Comparative Study of a 1064 nm Fractional Picosecond Laser Versus Intense Pulsed Light in Facial Rejuvenation: A Prospective Randomized Trial

BACKGROUND AND OBJECTIVES: Skin aging, characterized by wrinkles, pigment disorders, and enlarged pores, is driven primarily by photoaging. While a 1064 nm fractional picosecond laser shows efficacy in skin rejuvenation, comparative studies with intense pulsed light (IPL) remain limited. This randomized controlled trial (RCT) aimed to compare the efficacy and safety of the 1064 nm fractional picosecond laser with IPL in Asian women. METHODS: In this single-center RCT, 38 Asian women (30-60 years) were randomized to receive 1064 nm Nd:YAG picosecond laser with a fractional optic (1064 nm Ps) (n = 19) or IPL (n = 19) therapy for three treatments. Baseline and post treatments Global Score for Photoaging (GSP), fine lines and pigmented spots scores were assessed by two blinded dermatologists based on VISIA photographs. Skin texture, T-zone pores and skin tone were measured with VISIA, C-Cube and Delfin Skin Color Catch. Transepidermal water loss (TEWL) was measured before and after a single treatment by Delfin Vapometer. All adverse events were documented. RESULTS: 1064 nm Ps outperformed IPL in the periorbital fine lines (p = 0.0315) and T-zone pore counts (p = 0.0473). GSP, infraorbital texture area, pigmented spots and lightness (L*), compared to baseline, significantly improved after treatments in each group, while there was no difference between two groups. Regarding safety, erythema was the most frequent transient response in both groups. CONCLUSIONS: Both 1064 nm fractional picosecond laser and IPL were effective and safe in treatments of facial rejuvenation. Compared to IPL, 1064 nm fractional picosecond laser excelled in periorbital fine lines and T-zone pores. CLINICAL TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (identifier: NCT07122310).