Nonablative and minimally ablative facial rejuvenation has become increasingly popular over the last several years. Patients desire less invasive cosmetic procedures with maximal effect and minimal downtime. Despite the tremendous effort going into developing novel treatments, currently available nonablative laser and light therapies have demonstrated minimal to moderate improvement in photoaged skin. Recently, the concept of using two different modalities to treat the photoaged skin has been explored. The idea behind this is that two varying mechanisms that target the same downstream event theoretically could lead to an additive and even possibly a synergistic effect to improve the photoaged skin. There is recent evidence for the effectiveness of sequential combined treatment using a broadband light (BBL) therapy followed by an Er:YAG microlaser peel (Profile, Sciton Inc.) for skin rejuvenation.

BACKGROUND

BBL technology utilizes a polychromatic, noncoherent, continuous band of wavelengths to target multiple aspects of photoaging during a single treatment session. As the primary tissue chromophores are melanin and oxyhemoglobin, both pigmented and vascular lesions may be treated simultaneously, while nonspecific bulk heating stimulates dermal remodeling and new collagen formation. Clinically, this correlates with a concomitant reduction and lightening of melanin containing pigmented lesions, telangiectasia, and baseline erythema as well as a mild to modest softening of fine rhytids. Cutoff filters are used to define and limit the lower end of the wavelength spectrum, depending on the clinical lesions to be treated.