The comparison between microneedling and fractional CO 2 laser for amniotic membrane stem cell-conditioned medium and vitamin C in photoaging treatment

Context: Photoaging correlates with ultraviolet radiation (UVR). In addition to direct and indirect DNA damage, UVR leads to a breakdown of collagen, resulting in enlarged pores, visible wrinkles, also uneven skin tones and pigmentations. Amniotic membrane stem cell (AMSC) can be a useful modality in cell regeneration. Vitamin C has been known as an agent of depigmentation, antioxidants, and collagen synthesis. A topical combination of amniotic membrane stem cell-conditioned medium (AMSC-CM) and vitamin C is expected to improve photoaging. Fractional CO 2 laser and microneedling served as transdermal drug delivery. Aims: To compare between microneedling and fractional CO 2 laser for the administration of AMSC-CM and vitamin C in photoaging treatment. Methods and Material: Sixty Indonesian women with photoaged skins participated in this experimental analytic, controlled, matching research and were divided into two groups. Thirty women received fractional CO 2 laser, and others received microneedling. All participants received a topical combination of AMSC-CM and vitamin C. Three treatment sessions were repeated at a four-week interval for fractional CO 2 laser and a two-week interval for microneedling. We evaluated the progression and side effects using a skin analyzer on weeks 0, 4, and 8 for the microneedling group and for the fractional CO 2 laser group on weeks 0, 4, and 12. Results: Assessment of wrinkles, UV spots, skin tone, and pore revealed a statistically significant effect of a topical combination of AMSC-CM and vitamin C after fractional CO 2 laser (p < 0.05). Conclusions: Combination of AMSC-CM and vitamin c using fractional CO 2 laser can improve photoaging and is better compared to microneedling.