Split-face comparison study of cryogen spray cooling versus pneumatic skin flattening in skin tightening treatments using a long-pulsed Nd:YAG laser.

Background: Nd:YAG pulsed lasers are used for non-ablative skin tightening treatment. A common drawback of this procedure is pain, which is often intolerable. Pneumatic skin flattening (PSF) is a new technology which alleviates pain in laser treatments. The purpose of this study is to assess the clinical efficacy and pain reduction in Nd:YAG laser skin tightening treatments with PSF compared to Nd:YAG laser skin tightening treatments with cryogen spray cooling (CSC).

Methods: Eleven patients were treated on the face with an Nd:YAG laser operated at an energy setting of 30 J/cm(2) and a pulse duration of 50 ms. Half of the face was treated with the Nd:YAG using CSC and the other side was treated with the Nd:YAG using PSF. A comparison of pain elicited from each treatment was done by comparing each patient's VAS pain scoring of the two sides.

Results: Treatment efficacy with CSC and with PSF was identical. The study confirmed significant pain reduction with PSF (p < 0.01). The average pain scores for PSF and CSC were 2.4 and 6.9, respectively. Mild ecchymosis was observed in two patients on the PSF side.

Conclusion: Nd:YAG laser skin tightening treatments with PSF are less painful than Nd:YAG laser skin tightening treatments with CSC; the PSF treatments can be done with minimum side effects.