“Skin rejuvenation” durch nichtablative Laser- und Lichtsysteme Literaturrecherche und Übersicht

Abstract

Currently, ablative laser therapy (with CO2/Er:YAG lasers) and deep chemical peeling are effective and promising methods of skin rejuvenation. The induction of collagen synthesis was observed after peelings with trichloroacetic acid or phenol as well as after treatments with the CO2 laser. In past years, the undesirable side effects and risks of these methods have led to intensified research in the fields of non-ablative facial rejuvenation and subsurfacing by means of ablative laser systems and intense pulsed light systems. The objective is to achieve selective, heat-induced denaturalisation of dermal collagen that leads to subsequent reactive synthesis but does not damage the epidermis. Recently, the results of numerous clinical and histological studies have indicated that these new technologies are successful. After critical review and assessment of current literature, we can say that in terms of their efficacy, non-ablative methods are not a comparable alternative to ablative skin resurfacing.

IPL technology: A review

“…Such a method must entail few adverse effects, downtimes that are as short as possible, and not damage the epidermis. In numerous studies, IPL systems and a variety of non-ablative laser devices were used [59][60][61][62][63][64][65]. The mechanism of action is supposed to be a selective, heatinduced denaturalization of dermal collagen that leads to subsequent reactive synthesis but does not damage the epidermis.…”

Histological and Ultrastructural Evaluation of the Effects of a Radiofrequency-Based Nonablative Dermal Remodeling Device

“…2004;140:204-209 F OR MORE THAN HALF OF A DEcade, many different laserand light-based systems have been evaluated for their ability to reduce photodamage and age-induced rhytids in a nonablative manner. [1][2][3] Although several systems have been cleared by the US Food and Drug Administration for this purpose, the clinical results have been less than impressive, with most subjects showing only a mild improvement in wrinkles. 1,3 Furthermore, few reports discuss the mechanism of action of these systems.…”

“…1,3 Furthermore, few reports discuss the mechanism of action of these systems. [2][3][4] At present, the following 2 hypotheses exist as to how these devices work: (1) The light energy is absorbed by water, and perhaps by collagen, to cause a direct thermal effect on the dermal ground substance; and (2) The light energy is absorbed by hemoglobin and/or melanin, triggering the cutaneous vessels and/or adnexal structures to produce cellular mediators and growth factors that may stimulate a wound-healing response, which would also give rise to indirect heating of the dermis and cause a response similar to the first proposed mechanism.…”

Results of nonablative wrinkle reduction with a 1,450-nm diode laser: Difficulties in the assessment of “subtle changes”

“…Despite multiple reports claiming positive results for photorejuvenation type II [18], the efficacy of nonablative wrinkle reduction, however, is still discussed controversially [14,[19][20][21][22].…”