Facial skin rejuvenation: laser resurfacing or chemical peel: choose your weapon

Photoaging: Mechanisms and repair

Aging is a complex, multifactorial process resulting in several functional and esthetic changes in the skin. These changes result from intrinsic as well as extrinsic processes, such as ultraviolet radiation. Recent advances in skin biology have increased our understanding of skin homeostasis and the aging process, as well as the mechanisms by which ultraviolet radiation contributes to photoaging and cutaneous disease. These advances in skin biology have led to the development of a diversity of treatments aimed at preventing aging and rejuvenating the skin. The focus of this review is the mechanism of photoaging and the pathophysiology underlying the treatments specifically designed for its prevention and treatment.

LEARNING OBJECTIVES

At the conclusion of this learning activity, participants should be familiar with the mechanism of photoaging, the treatments for photoaging, and the data that supports the use of these treatments.

Use of combined modality for maximal resurfacing

Resurfacing of the skin plays a substantial role in facial rejuvenation. To better prepare the cosmetic surgeon for this endeavor, we have set out to define aging skin changes,review resurfacing indications, outline and compare various resurfacing practices, and discuss anticipated outcomes in our experience and in the current literature. We have found that appropriate patient selection, counseling, and technique have yielded a consistent result with a high degree of patient satisfaction. Furthermore, outcomes are maximized when one takes advantage of multiple modalities, combining resurfacing techniques, or when one combines resurfacing with surgical rejuvenation.

Nonablative laser treatment of wrinkles: meeting the objective? Assessment by 25 dermatologists

BACKGROUND

Established skin resurfacing methods causing superficial wounds and extended recovery times have become less popular since the introduction of nonablative lasers.

OBJECTIVES

To evaluate the clinical efficacy of a nonablative 1450-nm diode laser system.

METHODS

Nine patients (Fitzpatrick skin type II-IV) with periorbital wrinkling class I-II were treated three times at 3-weekly intervals with a 1450-nm diode laser. Clinical outcome was determined by 25 independent dermatologists evaluating standardized photographs taken before treatment and 1 month after treatment.

RESULTS

The patients were satisfied with the procedure, and reported a mild to moderate improvement in all cases. Among 25 dermatologists, only two provided ratings which were significantly in favour of a positive treatment effect.

CONCLUSIONS

Nonablative laser treatment subjectively satisfies patients but does not convince objective judgement.

Nonablative laser skin remodeling

Nonablative skin remodeling has become an attractive option for patients whose lifestyles demand a noninvasive approach to skin rejuvenation. This review addresses the rationales for therapy, specific devices, and study outcomes.