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Author: Alam M, Hsu TS, Dover JS, Wrone DA, Arndt KA
Author affiliation: Section of Cutaneous and Aesthetic Surgery, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. murad@alam.com
Publication date & source: 2003.01, Lasers Surg Med., 33(1):30-9.
Publication type: Review; Review, Tutorial
BACKGROUND AND OBJECTIVES: Nonablative laser and light treatments have largely replaced ablative laser therapy in clinical use for the improvement of the visible signs of cutaneous aging-photo, including rhytides, vascular lesions, and pigmentation. However, the mechanisms underlying the reported clinical efficacy of nonablative treatments are not well-understood. The purpose of this analysis is to critically evaluate what is known about histologic and tissue effects of nonablative laser therapy and suggest future directions for research. STUDY DESIGN/MATERIALS AND METHODS: This is a review of the English language literature pertaining to nonablative laser and light treatments available through MEDline (1995-2002), and unpublished reports presented at major national meetings. Only studies that included harvesting and analysis of tissue samples are included. RESULTS AND CONCLUSIONS: (a) Thermal injury to the dermis in association with epidermal cooling most likely affects the dermal vasculature, which initiates a cascade of inflammatory events that includes fibroblastic proliferation and apparent up-regulation of collagen expression; (b) There is no indication that nonablative treatments are harmful or able to induce skin cancer; (c) It is possible that the horizontally distributed collagen reported after nonablative treatments is a "microscar," an enlarged Grenz sone associated with repetitive photo-induced trauma; (d) Further research is needed to elucidate the biophysical mechanisms underlying nonablative treatment, as well as to distinguish the utility of different wavelengths on epidermal and dermal improvement. Copyright 2003 Wiley-Liss, Inc.
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