{{short description|Skin treatment}} '''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 to the skin. This prompts the skin to heal itself, by creating new cells. This process—to a certain extent—removes the signs of photoaging.<ref>{{cite book|last=Lim|first=Henry W. |author2=Herbert Honigsmann |author3=John L. M. Hawk |title=Photodermatology|publisher=CRC Press|year=2007|pages=402, 403|isbn=978-0-8493-7496-8}}</ref> The technique was invented by Thomas L Roberts, III using {{CO2}} lasers in the 1990s.<ref>Roberts, Thomas L III. The emerging role of the {{CO2}} lasers in aesthetic plastic surgery. Presented at the XIII Congress of the International Society for Aesthetic Plastic Surgery, New York, NY, Sept. 28-Oct. 1, 1995.</ref><ref>{{cite journal|last=Roberts|first=Thomas L III |author2=Lettieri, John T |author3=Ellis, Laura B. |title={{CO2}} Laser Resurfacing: Recognizing and Minimizing Complications|journal=Aesthetic Surgery Journal|publisher=American Society for Aesthetic Plastic Surgery|year=1996|pages=142–148|doi=10.1016/S1090-820X(96)70038-9 |volume=16|issue=2 |doi-access=free}}</ref> Observed complications have included scarring, hyperpigmentation, acne, and herpes.
==Skin rejuvenation== Skin rejuvenation can be effected through various modalities, including thermal, chemical, mechanical, injection, and light.<ref>{{cite web|url=http://www.yourplasticsurgeryguide.com/roundtables/roundtable-photo-rejuvenation.htm|title=Photo Rejuvenation for Better-Looking Skin: What Doctors Are Saying|access-date=2009-07-02}}</ref><ref>{{cite web|url=https://myfacials.co.uk/beyond-the-filter-how-advanced-skin-treatments-are-rewriting-the-rules-on-uneven-skin-tone/|title=How Advanced Skin Treatments Are Rewriting the Rules on Uneven Skin Tone|access-date=2009-08-02}}</ref>
==Laser resurfacing== alt=A physician performing laser resurfacing using an erbium laser|thumb|A physician performing laser resurfacing using an erbium laser 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.
Laser resurfacing can be performed using non-ablative lasers, such as the 1540 nm Er:glass laser, or ablative lasers, such as the 2940 nm Er:YAG laser or the 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.<ref>{{Cite web |date=2025-08-20 |title=CO2 Laser Resurfacing: Full Face vs. Neck Techniques |url=https://www.spbeauty.co.uk/comparing-co2-laser-resurfacing-techniques-full-face-vs-neck-applications/ |website=SP Beauty |language=en-GB}}</ref> 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.<ref>{{cite web|title=Portrait(R) Plasma Skin Regeneration|url=http://www.medicalnewstoday.com/releases/52311.php|work=medicalnewstoday.com|publisher=MediLexicon International Ltd|access-date=17 February 2014|date=September 2006}}</ref>
{{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.
===Fractional laser=== Fractional laser photothermolysis (FP) is a form of laser-based skin resurfacing, with several devices on the market, such as Fraxel. A fractional laser delivers laser light to the skin. Hundreds or thousands of laser pinpoints may be used per square inch, leaving healthy skin between the ablated areas.
Complications observed in a study of 961 treatments included acne and herpes outbreaks.<ref>{{Cite journal|last1=Graber|first1=Emmy M.|title=Side Effects and Complications of Fractional Laser Photothermolysis: Experience with 961 Treatments|journal=Dermatologic Surgery|last2=Tanzi |first2=Elizabeth L. |last3=Alster |first3=Tina S. |pages=301–307|doi=10.1111/j.1524-4725.2007.34062.x|pmid=18190541|date=March 2008|volume=34|issue=3|s2cid=23942929 }}</ref> There have been anecdotal negative accounts of bad scarring and hyperpigmentation.<ref>{{cite web|first=Christine |last=Hoene |title=Adverse Effects Fraxel Repair|url=http://www.realself.com/review/fraxel-laser-horrible |work=realself.com|publisher=RealSelf, Inc|access-date=17 February 2014}}</ref>
Erbium and {{CO2}} fractional systems have a better safety profile than lasers of the past.<ref>{{Cite journal|title=Ablative CO2 Lasers for Skin Tightening: Traditional Versus Fractional |date=December 2014 |journal=Dermatologic Surgery |doi=10.1097/DSS.0000000000000230 |pmid=25417566 |volume=40 |issue=Suppl 12 |pages=S147–51 |last1=Ortiz |first1=A. E. |last2=Goldman |first2=M. P. |last3=Fitzpatrick |first3=R. E.|s2cid=8266926 }}</ref>
==Intense pulsed light== Intense Pulsed Light (IPL) uses flashlamps (and not lasers) to produce high intensity light over broad visible and infrared wavelengths with filters that select the desired range. IPL is used to treat dyschromia, rosacea, melasma, acne, photodamage, vascular and pigmented lesions, and rhytides.<ref>{{Cite journal|title = Intense pulsed light (IPL): a review|date = Feb 2010|journal = Lasers Surg. Med.|doi = 10.1002/lsm.20877|pmid = 20166155 |volume=42 |issue = 2|pages=93–104|last1 = Babilas|first1 = P|last2 = Schreml|first2 = S|last3 = Szeimies|first3 = R. M.|last4 = Landthaler|first4 = M|doi-access = free}}</ref>
One study conducted by a group of four researchers from the Weill Cornell Medical College of Cornell University in 2004 found IPL to be a "non-invasive, non-ablative method for rejuvenating photoaged skin with minimal adverse events".<ref>{{cite journal|last1=Sadick NS, Weiss R, Kilmer S, Bitter P|date=January 2004|journal=Journal of Drugs in Dermatology|volume=3|issue=1|pages=41–49|url=http://jddonline.com/|pmid=14964745|first1=NS|last2=Weiss|first2=R|last3=Kilmer|first3=S|last4=Bitter|first4=P|title=Photorejuvenation with intense pulsed light: results of a multi-center study}}</ref>
Other studies, however, have noted that exposing cells to direct heat can cause DNA damage—not only in those cells, but also in surrounding tissue that was not directly exposed, and concluded treatments can cause microscopic thermal injuries, and that further research is warranted.<ref name="pubmed">{{cite journal|pmid=19587691|year=2010|last1=Purschke|first1=M|last2=Laubach|first2=HJ|last3=Anderson|first3=RR|last4=Manstein|first4=D|volume=130|issue=1|pages=86–92|doi=10.1038/jid.2009.205|journal=The Journal of Investigative Dermatology|title=Thermal injury causes DNA damage and lethality in unheated surrounding cells: active thermal bystander effect|doi-access=free}}</ref>
IPL is effective for pigmentation and telangiectasias, but has lesser results for wrinkles.<ref>{{Cite journal|title = Skin rejuvenation with intense pulsed light|date = 2010|journal = Acta Dermatovenerol Croat.|pmid = 20887700 |volume=18 |issue = 3|pages=181–4|last1 = Kohl|first1 = E. A.|last2 = Babilas|first2 = P|last3 = Landthaler|first3 = M}}</ref>
== Photodynamic therapy == Photodynamic therapy (PDT) uses photosensitive compounds that are activated by light. It is used to treat actinic keratoses, acne, photoaging, and skin cancer.
==See also== * Laser surgery
==References== {{Reflist}}
{{Lasers}}
Category:Laser medicine Category:Dermatologic surgery