Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, 75390.
Division of Plastic Surgery, UT Medical Branch, Galveston, TX, 77555.
Lasers Surg Med. 2020 Nov;52(9):822-830. doi: 10.1002/lsm.23233. Epub 2020 Mar 15.
Patient-reported outcomes and blinded observer rating scales are subjective and unreliable but are extensively utilized to evaluate cosmetic office-based treatments, including ablative lasers. This study aims to assess the practicality of using non-invasive and minimally invasive methods for objective skin assessment following a skin rejuvenation treatment.
STUDY DESIGN/MATERIALS AND METHODS: Twelve patients received a single 1,470/2,940 nm laser treatment for facial rejuvenation. Assessments were performed before treatment, and 7 days, 3 weeks, and 3 months post-treatment. Images were taken with the VISIA Skin Analysis System to measure wrinkles, textures, pores, ultraviolet (UV) spots, brown spots, red areas, and porphyrins. Other non-invasive skin measurements-high-resolution ultrasonography, optical coherence tomography, transepidermal water loss and BTC 2000-were used to measure epidermal/dermal thickness, blood flow, surface roughness, wrinkle depth, attenuation coefficient, elasticity, laxity, and viscoelasticity. Microbiopsies (0.33 mm in diameter or the equivalent of a 23-gauge needle) were collected for histology and gene expression of tissue rejuvenation.
Significant improvement in facial skin aesthetics after laser treatment was recorded in UV spots, brown spots and pores after 3 weeks and in UV spots and brown spots after 3 months. The dermal attenuation coefficient decreased significantly at 3 weeks, while blood flow 0.5 to 0.7 mm below the skin surface increased significantly between 5 days and 3 weeks following treatment. Epidermal hyaluronic acid expression assessed by immunostaining and expression of inflammatory genes were elevated at 7 days post-treatment compared with untreated or 3 months post-treatment. There were no statistically significant changes in collagen or elastin-related genes between groups at the studied parameters.
Non-invasive devices can be effectively used to provide objective measurements of skin structure, pigmentation, blood flow, and elasticity to assess the efficacy of facial skin rejuvenation treatments. Furthermore, microbiopsies can objectively evaluate facial skin rejuvenation without scarring. Using non-invasive skin imaging, a single treatment with the 1,470/2,940 nm laser was observed to be effective in improving skin appearance after 3 months, namely in reducing UV spots and brown spots, without significant changes in the tissue at the molecular level, as assessed by microbiopsy. Lasers Surg. © 2020 Wiley Periodicals, Inc.
患者报告的结果和盲法观察者评分量表是主观且不可靠的，但被广泛用于评估美容门诊治疗，包括消融性激光。本研究旨在评估使用非侵入性和微创方法对皮肤再生治疗后进行客观皮肤评估的实用性。
研究设计/材料和方法：12 名患者接受了单次 1,470/2,940nm 激光治疗面部年轻化。在治疗前、治疗后 7 天、3 周和 3 个月进行评估。使用 VISIA 皮肤分析系统拍摄图像，以测量皱纹、纹理、毛孔、紫外线（UV）斑点、棕色斑点、红色区域和卟啉。其他非侵入性皮肤测量——高分辨率超声、光学相干断层扫描、经表皮水分流失和 BTC 2000——用于测量表皮/真皮厚度、血流、表面粗糙度、皱纹深度、衰减系数、弹性、松弛度和粘弹性。采集 0.33mm 直径（或相当于 23 号针）的组织活检用于组织再生的组织学和基因表达。
激光治疗后，UV 斑点、棕色斑点和毛孔在 3 周后，UV 斑点和棕色斑点在 3 个月后显著改善。真皮衰减系数在 3 周时显著降低，而皮肤表面下 0.5 至 0.7mm 处的血流在治疗后 5 天至 3 周之间显著增加。与未经处理或治疗后 3 个月相比，治疗后 7 天通过免疫染色评估的表皮透明质酸表达和炎症基因表达升高。在研究参数中，各组之间胶原或弹性蛋白相关基因无统计学显著变化。
非侵入性设备可有效用于提供皮肤结构、色素沉着、血流和弹性的客观测量，以评估面部皮肤年轻化治疗的疗效。此外，组织活检可无疤痕地客观评估面部皮肤年轻化。使用非侵入性皮肤成像，单次 1,470/2,940nm 激光治疗观察到在 3 个月后有效改善皮肤外观，即减少 UV 斑点和棕色斑点，而组织在分子水平上无明显变化，通过组织活检评估。激光外科杂志。© 2020 威利父子公司
