title: Fractional, nonablative Q-switched 1,064-nm neodymium YAG laser to rejuvenate photoaged skin: a pilot case series.
abstract: BACKGROUND
  Scientific research in the field of energy-based and light-based procedures made it possible to develop a very new and innovative generation of lasers that combine the benefit of a nonablative and a fractional laser device, promising skin rejuvenation without harming the epidermis. With this pilot case series, we performed one of the first systematic reports evaluating efficacy and safety of the fractional, nonablative Q-switched 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser device in the treatment of rhytides of the face, neck, and chest.
  
  
  METHODS
  Seven healthy female subjects (mean ± standard deviation age, 53.8 ± 10.0 years) with visible signs of facial and neck skin aging were treated with fractional, nonablative Q-switched 1,064-nm Nd:YAG laser device (Pixel QS Nd:YAG; Alma Lasers Ltd, Caesarea, Israel). Treated areas were the face, including the periorbital and perioral regions (particularly the upper lip), neck, and chest. Treatments consisted of 3 sessions at 2- to 4-week intervals. Follow-up was performed monthly following the final treatment. The Alexiades-Armenakas Comprehensive Grading Scale of Skin Aging was employed to assess efficacy. Pain ratings were recorded by 10-point visual assessment scoring.
  
  
  RESULTS
  Employing the validated, quantitative grading scale for rhytides of the face and neck, a 0.29 grade improvement, or 11.3% improvement, over baseline grade was observed in the 7-subject cohort that completed follow-up following a mean of approximately 2 treatments at approximately 1-month follow-up. No pain and rapidly resolving minimal erythema were noted in all subjects during treatment.
  
  
  CONCLUSIONS
  The results of this pilot case series suggest that the treatment with the fractional, nonablative Q-switched 1,064-nm Nd:YAG laser device significantly improves superficial rhytides. With its outstanding safety, it seems to be particularly suitable for the treatment of sensitive areas, such as the periorbital region, lips, neck, and chest. The Q-switched Nd:YAG laser is a facile, safe, and fast treatment for aesthetic skin rejuvenation.
authors.affiliation: Dermatology and Laser Surgery Center, New York, NY, USA.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Luebberding
authors.forename: Macrene R
authors.initials: MR
authors.lastname: Alexiades-Armenakas
mesh_terms: D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques / Q000009:adverse effects; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009333:Neck; D010865:Pilot Projects; D012060:Rejuvenation; D015595:Skin Aging; D013909:Thorax; D013997:Time Factors; D016896:Treatment Outcome