Clinical evaluation of a single-wavelength fractional laser and a novel multi-wavelength fractional laser in the treatment of photodamaged skin

Background and Objectives Nonablative fractional lasers are well recognized for rejuvenating photoaged skin. We previously reported favorable outcomes with short follow‐up after the use of 1,440‐nm Nd:YAG laser energy used alone or in combination with a 1,320‐nm laser to effect rejuvenation and wrinkle reduction. We now report longer follow‐up data. Study Design/Materials and Methods Nineteen Caucasian subjects (average age 47±8.4; range 33–62) exhibiting mild‐to‐moderate photoaging of the face and neck were treated four times (average interval 18.1± 4.1 days; range 11–37 days) with the 1,440‐nm Nd:YAG fractional laser (average fluence 3.7±0.3 J/cm2) or the 1,320/1,440‐nm multiplex Nd:YAG fractional laser (1,320‐nm average fluence 8.4±0.4 J/cm2; 1,440‐nm average fluence 2.3±0.2 J/cm2). Outcomes were assessed by subjects and the treating physician using a quartile scale to evaluate skin tightening, surface texture, rhytids, dyschromia, erythema, and global appearance after 1, 3, and 6 months. Retroauricular punch biopsies from three patients were used to evaluate wound healing. Three patients withdrew from the study prior to evaluation, one missed the 1‐month evaluation, and one missed the 6‐month evaluation. Results Assessment by subjects and the treating physician revealed clinical improvement for all outcomes after 1, 3, and 6 months. The differences between the treatment groups were not statistically significant. Subjects demonstrated the greatest average 6‐month improvements in surface texture and global skin appearance. Subjects treated with the multiplex laser reported more skin tightening than the group treated only with the 1,440‐nm laser. Histological evaluation revealed wound healing within 10 days and significant neocollagenesis at 3 months. No adverse events were reported in any subject. Conclusion The 1,440‐nm Nd:YAG and 1,320/1,440‐nm multiplex Nd:YAG lasers safely and effectively produced improved surface texture, rhytids, dyschromia, erythema, global skin appearance, and skin tightening. Histopathologic findings correlated with clinical observations. Lasers Surg. Med. 41:408–426, 2009. © 2009 Wiley‐Liss, Inc.