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Dermatol Surg 2022 04;48(4):441-448

Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Background: Lasers and energy-based devices (EBD) are popular treatments for skin rejuvenation and resurfacing. Achieving desired outcomes and avoiding complications require understanding the effects of these devices at a histologic level. Currently, no comprehensive review summarizing the histologic effects of laser and energy-based treatments exists. Read More

Dermatol Surg 2022 May 19;48(5):589-591. Epub 2022 Jan 19.

Laser and Skin Surgery Center of New York, New York, New York.

Facial Plast Surg 2022 Apr 7;38(2):163-165. Epub 2022 Jan 7.

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Following our survey, we can appreciate that a variety of laser platforms exist to rejuvenate the skin by resurfacing the outer layer of the skin as well as heating the lower layers of the dermis. Based on reliable clinical effectiveness and a limited side effect profile, we can confirm that nonablative fractionated technologies greatly improve the appearance of lentigines, rhytids; eliminate sun damage, attenuate scarring due to acne and other causes; and treat hyperpigmentation. The Fraxel (Solta Medical) laser system delivers pulses across a wide range of density and energy levels. Read More

Dermatol Surg 2022 02;48(2):201-206

Department of Dermatology, University of California, Irvine, California.

Background: Despite history of multiple treatment modalities, repigmentation of hypopigmented scars remains a difficult clinical problem.

Objective: The purpose of this review is to evaluate the literature on laser and combination laser plus adjunct topical therapy for hypopigmented burn and traumatic scars.

Materials And Methods: A search on PubMed and on Oxford Academic was conducted with additional relevant literature obtained from reference lists. Read More

Clin Dermatol 2022 May-Jun;40(3):265-273. Epub 2021 Nov 25.

Department of Dermatology, University of California, School of Medicine, San Diego, California, USA. Electronic address:

Perioral rhytides are a common reason for presentation to the cosmetic dermatologist. Various treatment options exist, and it can be challenging to determine the optimal technique to use in a given patient encounter. We herein provide a review article highlighting various treatment options in the correction of perioral rhytides, focusing on the roles of neurotoxin, filler, microneedling (with and without radiofrequency), fractional resurfacing (nonablative and ablative), and fully ablative lasers, with a brief mention of deep chemical peels. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):323-334. Epub 2021 Apr 24.

Ophthalmology, Dermatology, Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA.

Periorbital rejuvenation is a common reason for patients to seek cosmetic treatment. There are several nonsurgical light and energy-based devices available to treat various aspects of periorbital rejuvenation without risks of an invasive, surgical procedure. Although ablative laser resurfacing appears to offer the most impressive clinical improvements, nonablative devices result in noticeable cosmetic improvement with more favorable side-effect profiles and shorter recovery times. Read More

J Cosmet Dermatol 2021 Jan 2;20(1):99-104. Epub 2020 Dec 2.

Department of Dermatology and Venereology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Background: Many modalities have been described for the treatment of periorbital wrinkling.

Aims: The purpose of this study is to quantify the improvement of periorbital wrinkling achieved by current nonablative modalities, using a fractional 1565 nm Er:glass fiber laser.

Methods: Our study is a retrospective two-center case series including 16 patients treated with nonablative laser for periorbital wrinkling at the Tel-Aviv Sourasky Medical Center in Israel and Laserplast Aesthetic Medicine Center in Italy between 2017 and 2019. Read More

Dermatol Surg 2021 04;47(4):500-503

Laser and Skin Surgery Center of New York, New York, New York.

Background: Spread of botulinum toxin outside the treated muscle is a concern, when energy-based device treatment is performed on the same day as toxin injection.

Objective: We assessed the frequency of eyelid ptosis after the glabella/periorbital botulinum toxin injection and nonablative fractionated laser performed at the same session.

Methods And Materials: This single-center, retrospective study identified treatments consisting of glabella and/or periorbital botulinum toxin injection and nonablative fractionated laser treatment to full face from 2017 to 2019 and eyelid ptosis determined by documentation of the complication at a follow-up encounter, or prescription of apraclonidine. Read More

Dermatol Ther 2021 01 2;34(1):e14432. Epub 2020 Nov 2.

Skin & Laser Surgery Center of New England, Nashua, New Hampshire, USA.

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA-compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms "ablative laser" and "skin resurfacing" from March 2002 until July 2020. Studies included meta-analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. Read More

J Cosmet Dermatol 2020 Dec 31;19(12):3245-3250. Epub 2020 Oct 31.

Laser & Skin Surgery Center of New York, New York, NY, USA.

Background: Topical adjuncts have been investigated to improve clinical outcomes associated with laser resurfacing for photodamage and cutaneous aging. One such product is a tripeptide/hexapeptide serum, which has been shown to increase dermal collagen and elastin as well as improve postprocedural recovery following treatments.

Aims: A randomized, blinded, split-face, comparative trial was performed to assess the utility of a tripeptide/hexapeptide serum as a peri-procedural adjunct to nonablative fractional laser resurfacing. Read More

J Eur Acad Dermatol Venereol 2020 Dec 30;34(12):2907-2913. Epub 2020 Jun 30.

Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

Background: Novel picosecond lasers using a diffractive optical element (P-DOE) have been available for skin resurfacing with distinct mechanisms. However, there are limited data directly comparing P-DOE and conventional fractional lasers for the treatment of atrophic acne scarring.

Objectives: We sought to compare the efficacy and safety of a 1064-nm neodymium-doped yttrium aluminium garnet P-DOE and a non-ablative fractional laser (NAFL) in the treatment of acne scarring. Read More

J Clin Aesthet Dermatol 2020 Jan 1;13(1):22-27. Epub 2020 Jan 1.

Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil.

Laser resurfacing is a common treatment for photoaging. This treatment creates skin incisions that initiate the wound healing cascade, including reorganization of the collagen matrix, in a dermal remodeling process that can last up to 12 months. We compared the effects of nonablative and ablative Erbium fractional laser resurfacing on dermal content and arrangement of Collagen Types I and III, and on fibroblast activation. Read More

J Cosmet Dermatol 2020 Apr 20;19(4):925-929. Epub 2020 Jan 20.

Department of Dermatology, University of California, San Diego, CA.

Background: Hybrid fractional laser skin resurfacing is a procedure that combines fractional nonablative and ablative wavelengths to improve photoaging. The postoperative period involves overt skin swelling, redness, and roughness.

Objective: A single-center, randomized trial was performed to compare the effect of a standard Skincare regimen, with and without an anhydrous gel with TriHex peptides (a proprietary tripeptide and hexapeptide blend), on recovery after hybrid laser resurfacing of the face. Read More

Facial Plast Surg Clin North Am 2020 Feb;28(1):37-44

University Hospital, 600 Highland Avenue, Madison, WI 53792, USA. Electronic address:

In the 2000s, there was a significant expansion in technology that was described as "nonablative." These devices featured several different wavelengths and technologies. What they shared in common was the goal of delivering improvement in skin appearance while minimizing downtime and complications. Read More

Aesthet Surg J 2020 07;40(8):892-899

Division of Plastic Surgery, Le Belvedere Hospital, Mont Saint Aignan, France.

Background: Improvements in skin erythema and elasticity have been observed with topical application of platelet-rich plasma after fractional laser (FXD) treatment. Injections of nanofat via small needles into the dermis improves tissue thickness, discoloration and wrinkle depth.

Objectives: The aim of this study was to evaluate improvements in skin following a nonablative FXD treatment combined with the application of a novel topical nanofat biocrème, called neo-U. Read More

Am J Clin Dermatol 2019 Oct;20(5):683-690

Advanced Dermatology, Lincolnshire and Glencoe, IL, USA.

Over the past 30 years, the treatment of acne scars has undergone changes that have been significantly influenced by the concurrent development of new devices. The advent of fractional resurfacing lasers was a watershed moment for acne scarring therapy. The author recounts a career history of considerations of acne scarring treatments as well as the literature supporting the experiences causing changes in practice. Read More

Facial Plast Surg 2019 Jun 12;35(3):248-255. Epub 2019 Jun 12.

Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Summit, New Jersey.

Laser technology continues to increase in popularity and expand treatment options for patients with common but challenging skin conditions including facial telangiectasias, facial aging, striae distensae, and acne scars. Facial telangiectasias have been estimated to occur in tens of millions of people worldwide. The 585-nm laser was the first to follow the principle of selective photothermolysis for the treatment of cutaneous vascular lesions, but it caused significant postoperative purpura. Read More

Plast Reconstr Surg 2019 01;143(1):64-74

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; private practice; and Dallas Plastic Surgery Institute.

Background: Use of nonsurgical skin rejuvenation has grown over the past two decades. This has led to an increase in ablative and nonablative resurfacing devices. Moderate to heavy perioral rhytides require an ablative laser to maximize results. Read More

Dermatol Surg 2019 03;45(3):468-470

Private Practice, Dermatology Institute, Chula Vista, California Department of Dermatology, University of California, San Diego, San Diego, California.

Dermatol Surg 2018 08;44(8):1109-1114

Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Serviço de Anatomia Patológica-Brasil, Rio de Janeiro, Brazil.

Background: Expression of p53 by keratinocytes may be important in the pathogenesis of skin cancer induced by ultraviolet light.

Objective: We used side-by-side nonablative and ablative erbium fractional laser resurfacing to assess the effects on expression of p53 by facial keratinocytes.

Methods: Ten female patients (age range, 50-63 years) with Fitzpatrick skin Types I-IV and clinical signs of photoaging underwent erbium fractional laser resurfacing (nonablative, 1,540-nm; ablative, 2,940-nm) on opposite sides of the face. Read More

Facial Plast Surg Clin North Am 2018 May;26(2):113-121

Holcomb-Kreithen Plastic Surgery, 1 South School Avenue, Suite 800, Sarasota, FL 34237, USA.

Laser and light skin rejuvenation have changed dramatically in the last 10 years. CO and erbium:YAG remain the main wavelengths, but fractional, nonablative, and combination devices have been added. For those patients with lighter skin types and extensive photodamage and rhytids, full-field ablative laser resurfacing remains the procedure of choice. Read More

J Drugs Dermatol 2018 Jan;17(1):41-46

BACKGROUND: Fractional photothermolysis (FP) is a popular treatment option for photodamaged skin and addresses shortcomings of ablative skin resurfacing and nonablative dermal remodeling. Previous studies have demonstrated that FP using the 1550nm wavelength has led to improvement of ultrastructural changes and clinical effects associated with photodamaged skin in the deeper dermal structures, while treatment with the 1927nm wavelength has shown clinical effects in the superficial dermis. Both wavelengths produce precise microscopic treatment zones (MTZs) in the skin. Read More

J Clin Aesthet Dermatol 2017 Jun 1;10(6):51-67. Epub 2017 Jun 1.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

Nonablative laser resurfacing represents one of the major advances in procedural dermatology over the past decade. However, its use in darker skin types is limited by safety concerns and a relative lack of available data. To provide evidence-based recommendations for the use of fractional lasers in darker skin types. Read More

J Cosmet Dermatol 2018 Apr 31;17(2):184-192. Epub 2017 Aug 31.

Clinical Department, Viora Inc., New York, NY, USA.

Background: Fractional radiofrequency (RF) technology is often the preferable skin resurfacing treatment, especially among Asian patients. Second generation fractional RF technology has exclusive capability to produce separate biological responses (ablation, coagulation, or a combination of both) with 3 distinguished penetration depth programs.

Aims: The aim of this study was to evaluate the efficacy and safety of a fractional RF handpiece such as this, on the Thai population. Read More

J Cosmet Laser Ther 2018 Nov - Dec;20(7-8):382-384. Epub 2018 Jun 28.

a Department of Dermatology and Cutaneous Biology , Sidney Kimmel Medical College , Philadelphia , PA , USA.

Objective: Pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) is a rare skin condition seen predominantly in elderly females. These asymptomatic lesions are brought to the dermatologist's attention due to patient's displeasure in their appearance. We report a case of a 28-year-old female with PXE-PDE on the right neck treated with nonablative fractional resurfacing (NAFR). Read More

Dermatol Surg 2017 Oct;43(10):1249-1262

*Department of Dermatology, Northwestern University, Chicago, Illinois; †Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; ‡Section of Dermatology, University of Chicago Medicine, Chicago, Illinois; §SkinCare Physicians, Chestnut Hill, Massachusetts; ‖Laser & Skin Surgery Center of New York, New York, New York; ¶Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; #Union Square Laser Dermatology, New York, New York; **Laser and Skin Surgery Center of Northern California, Sacramento, California; ††Department of Dermatology, University of California Davis School of Medicine, Davis, California; ‡‡Department of Dermatology, University of California San Diego Health System, San Diego, California; §§DermOne, LLC, West Conshohocken, Pennsylvania; ‖‖Division of Dermatology, Section of Procedural Dermatology, Cooper University Health Care, Marlton, New Jersey; ¶¶Westlake Dermatology and Cosmetic Surgery, Austin, Texas; ##Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; ***Department of Dermatology, Naval Medical Center, San Diego, California; †††Department of Dermatology, Naval Hospital Camp Lejeune, Camp Lejeune, North Carolina; Departments of ‡‡‡Otolaryngology, and §§§Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Background: Currently, the isotretinoin (13-cis-retinoic acid) package insert contains language advising the discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. It is common practice to follow this standard because of concerns regarding reports of sporadic adverse events and increased risk of scarring.

Objective: To develop expert consensus regarding the safety of skin procedures, including resurfacing, energy device treatments, and incisional and excisional procedures, in the setting of concurrent or recent isotretinoin use. Read More

Clin Dermatol 2017 Mar - Apr;35(2):183-189. Epub 2016 Oct 27.

Dermatology and Laser Surgery Center, Yale University School of Medicine, New York, New York , 955 Park Avenue, New York, NY 10028. Electronic address:

The treatment of acne and acne scarring with lasers and light-based and energy-based technologies has become an integral component of our therapeutic arsenal. Lasers including infrared wavelengths and pulsed dye lasers; light devices including blue light, red light, and broadband light; and photodynamic therapy with aminolevulinic acid and methylaminolevulinic acid have been shown to be effective in the treatment of acne vulgaris. The optimal outcomes are achieved with photodynamic therapy combined with medical therapy. Read More

JAMA Facial Plast Surg 2017 Jan;19(1):64-71

Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison.

Importance: The market for nonsurgical, energy-based facial rejuvenation techniques has increased exponentially since lasers were first used for skin rejuvenation in 1983. Advances in this area have led to a wide range of products that require the modern facial plastic surgeon to have a large repertoire of knowledge.

Objective: To serve as a guide for current trends in the development of technology, applications, and outcomes of laser and laser-related technology over the past 5 years. Read More

Semin Cutan Med Surg 2016 Dec;35(4):238-241

Department of Dermatology, Mount Sinai Hospital, New York, New York, USA.

The types of cosmetic procedures favored by Asian individuals are unique and tailored to their anatomical differences. Thus, a customized approach is taken for different cosmetic procedures, ranging from neurotoxins and fillers to nonablative fractional resurfacing. The purpose of this review article is to identify the different types of cosmetic procedures commonly sought by Asian individuals and to understand how these different procedures are customized toward their aesthetic preferences. Read More

Dermatol Surg 2017 Jan;43 Suppl 1:S19-S24

*The Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, New York; †Laser & Skin Surgery Center of New York, New York, New York; ‡McDaniel Institute of Anti-Aging Research, Virginia Beach, Virginia.

Background: Laser therapy is a continuously evolving treatment option for scars, and the underlying therapeutic mechanisms continue to be elucidated.

Objective: To comprehensively review the literature to summarize the role of elastin in the formation scars, as well as treatment via therapeutic lasers.

Methods: Review of the PubMED/MEDLINE database for available studies pertaining to the role of elastic fibers in scar formation and after laser-based therapy. Read More