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Nonablative skin resurfacing for skin rejuvenation

Author
Macrene Alexiades-Armenakas, MD, PhD
Section Editor
Jeffrey S Dover, MD, FRCPC
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

Over time, chronic sun exposure and chronological aging contribute to changes in the skin, such as dyschromia, rhytides (wrinkles), telangiectasias, textural alterations, and skin laxity (table 1). Although ablative laser resurfacing and surgical procedures are effective for improving features of cutaneous aging, concern regarding potential adverse effects and required recovery times deter many patients from proceeding with these procedures.

Nonablative lasers and light sources are therapeutic options for skin rejuvenation that demonstrate low risks for serious adverse effects and nonexistent or abbreviated recovery periods. Certain nonablative procedures are highly effective for the treatment of the dyschromia (eg, intense pulsed light [IPL] and fractional lasers) and vascular changes (eg, vascular lasers and IPL) seen in photoaged skin.

Significant improvements in rhytides and skin laxity require the induction of dermal collagen remodeling and are relatively more difficult to achieve with nonablative technology. Infrared lasers, radiofrequency devices, and fractional lasers are typically used for these indications. Since the degree of improvement achieved is often modest, patients with mild to moderate rhytides or skin laxity are better candidates for nonablative procedures than individuals with more severe manifestations of these features.

The modalities of nonablative skin resurfacing utilized for skin rejuvenation, including vascular lasers, IPL, infrared lasers and light sources, radiofrequency, photodynamic therapy, and nonablative fractional lasers, will be reviewed here. The basic principles of laser and light therapy for cutaneous lesions and ablative laser skin resurfacing are discussed separately. (See "Principles of laser and intense pulsed light for cutaneous lesions" and "Ablative laser resurfacing for skin rejuvenation".)

BACKGROUND

Restoration of a youthful appearance to the skin is dependent upon the ability to remove or improve features characteristic of photodamage (cutaneous damage induced by ultraviolet light) and chronological aging, such as irregular skin pigmentation, telangiectasias, and cutaneous erythema. Chronic exposure to ultraviolet light also promotes damage to the dermis, which manifests clinically as rhytides and skin laxity and histologically as disorganized collagen fibrils and abnormal elastotic material [1]. Because collagen is the major structural component of the skin, treatments that successfully restore collagen to a condition that resembles collagen in youthful skin are beneficial for the reversal of these features. (See "Photoaging".)

                    

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Literature review current through: Nov 2016. | This topic last updated: Thu Oct 01 00:00:00 GMT 2015.
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