Dr. Bruce Freedman
Plastic Surgery Associates of Northern Virginia

Reducing Photo Damage


Freedman, B.M., MD, Balakrishnan, T.P., PA-C, Earley, R.V., BSN

Purpose: To determine the effects of facial laserabrasion with the dual mode pulsed erbium laser on photodamaged skin.

Method: 15 patients with Fitzpatrick skin types I – III were evaluated for facial rejuvenation. They had clinical evidence of ultraviolet induced photodamage including dyschromia, rhytides, and freckling. These findings were recorded with both white light and ultraviolet fluorescence photography using the Canfield Digital UV Kit (Canfield Clinical Systems, Fairfield, NJ, USA). The patients (ages 38 – 67) underwent full-face dual mode pulsed erbium resurfacing using the Sciton Contour (Sciton Corporation, Palo Alto, CA, USA). Four passes using ablation/coagulation combination settings were used in each patient to reach the treatment endpoint of punctate dermal bleeding. Laser skin care was prescribed using the open technique along with routine viral and bacterial prophylaxes. Photographs and clinical assessments were taken 2,4, and 6 months following treatment.

Results: All patients re-epithelialized with 6 days following laserabrasion and were able to resume normal social schedules within 2 weeks. Serial white light photography documented progressive clinical improvement with respect to dyschromia, rhytides and skin laxity. Serial ultraviolet fluorescence photography identified a progressive decrease in mottled pigmentation caused by the selective absorption of light by melanin.

Conclusion: Dual mode erbium laserabrasion significantly reduced ultraviolet fluorescence dyspigmentation that has been shown to correlate with photodamage. A temporal correlation was also noted between the clinical improvement seen with white light photography and the level of photodamage observed with the UV system.


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