Nonablative laser resurfacing using the long-pulse (1064-nm) Nd:YAG laser.

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. MATERIALS AND 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.