Comparing a Low-Fluence Picosecond 1064 nm Nd:YAG Laser with a 532 nm Nd:YAG Laser for the Treatment of Pigmented Lesions in Chinese Patients: A Retrospective Analysis

The use of low-fluence picosecond (LFPS) 1064 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, referred to as laser toning, is increasingly acknowledged as an effective treatment for pigmentation disorders in the Asian skin phenotype. This study aimed to conduct a comparative analysis on the effectiveness and safety of utilizing LFPS 1064 nm Nd:YAG lasers against picosecond 532 nm Nd:YAG lasers in treating pigmented lesions among Chinese patients. A retrospective photographic analysis and chart reviews were performed on 31 subjects exhibiting Fitzpatrick skin types III–VI who underwent LFPS 1064 nm Nd:YAG or picosecond 532 nm Nd:YAG treatments at a single tertiary center. Utilizing VISIA Complexion Analysis, comparative photographs were taken. Two independent physicians evaluated treatment efficacy using a visual analog scale (VAS) to assess the percentage of pigmentary clearance in standard photographs. Solar lentigines were the most prevalent pigmentary disorder, followed by post-inflammatory hyperpigmentation (PIH), nevus zygomaticus, melasma, freckles, and nevus of Ota. The clinical effectiveness of picosecond 532 nm and LFPS 1064 nm laser treatments proved comparable for lesions on the face, with mean VAS scores of 2.2 ± 1.1 and 1.8 ± 0.8, respectively. There were two cases of PIH in the picosecond 532 nm group, which resolved within one month. Overall, the LFPS 1064 nm laser demonstrates promise as a safe and efficient therapeutic modality for managing pigmented lesions in Chinese patients.