Harvard Combined Dermatology Residency Program, Boston, Massachusetts.
Department of Dermatology, Northwestern Medical Group, Chicago, Illinois.
Dermatol Surg. 2022 Apr 1;48(4):441-448. doi: 10.1097/DSS.0000000000003397.
Lasers and energy-based devices (EBD) are popular treatments for skin rejuvenation and resurfacing. Achieving desired outcomes and avoiding complications require understanding the effects of these devices at a histologic level. Currently, no comprehensive review summarizing the histologic effects of laser and energy-based treatments exists.
To describe how lasers and EBD alter skin histology and improve the overall understanding of these devices.
A PubMed search was conducted for studies with histologic analysis of fractional picosecond laser, fractional radiofrequency microneedling, nonablative lasers, and ablative lasers.
Fractional picosecond lasers induce intraepidermal and/or dermal vacuoles from laser-induced optical breakdown. Fractional radiofrequency microneedling delivers thermal energy to the dermis while sparing the epidermis, making it safer for patients with darker skin phototypes. Fractional nonablative lasers induce conical zones of coagulation of the epidermis and upper dermis. Ablative lasers vaporize the stratum corneum down to the dermis. Traditional ablative lasers cause diffuse vaporization while fractional ablative lasers generate columns of tissue ablation.
Lasers and EBD are effective for skin resurfacing and rejuvenation and have different mechanisms with disparate targets in the skin. Safe and effective use of devices requires understanding the histologic laser-tissue interaction.
激光和能量设备（EBD）是皮肤年轻化和表面重塑的热门治疗方法。要实现预期的效果并避免并发症，需要在组织学水平上了解这些设备的作用。目前，尚无综合综述总结激光和能量治疗的组织学效应。
描述激光和 EBD 如何改变皮肤组织学，并提高对这些设备的整体理解。
对具有皮秒激光、射频微针、非剥脱性激光和剥脱性激光的组织学分析的研究进行了 PubMed 检索。
皮秒激光通过激光诱导光击穿在表皮内和/或真皮内产生空泡。射频微针分割在向真皮传递热能的同时保护表皮，使肤色较深的患者更安全。非剥脱性激光诱导出锥形的表皮和上真皮凝固区。剥脱性激光将角质层蒸发到真皮。传统的剥脱性激光引起弥漫性蒸发，而分段剥脱性激光产生组织消融的柱状物。
激光和 EBD 是皮肤表面重塑和年轻化的有效方法，它们在皮肤中的作用机制不同，靶点也不同。安全有效地使用这些设备需要了解组织学激光与组织的相互作用。
