Comparison of the efficacy and safety of 755-nm picosecond alexandrite laser with diffractive lens array vs. fractional microneedle radiofrequency for the treatment of facial photoaging: a retrospective study.

Authors

Xixin Wu, Houhuang Qiu, Jingchun Chen, Yunkai Zhu, Jialu Xu, Xi Chen, Yutong Wu, Fangfang Wang, Ping Zhong, Qiusheng Lin, Fei Li, John Chen, Hongduo Chen, Tianhua Xu

Published in

Frontiers in medicine. Volume 13. Pages 1913396. Epub Aug 31, 2026.

Abstract

To compare the efficacy and safety of a 755-nm picosecond alexandrite laser combined with a diffractive lens array (PSAL-DLA) vs. fractional microneedle radiofrequency (MNRF) in the treatment of facial photoaging.
This retrospective study enrolled 51 patients with facial photoaging (Glogau scale ≥ II), including 22 in the PSAL-DLA group and 29 in the MNRF group. Objective assessments were performed at baseline and within 3 months post-treatment using the VISIA skin analysis system (spots, wrinkles, texture, pores, UV spots, brown spots, red areas, porphyrins). Subjective evaluation was conducted independently by two board-certified physicians using the Modified Fitzpatrick Wrinkle Scale (MFWS) and Global Aesthetic Improvement Scale (GAIS). Analysis of covariance (ANCOVA) was used to compare between-group efficacy, with baseline VISIA scores, age, sex, skin type, and actual follow-up duration as covariates. Treatment-related adverse events were also recorded.
The PSAL-DLA group demonstrated significant improvements in brown spots and red areas, and the MNRF group showed a significant reduction in pore scores; however, the between-group differences were not statistically significant (P > 0.05). Notably, the MNRF group exhibited a statistically significant worsening of spots from baseline. ANCOVA revealed that the PSAL-DLA group achieved significantly greater improvements in spots total scores (adjusted means: 82.2 vs. 89.3, P = 0.004) and UV spots (55.4 vs. 59.6, P = 0.022) compared with the MNRF group. Wrinkle improvement correlated positively with baseline severity in both groups. The MNRF group demonstrated a significant within-group improvement in MFWS score, but the between-group comparison with PSAL-DLA showed no significant difference (P = 0.103). In the GAIS assessment, 68.18% and 72.41% of subjects in the PSAL-DLA and MNRF groups, respectively, were rated as improved or much improved, with no significant between-group difference (P = 0.779). Subgroup analysis revealed no significant interaction between treatment modality and age or skin type (P > 0.05). Adverse reactions were mainly transient erythema and swelling, with no severe hyperpigmentation or scarring observed.
Both PSAL-DLA and MNRF are safe and effective for treating facial photoaging. PSAL-DLA appears superior for pigmented indicators (spots, UV spots), while MNRF also demonstrates efficacy for pores and wrinkles, although between-group differences were not significant. Treatment selection should be individualized based on the patient's predominant photoaging manifestations.

PMID:
42740895
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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