Effect of the combination of long-pulse 1064 nm neodymium-doped yttrium aluminum garnet laser and picosecond 755 nm alexandrite laser with diffractive lens array on skin photoaging: a randomized, split-face multicenter clinical trial.

To evaluate the efficacy and safety of the combination of the long-pulse 1064 nm neodymium-doped yttrium aluminum garnet (LP1064 nm) laser and picosecond 755 nm alexandrite (P755 nm) laser with a diffractive lens array (DLA) in improving skin photoaging. This prospective, randomized, split-face trial was conducted between April 2024 and February 2025 at two centers. A total of 22 healthy volunteers with facial photoaging symptoms aged 30-65 years were enrolled. The full face was treated with the LP1064 nm laser, and one side was treated with the P755 nm laser with DLA for three sessions at 1-month intervals. Efficacy and safety were assessed before each treatment and 1, 3, and 6 months after treatment. The primary outcome was the Global Aesthetic Improvement Scale (GAIS) score. A total of 21 patients completed the study. The combined treatment side demonstrated further improvement in GAIS scores compared with the monotherapy side at 3 (85.7% vs. 66.7%) and 6 months (66.7% vs. 57.1%). Significant changes in the facial regions were observed. Volumetric analysis using 3D assessment revealed that the combined treatment had a more pronounced effect on the nasolabial folds and suborbital areas. VISIA analysis found significantly improved pigmentation and pore size at 1 and 3 months after treatment. No adverse events were observed on either side during or after treatment period. The combination of the LP1064 nm and P755 nm lasers with DLA can enhance skin rejuvenation by addressing the structural and pigmentary aspects of photoaging. These preliminary findings support the safety and efficacy of this combination approach. Further studies are needed to optimize this approach.