Split-face comparison of the picosecond 1064-nm Nd:YAG laser using a microlens array and the quasi-long-pulsed 1064-nm Nd:YAG laser for treatment of photoaging facial wrinkles and pores in Asians

  • Sunmin Yim
  • Yun Ho Lee
  • Young-Jun Choi
  • Won-Serk KimEmail author
Original Article


Skin photoaging manifests deeper wrinkles and larger pore size. Various lasers have been tried for rejuvenation of photoaging skin, and the quasi-long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is one promising treatment option. New types of laser device are emerging, including devices operating with picosecond pulse duration combined with a microlens array, which are regarded as a new breakthrough for skin rejuvenation. We aimed to evaluate the clinical effectiveness and safety of the picosecond 1064-nm Nd:YAG laser using a microlens array compared with the quasi-long-pulsed 1064-nm Nd:YAG laser in a split-face design. We designed a split-faced, prospective study and enrolled 25 subjects with photoaging facial wrinkles and enlarged pores. Each facial area was randomly assigned to undergo treatment with either the picosecond 1064-nm Nd:YAG laser (Pico-arm) or the quasi-long-pulsed 1064-nm Nd:YAG laser (Quasi-arm). We performed five laser sessions at 2-week intervals, and final results were assessed after 20 weeks after the initial laser session. We used a five-point global assessment scale, wrinkle and pore index derived from 3D camera analysis. We enrolled a total of 25 subjects (24 females and 1 male) with Fitzpatrick skin types III to IV and a mean age of 63.8 ± 5.7 years. After treatment, 54.2% of subjects in the Pico-arm reported at least moderate improvement in visible pores compared with 41.7% of the Quasi-arm (P = 0.001). A total of 12.5% of subjects in the Pico-arm showed moderate improvement in wrinkles versus 4.2% of the Quasi-arm (P = 0.125). There was a 41.3% reduction in the pore index in the Pico-arm compared to a 3.9% increase in the Quasi-arm (P = 0.048). There was a 16.4% reduction in the wrinkle index in the Pico-arm compared with a 0.5% reduction in the Quasi-arm (P = 0.01). Pain assessment score was higher in the Pico-arm than the Quasi-arm (3.65 ± 1.70 vs 1.28 ± 1.28, P = 0.001). No serious adverse events occurred during the study. Our findings suggest that the picosecond 1064-nm Nd:YAG laser with a microlens array is as effective as the quasi-long-pulsed 1064-nm Nd:YAG laser for treatment of photoaging wrinkles and pores.


Microlens array Nd:YAG laser Photoaging Picosecond Pore Wrinkle 


Funding information

This study was supported by a grant from the Korea Health Industry Development Institute (KHIDI) and the Ministry of Health and Welfare, Republic of Korea.

Compliance with ethical standards

The Kangbuk Samsung Hospital Institutional Review Board and Ethics Committee approved this study. The split-faced, prospective study protocol adhered to the guidelines in the 1975 Declaration of Helsinki.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Poon F, Kang S, Chien AL (2015) Mechanisms and treatments of photoaging. Photodermatol Photoimmunol Photomed 31:65–74CrossRefGoogle Scholar
  2. 2.
    Berneburg M, Plettenberg H, Krutmann J (2000) Photoageing of human skin. Photodermatol Photoimmunol Photomed 16:239–244CrossRefGoogle Scholar
  3. 3.
    Senftleben U, Karin M (2002) The IKK/NF-kappaB pathway. Crit Care Med 30:S18–S26CrossRefGoogle Scholar
  4. 4.
    Fisher GJ, Kang S, Varani J et al (2002) Mechanisms of photoaging and chronological skin aging. Arch Dermatol 138:1462–1470CrossRefGoogle Scholar
  5. 5.
    Chung JH, Kang S, Varani J, Lin JY, Fisher GJ, Voorhees JJ (2000) Decreased extracellularsignal regulated kinase and increased stress-activated MAP kinase activities in aged human skin in vivo. J Invest Dermatol 115:177–182CrossRefGoogle Scholar
  6. 6.
    Yaar M, Gilchrest B (2007) Photoageing: mechanism, prevention and therapy. Br J Dermatol 157:874–877CrossRefGoogle Scholar
  7. 7.
    Yaar M, Gilchrest BA (2003) Aging of skin. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI (eds) Fitzpatrick’s dermatology in general medicine, 6th edn. McGraw Hill, New York, pp 1386–1398Google Scholar
  8. 8.
    Tanaka Y, Matsuo K, Yuzuriha S (2011) Objective assessment of skin rejuvenation using near-infrared 1064-nm neodymium: YAG laser in Asians. Clin Cosmet Investig Dermatol 4:123–130CrossRefGoogle Scholar
  9. 9.
    Roh MR, Chung HJ, Chung KY (2009) Effects of various parameters of the 1064 nm Nd: YAG laser for the treatment of enlarged facial pores. J Dermatolog Treat 20:223–228CrossRefGoogle Scholar
  10. 10.
    Lee MC, Hu S, Chen MC, Shih YC, Huang YL, Lee SH (2009) Skin rejuvenation with 1,064-nm Q-switched Nd: YAG laser in Asian patients. Dermatol Surg 35:929–932CrossRefGoogle Scholar
  11. 11.
    Dayan S, Damrose JF, Bhattacharyya TK, Mobley SR, Patel MK, O’Grady K, Mandrea S (2003) Histological evaluations following 1,064-nm Nd: YAG laser resurfacing. Lasers Surg Med 33:126–131CrossRefGoogle Scholar
  12. 12.
    Goldberg DJ, Samady JA (2001) Intense pulsed light and Nd: YAG laser non-ablative treatment of facial rhytids. Lasers Surg Med 28:141–144CrossRefGoogle Scholar
  13. 13.
    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
  14. 14.
    Habbema L, Verhagen R, Van Hal R et al (2013) Efficacy of minimally invasive nonthermal laser-induced optical breakdown technology for skin rejuvenation. Lasers Med Sci 28:935–940CrossRefGoogle Scholar
  15. 15.
    Habbema L, Verhagen R, Van Hal R et al (2012) Minimally invasive non-thermal laser technology using laser-induced optical breakdown for skin rejuvenation. J Biophotonics 5:194–199CrossRefGoogle Scholar
  16. 16.
    Tanghetti EA, Tartar DM (2016) Comparison of the cutaneous thermal signatures over twenty-four hours with a picosecond alexandrite laser using a flat or fractional optic. J Drugs Dermatol 15:1347–1352PubMedGoogle Scholar
  17. 17.
    Tanghetti EA (2016) The histology of skin treated with a picosecond alexandrite laser and a fractional lens array. Lasers Surg Med 48:646–652CrossRefGoogle Scholar
  18. 18.
    Balu M, Lentsch G, Korta DZ et al (2017) In vivo multiphoton- microscopy of picosecond-laser induced optical breakdown in human skin. Laser Surg Med 49:555–562CrossRefGoogle Scholar
  19. 19.
    Bernstein EF, Schomacker KT, Basilavecchio LD, Plugis JM, Bhawalkar JD (2017) Treatment of acne scarring with a novel fractionated, dual-wavelength, picosecond-domain laser incorporating a novel holographic beam-splitter. Laser Surg Med 49:796–802CrossRefGoogle Scholar
  20. 20.
    Weiss RA, McDaniel DH, Weiss MA, Mahoney AM, Beasley KL, Halvorson CR (2017) Safety and efficacy of a novel diffractive lens array using a picosecond 755nm alexandrite laser for treatment of wrinkles. Lasers Surg Med 49:40–44CrossRefGoogle Scholar
  21. 21.
    Wu DC, Fletcher L, Guiha I, Goldman MP (2016) Evaluation of the safety and efficacy of the picosecond alexandrite laser with specialized lens array for treatment of the photoaging décolletage. Lasers Surg Med 48:188–192CrossRefGoogle Scholar
  22. 22.
    Khetarpal S, Desai S, Kruter L, Prather H, Petrell K, Depina J, Dover JS (2016) Picosecond laser with specialized optic for facial rejuvenation using a compressed treatment interval. Lasers Surg Med 48:723–726CrossRefGoogle Scholar
  23. 23.
    Matias AR, Ferreira M, Costa P, Neto P (2015) Skin color, skin redness and melanin biometric measurements: comparison study between Antera® 3D, Mexameter® and Colorimeter®. Skin Res Technol 21:346–362CrossRefGoogle Scholar
  24. 24.
    Linming F, Wei H, Anqi L, Yuanyu C et al (2018) Comparison of two skin imaging analysis instruments: The VISIA® from Canfield vs the ANTERA 3D® CS from Miravex. Skin Res Technol 24:3–8CrossRefGoogle Scholar
  25. 25.
    Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34:426–438CrossRefGoogle Scholar
  26. 26.
    Tierney EP, Hanke CW, Petersen J, Bartley T, Eckert JR, McCutchen C (2010) Clinical and echographic analysis of ablative fractionated carbon dioxide laser in the treatment of photodamaged facial skin. Dermatol Surg 36:2009–2211CrossRefGoogle Scholar
  27. 27.
    Mahmoud BH, Srivastava D, Janiga JJ, Yang JJ, Lim HW, Ozog DM (2010) Safety and efficacy of erbium-doped yttrium aluminum garnet fractionated laser for treatment of acne scars in type IV to VI skin. Dermatol Surg 36:602–609CrossRefGoogle Scholar
  28. 28.
    Cohen BE, Brauer JA, Geronemus RG (2016) Acne scarring: a review of available therapeutic lasers. Lasers Surg Med 48:95–115CrossRefGoogle Scholar
  29. 29.
    Min S, Park SY, Moon J, Kwon HH, Yoon JY, Suh DH (2017) Comparison between Er;YAG laser and bipolar radiofrequency combined with infrared diode laser for the treatment of acne scars: differential expression of fibrogenetic biomolecules may be associated with differences between ablative and non-ablative laser treatment. Lasers Surg Med 49:341–347CrossRefGoogle Scholar
  30. 30.
    Ha RY, Nojima K, Adams WP Jr, Brown SA (2005) Analysis of facial skin thickness: defining the relative thickness index. Plast Reconstr Surg 115:1769–1773CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Dermatology, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea

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