CO2 Laser for Lichen Planus Pigmentosus

Overseen By Heather Goff, MD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas Southwestern Medical Center

Must not be taking: Immunosuppressants, Anticoagulants, Isotretinoin, Gold therapy

Disqualifiers: Active skin infection, Pregnancy, Diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 1 session

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial investigates whether a fractional CO2 laser can safely and effectively treat Lichen Planus Pigmentosus (LPP), a skin condition causing dark patches, mostly on the face and arms. The study will apply the laser treatment to one side of the body to assess improvement compared to the untreated side. Individuals with a confirmed diagnosis of LPP who are willing to stop using other skin treatments may be suitable candidates for this trial. As an unphased study, this trial provides a unique opportunity to explore a new treatment option for LPP.

Will I have to stop taking my current medications?

The trial requires participants to refrain from using other topical medications besides those provided during the study. If you are on immunosuppressive medications, you cannot participate. The protocol does not specify about other medications, so it's best to discuss with the trial team.

What prior data suggests that this fractional CO2 laser treatment is safe for Lichen Planus Pigmentosus?

Research shows that CO2 fractional laser treatment is generally safe. Studies indicate it has fewer complications than older laser methods. While minor side effects can occur, they are usually not serious. Most often, patients might experience temporary redness or swelling after treatment.

Fractional CO2 lasers have been safely used in other skin treatments, such as those for sun damage. Although limited information exists specifically for Lichen Planus Pigmentosus (LPP), current evidence suggests it is safe. This trial aims to confirm these findings for LPP. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using the CO2 fractional laser to treat lichen planus pigmentosus because it offers a targeted approach to reducing skin pigmentation. Unlike standard treatments, such as topical steroids or hydroquinone creams, which primarily aim to suppress inflammation or lighten skin, the CO2 fractional laser directly resurfaces the skin to improve texture and pigmentation. This laser technology works by creating microscopic columns of treated tissue, which promotes collagen production and accelerates skin healing. This method has the potential to deliver faster and more noticeable improvements in skin appearance compared to traditional options.

What evidence suggests that CO2 fractional laser might be an effective treatment for Lichen Planus Pigmentosus?

Studies have shown that fractional CO2 lasers effectively treat skin issues, such as scars, with fewer complications than older lasers. Although direct data for Lichen Planus Pigmentosus (LPP) is not yet available, the laser's success with similar conditions is promising. Research indicates that CO2 lasers can significantly improve skin appearance, offering benefits like facial lightening and rejuvenation. Previous reports on other lasers, such as Nd:YAG, being effective for LPP suggest that lasers can help with this condition. In this trial, one arm will receive treatment with the CO2 fractional laser, which targets specific skin layers and may reduce the pigmentation seen in LPP. ^{1 2 3 6 7}

Who Is on the Research Team?

Heather Goff, MD, MPH

Principal Investigator

UT Southwestern Medical Center

Are You a Good Fit for This Trial?

Inclusion Criteria

Agree to not undergo any other procedures on affected area during the study

Agree to refrain from tanning for 6 months post-procedure

Willing and able to read, understand, and sign the consent form

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Preoperative Preparation

Participants complete a one-month preoperative daily use of SPF 50+ sunscreen to reduce further sun damage and protect skin from increased photosensitivity.

4 weeks

Treatment

Participants receive fractional CO2 laser treatment on one half of the body, with the other half left untreated as a control.

1 session

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with limited in-person follow-ups and virtual check-ins.

24 weeks

3 visits (in-person), multiple virtual check-ins

Optional Treatment Extension

Participants may opt for treatment of the control side after the study end-point at no cost.

What Are the Treatments Tested in This Trial?

Interventions

• CO2 fractional laser

How Is the Trial Designed?

Group I: Treatment (CO2 fractional laser) arm Experimental Treatment 1 Intervention

CO2 fractional laser will be used to treat dyspigmentation in lichen planus pigmentosus in one half along sagittal midline section in each subject.

Group II: No treatment (Control) arm Active Control 1 Intervention

One half along sagittal midline section in each subject will not receive the CO2 fractional laser treatment.

Who Is Running the Clinical Trial?

University of Texas Southwestern Medical Center

Lead Sponsor

Trials

1,102

Recruited

1,077,000+

Published Research Related to This Trial

The novel fractional CO2 laser developed for treating cervical diseases demonstrated greater depth of penetration and more consistent laser spot size compared to a conventional CO2 laser, indicating improved efficacy.

Both the novel and conventional CO2 lasers showed similar side effects, suggesting that the new apparatus is as safe as the traditional method while offering enhanced performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigation of the efficiency and stability of a novel visualized lattice CO2 laser-based gynecological therapeutic apparatus for the treatment of cervical diseases in rhesus monkeys. Chen, F., Gan, Y., Wang, HW.[2022]

In a study of 373 CO₂ laser treatments on 287 patients, adverse events (AEs) occurred in 12.6% of treatments, with the most common being allergic dermatitis (4.6%) and acneiform breakouts (3.5%).

The risk of AEs increased significantly when multiple body areas were treated simultaneously, with 37.5% of patients experiencing AEs when three areas were treated, while subsequent treatments on the same area after healing showed no increased risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events of fractionated carbon dioxide laser: review of 373 treatments. Campbell, TM., Goldman, MP.[2012]

Ablative carbon dioxide fractional laser treatment applied 2 to 3 weeks after thyroid surgery significantly improved the appearance of scars, as indicated by lower Vancouver Scar Scale scores in 23 women.

The treatment was found to be both effective and safe, with 12 out of 23 participants showing over 51% clinical improvement in scar appearance three months post-treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early postoperative treatment of thyroidectomy scars using a fractional carbon dioxide laser. Jung, JY., Jeong, JJ., Roh, HJ., et al.[2022]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05170308

Fractional CO2 Laser for the Treatment of Lichen Planus ... This study will assess the safety and efficacy of fractional carbon dioxide (CO2) laser treatment for Lichen Planus Pigmentosus (LPP).

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40965050/

Laser Therapy for Lichen Planus Pigmentosus and ... Conclusion: Q-switched and picosecond Nd:YAG seem effective for LPP and EDP in patients with pigmented skin. Fractional lasers were also ...

3. withpower.com withpower.com/trial/phase-lichen-planus-2022-30af7

Fractional CO2 Laser for the Treatment of Lichen Planus ... Research shows that CO2 fractional lasers are effective in improving the appearance of scars after surgery and have fewer complications compared to older laser ...

4. researchgate.net researchgate.net/publication/346515240_Lichen_planus_pigmentosus_successfully_treated_with_conventional_CO2_laser_resurfacing

(PDF) Lichen planus pigmentosus successfully treated with ... After the usual post-laser recovery period, the final cosmetic outcome was significant, including remarkable facial lightening and rejuvenation, ...

5. mdpi.com mdpi.com/2077-0383/13/7/2116

Advancements in Laser Therapies for Dermal ... A study treating PIH patients with a fractionated ps-755 nm laser brought 50–75% improvement at 3 years, suggesting that it could serve as a long-term treatment ...

6. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/ajd.14505

Laser Dermatology - 2025 Results were good in cases of post inflammatory hyperpigmentation and lichen planus pigmentosus but some residual pigmentation was still visible ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11012689/

Advancements in Laser Therapies for Dermal ... A study treating PIH patients with a fractionated ps-755 nm laser brought 50–75% improvement at 3 years, suggesting that it could serve as a ...