Fractionated Laser Resurfacing Corrects the Inappropriate UVB Response in Geriatric Skin

Abstract

Non-melanoma skin cancer is a disease primarily afflicting geriatric patients as evidenced by the fact that 80% of all non-melanoma skin cancers are diagnosed in patients over the age of 60 years. As such, geriatric skin responds to cancer-inducing UVB irradiation in a manner that allows the establishment of tumor cells. Currently, the only effective treatment for non-melanoma skin cancer is the removal of the tumors after they appear, indicating the need for a more cost-effective prophylactic therapy. Geriatric volunteers were treated with fractionated laser resurfacing therapy on either sun-protected (upper buttocks) or chronically sun-exposed (dorsal forearm) skin. Fractionated laser resurfacing therapy was demonstrated to decrease the occurrence of senescent fibroblasts in geriatric dermis, increase the dermal expression of insulin-like growth factor-1, and correct the inappropriate UVB response observed in untreated geriatric skin. These responses to fractionated laser resurfacing were equal to the effects seen previously using the more aggressive wounding following dermabrasion. Furthermore, fractionated laser resurfacing was equally effective in both sun-protected and sun-exposed skin. The ability of fractionated laser resurfacing treatment to protect against the occurrence of UVB-damaged proliferating keratinocytes indicates the potential of fractionated laser resurfacing to reduce or prevent aging-associated non-melanoma skin cancer.

Non-ablative Fractional Thulium Laser Irradiation Suppresses Early Tumor Growth

“…Moreover, AFL irradiation of precancerous lesions can reduce the risk of cancer occurrence in non-melanoma skin cancer (NMSC) as a byproduct of wound healing after the controlled injury [5,6]. By replacing geriatric keratinocytes with newly developed ones, the risk of NMSC developing from the precancerous lesion may be decreased.…”

Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

“…[74][75][76] Supportive data are limited. Medium-depth chemical peeling is an operator-dependent technique, and patients should be referred to a specialist with experience in the procedure.…”

Skin resurfacing procedures: new and emerging options

“…Importantly, restoration of dermal IGF-1 expression could prevent the initiation of UVB-induced carcinogenesis by restoring this secretion of dermal IGF-1. In fact, resurfacing techniques such as dermabrasion and fractionated laser resurfacing will normalize IGF-1 expression in geriatric skin and re-establish the youthful, appropriate UVB response 79,80. These treatment modalities are well known for their cosmetic applications in part by restoring dermal collagen expression through the removal of senescent fibroblasts and recruitment of new active fibroblasts, but these treatments also result in increased levels of dermal IGF-1 expression in the skin.…”