Moreover, he says, excimer laser only works for psoriasis and vitiligo, but success is very difficult to maintain, particularly with vitiligo.
“The 650 ms Nd:YAG works on many different entities, including more than 30 FDA-approved indications,” Dr. Nestor says. These include several aesthetic and medical indications. Dr. Nestor's group soon will publish a paper showing significant efficacy in acne.
“It's a very versatile laser,” he adds.
Pulsed-dye laser (PDL) does not work as well as excimer for psoriasis, says Dr. Nestor. In a 22-patient, controlled prospective trial, mean Psoriasis Severity Index (PSI) improvement for excimer laser was 4.7, versus 2.7 for PDL (p = 0.003). In a three-month, 14-patient nail psoriasis trial, however, patients treated with PDL achieved Nail Psoriasis Severity Index (NAPSI) improvements between 44.2% and 65.1%.
Low-level laser therapy (LLLT) is very effective for the scalp and other areas but needs more study, says Dr. Nestor.
Dr. Nestor was a paid researcher in the 650 µs Nd:YAG laser study but reports no relevant financial interests.
1. Mark S Nestor MD. “Lasers and Psoriasis: The Future of Phototherapy,” South Beach Symposium. February 8, 2019.
2. Nestor MS, Fischer D, Arnold D. Randomized, investigator-blinded study to compare the efficacy and tolerance of a 650-microsecond, 1064-nm YAG laser to a 308-nm excimer laser for the treatment of mild to moderate psoriasis vulgaris. J Drugs Dermatol. 2020;19(2)176-183. Doi:10.36849/JDD.2020.4769.