PARIS One of the newest trends in nonablative skin rejuvenation is the use of plasma energy to rid patients of sun damage, fine lines, and wrinkles.
The advantage of plasma energy technology is in the conduction of uniform and efficient thermal energy to the dermis without epidermal vaporization or charring, reported Alan T. Lewis, M.D., at the Fourth International Academy of Cosmetic Dermatology World Congress.
"Unlike CO2 lasers where you're taking away the epidermis and the protection that it affords, the epidermis is left behind with this device," he said. The intact epithelium provides posttreatment protection and speeds healing, resulting in less downtime.
One-year clinical histology studies show continuing regeneration and improvement over time. Elastosis is reduced, and there is a widening of the collagen band at the dermoepidermal junction. There have been no reports of scarring or hypopigmentation in clinical studies to date, according to Rhytec Inc., which markets the plasma energy device, Portrait PSR
The Portrait PSR
Topical anesthesia, with or without oral medication, is used.
The Portrait PSR
It can be used for people with darker skin tones without affecting skin color because the energy absorption is not chromophore dependent.
The device can deliver either low- or high-energy treatments, said Dr. Lewis, director of Mohs micrographic surgery and cutaneous oncology at Tulane University Hospital and Clinic in New Orleans.
Full-face rejuvenation using low-energy typically requires three 15-minute sessions spaced 21 days apart. There is no skin sloughing, minimal erythema, and little downtime, he said. Patients undergoing a single high-energy treatment may notice tight skin after the treatment and sloughing at about 7 days.
Another trend in nonablative facial rejuvenation is to "stack," or combine, different laser treatments to elicit a response in different layers of the skin, he said.
The approach takes a little more time but results in greater patient satisfaction.
Dr. Lewis cited a study in which 10 women who received five treatment sessions with a 595-nm pulsed dye laser immediately followed by a 1450-nm diode laser had overall better and faster results than did 20 women treated with either laser alone (Dermatol. Surg. 2004;30:12928).
The 6-month clinical outcome was best for patients receiving the combination treatment, followed by those treated with the 1450-nm diode laser and the 595-nm pulsed dye laser, respectively.
When stacking lasers, it's important to use the 595-nm laser first because infrared lasers can cause a good deal of redness that can become quite problematic if followed with a vascular laser.