Nonablative remodeling: Clinical, histologic, ultrasound imaging, and profilometric evaluation of a 1540 nm Er : glass laser

Background. Nonablative remodeling has been recently proposed as an alterna tive to CO2 and Er:YAG resurfacing. Objective. To evaluate the efficacy and safety of a 1540 nm Er:glass laser with contact cooling in nonablative skin remodeling, focused on perioral an d periorbital rhytides. Methods. Sixty patients (mean age 47 years), Fitzpatrick skin types I-IV we re treated four times over 6-week intervals. Patients were evaluated using digital photographs, histology, ultrasound imaging, and profilometry with s ilicone imprints in order to quantitate the degree of clinical improvement. Results. All subjects reported subjective improvement in the quality and vi sual aspect of their skin. This was confirmed by a 40.2% reduction of aniso tropy (P<.001) 6 weeks after the fourth treatment. Ultrasound imaging demon strated a 17% increase of dermis thickness (P<.005); Biopsy specimens showe d evidence of new collagen formation. Conclusion. This study has clearly demonstrated that irradiation with 1540 nm Er:glass laser can lead to new collagen formation, dermis thickening, re duction of anisotropy of the skin, and clinical improvements. The lack of a dverse effects confirmed that this 1540 nm laser emitting in a pulsed mode coupled with an efficient cooling system is safe.