title: Nonablative laser resurfacing using the long-pulse (1064-nm) Nd:YAG laser.
abstract: BACKGROUND
  Lasers with infrared wavelength ranges have been used in nonablative rejuvenation of skin. In this process, cooling of the epidermis allows for laser energy heat-induced injury to the dermis without ablation of the epidermal layer. This dermal injury is theorized to produce improvements in skin quality. In addition, long-pulse Nd:YAG lasers target melanin less efficiently, allowing safer treatment of patients with all skin types. In this study, we evaluate the use of the 1064-nm Nd:YAG laser for the purpose of rejuvenating the aging face.
  
  
  METHODS
  Fifty-one patients were enrolled in the study. Patients with Fitzpatrick skin types I through V were included. Standard photographs were taken before the first and after the last treatment. The Nd:YAG laser treatments were initiated with a chilled tip-cooling device. At each treatment session, patients were given self-assessment questionnaires. At completion of the study, 3 physicians performed masked evaluations of patient pretreatment and posttreatment photographs.
  
  
  RESULTS
  Thirty-four of 51 patients completed at least 7 treatments, had posttreatment photographs, and were entered into the study. Follow-up ranged from 1 to 6 months. No adverse events were noted. Masked analysis and patient subjective scores demonstrated a subtle improvement in several skin variables. Patient-assigned Fitzpatrick Scale scores declined after 6 treatments for coarse wrinkles (-22.3%; P<.01), skin laxity (-36.3%; P<.01), and overall improvement (-40.6%; P<.01). Physician-graded scores demonstrated decreases in coarse wrinkles (-11.9%; P<.01), skin laxity (-17.3%; P<.01), and overall improvement (-20.0%; P<.01).
  
  
  CONCLUSIONS
  Nonablative resurfacing techniques are well suited for patients requesting rejuvenating treatments of the aging face with minimal downtime. Although improvements in photodamaged skin are subtle and gradual, the 1064-nm Nd:YAG laser was well tolerated by patients of all skin types.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago 60657, USA. docdayan@aol.com
authors.forename: Steven H
authors.initials: SH
authors.lastname: Dayan
authors.forename: A John
authors.initials: AJ
authors.lastname: Vartanian
authors.forename: Gregg
authors.initials: G
authors.lastname: Menaker
authors.forename: Steven Ross
authors.initials: SR
authors.lastname: Mobley
authors.forename: Alyssa N
authors.initials: AN
authors.lastname: Dayan
mesh_terms: D000328:Adult; D062109:Dermatologic Surgical Procedures; D005145:Face / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D012060:Rejuvenation; D015595:Skin Aging / Q000528:radiation effects*