Rejuvenation: Ablative, nonablative options continue to expand

May 1, 2008

Key developments in facial rejuvenation techniques that promote new collagen induction include the introduction of fractional ablative lasers, as well as the advent of adjunctive treatments including LEDs, fillers and topical agents, an expert says.

Key Points

New York - The next phase of laser treatments for facial rejuvenation will involve ablative fractional modalities that combine the safety of fractional lasers with the efficiency of erbium or CO2 treatments, an expert says.

At the same time, recent research has shown that adjunctive treatments including light-emitting diode (LED) modalities, dermal fillers and topically applied growth factors also can promote collagen growth.

Laser and light source rejuvenation began 15 years ago with CO2 lasers, followed by erbium lasers.

Therefore, erbium and CO2 lasers have given way to fractional resurfacing.

"Instead of removing the entire outer layer of skin," Dr. Goldberg says, "this modality removes fractional components of the skin, which leaves zones of healthy tissue between treated areas and leads to less downtime."

Today, both nonablative and ablative fractional resurfacing technologies exist. The nonablative category includes two lasers operating at 1,540 to 1,550 nm - the Fraxel (Reliant Technologies) and the StarLux (Palomar) - as well as the Affirm (Cynosure), which operates at both 1,440 and 1,320 nm, he says.

"Essentially, they all do the same thing," Dr. Goldberg tells Dermatology Times.

Because they're nonablative, he says, they don't destroy the skin's outer layers, and selectively penetrate the deeper layers.

"The strength of this approach is that these lasers are able to treat patients with minimal to no downtime. And their safety profile is far superior to that of the older ablative lasers," he says.