Background: Pulsed 532-nm lasers have been widely used in the treatment of vascular and pigmented conditions of aged skin. In addition to lesion clearance, many patients report color and texture improvements to the skin. These improvements are often difficult to appreciate from photographic analysis alone, but are significant to the patient's impression of treatment success.
Objective: To grade and compare objective and subjective results of treatments with a 532-nm frequency-doubled pulsed Nd:YAG laser using criteria of skin color, skin texture, and wrinkles based on a blinded retrospective analysis of photographs compared with results from patient questionnaires.
Methods: Clinical before and after pictures from 20 patients (skin types I-IV) treated for diffuse vascular and pigmented lesions were selected for evaluation. A blinded grading was performed using criteria of skin color, skin texture, and wrinkles. Patients were asked by questionnaire to also grade improvement using the same criteria. The results of the blinded and patient grading were reported and compared using a chi-squared analysis.
Results: Clinical improvements recorded by blinded photographic evaluation and patient evaluation agreed with no statistically significant differences. Both the blinded observers and patients recorded remarkable improvement in the color signs of photoaging, slight to moderate improvement in skin texture and fine wrinkles, and negligible improvement of medium depth and deep wrinkles.
Conclusion: The 532-nm pulsed laser is a safe and effective device for the treatment of the visible signs of photoaging of skin types I-III. In addition to improvements in color defects, objectively and subjectively significant improvements in texture and fine wrinkles can be expected. Little to no improvement in medium to deep wrinkles can be anticipated.