Multiple minimally invasive Erbium: Yttrium Aluminum Garnet laser mini‐peels for skin rejuvenation: an objective assessment

Abstract

Summary Background As the demand for minimally invasive rejuvenation is increasing, micro-peel resurfacing using Erbium:Yttrium Aluminium Garnet (Er:YAG ) laser 2940 nm has been reported for the treatment of photoaged skin without ablation of the epidermis. However, little is known about the efficacy and underlying histologic changes associated with this type of treatment. Aims The purpose of this study is to evaluate the clinical effect and objectively quantify the histological changes in response to multiple sessions of Er:YAG laser 2940 nm mini-peels. Patients and methods Six female volunteers of Fitzpatrick skin type III-IV and Glogau’s class I-III wrinkles were subjected to six microresurfacing peels at 2-week intervals using Er:YAG 2940 nm laser at sub-ablative fluences of 2 - 3 J/cm2 to treat periorbital rhytides. Quantitative evaluation of collagen types I, III and VII, newly synthesized collagen, total elastin and tropoelastin was performed by histochemistry and immunohistochemistry coupled with computerized morphometric analysis at base line, end of treatment, and three months post treatment. Results Compared to the base line, evaluation of volunteers revealed obvious clinical improvement in response to Er:YAG mini-peels. Collagen types I, III, and VII, as well as newly synthesized collagen, together with tropoelastin showed a statistically significant increase in response to treatment, while the mean level of total elastin was significantly decreased in response to treatment. However, this was followed by regression of improvement at 3 months post treatment, but was still better than baseline. Conclusions The present study revealed that multiple Er:YAG mini-peels is a promising treatment option for photoaging as it reverses the signs of photoaged skin with little downtime and side effects. However, to maintain the short term improvement achieved after treatment, continued Er:YAG 2940 nm laser mini-peels is required.

Combination of Treatments in Nonsurgical Facelift Performance to Conduce a Case of Severe Photoaging

“…The remodeling of collagen is due the temporary skinkage when exposed to an appropriate temperature. This new tissue has an improvement of the elasticity [1,14]. Radiofrequency (RF) is an electromagnetic radiation unionized.…”

“…These changes culminate in the reduction of the thickness and elasticity of the skin, development of wrinkles and loss of facial contour [3][4][5]. The increased of longevity and also social requirements have raised the interest in minimally invasive aesthetic treatments, with lower downtime and risk of complications [1]. A new technological and therapeutic modality combination of techniques (Total Lift) enables access to different depths in skin improving performance in nonsurgical face lift.…”

“…Skin aging is a dynamic multifactorial process [1,2]. Several changes occur simultaneously in different compartments of the face such as decreased collagen, muscle atrophy, redistribution of fat compartments and bone remodeling [3,4].…”

Assessment Tools for Facial Rejuvenation Treatment: A Review

“…Among them, three studies have assessed the efficacy of mesotherapy, YAG laser and radiofrequency on skin rejuvenation. Two studies have investigated the periorbital wrinkle improvement after mesotherapy [26] and YAG laser therapy [31].…”

“…Otherwise, to assess the response of multiple fractional erbium laser sessions for skin rejuvenation, quantitative evaluations by histochemistry and immunochemistry of collagen types I, III and VII, newly synthesized collagen, total elastin and tropoelastin were performed [31]. Moreover, the assessment of the effect of bipolar radiofrequency on photoaged skin in Asian subjects was carried out on the quantification of the level of procollagen types I and III and elastin [27].…”