Use of 1,320 nm Nd:YAG laser for wrinkle reduction and the treatment of atrophic acne scarring in Asians.

BACKGROUND AND OBJECTIVES: The role of 1,320 Nd:YAG in non-ablative skin rejuvenation in Asians is has not been established. Furthermore, no study has investigated the effectiveness of 1,320 Nd:YAG laser in the treatment of atrophic scarring in Asians. The objective of our study was to investigate the effectiveness of 1,320 Nd:YAG laser in wrinkle reduction and the treatment of atrophic acne scarring in Asians.

STUDY DESIGN/MATERIALS AND METHODS: Twenty-seven female patients were included in the study: seven were treated for acne scarring and the others for wrinkle reduction. A 1,320 nm Nd:YAG laser (Cooltouch II, Roseville, CA) was used to treat both the cheeks and forehead for the patients with wrinkles, and both cheeks only for patients with atrophic acne scarring. All patients received treatment in the post-auricular areas. A spot size of 10 mm was used, and three passes were performed (two pre-cooling and one post-cooling). Patients were treated monthly for 6 months. All patients were subjectively assessed before and after their last treatment sessions using a structured questionnaire, and objectively assessed by the use of clinical photographs for by independent observers. A cutometer was used to assess viscoelasticity, and biopsies were taken at the post-auricular site for assessment by a pathologist.

RESULTS: The overall degree of patients' satisfaction was rated as 4.9 (range 0-9.8) for wrinkle reduction and 4 (range 0-10) for acne scarring. In terms of objective assessment by independent observers, the degree of improvement was considered to be mild or no change in most cases. The independent pathologist who assessed the degree of improvement in terms of increased collagen production detected no change in 8 patients, mild improvement in 9, and moderate improvement in 10. There was also improvement in term of epidermal thickness in 13 cases. Assessment by viscoelasticity indicated a significant degree of improvement in most parameters in both groups of patients. Blistering occurred in five cases, all in the central facial areas, and post-inflammatory hyperpigmentation occurred in three cases. All cases of PIH resolved after the use of 4% hydroquinoine. There was no scarring or hypopigmentation.

CONCLUSIONS: The 1,320 nm Nd:YAG laser is effective for wrinkle reduction and atrophic acne scar improvement, but to further enhance the clinical outcome a combination approach with another device such as IPL and a surgical technique such as subcision is necessary.