A systematic review and meta-analysis of the comparison between lasers and other therapeutic modalities in skin rejuvenation and resurfacing with a focus on RCTs.

Abstract

Aims and objectives: This systematic review and meta-analysis sought to compare the efficacy of lasers with other modalities in skin rejuvenation and resurfacing. Methodology: The database was thoroughly searched, and six articles meeting specific inclusion criteria were selected for meta-analysis. Inclusion criteria comprised studies that compared lasers with other methods, with four studies focusing on laser comparisons and two studies comparing more than two methods. The selected articles encompassed two randomized split-face trials, one side-by-side randomized clinical trial, and three comparative studies. The effectiveness of treatments was categorized as excellent, good, fair, poor, no change, or worsening. Article review and data extraction were conducted using Endnote X8, followed by analysis and categorization of the studies.

Results: The meta-analysis, involving six studies with 497 patients (mean age: 49.65 years), revealed an overall pooled prevalence of treatment effectiveness: 18% for "excellent," 31% for "good," 40% for "fair," 26% for "poor," and 14% for "no change." Erbium YAG laser exhibited superior results in the "excellent" category, with 20% displaying excellent responsiveness, and in the "good" category, 39% of radiofrequency cases treated with Erbium YAG laser demonstrated favorable results. Conversely, intense pulsed light showed better responsiveness in the "fair" group, with 39% of cases demonstrating fair results.

Conclusion: Our study indicated a higher percentage of excellent responses compared to other skin rejuvenation treatments with Erbium YAG laser and the highest percentage of good responses with radiofrequency treatment. However, intense pulsed light treatment yielded superior results in the fair response group. Based on our findings, it is evident that utilizing Erbium YAG laser in conjunction with radiofrequency represents a secure approach that surpasses other methods in enhancing and restoring skin quality. Furthermore, a plausible suggestion is made that a combination of these two methods may introduce the most optimal approach for skin rejuvenation in the future.