Histological and immunohistochemical changes in facial skin treated with combined ablative and non‐ablative laser therapy

Abstract

The appearance of one's skin reflects a person's general health and is one of the main indicators of human age. 1 As skin ages, it tends to become uneven in color, roughened, lax, and wrinkled due to intrinsic and extrinsic factors (eg, photodamage). A major feature of aged skin is fragmentation of the dermal collagen matrix. Fragmentation results from the actions of specific enzymes (matrix metalloproteinases) and impairs the structural integrity of the dermis. Fibroblasts that produce and organize the collagen matrix cannot attach to fragmented collagen. Loss of attachment prevents fibroblasts from receiving mechanical information from their support, and they collapse. 2 Stretch is critical for normal balanced production of collagen and collagen-degrading enzymes. In aged skin, collapsed fibroblasts produce low levels of collagen and high levels of collagen-degrading enzymes. This imbalance advances the aging process in a selfperpetuating, never-ending deleterious cycle. 2 Many different materials, energy-based devices, and techniques have been shown to offer good results in facial rejuvenation. 3 Ablative techniques are still considered the most effective methods for improving photodamaged skin, but are associated with a prolonged recovery time and high risk of side effects. 4 The CO 2 and Er:YAG (2940 nm) wavelengths are ablative wavelengths used for many different applications including facial skin resurfacing.Ablative lasers vaporize the epidermis and part of the dermis, leaving a zone of thermal injury responsible for collagen shrinkage and remodeling. [5][6][7] Post-procedure, the epidermis has to heal, requiring at least some recovery time. Non-invasive and minimally/non-ablative methods without downtime are therefore gaining popularity in modern dermatological laser therapy. Recently, a non-ablative mode of

Striae distensae treatment: evaluating laser efficacy and safety

“…The study found that hybrid fractional laser treatment can be used safely and effectively to treat photodamaged skin with high patient satisfaction and minimal adverse events. In another study, Shanina et al 11 focused on facial skin rejuvenation in 14 patients, using a dual-wavelength protocol combining a fractional ablative (2,940 nm) laser and a non-ablative (1,064 nm) laser. The results showed significant improvements in all areas of the face as compared to the pretreatment baseline, which was also confirmed by histology.…”

Non‐ablative Er:YAG laser is an effective tool in the treatment arsenal of androgenetic alopecia

“…The heat pulses penetrate the skin to approximately 0.5 mm in depth, resulting in paracrine signaling that activates fibroblasts to initiate regenerative processes in the skin. 23 , 24 …”

“…The heat pulses penetrate the skin to approximately 0.5 mm in depth, resulting in paracrine signaling that activates fibroblasts to initiate regenerative processes in the skin. 23,24 The aim of this retrospective clinical study was to assess the effectiveness of the novel non-ablative Er:YAG laser treatment, either as a monotherapy or in combination with subcutaneous injections of PRP to the scalp.…”

“…The advantage of Er:YAG laser used in SMOOTH™ mode is that laser light is absorbed in the most superficial (<10 µm) layer of the skin, with only heat diffusing to the deeper layers, making it a very safe form of energy, which is especially important when treating the scalp. The heat pulses penetrate the skin to approximately 0.5 mm in depth, resulting in paracrine signaling that activates fibroblasts to initiate regenerative processes in the skin 23,24 …”

Hair regrowth and maintenance in alopecia universalis patient treated with nonablative Er:YAG laser

“…The SMOOTH™ mode denotes trains of short subablative pulses of laser light, which is absorbed in the most superficial (<10 µm) layer of the skin, leaving only heat to diffuse to deeper layers (400 µm). This treatment modality results in paracrine signaling that activates fibroblasts and initiates regenerative processes in the skin 14,15 and has already been used for stimulation of hair growth. 16…”