Changes in skin tanning attitudes. Fashion articles and advertisements in the early 20th century.

Historical reviews suggest that tanning first became fashionable in the 1920s or 1930s. To quantitatively and qualitatively examine changes in tanning attitudes portrayed in the popular women's press during the early 20th century, we reviewed summer issues of Vogue and Harper's Bazaar for the years 1920, 1927, 1928, and 1929. We examined these issues for articles and advertisements promoting skin tanning or skin bleaching and protection. We found that articles and advertisements promoting the fashionable aspects of tanned skin were more numerous in 1928 and 1929 than in 1927 and 1920, whereas those promoting pale skin (by bleaching or protection) were less numerous. These findings demonstrate a clear shift in attitudes toward tanned skin during this period.

Nonablative facial remodeling: erythema reduction and histologic evidence of new collagen formation using a 300-microsecond 1064-nm Nd:YAG laser.

BACKGROUND: A variety of nonablative lasers have been used to improve skin color and toning. Evidence of new collagen has been seen. Using blinded observer analysis of electron microscopic changes, we have documented the effect of a nonablative Nd:YAG laser on collagen production and its relationship to patient age. OBSERVATIONS: Ultrastructural analysis of 9 patients showed a decrease in overall collagen fiber diameter in the papillary dermis at 1 month and 3 months after 3 treatment sessions. This is consistent with the formation of new collagen. Younger patients had a greater decrease in collagen fiber diameter compared with older patients. The change in collagen fiber diameter with time as well as the relationship between that change and the patient's age were statistically significant (P<.001). Photographic evaluation showed that those patients with preexisting erythema showed improvement in erythema along with an associated improvement in skin quality. There were no adverse events. CONCLUSIONS: Microsecond Nd:YAG lasers appear to be safe for nonablative laser remodeling. Our study indicates that microsecond Nd:YAG lasers can produce new collagen formation in the papillary dermis. In addition, the condition of patients with erythema may be improved. Younger patients may form more new collagen compared with older patients with photodamage.

A review of laser and photodynamic therapy for the treatment of nonmelanoma skin cancer.

BACKGROUND: The role of laser and light sources used alone and in conjunction with photodynamic therapy (PDT) for the treatment of nonmelanoma skin cancers (NMSCs) remains unclear. PDT is a newly accepted treatment option for actinic keratoses (AKs) with clearance rates comparable to 5-flourouracil. The purpose of this study was to review literature pertaining to the use of light-emitting technologies and PDT for the treatment of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and AKs. METHODS: A National Library of Medicine PubMed Internet search of English-language journals was performed using the terms laser, PDT, BCC, SCC, and AK. The search encompassed all English-language clinical trials on human subjects from the mid-1960s to the present using laser and light source therapy and/or topical aminolevulinic acid. Articles were excluded if they contained fewer than 10 patients, had a follow-up time of less than 1 month, used intravenous photosensitizers, or were review articles. RESULTS: A total of 20 papers were included for review (10 for BCC, 4 for AK, and 6 for SCC). Follow-up for these patients ranged from 1 to 36 months. Clearance rates were reported up to 100% for superficial BCCs, AKs, and SCC in situ, and lower (8%) for more invasive SCC. Recurrence rates ranged from to 0% to 31% for superficial BCCs, 16% to 31% for AKs, 0% to 52% for SCC in situ, and 82% for invasive SCC. CONCLUSION: Precise PDT and laser clearance and recurrence rates for superficial and nodular BCC and SCC treated with laser and PDT are not yet known. From the available data, it appears that PDT may be capable of achieving clearance rates comparable to radiation therapy for BCC. However, with current technology, PDT treatment of BCC remains inferior to surgical excision and Mohs surgery, for which recurrence rates have been reported to be less than 10%. The reported clearance rates currently limit the usefulness of PDT and laser therapy. However, multiple treatments and the use of penetration enhancers may significantly increase the efficacy of 5-aminolevulinic acid-PDT. With regard to SCCs, the risk of metastatic disease restricts the use of laser and PDT. Studies are currently underway with new light sources, photosensitizers, and various therapeutic regimens. At this time, because the reported recurrence rates are significantly higher than those achieved with standard therapies, laser and PDT should be reserved for only those patients who cannot undergo surgical therapy for BCC and SCC.