Effect of subdermal 1,444-nm pulsed neodymium-doped yttrium aluminum garnet laser on the nasolabial folds and cheek laxity

Background: Wrinkle formation usually accompanies skin aging. In particular, accentuated nasolabial folds and loss of elasticity are early signs of skin aging. The use of 1,444-nm pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers has increased in popularity. Objective To evaluate the safety and efficacy of a novel 1,444-nm pulsed Nd:YAG laser in the treatment of NLF and cheek laxity using subdermal laser therapy. Methods: Ten Korean patients with moderate to severe NLF were enrolled. Each received a single treatment session with a 1,444-nm Nd:YAG laser. Two blinded physicians evaluated clinical improvement by rating comparative photographs on a 5-point scale. Efficacy was also assessed by measuring elasticity and roughness. Skin biopsies were performed on five volunteers before treatment and 3 months after treatment. Results: The 1,444-nm Nd:YAG laser effectively promoted clinical improvement of NLF and cheek laxity (p <.05). Significant differences in elasticity and roughness were observed (p <.05). Epidermal proliferation was stimulated as demonstrated by increases in epidermal thickness and Ki-67 expression (p <.05). Quantitative image analyses of pre- and post-treatment biopsies revealed that collagen fibers increased from baseline (p >.05). Transforming growth factor beta and heat shock protein-70 messenger RNA levels quantified using real-time reverse transcriptase polymerase chain reaction increased significantly from baseline (p <.05). Conclusion: The 1,444-nm Nd:YAG laser is an effective treatment modality with minimal complications for the treatment of NLF and cheek laxity, but further research with a larger group of patients is needed to confirm these findings.