Novel picosecond-domain 1,064 nm and 532 nm neodymium: yttrium aluminum garnet (Nd:YAG) lasers used with a new holographic beam splitter safely and effectively treated facial acne scars in a prospective study.

Among the 27 participants who completed the study, the mean improvement in acne scarring was 1.4 on a 10-point global aesthetic scale (range –4 to 6 points; 95% confidence interval, 0.85-1.9); these assessments were performed by three blinded physician reviewers 12 weeks after the last treatment. In addition, 23 (85%) of the participants reported that they were satisfied or very satisfied with their treatment, Eric F. Bernstein, MD , who is in private practice in Ardmore, Pa., and his coauthors reported ( Lasers Surg Med. 2017 Nov;49[9]:796-802 ).

The study comprised 27 men and women with Fitzpatrick skin types II-V whose mean age was 45 years. They were treated with four monthly treatments. Of the participants, 19 were treated with the 1,064 nm laser and 8 with the 532 nm laser; both treatments employed a novel holographic hand piece to deliver precise beams of focused laser energy. Blinded physician reviewers evaluated digital images taken both before treatment and 12 weeks after the final treatment.

Based on the averages of scores from the reviewers, 81% of the participants showed some degree of improvement, 48% had a mean improvement of at least 2 points, and 26% had a mean improvement score of at least 3 points.

Participants experienced some side effects immediately after treatment, including mild to moderate erythema (100% of patients for both lasers), mild to moderate edema (95% for 1,064 nm, 97% for 532 nm), mild to moderate petechiae (50%, 38%), and mild purpura (17%, 0%). All these responses cleared within a few hours or a few days after treatments, according to patient reports.

None of the patients experienced pigmentary changes, based on before and after treatment photos. In contrast, the most commonly used laser for treating acne scarring – the nonfractionated CO2 laser – causes significant hyperpigmentation and even permanent hypopigmentation, the authors pointed out.

No significant difference was seen when comparing mean improvement scores between participants treated with the 1,064 nm lasers and those treated with the 532 nm lasers.

“The use of picosecond-domain pulses delivers clinical benefits at lower fluences and energies than would be required at longer pulse durations and may offer qualitatively different tissue effects than earlier-generation lasers,” Dr. Bernstein and his coauthors wrote. “Future studies investigating combinations of the 1,064 and 532 nm picosecond-domain fractionated wavelengths, as well as larger trials with skin types V and VI, should increase the ways the device is used and the conditions it is used to treat,” they added.

Limitations of the study included the short 3-month follow-up, they noted.

The study was funded by Syneron Candela, the manufacturer of the laser and the holographic beam-splitting optic used in the study; the company loaned the equipment for the study. Dr. Bernstein is a consultant for Syneron Candela. Two of the five authors were employees of Syneron Candela at the time the study was conducted. No other financial disclosures were reported.