Efficacy of nonablative laser treatment for rhytids: a controlled study with objective evaluation via clinical,...

A 980-nm diode laser was evaluated in rhytids treatment to ascertain its short- and long-term efficacy, as well as its potential value as an adjunct to aesthetic surgery.

Twenty subjects, 10 in each of 2 geographically distant sites, were treated with a 980-nm diode laser (macropulse of 1.9 seconds, two 200-ms micropulses, 25 J/cm(2) each). Group A subjects received 5 treatments, 15 days apart, with assessments at 1 and 6 months after the last treatment. Group B subjects received 2 treatment sessions, 30 days apart, with assessments at 1 and 6 months after the second treatment. The patient subjective satisfaction index (SI) was calculated, in addition to objective photographic, computer-based, profilometric, and histologic assessments.

Results were rated more highly by objective evaluation than by subjective patient evaluation. Improvement peaked around 1 month after the final treatment, and by the 6-month assessment, the skin condition had started to deteriorate. Among all evaluation methods, only the histology values showed some improvement at the 6-month compared with the 1-month assessment point. Group A patients responded better than Group B patients, and side effects were minimal.

A course of 5 treatments with the 980-nm diode laser gave positive short-term results in skin enhancement following nonablative rhytids treatment, which might have significance for the plastic surgeon when considering epidermal improvement after any surgical procedure. Introducing a "top-up" treatment, perhaps at the 3- or 4-month posttreatment point, supplemented with other adjunctive epidermal care regimens, might well increase overall efficacy and reverse the downward trend seen in all of the data except for histology. This strategy might well help the epidermis to better reflect the excellent histologic changes and is worthy of further study.