Nonablative laser skin resurfacing using a 1540 nm erbium glass laser: A clinical and histologic analysis

BACKGROUND. A variety of laser systems have recently become available that allow for selective dermal remodeling without disruption of the epidermal surface. Modest clinical improvement in mild to moderate photoinduced facial rhytides with minimal morbidity is typical of these nonablative lasers, providing a significant advantage over traditional ablative laser systems. OBJECTIVE. To determine the clinical and histologic effects of a novel 1540 nm erbium glass laser on facial rhytides. METHODS. Patients with mild to moderate periorbital and perioral rhytides received a series of three monthly treatments with a 1540-nm erbium-doped phosphate glass laser by a single operator. Photographic and clinical evaluations were independently conducted by the patient and a masked medical observer at each treatment visit and at 1, 3, and 6 months following the final treatment session. Skin biopsies were obtained for histologic analysis by a board-certified dermatopathologist at baseline, immediately following laser irradiation, and at one and six months post-treatment. RESULTS. Slow, progressive clinical Improvement of rhytides was noted in all patients after each treatment and continued throughout the extended follow-up period. Side effects of treatment were limited to transient erythema and edema immediately following laser irradiation. No serious adverse effects were noted. Histologic skin changes were not apparent until several months following treatment, when an increase in dermal collagen was noted. CONCLUSIONS. The nonablative 1540 nm erbium glass laser system with contact cooling produces gradual clinical and histologic improvement in mild to moderate facial rhytides with minimal risk of serious adverse sequelae.