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Lasers in Medical Science

, Volume 34, Issue 3, pp 457–464 | Cite as

Efficacy and safety of long pulse Nd:YAG laser versus fractional erbium:YAG laser in the treatment of facial skin wrinkles

  • Sahar Dadkhahfar
  • Kaveh Fadakar
  • Reza M. RobatiEmail author
Original Article
  • 116 Downloads

Abstract

Fractional lasers such erbium:YAG (Er:YAG) are among popular options for facial rejuvenation. Lasers with infrared wavelength ranges such as long pulse Nd:YAG have been used in nonablative rejuvenation of skin with variable outcomes. In this study, we plan to compare safety and efficacy of fractional Er:YAG and long pulse Nd:YAG for facial rejuvenation applying objective and subjective measurements. Twenty-five patients with Glogau photo aging scale of II to IV were recruited in this randomized face-split double-blind controlled trial. Individuals received three monthly treatments on two sides of the face; one side was treated by fractional Er:YAG laser and the other side by long pulse Nd:YAG laser. Outcomes were evaluated by two blinded dermatologists, patient satisfaction reports and objective measurements of cutaneous resonance running time (CRRT). Both modalities significantly improved periorbital wrinkling, nasolabial folds, dyschromia and skin laxity, and sagging of jowls (p value < 0.05), with no noticeable difference between two lasers. Mean CRRT values decreased significantly after treatment with both lasers. The downtime was significantly lower for the Nd:YAG-treated side. Fractional Er:YAG laser and long pulse Nd:YAG has comparable effects in facial rejuvenation but little to no downtime of the latter makes it popular for many patients. ClinicalTrials.gov Identifier: IRCT2015120320468N3

Keywords

Erbium:YAG laser Face Nd:YAG laser Wrinkle Rejuvenation 

Notes

Role of funding source

This study has been funded by Skin Research Center, Shahid Beheshti University of Medical Sciences with grant number of 94.162.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

This study was approved by the Ethical Committee of Shahid Beheshti University of Medical Sciences with number of Ir.sbmu.ram.rec.1394.418. This project was performed according to the principles of the Declaration of Helsinki. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT2015120320468N3).

Informed consent

All of the subjects signed a written informed consent after explanation of the procedure.

References

  1. 1.
    Alexiades-Armenakas MR, Dover JS, Arndt KA (2008) The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. J Am Acad Dermatol 58:719–737CrossRefGoogle Scholar
  2. 2.
    Johnson DL, Paletta F (2016) Skin resurfacing procedures of the upper face. Atlas Oral Maxillofac Surg Clin North Am 24:117–124CrossRefGoogle Scholar
  3. 3.
    Fitzpatrick RE (2000) Resurfacing procedures: how do you choose? Arch Dermatol 136:783–784CrossRefGoogle Scholar
  4. 4.
    Hunzeker CM, Weiss ET, Geronemus RG (2009) Fractionated CO2 laser resurfacing: our experience with more than 2000 treatments. Aesthet Surg J 29:317–322CrossRefGoogle Scholar
  5. 5.
    Gold MH (2010) Update on fractional laser technology. J Clin Aesthet Dermatol 3:42–50Google Scholar
  6. 6.
    Robati RM, Asadi E (2017) Efficacy and safety of fractional CO2 laser versus fractional Er: YAG laser in the treatment of facial skin wrinkles. Lasers Med Sci 32:283–289CrossRefGoogle Scholar
  7. 7.
    Hong JS, Park SY, Seo KK, Goo BL, Hwang EJ, Park GY, Eun HC (2015) Long pulsed 1064 nm Nd: YAG laser treatment for wrinkle reduction and skin laxity: evaluation of new parameters. Int J Dermatol 54:e345–e350CrossRefGoogle Scholar
  8. 8.
    Dayan SH, Vartanian AJ, Menaker G, Mobley SR, Dayan AN (2003) Nonablative laser resurfacing using the long-pulse (1064-nm) Nd: YAG laser. Arch Facial Plast Surg 5:310–315CrossRefGoogle Scholar
  9. 9.
    Glogau RG, Matarasso SL (1995) Chemical peels. Trichloroacetic acid and phenol. Dermatol Clin 13:263–276CrossRefGoogle Scholar
  10. 10.
    Carruthers A, Carruthers J (2010) A validated facial grading scale: the future of facial ageing measurement tools? J Cosmet Laser Ther 12:235–241CrossRefGoogle Scholar
  11. 11.
    Xin S, Man W, Fluhr JW, Song S, Elias PM, Man MQ (2010) Cutaneous resonance running time varies with age, body site and gender in a normal Chinese population. Skin Res Technol 16:413–421CrossRefGoogle Scholar
  12. 12.
    Robati RM, Einollahi B, Einollahi H, Younespour S, Fadaifard S (2016). Skin biophysical characteristics in patients with keratoconus: a controlled study. Scientifica (Cairo) 2016:6789081Google Scholar
  13. 13.
    Manstein D, Herron GS, Sink RK, Tanner H, Anderson R (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Laser Surg Med 34:426–438CrossRefGoogle Scholar
  14. 14.
    Trelles MA, Mordon S, Velez M, Urdiales F, Levy JL (2009) Results of fractional ablative facial skin resurfacing with the erbium: yttrium-aluminium-garnet laser 1 week and 2 months after one single treatment in 30 patients. Lasers Med Sci 24:186–194CrossRefGoogle Scholar
  15. 15.
    Newman J (2001) Nonablative laser skin tightening. Facial Plast Surg Clin North Am 9:343–349Google Scholar
  16. 16.
    Robati RM, Asadi E, Shafiee A, Namazi N, Talebi A (2018) Efficacy of long pulse Nd: YAG laser versus fractional Er: YAG laser in the treatment of hand wrinkles. Lasers Med Sci 33:461–467CrossRefGoogle Scholar
  17. 17.
    Lee HM, Haw S, Kim JE, Won CH, Lee MW, Choi JH, Chang SE, Kim YJ, Goo BL (2012) A fractional 2940 nm short-pulsed, erbium-doped yttrium aluminium garnet laser is effective and minimally invasive for the treatment of photodamaged skin in Asians. J Cosmet Laser Ther 14:253–259CrossRefGoogle Scholar
  18. 18.
    El-Domyati M, Abd-El-Raheem T, Medhat W, Abdel-Wahab H, Anwer MA (2014) Multiple fractional erbium: yttrium–aluminum–garnet laser sessions for upper facial rejuvenation: clinical and histological implications and expectations. J Cosmet Dermatol 13:30–37CrossRefGoogle Scholar
  19. 19.
    Goldberg DJ, Samady J (2001) Intense pulsed light and Nd: YAG laser non-ablative treatment of facial rhytids. Lasers Surg Med 28:141–144CrossRefGoogle Scholar
  20. 20.
    Taylor MB, Prokopenko I (2006) Split-face comparison of radiofrequency versus long-pulse Nd-YAG treatment of facial laxity. J Cosmet Laser Ther 8:17–22CrossRefGoogle Scholar
  21. 21.
    Kim HS, Lee JH, Park YM, Lee JY (2012) Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: a pilot study. J Cosmet Laser Ther 14:89–93CrossRefGoogle Scholar
  22. 22.
    Jun HJ, Kim SM, Choi WJ, Cho SH, Lee JD, Kim HS (2014) A split-face, evaluator-blind randomized study on the early effects of Q-switched Nd: YAG laser versus Er: YAG micropeel in light solar lentigines in Asians. J Cosmet Laser Ther 16:83–88CrossRefGoogle Scholar
  23. 23.
    Cohen JL, Ross EV (2013) Combined fractional ablative and nonablative laser resurfacing treatment: a split-face comparative study. J Drugs Dermatol 12:175–178Google Scholar
  24. 24.
    Balin A, Pratt L (1989) Physiological consequences of human skin aging. Cutis 43:431–436Google Scholar
  25. 25.
    Kohl E, Steinbauer J, Landthaler M, Szeimies RM (2011) Skin ageing. J Eur Acad Dermatol Venereol 25:873–884CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Skin Research CenterShahid Beheshti University of Medical SciencesTehranIran
  2. 2.Eye Research Center, Farabi Eye HospitalTehran University of Medical SciencesTehranIran

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