title: Comparative effectiveness of nonpurpuragenic 595-nm pulsed dye laser and microsecond 1064-nm neodymium:yttrium-aluminum-garnet laser for treatment of diffuse facial erythema: A double-blind randomized controlled trial.
abstract: BACKGROUND
  Facial erythema is a common symptom that responds to vascular laser treatment, but there are few comparative studies.
  
  
  OBJECTIVE
  We sought to compare the effectiveness of microsecond 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with nonpurpuragenic 595-nm pulsed dye laser (PDL) for diffuse facial erythema.
  
  
  METHODS
  This was a split-face, double-blind randomized controlled trial. Bilateral cheeks received 4 treatments each at one month intervals with PDL or Nd:YAG. Spectrophotometer measurements, digital photographs, pain scores, and patient preferences were recorded.
  
  
  RESULTS
  Sixteen patients enrolled and 2 dropped out. Fourteen patients, all skin types I to III, 57% women, mean age 42 years, completed the study and were analyzed. Spectrophotometer readings changed after both PDL (8.9%) and Nd:YAG (2.5%), but varied by treatment type, with PDL reducing facial redness 6.4% more from baseline than Nd:YAG (P = .0199; 95% confidence interval -11.6 to -1.2). Pain varied (P = .0028), with Nd:YAG associated with less pain, at 3.07, than PDL at 3.87. Subjects rated redness as improved by 52% as a result of PDL, and 34% as a result of Nd:YAG (P = .031; 95% confidence interval -34.6 to -1.94). No serious adverse events were observed.
  
  
  CONCLUSIONS
  Lasers settings are not standardized across devices.
  
  
  CONCLUSIONS
  Facial erythema is safely and effectively treated with PDL and Nd:YAG. Nonpupuragenic PDL may be more effective for lighter-skinned patients, but microsecond Nd:YAG may be less painful.
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. m-alam@northwestern.edu
authors.forename: Murad
authors.initials: M
authors.lastname: Alam
authors.forename: Nataya
authors.initials: N
authors.lastname: Voravutinon
authors.forename: Melanie
authors.initials: M
authors.lastname: Warycha
authors.forename: Dennis
authors.initials: D
authors.lastname: Whiting
authors.forename: Michael
authors.initials: M
authors.lastname: Nodzenski
authors.forename: Simon
authors.initials: S
authors.lastname: Yoo
authors.forename: Dennis P
authors.initials: DP
authors.lastname: West
authors.forename: Emir
authors.initials: E
authors.lastname: Veledar
authors.forename: Emily
authors.initials: E
authors.lastname: Poon
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D004890:Erythema / Q000532:radiotherapy*; D005148:Facial Dermatoses / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D054025:Lasers, Dye / Q000009:adverse effects / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D057240:Patient Preference; D010781:Photography; D013053:Spectrophotometry; D055815:Young Adult
keywords: CI; IPL; Nd:YAG; PDL; comparative effectiveness research; confidence interval; dye; erythema; intense pulsed light; lasers; neodymium:yttrium-aluminum-garnet; pulsed dye laser; rosacea