated for "noticeable wrinkles," around the mouth, Kitzmiller says. Each woman had half her face treated with dermabrasion, a procedure in which a hand-held rotary device is used to plane the layers of skin. On the other side, the women had a CO2 laser treatment, which in effect vaporizes skin surfaces.

To judge the results, a panel of 10 plastic surgeons evaluated high-quality photographs taken during each woman's recovery at one-week, one-month, and six-month intervals. The judges were unaware which procedure was used on any of the "half-faces."

They compared each half-face for the absence of wrinkles, as well as the healing time involved.

"The results [of the two procedures] were really pretty comparable," Kitzmiller tells WebMD. Lasers provided slightly better wrinkle removal -- 10% to 20% more improvement compared to the dermabrasion side. "A small but significant difference to the critical observer."

However, differences in healing time were more dramatic. "With dermabrasion, both healing and redness resolved a little faster than with laser," he says. "So there's a trade-off."

The women also evaluated the procedures and "confirmed our impressions," Kitzmiller says. "From their perspective, there was a slight advantage for the laser as far as wrinkle removal. But they were evenly divided as far as what they would recommend to their friends. Some women felt the extra wrinkle removal was not worth the extra healing time and discomfort of the laser treatment."

Because both procedures involve removing the top layers of the skin, "there is a significant period when it's weepy, uncomfortable and sore, and looks strange to the public," Kitzmiller tells WebMD. "It's seven to 10 days before you can wear makeup. Some women have a harder time dealing with that, especially if they ... have go back to work with the public. And when being away from a job or social responsibilities for a week is a big deal, that's a hardship."

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