Med Laser  
Combination of High- and Low-Fluenced Erbium:Yttrium-Aluminum-Garnet Laser Treatments for Striae Distensae in Asian Patients
Heesu Kim1, Zhenlong Zheng1,2, Sung Bin Cho1,3
1Department of Dermatology and CutaneousBiology Research Center, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
2Department of Dermatology, Yanbian University Hospital, Yanji, China
3Kangskin Dermatology Clinic, Seoul, Korea
Correspondence to: Sung Bin Cho
Department of Dermatology and Cutaneous Biology Research Center, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, 25 Simgok-ro, Seo-gu, 22711 Incheon, Korea
Tel.: +82-32-290-3141
Fax: +82-32-290-3142
E-mail: drsbcho@gmail.com
Received: September 18, 2018; Accepted: October 14, 2018; Published online: November 6, 2018.
© Korean Society for Laser Medicine and Surgery. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The safety and efficacy of 2,940-nm erbium (Er):yttrium-aluminum-garnet(YAG) laser treatments have been remarkably improved by incorporating technology in which high-fluenced, fractionated laser pulses are delivered to target areas, leaving the surrounding skin uninjured, and low-fluenced resurfacing technology delicately generates photothermal tissue reactions in the uppermost epidermis. In this report, we describe two Korean patients with striae distensae on the lower back and abdomen, respectively, who were effectively treated with a single session of combined high-fluenced, fractionated Er:YAG laser and low-fluenced Er:YAG resurfacing laser treatment. High-fluenced, 2,940-nm fractionated Er:YAG laser treatment was delivered along the striae distensae lesions at a fluence of 37 J/cm2 and coverage of 11% over a single pass. Immediately after high-fluenced, fractionated Er:YAG laser treatment, low-fluenced Er:YAG laser resurfacing was performed with a beam size of 4 mm and a fluence of 2.0 J/cm2 at the expected penetration depth of 8 μm and an overlap of 30% over a single pass. Two to three months after treatment, both patients exhibited marked improvements in the striae distensae lesions without remarkable major side effects. Our data demonstrate that combined high-fluenced, fractionated Er:YAG laser and low-fluenced Er:YAG resurfacing laser treatment can be used to effectively treat striae distensae in Asian patients.
Keywords: Erbium:yttrium-aluminum-garnet laser; Fractionated laser; Intraepidermal laser resurfacing; Stria distensa; Stria alba


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