Ten women aged 28 to 67 years with erythema and/or fine lines were enrolled in a study approved by the Pascack Valley Hospital (Westwood, NJ) institutional review committee. Subjects had Fitzpatrick skin types I through III. After signing a consent form, all subjects’ faces (excluding the periorbital area) and jawline were treated 3 times at 2-week intervals with a 1064-nm Nd:YAG laser (CoolGlide Vantage; Cutera, Brisbane, Calif). Prior to treatment, the skin was cleansed with a standard bacteriostatic soap and water. Subjects’ eyes were protected with stainless steel external ocular shields, and laser pulses were applied on the skin adjacent to but outside the orbital rim. The laser parameters were set to a fluence of 13 J/cm2, a pulse duration of 300 microseconds, and a spot size of 5 mm. A smooth, rapid painting motion was used to administer treatment, with the tip of the instrument 2 to 4 cm above the skin surface. Based on this separation from the skin, the actual laser beam at the skin surface is 6 to 7 mm in diameter, with corresponding fluences from 9 to 7 J/cm2, respectively. No cooling was performed.