Skin resurfacing utilizing a low-fluence Nd:YAG laser.

OBJECTIVE The purpose of this clinical study was to determine the effectiveness of low fluence topical carbon suspension assisted Q-switched Nd:YAG laser treatment of fine rhytids. MATERIALS AND METHODS Some 242 solar-damaged anatomical sites on 61 human subjects were treated with three laser treatments at two study centers. The treatment involved applying a carbon suspension to the skin surface and irradiating the exogenous chromophore with a Q-switched Nd:YAG laser. Cosmetic skin-resurfacing was accomplished using a wavelength of 1064 nm, a fluence of 2.5 J/cm2, a pulse duration of 6-20 ns, a pulse repetition rate of 1-10 Hz and a fixed beam size of 7 mm. The treatment sites were evaluated at baseline, 4, 8, 14, 20 and 32 weeks for skin texture, skin elasticity and rhytid reduction. All sites were treated at baseline, 4 and 8 weeks. Skin replicas taken prior to treatment and at the conclusion of the study were analyzed for wrinkle and cosmetic improvement using the Magiscan digital image process system. Adverse events were recorded throughout the study. RESULTS At 8 months the investigators reported improvement in both skin texture and skin elasticity, as well as rhytid reduction compared to baseline. In self-assessments, subjects also reported noticeable skin texture and cosmetic improvement, but assessed wrinkle reduction less favorably than seen by the investigators. The majority of adverse events were limited to mild, brief erythema. CONCLUSIONS Topical carbon suspension assisted Q-switched Nd:YAG laser treatment offers a safe cosmetic method of resurfacing solar-damaged skin. The effect, as reported by investigators and subjects in this study, and confirmed by skin replica analyses, included improvement in skin texture, elasticity and rhytid appearance.