Summary

Ablative laser skin resurfacing has revolutionized the approach to photodamaged facial skin. Technology and techniques continue to evolve, further enhancing the ability to achieve substantial clinical improvement of rhytides and dyspigmentation with reduced postoperative morbidity. Utilizing proper technique and treatment parameters, excellent clinical results can be obtained with any one or combination of CO₂ and Er:YAG laser systems available. Therefore, the best choice of laser ultimately depends on the operator’s expertise, clinical indication, and individual patient characteristics. Regardless of the type of ablative resurfacing laser used, the importance of careful postoperative follow-up cannot be overemphasized.

For those patients who desire a less aggressive approach to photorejuvenation, non-ablative dermal remodeling represents a viable alternative for patients willing to accept modest clinical improvement in exchange for ease of treatment and a favorable side-effect profile. Treatments are typically delivered at monthly time intervals with final clinical results taking several months after laser irradiation to be realized. Although clinical outcomes with these non-ablative systems are not yet comparable with those of ablative CO₂ or Er:YAG lasers, they do improve overall skin texture, tone and elasticity – subjective findings often difficult to represent in photographs. None of the non-ablative laser systems has yet emerged as being clearly superior – each produces similar degrees of improvement in dermal pathology after multiple sessions at standard treatment parameters. With continued research efforts focused on non-ablative laser skin remodeling, it is possible that further refinements and advances in this technology will more closely approximate the effects of ablative laser treatment without its associated complications and risks.