Fractional nonablative laser resurfacing: is there a skin tightening effect?

BACKGROUND Fractional photothermolysis, an approach to laser skin resurfacing that creates microscopic thermal wounds in skin separated by islands of spared tissue, was developed to overcome the high incidence of adverse events and prolonged healing times associated with full coverage ablative laser procedures. OBJECTIVE To examine whether fractional nonablative laser resurfacing induces skin tightening. MATERIALS AND METHODS A literature review was performed to evaluate the clinical and histologic effects of fractional nonablative laser resurfacing and full coverage ablative resurfacing procedures. RESULTS Fractional nonablative lasers produce excellent outcomes with minimal risk and morbidity for a variety of clinical conditions, including photodamaged skin, atrophic scars, surgical and burn scars. Efforts to induce robust fibroplasia in histologic specimens and skin tightening in the clinical setting have yielded inconsistent results. CONCLUSION A better understanding of the histology of fractional laser resurfacing will help to optimize clinical outcomes.