Introduction
Laser-assisted drug delivery is an evolving technology with potentially broad clinical applications.
Aim
To determine the effect of topical 15% Vitamin C, 1.0% Vitamin E, and 0.5% Ferulic acid serum application after fractional ablative laser to improve postoperative wound healing
Patient Profile
Patients exhibiting moderate photodamage
Methods
- Double blinded, prospective, single center, randomized split face trial
- N=15 healthy men and women of ages 30–55 years
- Patients were treated with the Vitamin C, E, and Ferulic acid serum to one side of face and vehicle to the other side of face, within 2 minutes immediately after fractional ablative CO2 laser surgery and daily during the healing process
- Test formula composed of l-ascorbic acid, alpha-tocopherol, Ferulic acid, water, ethoxydiglycol, propylene glycol, glycerin, laureth-23, phenoxyethanol, triethanolamine, panthenol, and sodium hyaluronate
- Patients were evaluated daily on days 1–7 using photographs, patient questionnaires, and molecular evaluation
- Photographs were subsequently evaluated for improvements in edema and erythema using a quartile scale
- The quartile scale consisted of overall improvement in edema and erythema, each day blinded investigators rated edema and erythema with scale 0 (no edema/erythema), 1 (mild edema/erythema), 2 (moderate edema/erythema), 3 (severe erythema or edema)
- Biomarkers for protein-coding genes Col 1, Col 3, TGF-b1, TGF-b2, TGF-b3, MMP-1 (collagenase 1), MMP-13, bFGF and biomarkers for non-proteincoding genes miRNA biomarkers were analysed
Results
- Postoperatively after ablative fractional laser, Vitamin C, E and Ferulic acid delivery resulted in decreasing edema versus vehicle on postoperative day 7 (P>0.05) and decreased erythema versus vehicle on postoperative days 3 and 5 (P>0.05)
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|
CEF serum 740019 |
|
Placebo 740019 28 |
||
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|
Time point |
Mean |
Mean % change from baseline |
Mean |
Mean % change from baseline |
|
Edema |
Baseline |
0.4 |
|
0.4 |
|
|
|
Day 1 |
1.5 |
Significant |
1.5 |
Significant |
|
|
Day 3 |
1.5 |
Significant |
1.5 |
Significant |
|
|
Day 5 |
1.5 |
Significant |
1.4 |
Significant |
|
|
Day 7 |
0.8 |
Not significant |
0.9 |
Not significant |
|
Erythema |
Baseline |
0.5 |
|
0.5 |
|
|
|
Day 1 |
1.7 |
Significant |
1.9 |
Significant |
|
|
Day 3 |
1.7 |
Significant |
1.9 |
Significant |
|
|
Day 5 |
1.4 |
Significant |
1.5 |
Significant |
|
|
Day 7 |
1.5 |
Significant |
1.4 |
Significant |
Significant implies significant improvement, compared to baseline P<0.05
Significant increase compares to baselines
- Molecularly, the expression of basic fibroblast growth factor (bFGF) was significantly increased at day 5 on the lesion treated with Vitamin C, E, and Ferulic acid serum compared to vehicle control on the other side
- Overall, the formula of Vitamin C, E, and Ferulic acid was well tolerated immediately post-fractional ablative laser
Conclusion
- The study demonstrated that use of vitamin C, E, and Ferulic acid serum post-fractional ablative laser leads to more rapid wound healing.
- Vitamin C, E, and Ferulic acid may have wider implications for all human wound healing and change the paradigm of postoperative laser resurfacing patient care.
Reference
Lasers Surg. Med. 48:238–244, 2016