“Comparative study between the efficacy of fractional CO2 laser, Q-switched Nd:YAG laser (1064 nm), and both types in treatment of keratosis pilaris”


The aim of this study was to assess and compare the efficacy of fractional CO2 laser, Q-switched Nd:YAG laser (1064 nm), and their combined use in treatment of keratosis pilaris. The study included twenty female patients. For each patient, three areas were randomly assigned to treatment by either fractional CO2 laser (area A) or Q-switched laser (1064 nm) (area C), or both types of laser (area B). All patients were assessed by digital photography at baseline and 1 month after the last session. Assessment was done by two non-blinded and two blinded investigators (blinded investigators do not know which area is treated with which machine and non-blinded knows). Patients reported the degree of satisfaction or any adverse effects also after 1 month from the last session. The three treatment modalities led to overall improvement in the KP lesions. According to patients’ score and investigator two, area B showed statistically significant improvement compared to areas A and C (p=0.001 and p=0.039, respectively). The first blinded investigators’ assessment revealed that there was statistically significant improvement in area C compared to A and B (p = 0.023). The assessment of both investigator one and the second blinded investigator revealed that there was improvement in the three areas with no statistically significant difference between them. Both fractional CO2 and Q-switched Nd:YAG laser (1064 nm) proved to be safe and effective in the treatment of keratosis pilaris regarding not only pigmentation but also follicular prominence; their combination may have an additive effect.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. 1.

    Lee NY, Ibrahim O, Khetarpal S et al (2018) Dermal microflora restoration with ammonia-oxidizing bacteria Nitrosomonas eutropha in the treatment of keratosis pilaris: a randomized clinical trial. Journal of drugs in dermatology 17(3):285–288

    PubMed  Google Scholar 

  2. 2.

    Wang JF and Orlow SJ (2018): Keratosis pilaris and its subtypes: associations, new molecular and pharmacologic etiologies, and therapeutic options. Am J Clin Dermatol 19(5):733–757

  3. 3.

    Hwang S, Schwartz RA (2008) Keratosis pilaris: a common follicular hyperkeratosis. Cutis 82(3):177–180

    PubMed  Google Scholar 

  4. 4.

    Gruber R, Sugarman JL, Crumrine D et al (2015) Sebaceous gland, hair shaft, and epidermal barrier abnormalities in keratosis pilaris with and without filaggrin deficiency. Am J Pathol 185(4):1012–1021

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  5. 5.

    Vachiramon V, Anusaksathien P, Kanokrungsee S et al (2016) Fractional carbon dioxide laser for keratosis pilaris: a single-blind, randomized, comparative study. Biomed Res Int 3:1–6

    Article  Google Scholar 

  6. 6.

    Cameli N, Mariano M (2016) Complications of fractional lasers (ablative and non-ablative). In: Nonsurgical Lip and Eye Rejuvenation Techniques, vol 14. Springer, Cham, pp 117–123

  7. 7.

    Arora P, Sarkar R (2015) Lasers for Melasma. Melasma, A Monograph, p 66

    Google Scholar 

  8. 8.

    Qin Y, Qin X, Xu P et al (2018) Potential role of S100A8 in skin rejuvenation with the 1064-nm Q-switched Nd: YAG laser (1064nm). Lasers Med Sci 33(3):581–588

    PubMed  Article  Google Scholar 

  9. 9.

    Park J, Kim BJ, Kim MN et al (2011) A pilot study of Q-switched Nd:YAG laser (1064nm) treatment in the keratosis pilaris. Ann Dermatol 23(3):293–298

    PubMed  PubMed Central  Article  Google Scholar 

  10. 10.

    Chan YH (2003a) Biostatistics 103: qualitative data –tests of independence. Singap Med J 44(10):498–503

    CAS  Google Scholar 

  11. 11.

    Chan YH (2003b) Biostatistics 104: correlational analysis. Singap Med J 44(12):614–619

    CAS  Google Scholar 

  12. 12.

    Panchaprateep R, Tanus A, Tosti A (2015) Clinical, dermoscopic, and histopathologic features of body hair disorders. J Am Acad Dermatol 72(5):890–900

    PubMed  Article  Google Scholar 

  13. 13.

    Yosipovitch G, Devore A, Dawn A (2007) Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol 56(6):901–916

    PubMed  Article  Google Scholar 

  14. 14.

    Tierney EP, Eisen RF, Hanke CW (2011) Fractionated CO2 laser skin rejuvenation. Dermatol Ther 24(1):41–53

    PubMed  Article  Google Scholar 

  15. 15.

    Hantash BM, Bedi VP, Sudireddy V et al (2006) Laser-induced trans epidermal elimination of dermal content by fractional photothermolysis. J Biomed Opt 11:411–415

    Article  Google Scholar 

  16. 16.

    Katz TM, Goldberg LH, Firoz BF, Friedman PM (2009) Fractional photothermolysis for the treatment of postinflammatory hyperpigmentation. Dermatol Surg 35:1844–1848

    CAS  PubMed  Article  Google Scholar 

  17. 17.

    Issler-Fisher AC, Waibel JS, Donelan MB (2017) Laser modulation of hypertrophic scars: technique and practice. Clin Plast Surg 44(4):757–766

    PubMed  Article  Google Scholar 

  18. 18.

    Schmults CD, Phelps R, Goldberg DJ (2004) Nonablative facial remodeling: erythema reduction and histologic evidence of new collagen formation using a 300-microsecond 1064-nm Nd: YAG laser. Archives of Dermatology 140(11):1373–1376

    PubMed  Article  Google Scholar 

  19. 19.

    Kim S (2011) Treatment of pigmented keratosis pilaris in Asian patients with a novel Q-switched Nd:YAG laser (1064) laser. Journal of Cosmetic and Laser Therapy 13(3):120–122

    PubMed  Article  Google Scholar 

  20. 20.

    Ueda A (2014) Treatment of lichen pilaris with a Q-switched Nd:YAG laser (1064nm) in quasi long-pulsed mode: a case report. Laser Therapy 23(3):211–220

    PubMed  PubMed Central  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Rehab Mohamed Sobhi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study is approved by the ethical committee.

Informed consent

All patients signed written consent.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sobhi, R.M., Adawy, N.A.H. & Zaky, I.S. “Comparative study between the efficacy of fractional CO2 laser, Q-switched Nd:YAG laser (1064 nm), and both types in treatment of keratosis pilaris”. Lasers Med Sci 35, 1367–1376 (2020). https://doi.org/10.1007/s10103-020-02956-w

Download citation


  • Keratosis pilaris
  • Laser
  • Fractional CO2 laser
  • Q-switched Nd:YAG laser (1064 nm)