Nonablative laser resurfacing using the long-pulse (1064-nm) Nd:YAG laser.

BACKGROUND Lasers with infrared wavelength ranges have been used in nonablative rejuvenation of skin. In this process, cooling of the epidermis allows for laser energy heat-induced injury to the dermis without ablation of the epidermal layer. This dermal injury is theorized to produce improvements in skin quality. In addition, long-pulse Nd:YAG lasers target melanin less efficiently, allowing safer treatment of patients with all skin types. In this study, we evaluate the use of the 1064-nm Nd:YAG laser for the purpose of rejuvenating the aging face. MATERIALS AND METHODS Fifty-one patients were enrolled in the study. Patients with Fitzpatrick skin types I through V were included. Standard photographs were taken before the first and after the last treatment. The Nd:YAG laser treatments were initiated with a chilled tip-cooling device. At each treatment session, patients were given self-assessment questionnaires. At completion of the study, 3 physicians performed masked evaluations of patient pretreatment and posttreatment photographs. RESULTS Thirty-four of 51 patients completed at least 7 treatments, had posttreatment photographs, and were entered into the study. Follow-up ranged from 1 to 6 months. No adverse events were noted. Masked analysis and patient subjective scores demonstrated a subtle improvement in several skin variables. Patient-assigned Fitzpatrick Scale scores declined after 6 treatments for coarse wrinkles (-22.3%; P<.01), skin laxity (-36.3%; P<.01), and overall improvement (-40.6%; P<.01). Physician-graded scores demonstrated decreases in coarse wrinkles (-11.9%; P<.01), skin laxity (-17.3%; P<.01), and overall improvement (-20.0%; P<.01). CONCLUSIONS Nonablative resurfacing techniques are well suited for patients requesting rejuvenating treatments of the aging face with minimal downtime. Although improvements in photodamaged skin are subtle and gradual, the 1064-nm Nd:YAG laser was well tolerated by patients of all skin types.

[1]  P. Bitter,et al.  Noninvasive Rejuvenation of Photodamaged Skin Using Serial, Full‐Face Intense Pulsed Light Treatments , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[2]  G. Monheit,et al.  Chemical peels. , 2001, Facial plastic surgery clinics of North America.

[3]  H. Chan,et al.  An In Vivo Study Comparing the Efficacy and Complications of Diode Laser and Long‐Pulsed Nd:YAG Laser in Hair Removal in Chinese Patients , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[4]  R. Moy,et al.  Treatment of facial rhytids with a nonablative laser: a clinical and histologic study. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[5]  Pham Rt.  Nonablative laser resurfacing. , 2001 .

[6]  Pulsed Carbon Dioxide Laser Resurfacing of Photoaged Facial Skin , 1996 .

[7]  Leonard J. Bernstein,et al.  Cryogen spray cooling in combination with nonablative laser treatment of facial rhytides. , 1999, Archives of dermatology.

[8]  B. Nelson,et al.  Pilot histologic and ultrastructural study of the effects of medium-depth chemical facial peels on dermal collagen in patients with actinically damaged skin. , 1995, Journal of the American Academy of Dermatology.

[9]  R. Fitzpatrick,et al.  Pulsed carbon dioxide laser, trichloroacetic acid, Baker-Gordon phenol, and dermabrasion: a comparative clinical and histologic study of cutaneous resurfacing in a porcine model. , 1996, Archives of dermatology.

[10]  T. Alster,et al.  Long-pulsed Nd:YAG laser-assisted hair removal in pigmented skin: a clinical and histological evaluation. , 2001, Archives of dermatology.

[11]  C W Hanke,et al.  Histologic evaluation of preauricular and postauricular human skin after high-energy, short-pulse carbon dioxide laser. , 1996, Archives of dermatology.

[12]  Paul M Friedman,et al.  3D In‐Vivo Optical Skin Imaging for Topographical Quantitative Assessment of Non‐Ablative Laser Technology , 2002, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[13]  D. Goldberg,et al.  Intense pulsed light and Nd:YAG laser non‐ablative treatment of facial rhytids , 2001, Lasers in surgery and medicine.

[14]  D. Goldberg,et al.  Hair Removal Using a Long‐Pulsed Nd:YAG Laser: Comparison at Fluences of 50, 80, and 100 J/cm2 , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[15]  R A Deyo,et al.  The importance of placebo effects in pain treatment and research. , 1994, JAMA.

[16]  Bahman Anvari,et al.  Nonablative laser treatment of facial rhytides , 1997, Photonics West - Biomedical Optics.

[17]  R. Fitzpatrick,et al.  Pulsed carbon dioxide laser resurfacing of photo-aged facial skin. , 1996, Archives of dermatology.

[18]  M. Goldman.  CO2 laser resurfacing of the face and neck. , 2001, Facial plastic surgery clinics of North America.

[19]  E V Ross,et al.  Nonablative skin remodeling: Selective dermal heating with a mid‐infrared laser and contact cooling combination , 2000, Lasers in surgery and medicine.