Expression of p53 protein after nonablative rejuvenation: The other side of the coin

Background Disturbance of p53 expression may play an important role in the pathogenesis of ultraviolet (UV) light-induced skin cancer as well as photoaging. Objectives To objectively evaluate the potential effect of nonablative facial rejuvenation on p53 expression. Participants and Methods Thirty patients with Fitzpatrick skin type III to IV were divided into five groups. Each group underwent a different nonablative modality: radiofrequency (RF), intense pulsed light (IPL), electro-optical synergy (ELOS) (combined RF and IPL), 1,320-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, and 2,940-nm erbium-doped (Er):YAG laser minipeel. Skin biopsies were obtained before treatment, by the end of treatment, and 3 months after treatment. Biopsies were also taken from 30 controls. Quantitative evaluation of p53 was performed using computer image analysis for immunostained tissues. Results P53 expression was statistically significantly greater at the end of IPL (p =.02) and ELOS (p =.02) treatments than before treatment but was statistically insignificantly lower (p >.05) 3 months after treatment than at the end of treatment. No significant differences (p >.05) were observed in p53 level after RF, 1,320-nm Nd:YAG, and 2,940-nm Er:YAG mini-peel treatments from baseline. Conclusions The increase in epidermal p53 expression after IPL treatment could increase the risk of skin neoplasia by intense pulsed light-induced DNA damage which may lead to dysregulation of apoptosis and initiation of skin cancer. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.