ABSTRACT
Previous chapters have discussed CO2, Er:YAG, combined CO2/Er:YAG and variable pulsed Er:YAG lasers. Each of these modalities is associated with both advantages and disadvantages.
Historically, chemical peeling of the skin has been used in the treatment of actinic damage, pigmentary dyschromias and facial rhytides. This particular method can be very cost effective, but results vary greatly due to the inconsistent level of injury. Such inconsistencies have been thought to be secondary to such variables as skin preparation methods, chemical agents used and application technique.1-4 Classic dermabrasion can also be a very cost-effective method of treating small areas, but
(1) Radiofrequency electrosurgical resurfacing involves the skin application of low voltage energy through multiple current delivery electrodes
(2) The delivered energy, in combination with saline conduction media, generates an ionized vapor (or plasma) layer that disassociates the treated skin
(3) The thickness of the residual thermal collagen damage zone varies consistently with increasing number of passes
(4) The thickness of the residual thermal collagen damage zone may not vary consistently with increasing voltage
(5) The overall depth of injury seen with electrosurgical resurfacing can be similar to that seen with CO2 laser resurfacing
(6) Electrosurgical resurfacing causes localized tissue ablation and has been used to treat post-operative surgical scars, as well as perioral and periorbital rhytides
holds the greatest risk of transmission of infectious diseases.5 Laser resurfacing offers great marketability, due to high popular demand and decreased variability of results secondary to operator technique. However, laser approaches can be costly and have associated post-procedure morbidity.6-11 Due to their mechanism of action, lasers also pose a risk of ocular damage to both the patient and the physician, thus requiring the use of protective eye wear.
