This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cosmetic Surgery/ Procedures  • Alert me on articles by topic

Jeffrey A. Hall, MD; Pamela J. Keller, RN; Gregory S. Keller, MD

Arch Facial Plast Surg. 2004;6:374-378.

Objective  To report the results of a dose-response study using a novel photorejuvenation regimen consisting of intense pulsed light–activated photodynamic therapy and radiofrequency energy in patients with Fitzpatrick skin types I through III.

Methods  A combination intense pulsed light and radiofrequency device (Syneron Medical Ltd, Yokneam, Israel) was used in combination with the topical photosensitizer aminolevulinic acid (ALA) (Levulan Kerastick; DUSA Pharmaceuticals Inc, Wilmington, Mass). Duplicate titration trials were performed on the dorsal forearm skin of 3 patients with Fitzpatrick skin types I through III. Multiple treatments, with varying times of application of ALA (30 minutes and 1, 2, and 3 hours) and intense pulsed light fluence (24-30 J/cm²), were completed to determine a minimal erythema dose and a maximal tolerated dose based on epidermal reaction (erythema and crusting) and patient discomfort. Radiofrequency energy levels were constant in all treatment groups.

Results  The ALA application time of 1 to 2 hours for all skin types and fluence levels of 26 to 28 and 24 to 26 J/cm² for Fitzpatrick skin types I/II and III, respectively, were determined to be the minimal erythema dose. The ALA application times of 2 to 3 hours and fluence levels of 28 to 30 and 26 to 28 J/cm² for skin types I/II and III, respectively, were determined to be the maximal tolerated dose and resulted in severe erythema and crusting. The presence of severe erythema and discomfort precluded longer ALA exposure and higher fluence levels. No epithelial breakdown was observed at any treatment levels.

Conclusion  The dose-response results defining the minimal erythema dose and the maximal tolerated dose of intense pulsed light–activated photodynamic therapy and radiofrequency energy have led to the development of 2 photorejuvenation protocols based on skin type and severity of photodamage.

Author Affiliations: Division of Facial Plastic and Reconstructive Surgery, David Geffen School of Medicine at UCLA, Los Angeles, Calif. Dr Hall is now in private practice, Columbus, Ohio.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lasers and Optical Technologies in Facial Plastic Surgery
Wu and Wong
Arch Facial Plast Surg 2008;10:381-390.
ABSTRACT | FULL TEXT  

Rejuvenating the Aging Face
Hruza
Arch Facial Plast Surg 2004;6:366-369.
FULL TEXT  

Rejuvenating the Aging Face
Hruza
Arch Dermatol 2004;140:1383-1386.
FULL TEXT