Nonablative Laser Skin Resurfacing

While ablative skin resurfacing with CO₂ and Er:YAG lasers has been proven highly efficacious in reversing the signs of facial photoaging and atrophic scars, the associated lifestyle hindrance and potential complications are often unacceptable to patients. In recent years, focus has shifted towards nonablative technologies that deliver either laser, light-based, or radiofrequency energies to the skin. Inconsistent and often only modest clinical results are the accepted tradeoffs for a virtually nonexistent recovery period and a low side-effect profile. A myriad of systems with “subsurfacing” capabilities has been studied, including intense pulsed light (IPL) and pulsed dye, Nd:YAG, diode, and Er:Glass lasers [43, 44, 45]. Typically, a series of monthly treatments are advocated. Each treatment generates thermal injury in the dermis with subsequent inflammation, cytokine upregulation, and fibroblast proliferation [46]. Over several months, deposition of papillary dermal collagen in a parallel array occurs [45, 46].