The 10,600-nm CO 2 and 2940-nm Erbium lasers were the first ones used for rejuvenescence, with surprising results due to their ability stimulate collagen. Since they are ablative lasers, the postoperative period is difficult and prolonged, and with important complications. To minimize those undesirable effects, non-ablative lasers with different wavelengths were introduced (840 nm, 1320 nm, long pulse 1640 nm, among others), with a very mild postoperative period, but with a very limited capacity to promote neocollagenesis. New studies were responsible for non-ablative fractional lasers (1440 nm, 1540 nm, and 1550 nm) with a different action: they promote dermal-epidermal coagulation columns, have a moderate postoperative period, and a reasonable capacity to stimulate collagen fibers with a negligible risk of side effects. However, they are very limited in severe photoaging. To fill this gap, new fractional 10,600-nm CO2 and 2940-nm Erbium lasers were introduced. This reduced the incidence of side effects, but also reduced the final effect, which is not as good when compared with the same, non-fractional, lasers. They represent a good option for the treatment of severe photoaging.

Pulsed light devices have been simultaneously introduced to lasers in dermatology. Based on the emission of photons which have melanin, hemoglobin and water in the collagen as targets, their technology differs completely from lasers. The current devices contain many items of security, making the treatment effective and safe. New technologies were developed to combat the fl accidity: the radiofrequency based on the electrons emission and infrared light devices. The photodynamic therapy has also been more recently applied for rejuvenation with the aim of stimulating the collagen.

Keywords: PULSED LIGHT, INTENSE PULSED LIGHT, RADIO FREQUENCY, INFRARED, REJUVENATION

Introduction: The dorsum of the hands is a visible part of the body and needs special attention regarding rejuvenation treatments. The combination of different techniques in this area is important to increase the effectiveness of the treatments.
Objective: This study was aimed to evaluate the clinical efficacy of a fractional non-ablative laser (1,340nm Nd:YAP) combined with intense pulsed light (IPL) for rejuvenating the hands.
Methods: A prospective comparative study evaluated 11 patients complaining of aging on hands, for 90 days. Two sessions were carried out with a two-week interval using IPL and 1,340nm Nd:YAP laser. The left hand was treated with 1,340nm Nd:YAP laser associated with IPL and the right hand with isolated IPL. The improvement was rated using scores from 1 to 4, evaluating the parameters: wrinkles, pigmentation, brightness, keratosis and overall rejuvenation observing the elasticity and filling of visible structures such as bones, tendons and vessels.
Results: By analyzing the frequencies of the categories of the variables, it was possible to observe that there was a higher frequency of improvement in the left hand. For the comparative analysis of the studied variables, the mean value of each variable computed for each hand, evidenciated that the variable overall rejuvenation and the left hand showed more marked improvements for the studied characteristics. Ten among 11 patients had a higher satisfaction degree with the combined treatment, with absence of significant adverse effects.
Conclusion: The association of 1,340nm laser to the IPL was shown to be safe and more effective than isolated intense pulsed light in the rejuvenation of the hands.

Keywords: LASERS; REJUVENATION; HAND

The topical route for the delivery of drugs is essential in dermatology: it optimizes the penetration of medicaments, and when performed with the assistance of lasers, it takes place in a uniform and controlled manner. The degree of evidence of drug delivery is being investigated for many drugs. Moreover, the technique combines outstandingly with lasers for rejuvenation and treatment of skin diseases. It is therefore possible to conclude that the use of lasers for drug delivery is promising. While there are clinical studies on some substances that allow their indication and use, others require further controlled analyses, with longer follow-up periods, aimed at allowing thorough evaluations.

Keywords: LASERS; ADMINISTRATION, CUTANEOUS; SKIN ABSORPTION; DRUG DELIVERY SYSTEMS; DRUG ADMINISTRATION ROUTES

Six patients underwent two sessions of microneedling associated to drug delivery on the face, hands or stretch marks, at three-week interval between sessions. Patients were evaluated using clinical analysis and objective measures. Compared to baseline, objective face analysis showed decrease in acne lesions and improvement in the skin texture. The evaluation of stretch marks showed great improvement, and face and hands presented excellent results compared to baseline. The association of microneedling to drug delivery for rejuvenation of the face and hands, and for the treatment of stretch marks presented promising results in our study.

Keywords: ADMINISTRATION, CUTANEOUS; HYALURONIC ACID; REJUVENATION; STRIAE DISTENSAE; TRANEXAMIC ACID; HYDROXYPROLINE

Both microneedling and ablative fractional laser can be used for the treatment of scars. The present article reports the case of a female patient who had the first half of a perioral scar treated with ablative fractional CO2 laser, and the second half treated with microneedling, using a 2mm roller. Outcomes were superior in the half treated with laser.

Keywords: Cicatrix; Collagen; Lasers

INTRODUCTION: Non-ablative fractional lasers are well-known effective treatments for skin rejuvenation. However, the high incidence of post-inflammatory hyperpigmentation increases the risk of complications, especially in higher skin phototypes. Caviar phospholipid supplementation has been used successfully to reduce the inflammatory process, which may be beneficial to manage post-inflammatory hyperpigmentation after laser.
OBJECTIVE: To compare the incidence of post-inflammatory hyperpigmentation in high phototypes after caviar phospholipid supplementation.
METHODS: 20 patients underwent a non-ablative fractional laser session (Nd:YAP 1340nm, Zye Vydence, Brazil), and 10 of them used 200 mg of caviar phospholipid orally daily for 15 days before treatment and 40 days after. Patient images were evaluated before and after 40 days of laser application. Clinical assessment was based on the presence or absence of post-inflammatory hyperpigmentation. Statistical analysis was performed using the Z test.
RESULTS: We observed no cases of post-inflammatory hyperpigmentation in the experimental group; however, the control group presented 30%.
CONCLUSIONS: Caviar phospholipid may be an option for preventing post-inflammatory hyperpigmentation after non-ablative fractional lasers, aiming to avoid adverse events.

Keywords: Lasers; Skin; Rejuvenation; Fatty Acids; Omega-3.

The 1064-nm Nd:YAG laser in Q-switched and micropulsed modes has been used in rejuvenation, pore reduction, skin texture improvement, and wrinkle reduction. The aim of this study is to evaluate the combination of 1064-nm Nd:YAG laser in micropulsed and Q-switched modes in the same session for global facial treatment. Thirty female patients underwent six treatment sessions every two weeks. Three blinded dermatologists evaluated the results through clinical photographs and Visia^® or Focco^® images obtained before and 30 days after the last treatment session. The parameters of interest were solar melanosis, telangiectasias, wrinkles, dilated pores, melasma and skin texture. Three patients had face biopsies before and 30 days after the end of treatment. Most patients showed improvement in all evaluated parameters, except for two patients who had worsening of melasma. An increase in collagen was observed in two of the three histological examinations performed after treatment. The combination of laser modes studied herein offers a safe treatment that can improve wrinkles, skin texture, and laxity with minimal downtime.

Keywords: Lasers; Skin Aging; Rejuvenation