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November 2004

Nonablative Laser and Light Therapies for Skin Rejuvenation

Arch Facial Plast Surg. 2004;6(6):398-409. doi:10.1001/archfaci.6.6.398

Financial Disclosure: Dr Geronemus has received research support from Thermage, Light BioScience, and Palomar.

Nonablative skin rejuvenation, also referred to as “subsurface remodeling,” encompasses a wide spectrum of noninvasive techniques using laser, noncoherent light, or radiofrequency to improve the appearance of aging skin. Various procedures have been used to treat facial rhytids and photodamage, including dermabrasion, chemical peels, and carbon dioxide (CO2) or erbium:yttrium-aluminum-garnet (Er:YAG) laser resurfacing.1-2 These treatments promote epidermal regeneration and collagen remodeling, with excellent clinical results. However, interest in these therapies has waned significantly in recent years because of the substantial posttreatment “downtime” and prolonged recovery period. Skin resurfacing involves the destruction and removal of the epidermis accompanied by dermal contraction and remodeling. The resulting wounds require intensive skin care and have risks of adverse effects such as infection, scarring, persistent erythema, and pigmentary alteration. Growing demand for lessinvasive procedures with a short recuperation time that would allow minimal interruption and a quick return to daily routine has paved the way for nonablative techniques to emerge as important therapeutic options for patients. Nonablative modalities obviate the need for epidermal injury and promote the reorganization and increase of important dermal structures to reverse photoinduced aging of the skin via thermal or photochemical processes. This review discusses the available technological advancements in facial rejuvenation that improve the appearance of photodamage without wounding the epidermis while minimizing the recovery period.

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