Abstract

Chronic sun-exposure results in five main changes to exposed skin: telangiectasia, hyperpigmentation, rhytides, enlarged pores, and sagging skin. Various laser and non-laser modalities have been used to improve sun-damaged skin. The pulsed-dye laser (PDL) has an unparalleled safety record and an ideal wavelength for treating the signs of photodamage. In this study, we investigate the ability of the long pulse-duration PDL to improve the appearance of photodamaged skin. Ten subjects with cutaneous photodamage were treated with the high-energy, long pulse-duration PDL using fluences ranging from 8.0 to 10.0 J/cm(2), a 10-mm spot, and a 10-millisecond pulse-duration. Five subjects judged to have discrete solar lentigos or ephiledes were also treated to these lesions using a compression handpiece. Improvement was determined by blinded evaluation of photographs taken before and after the final treatment, and by subjects' self-evaluation 8 weeks following the final treatment. Subjects rated overall improvement as 65%, facial veins as 72% improved, hyperpigmentation 65% improved, enlarged pores 65% improved, and wrinkles 62% improved. Improvement was also determined by 3 physicians rating digital photographs and blinded as to which photos were pre- or post-treatment. They rated wrinkles as improved in 50% of photographs, veins as improved in 82%, diffuse redness as improved in 80%, pigmentary alterations as improved in 61.4%, and pore size as improved in 25%. The high-energy, long pulse-duration PDL improves photodamaged skin using non-purpuric settings.

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