Comparing the efficacy and safety of a 730-nm picosecond laser with a 532-nm Q-switched Nd:YAG laser for facial pigmented disorders: a retrospective comparative study.

Abstract

Background: Laser therapies are commonly employed for their effectiveness in reducing pigmentation, yet the comparative efficacy and safety profile of novel picosecond lasers against established gold-standard treatments warrant further investigation. This study aimed to directly compare 730-nm picosecond laser therapy with 532-nm Q-switched Nd:YAG laser therapy, the traditional mainstay for managing facial pigmented disorders.

Methods: This retrospective comparative study at a tertiary hospital in China enrolled 131 adults (18-70 years) with facial pigmentation disorders. The participants were categorized into two groups: 85 received a 730-nm picosecond laser and 46 received a 532-nm Q-switched Nd:YAG laser. Treatment outcomes were compared via appropriate statistical analyses, including Student's t-test, Mann-Whitney U test, and multivariate regression analyses.

Results: The 730-nm picosecond laser group demonstrated significantly superior outcomes compared to the 532-nm Q-switched Nd:YAG group, with a greater reduction in posttreatment pigmentation scores (2.55 ± 1.11 vs. 3.82 ± 1.45, p < 0.001) and a greater improvement rate (56% ± 10% vs. 38% ± 9%, p < 0.001). The picosecond group also reported fewer side effects (0.99 ± 0.59 vs. 2.25 ± 0.78, p < 0.001), greater patient satisfaction (7.96 ± 0.95 vs. 7.15 ± 1.52, p < 0.001), and superior dermatological outcomes, including lower erythema indices and higher elasticity scores. Multivariate analysis confirmed that picosecond laser treatment was the strongest independent predictor of treatment success (Adjusted OR = 4.85, 95% CI 2.51-9.38, p < 0.001).

Conclusion: Compared with 532-nm Q-switched Nd:YAG laser, 730-nm picosecond laser therapy is more effective and safer for treating facial pigmentation disorders. It achieves greater clinical improvement, enhanced patient satisfaction, and superior skin quality outcomes with fewer adverse effects, supporting its preferential use in clinical practice.