Comparative analysis of erbium: glass 1550 nm and combined erbium: YAG & Nd: YAG lasers for perioral rejuvenation: a prospective study

Abstract

Perioral aging manifests as fine lines, wrinkles, and structural changes, often requiring specialized treatment. Although laser systems are widely used in facial rejuvenation, few studies directly compare their efficacy in perioral rejuvenation. This study evaluates and compares the efficacy and safety of two laser systems-Erbium: glass laser and Nd: YAG combined with Er: YAG laser-for perioral rejuvenation. A prospective, comparative clinical trial was conducted with 36 female patients who sought perioral rejuvenation at a tertiary dermatology hospital. Participants were randomly assigned to either the erbium: glass group or the Nd: YAG combined with Er: YAG group, each receiving three treatment sessions at 4-week intervals. Efficacy was assessed through clinical wrinkle severity ratings, VisioFace^® imaging, and patient satisfaction scores. Safety was evaluated by monitoring adverse events. The mean ages in the erbium: glass and Nd: YAG combined with Er: YAG laser groups were 49.78 ± 6.59 and 46.72 ± 6.36 years, respectively, without significant difference (p > 0.05). All participants had Fitzpatrick skin types III- IV. Both treatment groups demonstrated significant improvements in supralabial lines and skin hyperpigmentation (p < 0.05). While erbium: glass was more effective in reducing supralabial lines, the difference between the two laser systems was not statistically significant. Conversely, improvement in corner lip wrinkles was statistically significant only in the Nd: YAG combined with Er: YAG laser group (p < 0.05). Erbium: glass showed significantly superior results in reducing pore count (p < 0.05). No significant difference was observed between the groups in terms of skin hyperpigmentation improvement. Both erbium: glass and Nd: YAG combined with Er: YAG laser are effective and safe options for perioral rejuvenation. Erbium: glass may be particularly suited for targeting superficial lines and pores, while Nd: YAG combined with Er: YAG laser appears more effective for treating deeper wrinkles. These findings support an individualized laser treatment selection approach based on specific skin concerns. Further studies with larger sample sizes and extended follow-up periods are recommended to confirm and expand on these results.

Keywords: 1550-nm fractional erbium: glass laser; Enlarged pores; Er:YAG resurfacing; Nd:YAG 1064-nm; Non-ablative fractional laser; Perioral rejuvenation.