The effect of a dual-wavelength 532nm and 1064nm picosecond-domain laser with a fractionated holographic optic on photoaging and patient age perception: A pilot study.

Abstract

This study evaluated the efficacy of a dual-wavelength 532nm/1064nm Nd:YAG picosecond-domain laser with a holographic lens array in treating facial photoaging. Thirteen subjects were enrolled with 10 completing the study. Receiving three-month treatments, subjects underwent full-face spot treatment of facial lentigines with the 532-nm non-fractionated handpiece, followed by two sequential facial passes of the 1064-nm and the 532-nm fractionated handpieces. Improvement was measured by treating physician evaluation of pigmentation and rhytids as well as blinded reviewer evaluation of pre- and post-treatment image sets taken 12weeks after the final treatment. Participants completed treatment surveys to assess satisfaction. Physician grading on a 5-point scale revealed an average improvement of 1.6 in pigmentation (p=0.0042) and 0.9 in rhytids (p=0.0196). Blinded physicians appropriately selected baseline images in 44 of 50 (88%) image sets (10subjects; five reviewers). On an 11-point scale for overall facial photoaging (0=no change, 1=10% improvement, 2=20% improvement, etc.) treating physicians scored mean improvement as 3.3±1.83 (95% CI 1.99 to 4.61; range 1-6), while blinded reviewers scored mean improvement as 2.32±2.62 (range % -4 to 8, 95% CI 1.57 to 3.07). The greatest majority (80%) of participants reported satisfaction with the treatment. Adverse events were mild; however, one patient developed hyperpigmentation, consistent with melasma that was successfully treated with topical agents. This is the first study to show that picosecond-domain 532nm/1064nm laser treatments with combination non-fractionated and fractionated handpieces are well-tolerated, safe, and effective for the treatment of photodamage.