Prospective studies of the efficacy and safety of the picosecond 755, 1,064, and 532 nm lasers for the treatment of infraorbital dark circles

Background Infraorbital dark circles result from a combination of factors. The fractionated picosecond 755 nm alexandrite laser and dual wavelength picosecond Nd:YAG laser have not been examined as a method of addressing infraorbital hyperpigmentation. Objective To determine the efficacy and safety of treatment of infraorbital dark circles using fractionated picosecond 755 nm and dual wavelength picosecond Nd:YAG laser. Methods and Materials These trials did not utilize a comparative design; rather, these were separate, prospective, open‐label, evaluator‐blinded trials utilizing two treatment regimens: (i) 19 adult subjects were treated in a single session with the dual wavelengths of 532 nm and 1,064 nm in consecutive passes using the fractionated lens; (ii) 10 adult subjects were treated using the picosecond 755 nm laser via the fractionated lens in three treatment sessions at 3 week intervals. Subjects in both studies were followed‐up for blinded‐investigator assessment of infraorbital hyperpigmentation, adverse events, and improvement compared to baseline. Results The dual wavelength picosecond Nd:YAG laser, blinded‐investigator assessment did not demonstrate a significant improvement in infraorbital hyperpigmentation at day 60 ( P  = 0.16). The picosecond 755 nm alexandrite laser significantly improved infraorbital hyperpigmentation by day 42, with improvement maintained through day 132 ( P  = 0.07 and 0.00001, respectively). Adverse events were mild and temporary. Conclusion A single treatment with the fractionated picosecond 1,064/532 nm lasers did not produce a significant improvement in infraorbital hyperpigmentation. A series of three treatments with the fractionated picosecond 755 nm laser resulted in significant improvement in hyperpigmentation. Lasers Surg. Med. 50:45–50, 2018. © 2017 Wiley Periodicals, Inc.