Efficacy of Fractional Ablative Laser Followed by Immediate Topical 15% Vitamin C, 1.0% Vitamin E, and 0.5% Ferulic acid Serum in Patients Exhibiting Moderate Photodamage

Table of Content

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)
Table 1: Statistical analysis with p-values of improvement in healing time from days 1 to 7

 

CEF serum 740019

 

Placebo 740019 28

 

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