1,064 nm Nd:YAG laser ablation may be option for acne scars in patients with darker skin

The use of a fractional ablative 1,064 nm Nd:YAG laser may be a viable alternative in the treatment of acne scarring in patients with higher Fitzpatrick skin types.

“Treatment options for scarring are myriad with often suboptimal results,” Megan McClean, MD, and Mark Taylor, MD, of Gateway Aesthetic Institute and Laser Center in Salt Lake City, wrote in a presentation at the American Society for Dermatologic Surgery annual meeting. “More aggressive treatments with subcision and ablative lasers show promising results but may have an increased risk of adverse effects including hyperpigmentation, especially in patients with higher Fitzpatrick skin types.”

The retrospective review included 18 cases, and improvement was based on before and after photographs assessed on a quartile scale by three masked physicians. Four patients were classified as Fitzpatrick type 1, three as Fitzpatrick type 2, three as Fitzpatrick type 3, seven as Fitzpatrick type 4 and one as Fitzpatrick type 5.

The average improvement was 2.5 on a quartile scale. No serious adverse effects such as scarring, infection, hematoma, hypopigmentation or hyperpigmentation were reported.

“This study demonstrates a similar level of improvement [as fractional CO₂ laser] using a fractional ablative 1,064 nm Nd:YAG laser with an excellent safety profile demonstrated in this review,” McClean and Taylor wrote. “This preliminary data suggests that fractional 1,064 nm laser ablation may be a comparable alternative to traditional fractional CO₂, with a potentially superior safety profile especially in patients with darker skin.”