title: Clinical evaluation of a single-wavelength fractional laser and a novel multi-wavelength fractional laser in the treatment of photodamaged skin.
abstract: OBJECTIVE
  Nonablative fractional lasers are well recognized for rejuvenating photoaged skin. We previously reported favorable outcomes with short follow-up after the use of 1,440-nm Nd:YAG laser energy used alone or in combination with a 1,320-nm laser to effect rejuvenation and wrinkle reduction. We now report longer follow-up data.
  
  
  METHODS
  Nineteen Caucasian subjects (average age 47+/-8.4; range 33-62) exhibiting mild-to-moderate photoaging of the face and neck were treated four times (average interval 18.1+/- 4.1 days; range 11-37 days) with the 1,440-nm Nd:YAG fractional laser (average fluence 3.7+/-0.3 J/cm(2)) or the 1,320/1,440-nm multiplex Nd:YAG fractional laser (1,320-nm average fluence 8.4+/-0.4 J/cm(2); 1,440-nm average fluence 2.3+/-0.2 J/cm(2)). Outcomes were assessed by subjects and the treating physician using a quartile scale to evaluate skin tightening, surface texture, rhytids, dyschromia, erythema, and global appearance after 1, 3, and 6 months. Retroauricular punch biopsies from three patients were used to evaluate wound healing. Three patients withdrew from the study prior to evaluation, one missed the 1-month evaluation, and one missed the 6-month evaluation.
  
  
  RESULTS
  Assessment by subjects and the treating physician revealed clinical improvement for all outcomes after 1, 3, and 6 months. The differences between the treatment groups were not statistically significant. Subjects demonstrated the greatest average 6-month improvements in surface texture and global skin appearance. Subjects treated with the multiplex laser reported more skin tightening than the group treated only with the 1,440-nm laser. Histological evaluation revealed wound healing within 10 days and significant neocollagenesis at 3 months. No adverse events were reported in any subject.
  
  
  CONCLUSIONS
  The 1,440-nm Nd:YAG and 1,320/1,440-nm multiplex Nd:YAG lasers safely and effectively produced improved surface texture, rhytids, dyschromia, erythema, global skin appearance, and skin tightening. Histopathologic findings correlated with clinical observations.
authors: Department of Ophthalmology, Otolaryngology, Dermatology, Vanderbilt University Medical Center Laser and Facial Surgery, 345 23rd Ave., N. Suite 416, Nashville, Tennessee 37203, USA.
authors: Laurel Naversen
authors: LN
authors: Geraghty
authors: Brian
authors: B
authors: Biesman
mesh_terms: D000328:Adult; D019583:Dose Fractionation, Radiation; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation* / Q000379:methods; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015595:Skin Aging / Q000473:pathology / Q000528:radiation effects*; D012880:Skin Pigmentation / Q000528:radiation effects; D016896:Treatment Outcome