Antioxidants play a critical role in keeping skin healthy. The antioxidant benefits of vitamin C and E are well known, but the importance of the trace mineral, zinc, has been overlooked. This article reviews the evidence supporting zinc's antioxidant role in protecting against free radical-induced oxidative damage. Zinc protects against UV radiation, enhances wound healing, contributes to immune and neuropsychiatric functions, and decreases the relative risk of cancer and cardiovascular disease. All body tissues contain zinc; in skin, it is five to six times more concentrated in the epidermis than the dermis. Zinc is required for the normal growth, development and function of mammals. It is an essential element of more than 200 metalloenzymes, including the antioxidant enzyme, superoxide dismutase, and affects their conformity, stability, and activity. Zinc also is important for the proper functioning of the immune system, and for glandular, reproductive and cell health. Abundant evidence demonstrates the antioxidant role of zinc. Topical zinc, in the form of divalent zinc ions, has been reported to provide antioxidant photoprotection for skin. Two antioxidant mechanisms have been proposed for zinc: zinc ions may replace redox active molecules, such as iron and copper, at critical sites in cell membranes and proteins; alternatively, zinc ions may induce the synthesis of metallothionein, sulfhydryl-rich proteins that protect against free radicals. No matter how they work, topical zinc ions may provide an important and helpful antioxidant defense for skin.

This formulation of vitamin C results in clinically visible and statistically significant improvement in wrinkling when used topically for 12 weeks. This clinical improvement correlates with biopsy evidence of new collagen formation.

The application of a mixture of topical growth factors may stimulate the repair of facial photodamage resulting in new collagen formation, epidermal thickening and the clinical appearance of smoother skin with less visible wrinkling.

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PIH is the most common complication of facial resurfacing in patients with skin type IV. It is not preventable by choice of laser or skin care regimen pre-operative, but appears to respond to appropriate treatment once it has developed.

The 595 nm LPDL may be used in the treatment of moderate to severe wrinkles. A mild improvement may be expected with minimal to no side effects.

Our impression is that given a choice of lasers, the Q-switched ruby laser provides the greatest efficacy for treating postsclerotherapy hyperpigmentation.

Although wound contraction secondary to tissue healing may result in nearly the same tissue tightening as heat-induced collagen contraction, the two processes are very different and variable, with increased risk of scarring seen with wound contracture, compared with heat-induced collagen tightening. The tissue tightening seen with thermally induced collagen contraction is long-lasting, if not "permanent."