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Background. Rejuvenation of photoaged skin involves removal of the epidermis and superficial dermis, encouraging the production of new epidermis with collagenesis and remodeling. The facial appearance during healing is unpleasant, and the complication rate is high.

Objective. We evaluate a Q-switched Nd:YAG laser operating at 1320 nm, with a cryogen delivery system and a skin temperature sensor. The system cools the target skin, followed by the laser impulse which passes through the cooled epidermis into the dermis.

Methods. Ten patients are presented. Two treatments a week were given over 4 weeks, and the patients were seen at 2 and 6 weeks after the final treatment.

Results. The histology showed improvement in the condition of the dermis in all 10 patients, but only 2 of the 10 patients expressed satisfaction with the results, despite similar histologic findings.

Conclusions. Careful patient selection is required. Better patient education is necessary to ensure that the patients' expectations are realistic. We should add treatments that will improve the youthful aspect of the epidermis. The system may well help in maintaining the effects of collagen remodeling following traditional ablative resurfacing procedures, but studies are necessary to show this.