What are the Complications Seen in Nonablative Rejuvenation Applications?
The desire to achieve a younger and healthier skin appearance in aesthetic dermatology has increased the interest in rejuvenation methods. Due to the long recovery period and high complication risk of ablative methods, nonablative rejuvenation systems have been preferred more in recent years.

What are Nonablative Rejuvenation Systems?
Nonablative systems are energy-based technologies that act on the dermal layer without damaging the epidermis. These include:

Intense Pulsed Light (IPL): It works in the range of 515–1200 nm, targeting targets such as melanin, hemoglobin and water. It is used in epilation, vascular lesions, pigmentation disorders and rejuvenation.

Nonablative Laser Systems: Infrared lasers such as 1320 nm Nd:YAG, 1450 nm Diode, 1540 nm Er:Glass are used.

Nonablative Fractional Lasers (NAFL): They are widely preferred for scar correction, photoaging, fine wrinkles and skin tightening.

Radiofrequency (RF) Systems: They are available in monopolar, bipolar and multipolar forms. They work by converting electrical current into thermal energy through tissue resistance.

Focused Ultrasound (US): Intense focused and microfocused ultrasound systems trigger microscopic wound healing and neocollagenesis.

Complications That May Be Seen in Nonablative Rejuvenation Applications
Although the risk of complications is low in nonablative systems, undesirable effects may develop as a result of incorrect patient selection or parameter use. Complications are generally classified as mild, moderate and severe. This article will focus on mild complications and patient management.

1. Erythema and Edema
Reason for Seeing: Occurs as a result of vascular dilation with increased temperature.

Clinical Features: Regresses within a few hours after the procedure. May last longer in the periorbital region.

Management: Cold compresses, topical corticosteroids, camouflage with makeup. Short-term systemic steroids for severe edema.

Prolonged erythema (lasting more than 4 days) may carry the risk of PIH and scarring. Sun protection, vitamin C serums, treatment with PDL or IPL are recommended.

2. Urticaria
Risk Factors: Dermographism, previous history of urticaria.

Clinical Features: Usually physical urticaria type, transient.

Management: Cold application, antihistamines. However, excessive cooling may also trigger “cold urticaria”.

3. Acne and Milia
Reasons: Impaction of pilosebaceous unit after NAFL, use of intensive occlusive products.

Management:

Acne: Topical or systemic antibiotics.

Milia: Water-based product recommendation, manual extraction or topical tretinoin.

4. Erosion and Crust
Reason for Seeing: Inadequate epidermal cooling, edema and erythema causing micro damage to the epidermis.

Management:

In mild cases: Healing in 2–3 days with moisturizers and barrier repair products.

In prolonged cases: Topical corticosteroid. In persistent cases, infection or removal of the crust by the patient should be considered.

Recommendations for Preventing Complications
Discontinuing retinoids and acid-containing products 1 week before application,

Appropriate patient selection (conditions such as rosacea, plethoric skin should be carefully evaluated),

Using the correct parameters and working with appropriate cooling systems,

The patient should be educated about sun protection, skin barrier-supporting products and avoiding triggers such as exercise/heat exposure after the procedure.

Conclusion
Nonablative rejuvenation systems offer effective results while having a lower risk of complications compared to ablative systems. However, it should not be forgotten that these methods are not completely risk-free. Appropriate patient selection, device knowledge, correct application, and effective management when complications develop are the keys to successful outcomes.