Future trends in skin resurfacing

Laser skin resurfacing continues to evolve through engineering and biological advances. The optimal combination of pulse duration and wavelength is still debated. Also, operative technique and wound management probably play as great a role in the cosmetic outcome as the characteristics of the laser pulse. Finally, the use of biologic response modifiers may eventually allow for skin rejuvenation without physical injury. The author summarizes recent developments and narrates the progression of laser skin resurfacing (LSR) since the inception of CO₂ LSR with 1 msec laser tissue interaction times. Topics covered include: shortening the pulse duration; using different CO₂ wavelengths; using non-laser sources; lengthening the pulse with erbium; using discrete chromophores in the dermis; non-ablative laser methods using water as the chromophore; biologic response modifiers; and combining CO₂ and erbium