assessed pore appearance, skin texture, and overall appearance. A quartile improvement scale (0 = no improvement; 4 = very significant improvement [76%–100%]) was used to quantify changes posttreatment. A significant mean reduction from baseline of 17% (P≤0.002) in the pore score was observed 2 weeks after treatment 6. The clinician-rated mean improvement scores for pore appearance and overall appearance were 1.95 ± 0.3 and 2.75 ± 0.2, respectively; patient efficacy ratings were similar to clinician ratings. Patient satisfaction ratings were significantly associated with improvement in overall facial appearance (P=0.001). During treatment, the mean (± SD) pain discomfort score (0 = no pain; 10 = most painful) was 4.6 ± 0.1. Two weeks after treatment 6, 30.0% of patients (6/20) had mild erythema; there were no reported cases of edema, hyperkeratosis, hyperpigmentation, or hypopigmentation.
Photodamage
Skin damage related to chronic UV radiation exposure is characterized by actinic keratosis, atrophy, dyspigmentation, loss of dermal elasticity, lentigines, rhytids, and telangiectasia. 21,22 Other skin conditions that can be exacerbated by UV light include melasma and PIH.16 Forty women with Fitzpatrick skin type I-IV received 6 treatments over the entire face with the 1927 nm wavelength handpiece of the NFDL system (multiple passes [number dependent on patient tolerability]; 5 mJ/pulse; coverage, 5%–10%) ± an aqueous serum containing 15% L-ascorbic acid, 1% alpha-tocopherol, and 0.5% ferulic acid.13 Clinicians assessed improvement in fine lines, skin texture, dyschromia, and overall appearance at 1 week, 1 month, and 3 months posttreatment using a 5-point quartile improvement scale (0 = none; 4 = very significant). Women assessed side effects on a 4-point scale (0 = none; 3 = marked) and pain on an 11-point scale (0 = no pain; 10 = worst pain). Overall satisfaction was evaluated using a 5-point scale (range, 1 = very dissatisfied; 5 = very satisfied) at 1, 4, and 12 weeks posttreatment. Mild to moderate improvement (scores of 1–2) from baseline in all areas assessed was reported for the laser alone and laser + aqueous serum groups, with patients in both groups showing clinician-rated improvement in fine lines, skin texture, and dyschromia. Slightly larger improvements in dyschromia and overall facial appearance were observed with the 1927 nm wavelength handpiece + serum versus the 1927 nm wavelength handpiece alone. Numeric improvements from baseline in skin tone and skin texture were observed with the 1927 wavelength handpiece alone (Figure 5A), and improvements in skin tone, skin texture, and dyschromia were observed with the 1927 nm wavelength handpiece + serum (Figure 5B). Averaging data over 6 treatments for the
