The Comparison between Microneedling and Fractional CO2 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 CO2 laser and microneedling served as transdermal drug delivery. Aims: To compare between microneedling and fractional CO2 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 CO2 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 CO2 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 CO2 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 CO2 laser (p < 0.05). Conclusions: Combination of AMSC-CM and vitamin c using fractional CO2 laser can improve photoaging and is better compared to microneedling.