Subsurface wrinkle removal by laser treatment in combination with dynamic cooling

摘要

Compared to traditional CO$-2$/ or Er:YAG laser resurfacing, sub-surface thermal injury to stimulate skin remodeling for the removal of wrinkles is attractive due to the lower morbidity associated with epidermal preservation. We have developed a technique that thermally damages dermal collagen while preserving the epidermis by a combination of infra-red laser irradiation and dynamic cooling of skin. Wound healing response to the thermal denaturation of collagen may trigger synthesis of fresh collagen and result in restoration of a more youthful appearance. The laser wavelength is chosen so as to thermally injure dermis in a narrow band at depths of 150 to 500 microns from the surface of the skin. The epidermis is preserved by a Candela dynamic cooling device (DCD$+TM$/) cryogen spray. Three-dimensional Monte Carlo calculations have been done to calculate the light distribution within tissue while taking into account light absorption and scattering. This light distribution has been used to calculate heat generation within tissue. Heat transfer calculations have been done while taking into consideration the cryogen cooling. The resulting temperature profiles have been used to suggest heating and cooling parameters. Freshly excised ex vivo pig skin was irradiated with laser and DCD at these heating and cooling parameters. Histological evaluation of the biopsies has shown that it is possible to spare the epidermis while thermally denaturing the dermal collagen. The modeling and histology results are discussed.