Name: Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation (Video) | JoVE Journal
Uploaded: 2025-05-23T13:05:00.000+00:00
Duration: 4 min 43 s
Description: Learn a protocol for treating periorbital hyperpigmentation using a 1064-nm picosecond Nd:YAG laser with a microlens array. This method enhances treatment efficacy and improves patient outcomes in cosmetic dermatology.

ai_agent_IP

ai_agent

maintenance

instantTrialDurationMinutes

isBiopharma

enableNewMyJoveSectionDesign

educationFeatures

seoMetaApi

ai_copilot_institution_blacklist

ai_chat_institution_blacklist

freeAccessWindow

ssoRoleCapture

scheduledMaintenanceBanner

joveLabsFeatures

disable_autoplay_for_bots

extended_trial_duration

5 minutes

All procedures that involve the participation of human subjects strictly adhere to the established ethical standards set forth by the Ethics Committee of The First Affiliated Hospital of Soochow University and follow the Declaration of Helsinki. Image data collection was conducted with patient consent, and routine examination photographs were captured before treatment.
1. Preoperative evaluation
<ol>
	<li>Review the patient&#39;s medical history. 
	NOTE: Patient&#39;s medical history, including medication history, allergy history, contraindications to treatment, pigmentary changes, previous cosmetic treatments, and manual surgery.</li>
	<li>Perform a thorough physical examination. Both the therapist and the patient hold a mirror to examine the area to be treated at the same time.</li>
	<li>Have the patient sign the informed consent form and take the image data using a digital camera and a skin analysis imaging system. 
	NOTE: Photos were taken at 0&#176;, 45&#176;, and 90&#176; angles before and after treatment, and consistent light and position should be selected when taking pictures.</li>
</ol>
2. Preparation for laser treatment
<ol>
	<li>Ask the patient to put on shoe covers when entering the treatment room. Have the patient lie supine to expose the treatment area. Remove jewelry and contact lenses.</li>
	<li>Use a makeup remover and clean the area with a gentle cleaning product.</li>
	<li>Shave the hair in the treated area clean to avoid hair burning and competing with melanin for laser energy absorption.</li>
	<li>Turn on the laser treatment room lights and pre-disinfection of the laser handpiece with 75% alcohol.</li>
	<li>Take a comfortable position, usually sitting, wash hands, and wear a hat, mask, and gloves. 
	NOTE: Patients use out-of-eye goggles. The therapist wore laser safety goggles for the wavelength used.</li>
</ol>
3. Treatment
<ol>
	<li>Choose the Resolve 1064 handpiece (Figure 1A) for the treatment of the patient. 
	NOTE: The system delivers a 10 &#215; 10 array of 150 &#181;m-diameter microbeams arranged in a 6 mm &#215; 6 mm square treatment area.</li>
	<li>Set the energy level between 2.1-2.9 mJ/microbeam, pulse duration of 450 ps, frequency of 5 Hz (Figure 1B). 
	NOTE: Patients with Fitzpatrick III or IV typically need treatment energy of 2.1-2.3 mJ.</li>
	<li>Place the end of the treatment handpiece against the skin, ensuring that the handpiece is perpendicular to the skin. 
	NOTE: In the periocular area, the orientation of the laser handpiece should be away from the eyeball to reduce the risk of eye injury.</li>
	<li>Ensure the pulses overlap by 20% and cover the entire treatment area with laser pulses. Perform the treatment from the side to the middle of the face.</li>
	<li>Aim for the ideal endpoint of treatment, which is the mild darkening of the lesion with slight exudation and bleeding. 
	NOTE: A 1064 nm picosecond Nd:YAG laser with a mean fluence of 2.1-2.9 J/cm2 was used at 1 month intervals. Treating once a month for a total of 3 treatments.</li>
</ol>
4. Postoperative care
<ol>
	<li>Apply an ice pack for 15-20 min after treatment and apply a medium-acting corticosteroid cream twice a day for 3 days.</li>
	<li>Use soothing and moisturizing products for 2 weeks after surgery and avoid harsh skin care products.</li>
	<li>Avoid sun exposure for 4 weeks after treatment to reduce risks such as postinflammatory hyperpigmentation (PIH). Use a broad-spectrum sunscreen with SPF30+ every day, and use umbrellas, hats, goggles, etc.</li>
</ol>

<ol><li>Roberts, W. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Periorbital+hyperpigmentation%3A+review+of+etiology%2C+medical+evaluation%2C+and+aesthetic+treatment%5BTitle%5D)+AND+%22J+Drugs+Dermatol%22%5BJournal%5D)">Periorbital hyperpigmentation: review of etiology, medical evaluation, and aesthetic treatment.</a> J Drugs Dermatol. 13 (4), 472-482 (2014).</li>
<li>Michelle, L., Pouldar Foulad, D., Ekelem, C., Saedi, N., Mesinkovska, N. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Treatments+of+periorbital+hyperpigmentation%3A+a+systematic+review%5BTitle%5D)+AND+%22Dermatol+Surg%22%5BJournal%5D)">Treatments of periorbital hyperpigmentation: a systematic review.</a> Dermatol Surg. 47 (1), 70-74 (2021).</li>
<li>Nilforoushzadeh, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Comparison+of+carboxy+therapy+and+fractional+Qswitched+ND%3AYAG+laser+on+periorbital+dark+circles+treatment%3A+a+clinical+trial%5BTitle%5D)+AND+%22Lasers+Med+Sci%22%5BJournal%5D)">Comparison of carboxy therapy and fractional Qswitched ND:YAG laser on periorbital dark circles treatment: a clinical trial.</a> Lasers Med Sci. 36 (9), 1927-1934 (2021).</li>
<li>Alavi, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Evaluation+of+efficacy+and+safety+of+lowfluence+Qswitched+1064nm+laser+in+infraorbital+hyperpigmentation+based+on+biometric+parameters%5BTitle%5D)+AND+%22J+Lasers+Med+Sci%22%5BJournal%5D)">Evaluation of efficacy and safety of lowfluence Qswitched 1064nm laser in infraorbital hyperpigmentation based on biometric parameters.</a> J Lasers Med Sci. 13, e16(2022).</li>
<li>Tanghetti, E. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+histology+of+skin+treated+with+a+picosecond+alexandrite+laser+and+a+fractional+lens+array%5BTitle%5D)+AND+%22Lasers+Surg+Med%22%5BJournal%5D)">The histology of skin treated with a picosecond alexandrite laser and a fractional lens array.</a> Lasers Surg Med. 48 (7), 646-652 (2016).</li>
<li>Yeh, Y. -T., Peng, J. -H., Peng, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Histology+of+ex+vivo+skin+after+treatment+with+fractionated+picosecond+ND%3AYAG+laser+in+high+and+lowenergy+settings%5BTitle%5D)+AND+%22J+Cosmet+Laser+Ther%22%5BJournal%5D)">Histology of ex vivo skin after treatment with fractionated picosecond ND:YAG laser in high and lowenergy settings.</a> J Cosmet Laser Ther. 22 (1), 43-47 (2020).</li>
<li>Habbema, L., Verhagen, R., Van Hal, R., Liu, Y., Varghese, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Minimally+invasive+nonthermal+laser+technology+using+laserinduced+optical+breakdown+for+skin+rejuvenation%5BTitle%5D)+AND+%22J+Biophotonics%22%5BJournal%5D)">Minimally invasive nonthermal laser technology using laserinduced optical breakdown for skin rejuvenation.</a> J Biophotonics. 5 (2), 194-199 (2012).</li>
<li>Kounidas, G., Kastora, S., Rajpara, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Decoding+infraorbital+dark+circles+with+lasers+and+fillers%5BTitle%5D)+AND+%22J+Dermatol+Treat%22%5BJournal%5D)">Decoding infraorbital dark circles with lasers and fillers.</a> J Dermatol Treat. 33 (3), 1563-1567 (2022).</li>
<li>Lipp, M., Weiss, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Nonsurgical+treatments+for+infraorbital+rejuvenation%3A+a+review%5BTitle%5D)+AND+%22Dermatol+Surg%22%5BJournal%5D)">Nonsurgical treatments for infraorbital rejuvenation: a review.</a> Dermatol Surg. 45 (5), 700-710 (2019).</li>
<li>Park, K. Y., Kwon, H. J., Youn, C. S., Seo, S. J., Kim, M. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Treatments+of+infraorbital+dark+circles+by+various+etiologies%5BTitle%5D)+AND+%22Ann+Dermatol%22%5BJournal%5D)">Treatments of infraorbital dark circles by various etiologies.</a> Ann Dermatol. 30 (5), 522-528 (2018).</li>
<li>Anderson, R. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Selective+photothermolysis+of+cutaneous+pigmentation+by+Qswitched+ND%3AYAG+laser+pulses+at+1064%2C+532%2C+and+355+nm%5BTitle%5D)+AND+%22J+Invest+Dermatol%22%5BJournal%5D)">Selective photothermolysis of cutaneous pigmentation by Qswitched ND:YAG laser pulses at 1064, 532, and 355 nm.</a> J Invest Dermatol. 93 (1), 28-32 (1989).</li>
<li>Chan, N. P. Y., Ho, S. G. Y., Shek, S. Y. N., Yeung, C. K., Chan, H. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+case+series+of+facial+depigmentation+associated+with+low+fluence+Qswitched+1064+nm+ND%3AYAG+laser+for+skin+rejuvenation+and+melasma%5BTitle%5D)+AND+%22Lasers+Surg+Med%22%5BJournal%5D)">A case series of facial depigmentation associated with low fluence Qswitched 1064 nm ND:YAG laser for skin rejuvenation and melasma.</a> Lasers Surg Med. 42 (8), 712-719 (2010).</li>
<li>Sowash, M., Alster, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Review+of+laser+treatments+for+postinflammatory+hyperpigmentation+in+skin+of+color%5BTitle%5D)+AND+%22Am+J+Clin+Dermatol%22%5BJournal%5D)">Review of laser treatments for postinflammatory hyperpigmentation in skin of color.</a> Am J Clin Dermatol. 24 (3), 381-396 (2023).</li>
<li>Laubach, H. -J., Tannous, Z., Anderson, R. R., Manstein, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Skin+responses+to+fractional+photothermolysis%5BTitle%5D)+AND+%22Lasers+Surg+Med%22%5BJournal%5D)">Skin responses to fractional photothermolysis.</a> Lasers Surg Med. 38 (2), 142-149 (2006).</li>
<li>Liu, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Comparison+of+the+1064nm+picosecond+laser+with+fractionated+microlens+array+and+1565nm+nonablative+fractional+laser+for+the+treatment+of+enlarged+pores%3A+a+randomized%2C+splitface%2C+controlled+trial%5BTitle%5D)+AND+%22Lasers+Med+Sci%22%5BJournal%5D)">Comparison of the 1064nm picosecond laser with fractionated microlens array and 1565nm nonablative fractional laser for the treatment of enlarged pores: a randomized, splitface, controlled trial.</a> Lasers Med Sci. 39 (1), 80(2024).</li>
<li>Dai, R., Cao, Y., Su, Y., Cai, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Comparison+of+1064nm+ND%3AYAG+picosecond+laser+using+fractional+microlens+array+vs.+ablative+fractional+2940nm+Er%3AYAG+laser+for+the+treatment+of+atrophic+acne+scar+in+Asians%3A+a+20week+prospective%2C+randomized%2C+splitface%2C+controlled+pilot+study%5BTitle%5D)+AND+%22Front+Med%22%5BJournal%5D)">Comparison of 1064nm ND:YAG picosecond laser using fractional microlens array vs. ablative fractional 2940nm Er:YAG laser for the treatment of atrophic acne scar in Asians: a 20week prospective, randomized, splitface, controlled pilot study.</a> Front Med. 10, 1248831(2023).</li>
<li>Disphanurat, W., Charutanan, N., Sitthiwatthanawong, P., Suthiwartnarueput, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Efficacy+and+safety+of+fractional+1064nm+picosecond+laser+for+atrophic+traumatic+and+surgical+scars%3A+a+randomized%2C+singleblinded%2C+splitscarcontrolled+study%5BTitle%5D)+AND+%22Lasers+Surg+Med%22%5BJournal%5D)">Efficacy and safety of fractional 1064nm picosecond laser for atrophic traumatic and surgical scars: a randomized, singleblinded, splitscarcontrolled study.</a> Lasers Surg Med. 55 (6), 536-546 (2023).</li>
</ol>

The authors have no conflicts of interest to declare.

POH manifested as brown or dark brown pigmentation spots in the bilateral periocular area. There are different causes of periorbital hyperpigmentation, such as genetics, gender, age, physical conditions, anatomical differences, excessive blood vessels, etc. It is a concern at any age because it can make a person look sad, old, or tired and weaken their sense of well-being and self-esteem. The therapeutic approach must vary depending on the cause, as POH is caused by a variety of factors. For POH due to melanin, there are...

Periorbital hyperpigmentation (POH), also known as eye dark circles, is a common cosmetic skin disordercausedby various conditions. Clinically, it presents as symmetric hyperpigmented patches around the eyes distributed on the lower and upper eyelid and may extend to involve the glabella and upper nose1.Some etiologies that contribute to POH are pigmentation, prominent vasculature, skin laxity, and mixed factors.The dark circle around the eyes causes a tired and old appearance, which becomes a psychological concern for patients, so they seek ways to treat it. The disease is easily diagnosed but refractory to treat. Various equipment and tools have been developed to improve the disorder, liketopical cosmetics, chemical peels,lasers, radiofrequency devices, carboxytherapy, fillers, fat injections, and surgical procedures2.
The laser therapy is an effective method for the POH treatment3. Lasers have a selective ability to target endogenous chromophores.The neodymium-doped yttrium aluminum garnet (Nd:YAG) laser is effectively used to treat periorbital dark circles4. The ND: YAG laser is known as a selective photothermolysis system. The laser pulse width is extremely short, which can achieve extremely high peak power in an instant, thereby producing a photoacoustic effect on the target color base. The nonlinear absorption energy of the target color base produces a photodecomposition effect, which ultimately produces a blasting phenomenon leading to the formation of cavitation in the epidermis or dermis, in a process known as laser-induced optical breakdown (LIOB)5,6. There is no damage to the tissues around the LIOB, and the inflammatory reaction is also very slight. With the occurrence of LIOB, new collagen and elastic fibers may appear in the dermis7. The 1064-nm picosecond Nd:YAG laser with fractional microlens array offers several advantages, including effective targeting of pigment particles, a short treatment duration, notable results, and minimal adverse reactions. This article outlines the operation and safety precautions associated with the use of the 1064-nm picosecond Nd:YAG laser for treating periorbital hyperpigmentation and presents clinical cases to illustrate the effectiveness of this treatment.

<table><tbody><tr><td>1064-nm Nd:YAG picosecond laser&amp;nbsp;</td><td>Syneron-Candela, Wayland, MA, USA</td><td>Resolve 1064 handpiece</td><td>1064-nm Nd:YAG picosecond laser with fractional microlens array</td></tr></tbody></table>

using a 1064-nm picosecond neodymium-doped yttrium aluminum garnet laser for periorbital hyperpigmentation

Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation

Periorbital hyperpigmentation is a complex condition with multiple underlying causes, such as pigmented, vascular, structural, and mixed factors. The multifaceted nature of the disease presents significant challenges and complexities in its treatment, making it a difficult condition to address effectively. These options include topical cosmetics that can improve the appearance of the affected areas and various chemical treatments. Additionally, fillers are available to enhance volume and smoothen texture, while surgical methods can be employed in more severe cases. Despite these advancements, treating periorbital hyperpigmentation remains challenging. Nowadays, lasers have proven to be highly effective tools in the treatment of a wide range of pigmented diseases. However, there are many types of lasers, and the lack of corresponding guidelines makes the treatment of periorbital hyperpigmentation difficult. Here, we present a protocol describing the use of a 1064-nm picosecond Nd:YAG laser with a microlens array for treating periorbital hyperpigmentation. We discuss optimal energy settings, treatment endpoints, and other side effects while enhancing treatment effectiveness. This approach provides a basis for clinicians to screen and treat patients with eyelids dark circles, ensuring efficacy and safety.

We evaluated 20 patients aged 21 to 44 years old(8 females and 12 males, mean age 32.4 ± 6.05 years). A total of 4 patients were classified as having Fitzpatrick skin type III, and 16 patients were classified as having Fitzpatrick skin type IV. A total of 7 patients had a family history of POH, and 13 patients had no family history of POH (Table 1).
All patients received three consecutive treatment sessions using a 1064-nm picosecond laser with a microlens array at 1-month int...

Here, we present a protocol to describe using a 1064-nm picosecond Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) laser with a microlens array for treating periorbital hyperpigmentation.

Periorbital hyperpigmentation is a complex condition with multiple underlying causes, such as pigmented, vascular, structural, and mixed factors. The ...

using-1064-nm-picosecond-neodymium-doped-yttrium-aluminum-garnet

Research

JoVE Journal

Medicine

This video demonstrates a non-invasive laser-assisted procedure to selectively damage the corneal endothelial cells in the porcine eye. The developed ex vivo model of endothelial cell damage can be used to study diseases of the corneal endothelium.

Laser-assisted Selective Ablation of Porcine Corneal Endothelial Cells: A Technique to Induce Focused Porcine Corneal Endothelial Injury for Ex Vivo Studies

We developed novel intrinsic multifunctional nanovesicles called porphysomes, which have structure-dependent fluorescence self-quenching and unique photothermal properties, thus functioning as potent photothermal therapy agents. We formulated porphysomes using high pressure extrusion and investigated their photothermal therapy efficacy in a xenograft tumor model.

One Minute, Sub-One-Watt Photothermal Tumor Ablation Using Porphysomes, Intrinsic Multifunctional Nanovesicles

An all laser procedure is proposed in the endothelial transplant. The surgical technique is based on the use of a femtosecond laser to prepare the donor tissue. Laser welding technique is then used to secure the donor endothelium in the correct position.

An &#8220;All-laser&#8221; Endothelial Transplant

An original experimental setup for heating cells in a culture dish using 1.94 µm continuous-wave laser radiation is introduced here. Using this method, the biological responses of retinal pigment epithelial (RPE) cells after different thermal exposures can be investigated.

Continuous-wave Thulium Laser for Heating Cultured Cells to Investigate Cellular Thermal Effects

A protocol for the operation of a high-energy, high-power optical parametric chirped pulse amplifier pump source based on an Yb:YAG thin-disk regenerative amplifier is presented here.

20 mJ, 1 ps Yb:YAG Thin-disk Regenerative Amplifier

Here, we present a protocol for modified 980 nm diode laser enucleation to treat large volume benign prostatic hyperplasia.

Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser

Here, we present a protocol to detach corneal endothelial cells (CEC) from Descemet’s membrane (DM) using a neodymium:YAG (Nd:YAG) laser as an ex vivo disease model for bullous keratopathy (BK).

Development of a Noninvasive, Laser-Assisted Experimental Model of Corneal Endothelial Cell Loss

The purpose of this project is to effectively reduce the occurrence of adverse reactions such as erythema and pigmentation after non-ablative fractional laser treatment by combining 1565 non-ablative fractional laser with 30% super molecular salicylic acid, providing patients with a safer new method of facial rejuvenation treatment.

Enhancement of Facial Rejuvenation Through a Combination of 1565 nm Non-Ablative Fractional Laser with 30% Supramolecular Salicylic Acid

This paper illustrates an innovative visual approach (photovoice or photo-elicitation) to achieve fair process in clinical care for patients living with chronic health conditions, illuminate gaps in clinical knowledge, forge better therapeutic relationships, and identify patient-centered goals and possibilities for healing.

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Laser microdissection is a technique that allows the recovery of selected cells from minute amounts of parenchyma. Here we describe a protocol for acquiring human pancreatic islets from surgical specimens to be used for transcriptomic studies. Our protocol improves the intrinsic autofluorescence of human beta cells, thus facilitating their collection.

Improved Protocol For Laser Microdissection Of Human Pancreatic Islets From Surgical Specimens

Learn a protocol for treating periorbital hyperpigmentation using a 1064-nm picosecond Nd:YAG laser with a microlens array. This method enhances treatment efficacy and improves patient outcomes in cosmetic dermatology.

Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation

Explore More Videos