A Prospective, Split-Face, Randomized Study Comparing Picosecond to Q-Switched Nd:YAG Laser for Treatment of Epidermal and Dermal Pigmented Lesions in Asians

BACKGROUNDWhether picosecond lasers outperform Q-switched lasers in treating pigmented lesions has not been clearly evaluated.OBJECTIVETo compare the efficacy and safety of picosecond and Q-switched lasers in treating epidermal and dermal pigmented lesions in Asians.METHODSEight subjects with lentigines and 6 subjects with acquired bilateral nevus of Ota-like macules were enrolled. Subjects was randomly treated with a picosecond laser on one side of the face and a Q-switched laser on the other side. Subjective assessments on pigment clearance, and adverse effect were obtained at Weeks 0, 4, 12, and 24 after the final treatment.RESULTSClinical improvement differed between the 2 laser systems at Week 4 (p =.034), Week 12 (p =.039), and Week 24 (p =.027), with 85.7% of picosecond and 57.2% of Q-switched laser sites showing >50% improvement at 6 months. There was no significant difference in the incidence of side effect and healing time, but picosecond laser was significantly associated with a lower treatment discomfort (p =.05).CONCLUSIONThe picosecond laser seems to be more effective and better tolerated than Q-switched laser for the treatment of pigmented lesions in Asians.