Comparative Effectiveness of Long-Pulsed 1064-nm Nd:YAG and Fractional CO₂ Laser in Skin Rejuvenation

A Comparative Split-Face Study of Long-Pulsed 1064-nm Nd:YAG and Fractional CO₂ Laser for Skin Rejuvenation Based on Dermal Thickness, Skin Elasticity, Wrinkle Assessment, and Global Aesthetic Improvement Scale Scores

Skin rejuvenation is an effort to improve skin condition from the signs of skin aging. Skin aging is a complex biological process influenced by intrinsic and extrinsic factors, leading to changes in the epidermis and dermis, including decreased collagen characterized by dermal thinning, as well as alterations in skin appearance such as laxity and wrinkles. Laser therapy is one of the treatment modalities for skin rejuvenation, aiming to induce neocollagenesis and collagen remodeling, resulting in dermal thickening and improvement in skin appearance. Fractional CO₂ laser is an ablative laser considered the gold standard therapy for skin rejuvenation, whereas Long Pulsed (LP) Nd:YAG 1064 nm is a nonablative laser that is also used for skin rejuvenation. To date, there have been no studies evaluating the comparative effectiveness between fractional CO₂ laser and LP Nd:YAG 1064 nm for skin rejuvenation. Therefore, research comparing the effectiveness of fractional CO₂ laser and LP Nd:YAG 1064 nm for skin rejuvenation is needed, assessed based on dermal thickness, skin elasticity, wrinkles, and Global Aesthetic Improvement Scale scores.

Inclusion Criteria:

• Male and female patients with skin aging classified as Glogau scale II-III
• Age 30-59 years.

Exclusion Criteria:

• Pregnant or breastfeeding women.
• Active smokers.
• Individuals with high levels of sun exposure.
• History of facial laser therapy, microdermabrasion, chemical peeling, botulinum toxin injection, microneedling, or skin booster injections within the past six months.
• Use of oral isotretinoin within the past six months.
• Use of topical retinoids or their derivatives, topical vitamin C, or other collagen-stimulating and skin-rejuvenating agents within the past two weeks.
• Use of oral vitamin C, collagen-stimulating supplements, antioxidants, or hormone therapy with skin-rejuvenating effects within the past one month.
• Presence of active facial skin inflammation.
• History of keloid formation.
• History of allergy to topical lidocaine anesthesia.