Comparison of 1064-nm Nd: YAG picosecond laser with fractional micro-lens array and electro-optical synergy for post-acne erythema: a prospective, randomized, split-face trial.

Abstract

Comparative data regarding the effectiveness of the 1064-nm Nd: YAG picosecond laser with fractional micro-lens array (P-MLA) versus traditional electro-optical synergy (ELOS) for treating post-acne erythema (PAE) are limited. Therefore, we aimed to compare the efficacy and safety of P-MLA and ELOS in the treatment of PAE. This prospective, randomized, split-face trial enrolled 20 patients with PAE, primarily of darker skin tones (Fitzpatrick skin types III-VI). Patients were randomly assigned to receive P-MLA treatment on one side of the face, and ELOS treatment on the other side. Three treatments were administered at 4-week intervals, with follow-up conducted at weeks 0, 4, 8, and 12. Standardized photographs were obtained using the VISIA system. Efficacy was assessed based on improvements in PAE lesion counts, clinical erythema assessment, VISIA skin analysis data, and patient-reported satisfaction. Adverse events were recorded. Both the P-MLA and ELOS groups showed significant reductions in erythema, with the P-MLA group demonstrating a notably greater decrease in PAE lesion counts and a higher clinical response rate at week 12 than the ELOS group. VISIA analysis revealed a greater reduction in red zone scores for the P-MLA group, alongside significant improvements in wrinkles and pigmentation. Patient satisfaction scores were comparable between the two groups, with an overall satisfaction rate of 94.74%. Adverse events, including erythema duration, edema, and pain, were similar across both groups, with no serious complications observed. P-MLA demonstrates superior efficacy and lower risk of adverse effects than ELOS in PAE treatment among Asian patients.