抄録
Skin rejuvenation via the nonablative approach remains a hot topic, but the results have been disappointing with single modality treatment. The combination of two different wavelengths, 1064 nm from the Nd:YAG laser and an IPL broad waveband with a 570 nm cut-off filter were combined to assess the results, and the strong contributory role of athermal photobiomodulation was carefully considered. Forty female patients (11 forehead, 14 periocular and 15 perioral), ages ranging from 27 - 50, skin types II - IV, wrinkle types I - III participated in the study. The IPL system was applied with the yellow (570 nm) cut-off filter, 30 J/cm2, single shot, followed by the Nd:YAG at 120 J/cm2 , double shot (7 ms per shot with 20 ms between shots) on the wrinkled areas only. Three sessions were given at monthly intervals, and an assessment was made one month after the third session, following which another treatment was given, and the patients followed for 6 months. Biopsies were taken from 4 consenting patients as a cross-section before the first treatment, one month after the 3rd session and at the 6 months point, to help assess collagen production and remodeling. The histology showed thickening of the epidermis with good dermal collagen organization. Thirty-seven patients completed the entire study protocol, with an overall satisfaction index (SI) of 20 (54%) at the 1st control point and 30 (81%). at the 2nd control point, showing the long-term contributory role of the athermal photobiomodulation zone accompanying the zone of delivered thermal damage. The addition of the Nd:YAG laser to the IPL regimen in nonablative skin rejuvenation gave very good histological results which were echoed in strong patient satisfaction with the visible improvement in their skin condition. The role of the various photoactivated skin cells in the photobiomodulation was deemed extremely important to the final good result, coupled with the potential role of heat shock protein
