Biomolecular Changes Upon Ablative Laser Therapy of the Skin: A Scoping Review

Area of Science:

• Dermatology
• Molecular Biology
• Laser Therapy

Background:

• Ablative laser therapy is a key dermatological treatment for various skin conditions.
• The precise biomolecular changes induced by ablative laser therapy remain incompletely understood.
• Understanding these molecular alterations is crucial for optimizing treatment outcomes and developing new therapeutic strategies.

Purpose of the Study:

• To provide a comprehensive overview of the molecular changes following ablative laser therapy.
• To systematically review gene and protein expression alterations induced by different types of ablative lasers.
• To compare the biomolecular effects of fractional versus full ablative laser treatments.

Main Methods:

• Systematic literature search of PubMed, Embase, and Web of Science databases.
• Inclusion of studies focusing on gene and protein expression changes after ablative laser therapy.
• Analysis of data from 20 studies utilizing CO2, Er:YAG, and Er:YSGG laser devices.

Main Results:

• Both fractional and full ablative lasers initiate wound healing, dermal remodeling, and neocollagenesis, marked by increased metalloproteinases and collagen.
• Ablative laser therapy leads to degradation of old elastic fibers and stimulates the formation of new ones (elastogenesis), with greater effect seen in full ablation.
• The inflammatory response and expression of innate immune-related genes were more pronounced after ablative laser compared to fractional therapy.
• Sustained high levels of collagen types I, III, and VII were observed for up to 6 months post-treatment.
• Er:YAG mini-peels induced comparable biomolecular changes to full ablative treatments, despite preserving the basal membrane.

Conclusions:

• Ablative laser therapy, including fractional and full modalities, effectively induces neocollagenesis and elastogenesis through a wound-healing cascade.
• Fractional ablative lasers elicit a less pronounced inflammatory response compared to full ablative lasers.
• The findings provide valuable insights into the molecular mechanisms underlying laser skin treatments, informing clinical practice and future research.