Rinaldi Fabio
Rinaldi Dermatologic Clinic, Milan, Italy.
Clin Dermatol. 2008 Nov-Dec;26(6):590-601. doi: 10.1016/j.clindermatol.2007.09.014.
Lasers and light-based treatments are extremely useful and now standardized techniques in the management of different stages of photoaging. To obtain the most successful results, protocols involving single or combination systems can be used, depending on skin photodamage. In the last years, the trend is to choose noninvasive or minimally invasive treatments, with the aim of reducing the risk of side effects, complications, and downtime. Selective photothermolysis obtained with lasers and with intense pulse light, which is presently considered the most suitable technique by a growing number of authors, is an extremely valid procedure, in particular in types I and II, according to the Glogau classification. Photodynamic therapy is another effective tool in photoaging treatment, especially in the presence of precancerous conditions. In mild and severe photoaging, ablative laser resurfacing is a particularly successful technique, although requiring a very skilled hand. The new systems, such as fractional photothermolysis, seem to be the very next future to face up to resurfacing procedure with high efficacy and less risks. Obviously, lasers and light-based treatments alone might not be sufficient to control all aging symptoms. For this reason, any another treatment (botulinum toxin, filling agents, chemical peels, systemic and topic antioxidants) can be used in combination to improve the final clinical outcome.
激光和光基治疗极为有用，如今已成为治疗不同阶段光老化的标准化技术。为获得最成功的效果，可根据皮肤光损伤情况，采用涉及单一或联合系统的方案。近年来，趋势是选择非侵入性或微创治疗，以降低副作用、并发症和恢复时间的风险。激光和强脉冲光实现的选择性光热解，目前被越来越多的作者认为是最合适的技术，这是一种极为有效的方法，特别是根据格洛高分类法的I型和II型。光动力疗法是光老化治疗中的另一种有效工具，尤其是在存在癌前病变的情况下。在轻度和重度光老化中，剥脱性激光换肤是一种特别成功的技术，尽管需要非常熟练的操作。诸如分次光热解等新系统似乎是应对具有高疗效和低风险的换肤手术的下一步未来发展方向。显然，仅靠激光和光基治疗可能不足以控制所有衰老症状。因此，可联合使用任何其他治疗方法（肉毒杆菌毒素、填充剂、化学换肤、全身和局部抗氧化剂）来改善最终的临床效果。
