A Comparative Study of Picosecond Fractional 1064-nm Nd:YAG Laser Versus Fractional 10,600-nm Carbon Dioxide Laser in the Treatment of Abdominal Striae Alba: A Randomized, Prospective, Assessor-blinded, Split-abdomen Trial

BACKGROUND: Striae distensae are common disfiguring atrophic dermal scars. Fractional lasers have been utilized to improve the appearance of this condition. OBJECTIVES: To compare the efficacy and safety of picosecond fractional 1064-nm Nd:YAG (PS Nd:YAG) laser versus fractional 10,600-nm Carbon Dioxide (CO2) laser in treating abdominal striae alba (SA). METHODS: Thirty-two women with Fitzpatrick skin types III-V and abdominal SA participated in a split-abdomen study, receiving four sessions of fractional PS Nd:YAG and CO2 laser treatments on each side at four-week intervals. Striae texture, atrophy, clinical improvement, and satisfaction were assessed for each side at one and three months, with striae length and width compared pre- and post-treatment. Adverse reactions were noted at each visit. RESULTS: Abdomen treated with both lasers had significantly improved skin texture, atrophy and clinical improvements (assessed by physicians and patients) at both follow-ups (p < 0.05), with no difference between the two. Striae length and width did not change significantly (p = 0.203 and p = 0.558). Patients reported greater improvement on the CO2-treated side at 1 month, but not at the final follow-up. High satisfaction was noted for both lasers. Adverse reactions noted after both lasers include erythema, edema, crusting/scaling, pruritus, pain and post-inflammatory hyperpigmentation. The PS Nd:YAG laser was associated with greater pain (p < 0.05), but shorter healing time of 10.26 days. CONCLUSION: Both fractional PS Nd:YAG and CO2 lasers were effective, well-tolerated and safe treatment options for SA.