Histological perspective of laser resurfacing

Abstract

Cutaneous laser exfoliation has gained widespread acceptance among multispecialities involved with skin care. The evolution of this acceptance has surrounded improved delivery systems, allowing for the delivery of a selective and precision controlled means of tissue exfoliation. Acquiring a working knowledge of the histological aspects of the skin as well as the clinical correlates of laser tissue biophysics is essential for the surgeon considering using this technology. Histological studies have revealed correlations between clinical treatment endpoints, histological depths of exfoliation, postoperative erythema, and rhytid resolution. Failure to respect these correlates can yield tragic scarring in this patient population. The past few years have seen an increasing number of carbon dioxide laser systems entering the market as it pertains to cutaneous laser exfoliation. These systems encompass two main varieties, either surrounding a time energy modulation delivering high peak powers in short exposure times, or a special energy modulation that moves sharply focused beams over short exposure times. Regardless of what system is used by the physician, a working knowledge of both laser physics as well as tissue biophysics is essential for the proper treatment of patients. Cutaneous laser exfoliation has gained widespread acceptance among multispecialities involved with skin care. The evolution of this acceptance has surrounded improved delivery systems, allowing for the delivery of a selective and precision controlled means of tissue exfoliation. Acquiring a working knowledge of the histological aspects of the skin as well as the clinical correlates of laser tissue biophysics is essential for the surgeon considering using this technology. Histological studies have revealed correlations between clinical treatment endpoints, histological depths of exfoliation, postoperative erythema, and rhytid resolution. Failure to respect these correlates can yield tragic scarring in this patient population. The past few years have seen an increasing number of carbon dioxide laser systems entering the market as it pertains to cutaneous laser exfoliation. These systems encompass two main varieties, either surrounding a time energy modulation delivering high peak powers in short exposure times, or a special energy modulation that moves sharply focused beams over short exposure times. Regardless of what system is used by the physician, a working knowledge of both laser physics as well as tissue biophysics is essential for the proper treatment of patients.