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Steven H. Dayan, MD; A. John Vartanian, MD; Gregg Menaker, MD; Steven Ross Mobley, MD; Alyssa N. Dayan, MD

Arch Facial Plast Surg. 2003;5:310-315.

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.

From the Department of Otolaryngology–Head and Neck Surgery, University of Illinois at Chicago (Drs S. H. Dayan, Vartanian, and Mobley), and the Department of Dermatology, Northwestern University, Chicago (Dr Menaker); and Chicago Medical School, North Chicago, Ill (Dr A. N. Dayan).

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