Photodamaged skin of the hands occurs as a result of chronic exposure to ultraviolet light and is characterized by roughened surface texture, dyspigmentation, telangiectasias, rhytids, and skin laxity. Although several different noninvasive procedures have been advocated for hand rejuvenation (Table 47.1), many are characterized by an unattainable balance between effectiveness and morbidity. The necessity of epidermal removal during most skin resurfacing treatments leads to significant morbidity during the reepithelialization process, particularly in areas such as the hands, where limited pilosebaceous glands are present.

Plasma skin regeneration Technology

Plasma skin regeneration is a novel process that involves the generation of plasma through the use of ionized energy that thermally heats tissue. A pulse of ultrahigh-energy radio-frequency (RF) from the device generator (Portrait plasma skin regeneration) converts nitrogen gas into plasma within the handpiece. The plasma emerges from the distal end of the device handpiece and is directed onto the skin area to be treated. Rapid heating of the skin occurs as the excited gas transfers heat to the skin, resulting in increased fibroblast activity during dermal regeneration. The retained necrotic epidermis effectively serves as a biological dressing for the efficient formation of a new stratum corneum and epidermis.

The essentially instantaneous generation of plasma with controlled application of RF energy produces individual plasma pulses that heat tissue. Adjustment of RF power and pulse width enables control of tissue effects by altering the amount of energy delivered to tissue per pulse.