Efficacy of combined 1927 nm thulium fiber laser and supramolecular salicylic acid in photoaging treatment

Purpose: 1927 nm fractional thulium fiber laser (TFL) has been shown to be effective in improving skin appearance by reducing pigmentation and loss of elasticity caused by photoaging. Supramolecular salicylic acid (SSA) has been utilized for chemical peeling with rejuvenation effect. This study aims to evaluate the effectiveness and safety of combined TFL and SSA treatment for photoaging. Methods: Thirty-six patients with moderate-to-severe photoaging were enrolled and the two sides of the participants’ face were randomly assigned to receive 30% SSA combined with TFL or TFL monotherapy. TFL was administered to both sides of the face on four occasions at four-week intervals, while the side receiving combined treatment additionally underwent eight chemical peels of 30% SSA fortnightly, supplemented by daily applications of 2% SSA. For the TFL-alone side, an equivalent dose of a placebo preparation was applied. The photographs, photoaging scores, melanin index (MI), erythema index (EI), skin hydration, trans-epidermal water loss (TEWL), dermal thickness, elasticity index, and skin rebound time were assessed. Results: The combined TFL and SSA treatment was significantly more effective in reducing photoaging scores than TFL treatment alone. The average reduction in photoaging scores was 10.51% for the combined treatment group and 7.26% for the TFL-only group (P < 0.001). The combined therapy enhanced skin parameters including MI, EI, hydration, and TEWL, along with ultrasound-measured dermal thickness, elasticity index, and skin resilience post-treatment. Conclusion: The synergistic application of 1927 nm fractional thulium fiber laser and SSA for photoaging treatment has been demonstrated to be both effective and safe.