Efficacy and safety of non-thermal nitrogen plasma versus long-pulsed Nd:YAG laser for hand rejuvenation.

Abstract

This randomized controlled study aimed to investigate the efficacy and safety of multiple treatment sessions of pulsed non-thermal atmosphericpressure nitrogen plasma compared with long-pulsed Nd:YAG laser for hand rejuvenation. To optimize the nitrogen plasma mode for rejuvenation, the relative intensity of reactive species and skin temperature was compared at different input powers and time periods. Twenty-five patients with mild-moderate photodamaged skin were recruited; one hand was randomly selected for eightweekly treatment sessions with plasma (two passes), while the other was subjected to threemonthly treatments with laser (until erythema became obvious). A blinded dermatologist scored the mean wrinkle and dyschromia improvement at 1 and 2months after the first treatment and 1 and 3months after the last treatment. The patients' satisfaction and the biomechanical characteristics of the skin including cutaneous resonance running time (CRRT), melanin, transepidermal water loss (TEWL), and hydration were evaluated. Clinically, both methods gave rise to a similar, significant improvement in wrinkles (49.09 ± 19.18% and 39.32 ± 18.21% after plasma and laser, respectively) and dyschromia (45.00 ± 26.32% and 30.62% ± 24.99% after plasma and laser, respectively) (P < 0.05). A significant decrease in CRRT and melanin was seen following treatment with either method (P < 0.05). Notably, plasma therapy led to a significant decrease in TEWL and boosted skin hydration. This is while laser therapy augmented the TEWL and reduced skin hydration. Our findings corroborate that cold plasma is as effective and safe as long-pulsed Nd:YAG laser, with less discomfort and dryness during treatment. The protocol was approved by the Iranian Registry of Clinical Trials. IRCT20160320027109N4. Registered 9 April 2019 (This manuscript is only a part of this registered project.).