Background: Dissecting cellulitis, a chronic progressive inflammatory condition of the scalp, is characterized by pustular nodules, sinus tract formation, and eventuates in a cicatricial alopecia. Treatments to date include antibiotics, isotretinoin, incision and drainage, intralesional steroids, x-ray epilation, and excision with grafting. Recent case reports using a diode laser (800 nm) and long pulsed ruby laser (694 nm) resulted in disease improvement with side effects of permanent alopecia and transient or persistent hyper or hypopigmentation. Because the pathophysiology centers around dysfunction of the pilosebaceous unit, we explore the concept of trichothermolysis using the long pulsed Nd:YAG (1064nm) laser as a treatment option. Objectives: 1) To determine the efficacy of the long pulsed Nd:YAG laser in reducing signs and symptoms of dissecting cellulitis. 2) To monitor patients for side effects such as scarring alopecia, hyperpigmentation, pain, and infection. Patients: The case series includes four consecutive patients with chronic dissecting cellulitis. Results: Trichothermolysis with the 1064nm Nd:YAG resulted in reduction in drainage, number of nodules, and need for systemic medication. Conclusion: The long pulsed Nd:YAG (1064nm) laser is a safe and effective treatment for pustular nodules of dissecting cellulitis and can decrease the use of systemic therapies and their associated side effects.