Treatment of neck lines and forehead rhytids with a nonablative 1540-nm Er:Glass laser:: A controlled clinical study combined with the measurement of the thickness and the mechanical properties of the skin

Background. Nonablative remodeling has been recently proposed as a new, no-down-time, antiaging treatment. Objective. The objective was to evaluate the efficacy and safety of nonablative skin remodeling with a 1540-nm Er:Glass laser on neck lines and forehead rhytids. Methods. Twenty female patients (mean age 45 years) were enrolled. Skin thickness and mechanical properties were measured before the first treatment, 1 month after the third treatment, 1 month after the fifth treatment, and 3 months after the fifth treatment. Results. All patients reported an improvement in both skin tone and texture. Using ultrasound imaging, dermal thickness of neck and forehead increased, respectively, by 70+/-13 mum (p<0.001) and 110+/-19 mum (p<0.003). A dramatic increaseof initial stress of the forehead skin (firmness) was obtained, from 7.62+/-3.68 before treatment to 16.68+/-7.44 3 months after the fifth treatment (p<0.0002). No immediate or late adverse effects were noted throughout the treatment regimen. Conclusion. This study demonstrates that irradiation with a 1540-nm Er:Glass laser emitting in a pulsed mode and coupled with an efficient contact cooling system increases dermal thickness and firmness, leading to a clinical improvement of neck lines and forehead rhydits. .