Photorejuvenation

Photorejuvenation is a skin treatment that uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and remove effects of photoaging such as wrinkles, spots, and textures. The process induces controlled wounds on the skin, prompting it to heal itself by creating new cells. This process reverses the signs of photoaging to a certain extent by removing appearances of damage. The technique was invented by Thomas L Roberts, III using CO₂ lasers in the 1990s.

Skin rejuvenation can be achieved through various modalities including: thermal, chemical, mechanical, injection, and light.

Laser resurfacing is a laser surgery technique that disassociates molecular bonds. It is used for the treatment of wrinkles, solar lentigenes, sun damage, scarring (acne scars and surgical scars), stretch marks, actinic keratosis, and telangiectasias. It can be combined with liposuction to help tighten and smooth over the new contours after removal of excess fat. Resurfacing can be ablative, which vaporizes tissue and creates wounds, or non-ablative which keeps the skin intact. When compared to a chemical peel, dermabrasion or other forms of treatment, a laser allows the surgeon to customize the surgery not only for each patient but also to each area of the face.

Laser resurfacing is usually done with a 2940 nm Er:YAG laser or a 10,600 nm CO₂ laser. Complete resurfacing was first done with a CO₂ laser. Both Erbium and CO₂ are used to treat deep rhytides, sun damage and age spots. Through the heating of the deep dermis, fibroblasts are stimulated to form new collagen and elastin helping to bring increased turgor and thickness to the skin. A variety of modes have been developed including Nd:Yag lasers and a plasma device. CO₂ resurfacing has been shown to have an increased risk of hypopigmentation and scarring than erbium lasers. This is due to the high degree of coagulation and thus heat production that occurs as a nature of the CO₂ wavelength.

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