Periocular rejuvenation using a unique non-ablative long-pulse 2940 nm Er:YAG laser

Abstract

The periocular region is challenging for cosmetic laser surgeons. Surgery and laser resurfacing have traditionally been used to correct periorbital lines and wrinkles. Although effective, the associated downtime with these methods has made many people reluctant to decide for such treatments. More recently, the non-ablative long-pulse 2940 nm Er:YAG laser is being used to improve the structure and function and hence the appearance of skin in the periorbital region. The objective of this study is to evaluate the safety and efficacy of long-pulse 2940 nm Er:YAG laser for non-ablative treatment of periorbital static wrinkles and skin laxity. This is a prospective analysis of 30 patients treated for periorbital rejuvenation using three sessions of non-ablative long-pulse Er:YAG laser over a 3-month period. All patients were assessed according to Fitzpatrick's classification of periorbital wrinkles to class I, II, or III and were treated with 2940 nm Er:YAG laser using a fluence of 3.75 J/cm², a repetition rate of 1.7-2 Hz, and with the SMOOTH™ pulse mode (250 ms). The treatment sessions were performed on each patient, 4 weeks apart. Patient improvement was assessed before each laser session as well as at 12 months after the final treatment. Blind photographic evaluations were performed by three independent physicians using unlabeled before and after photos arranged in non-chronological order. Reviewers were asked to determine the before and after photos. Patients were asked to answer a questionnaire measuring satisfaction 4 weeks after each session, and to report any adverse reactions. There was statistically and clinically significant improvement in the Fitzpatrick classification of the periorbital wrinkles. Blinded evaluators correctly identified the before and after photos in all cases. All patients reported mild edema and erythema, which persisted for 1 to 2 days, and superficial peeling of the skin for 4 to 6 days after each laser treatment. No long-term adverse effects were reported. The non-ablative long-pulse 2940 nm Er:YAG laser seems to be a safe and effective treatment for periocular rejuvenation with minimal and tolerable adverse reaction. The improvement attained from the laser sessions was persisting after 1 year denoting the long-term efficacy of the procedure.

Keywords: Dark circles; Erbium YAG; Laser; Non-ablative; Periocular; Periorbital rejuvenation; Rejuvenation; Skin laxity; Wrinkles.

Fig. 1

Improvement of periorbital wrinkles: (a) before treatment; (b) 12 months after the 3rd treatment

Fig. 2

Improvement of periorbital wrinkles: (a) before treatment; (b) 1 year after last treatment

Fig. 3

Improvement of periorbital wrinkles: (a) before treatment; (b) 1 year after last treatment

Fig. 4

A Mean values of Lemperle Score and (B) Fitzpatrick Score at baseline, after 1st, 2nd, and 3rd sessions. B—baseline, T1—after 1st session, T2—after 2nd session, T3—after 3rd session