Pozner Jason N, Goldberg David J
University of Miami School of Medicine and Aesthetic Science Institute, Boca Raton, FL 33431, USA.
J Cosmet Laser Ther. 2006 Jun;8(2):89-91. doi: 10.1080/14764170600717852.
Light chemical peels and microdermabrasion have enjoyed recent popularity for the treatment of mild photoaging. However, clinical improvement from these modalities is often minimal from both a patient's and physician's perspective. Erbium:YAG lasers have been effective in treating mild to moderate photoaging, but the need for either regional or general anesthesia, as well as the significant post-treatment recovery period has limited its use.
We sought to utilize a very low fluence approach to erbium:YAG laser resurfacing, with topical anesthesia, to ascertain its efficacy in treating mild to moderate photoaging.
A total of 250 subjects aged 28-80 years with skin types 1-4 and mild to moderate facial rhytids were treated with topical anesthesia and subsequently one pass of a 2940 nm erbium:YAG laser, using between 5 and 17.5 J/cm2. In addition, 58 of the treated facial subjects underwent neck resurfacing with fluences between 5 and 15 J/cm2 and eight treated facial subjects underwent upper chest resurfacing at fluences of 5-7 J/cm2. A single treatment was received by 246 subjects; four subjects were treated a second time after a 1-month interval.
Most subjects completely re-epithelialized by 3-4 days; healing time was depth dependent. Most subjects were able to start skin care regimens within 1-2 weeks after the procedure. Results were judged to be excellent in individuals with thin skin and good in subjects with thicker skin.
One pass of low fluence erbium:YAG resurfacing, under topical anesthesia, was effective for the treatment of mild to moderate photoaging.
轻度化学换肤术和微晶磨皮术近来在治疗轻度光老化方面颇受青睐。然而，从患者和医生的角度来看，这些治疗方式带来的临床改善往往微乎其微。铒钇铝石榴石激光在治疗轻至中度光老化方面颇为有效，但由于需要局部或全身麻醉，且术后恢复期较长，限制了其应用。
我们试图采用极低能量密度的方法进行铒钇铝石榴石激光换肤，并采用局部麻醉，以确定其治疗轻至中度光老化的疗效。
对总共250名年龄在28 - 80岁、皮肤类型为1 - 4型且有轻至中度面部皱纹的受试者进行局部麻醉，随后使用波长为2940 nm的铒钇铝石榴石激光单次照射，能量密度为5至17.5 J/cm²。此外，58名接受面部治疗的受试者还接受了颈部换肤，能量密度为5至15 J/cm²，8名接受面部治疗的受试者接受了上胸部换肤，能量密度为5至7 J/cm²。246名受试者接受了单次治疗；4名受试者在间隔1个月后接受了第二次治疗。
大多数受试者在3 - 4天内完全重新上皮化；愈合时间取决于照射深度。大多数受试者在术后1 - 2周内即可开始皮肤护理方案。皮肤薄的个体治疗效果被判定为极佳，皮肤厚的受试者效果良好。
在局部麻醉下，单次低能量密度铒钇铝石榴石激光换肤对治疗轻至中度光老化有效。
