Lasers, light sources, and radiofrequency devices for skin rejuvenation.

摘要

The introduction of devices for noninvasive skin rejuvenation has witnessed an unparalleled renaissance and any update in esthetic dermatology would not be complete without a discussion of the technology available. A spectrum of minimally invasive approaches to device-based rejuvenation is available, including photomodulation, selective pho-tothermolysis, fractional photothermolysis, and radiofrequency (RF) skin tightening. This article will review a systematic approach to device based rejuvenation as mono-therapy and the utilization of devices as part of combination therapy with botulinum toxins and semipermanent fillers. Nonablative devices can be divided into the following categories (Table 1): (1) devices targeting pigmented lesions; (2) devices targeting vascular lesions; (3) devices targeting water; and (4) combination devices. The 3 biologically significant chromophores are hemoglobin, melanin, and water. Traditional device-based monotherapy is predicated on the theory of selective photothermolysis in which devices are tailored to target melanin, hemoglobin, or water. Coincidental thermal transfer of these targets capitalizes on nonselective heating, which may contribute to the myriad of devices for nonablative rejuvenation. Nonablative rejuvenation is better denned as target-specific rejuvenation and nonablative skin remodeling (NSR) is optimized when there is an optimal target, and the goals are 3-fold: reduction in vascular anomalies, pigmented anomalies, and improvement of static fine rhyt-ids. Deeper rhytids are best addressed with ablative devices.