title: Treatment of facial rhytids with a nonablative laser: a clinical and histologic study.
abstract: BACKGROUND
  Current facial resurfacing modalities (laser, chemical peels, and dermabrasion) remove the epidermis and thus cause open wounds which carry significant risks and extended recovery periods. The nonablative laser is a novel Nd:YAG system designed to alleviate facial rhytids without injuring the epidermis. This new modality may offer patients rhytid removal without the risk seen in currently used resurfacing techniques.
  
  
  OBJECTIVE
  To describe a novel nonablative laser system and assess its safety profile and efficacy.
  
  
  METHODS
  Ten patients received laser treatments of their periocular rhytids and postauricular skin. Clinical variables (rhytid severity, hyperpigmentation, hypopigmentation, scarring, and level of discomfort) were assessed at 1 and 3 months posttreatment. Postauricular skin biopsies were taken both pre- and posttreatment for histologic analysis.
  
  
  RESULTS
  Patient discomfort was minimal. Three months posttreatment, 4 of 10 patients showed a one-point improvement in periocular rhytid severity when judged on a six-point scale. The results were not statistically significant. Biopsy analysis showed a small posttreatment increase in the amount of dermal collagen in three patients. A small decrease in collagen was noted in one patient. Three patients also showed a small posttreatment increase in the degree homogenization of dermal collagen. No change from baseline was noted in other assessed histologic parameters. Complications observed included hyperpigmentation in three patients and pitted scarring in three patients.
  
  
  CONCLUSIONS
  The nonablative laser gave clinically subtle and statistically insignificant improvement in rhytid severity. Unfortunately its use was associated with complications that included hyperpigmentation and scarring. This technology may eventually offer patients a new resurfacing option, but its efficacy and complication rate must be improved first.
authors.affiliation: Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Menaker
authors.forename: D A
authors.initials: DA
authors.lastname: Wrone
authors.forename: R M
authors.initials: RM
authors.lastname: Williams
authors.forename: R L
authors.initials: RL
authors.lastname: Moy
mesh_terms: D000328:Adult; D000368:Aged; D005145:Face; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D010865:Pilot Projects; D015595:Skin Aging / Q000473:pathology / Q000528:radiation effects*