Combined treatment with 595-nm pulsed dye laser and 1550-nm erbium-glass fractional laser for traumatic scars

Facial scars can be caused by a traumatic event or indeed surgical procedures. Several treatment modalities have been suggested including surgical or resurfacing techniques, autologous fat transfer, and injection of fillers. However, these approaches have varying degrees of success and associated side effects. We report two Korean patients with traumatic scars. Both patients received combined consecutive treatment with 595-nm pulsed dye laser (PDL) and 1550-nm erbium-glass fractional laser. Both patients showed remarkable clinical improvements after a course of sessions. Therefore, simultaneous combined treatment with PDL and fractional laser may be considered a reasonable therapeutic option for traumatic facial scars.     

Combination of 595-nm pulsed dye laser,long-pulsed 755-nm alexandrite laser,and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients

Abstract

Keratosis pilaris (KP) has beenpresented as small keratotic follicular papules with or without surrounding erythema. Various treatments with laser or light therapy have been used for the management of KP with various clinical outcomes. In the present study, we investigated the efficacy and safety of a combination therapy for KP. A total of 29 anatomical sites with KP in 26 patients were treated using a 595-nm pulsed dye laser (PDL) with nonpurpuragenic fluences, a long-pulsed 755-nm alexandrite laser, and microdermabrasion. Clinical improvement was assessed by comparing preand posttreatment clinical photographs and patient satisfaction rates. Evaluation of the clinical results three months after the treatments showed that 12 of the 29 anatomical sites (41.4%) demonstrated Grade 3 clinical improvement, ten (34.5%) had Grade 2 clinical improvement, four (13.8%) showed Grade 1 improvement, and three (10.3%) showed Grade 4 improvement. We observed that KP lesions improved not only in erythema and skin texture, but also in brownish dyschromias. Potential adverse events were not observed, except prolonged posttherapy scaling. Our observations demonstrate that combination therapy using a 595-nm PDL, a long-pulsed 755-nm alexandrite laser, and microdermabrasion can have a positive therapeutic effect on KP.     

A comparative study of a 595-nm with a 585-nm pulsed dye laser in refractory port wine stains

BACKGROUND: The pulsed dye laser (PDL) is the treatment of choice for port wine stains (PWS); however, some patients' PWS become refractory to further treatments. Technological advances have enabled new machines with the advent of surface cooling devices to deliver longer wavelengths and higher fluence more safely. These advances have the potential to achieve improved response rates in refractory PWS. There are few studies comparing the efficacy of standard PDL treatments for refractory PWS with the wider choice of treatment variables available from newer PDL machines. OBJECTIVES: To determine if there is any advantage of using a longer wavelength (595 nm) and pulse widths (1.5 ms, 6 ms and 20 ms) over conventional PDL settings (wavelength 585 nm, pulse width 1.5 ms) in refractory PWS. METHODS: Eighteen consecutive consenting patients with Fitzpatrick skin types 1-4 with a mean age 35 years (range 17-59 years) with refractory PWS were treated routinely with three separate test areas using 595-nm PDL (using three different pulse width settings of 1.5 ms, 6 ms and 20 ms), compared with test areas treated with 585-nm PDL (pulse width 1.5 ms). All test areas were treated with an identical fluence (15 J cm(-2)), spot size (7 mm) and cooling setting (dynamic cooling 60 ms, delay 60 ms). RESULTS: We found a statistically significant advantage of 595-nm PDL (pulse width 1.5 ms) over 595-nm PDL (pulse width 6 ms) (P < 0.05) in the treatment of refractory PWS; however, we found no significant advantage using longer pulse widths of 20 ms compared with 1.5 ms with the 595-nm PDL. There was no statistically significant advantage in using a 595-nm PDL over a 585-nm PDL using identical pulse widths of 1.5 ms, spot size, fluence and cryogen cooling settings; however, the number of directly comparable test areas was smaller. Some individual patients in our study obtained a better response with certain 595-nm PDL settings (pulse width 1.5 ms and 6 ms) compared with 585-nm PDL (pulse width 1.5 ms). CONCLUSIONS: Our experience of high fluence PDL in the treatment of refractory PWS suggests patients treated with 585 nm (pulse width 1.5 ms) improve to a similar degree as patients treated with 595-nm PDL (pulse width 1.5 ms). However, the use of the 595-nm PDL with longer pulse widths yields no extra advantage. For those patients who have failed to improve with high-fluence 585-nm PDL (pulse width 1.5 ms), test areas using 595-nm PDL (pulse width 1.5 ms and 6 ms) should be undertaken to ascertain if individual patients may benefit from the longer pulse width 595-nm PDL.     

Topical application of 5-aminolevulinic acid followed by 595-nm pulsed dye laser irradiation for the treatment of recalcitrant port-wine stains: A primary study

Abstract

Objective: To evaluate the effectiveness and safety of topical application of 5-aminolevulinic acid (ALA) followed by pulsed dye laser (PDL) irradiation for the treatment of recalcitrant port-wine stain (PWS). Methods: Thirty-five patients (19 females and 16 males) with recalcitrant PWS were treated with topical application of 20% ALA and then irradiated with a 595-nm PDL (energy density of 6.5–9.0 J/cm² and pulse duration of 6 or 10 ms) at 6–8 weeks intervals. Clinical improvement of lesions was evaluated by comparing photographs of lesions at baseline and 2 months after the last treatment. Results: Topical ALA spreading followed by irradiation with a 595-nm PDL improved PWS in 21 out of 35 patients who were previously recalcitrant to PDL treatment alone. Side effects were limited to transient erythema, vesicle formation, edema and mild purpura with no obvious subsequent scarring or undesirable pigment changes. Conclusion: The topical application of ALA followed by irradiation with a 595-nm PDL is an effective and safe treatment for PWS recalcitrant to PDL therapy alone.     

Long-term results of the treatment of pregnancy-induced striae distensae using a 1550-nm non-ablative fractional laser

Background: Striae distensae (SD) are a type of dermal scarring that is quite common and difficult to treat. Two forms are known: striae rubrae (SR) and striae albae (SA). Objective: We compared the long-term clinical effectiveness of a 1550-nm non-ablative fractional laser (NAFL) in treating SR and SA. Materials and methods: We included 16 female patients (8 with SR and 8 with SA) who had developed abdominal SD during pregnancy. All underwent five moderately high-energy sessions of 1550-nm NAFL treatment at 4-week intervals. The strial widths and lengths were measured before, and 1 month and 1 year after treatment. Results: The mean strial width decreased from 6.94 mm before treatment to 3.25 mm at the first follow-up visit (p = 3.95 × 10^?5) and to 3.13 mm at the second follow-up visit (p = 2.44 × 10^?5). Similarly, the mean strial length decreased from 6.06 to 2.88 cm at the first follow-up visit (p = 1.7 × 10^?4) and to 2.75 cm at the second follow-up visit (p = 9.52 × 10^?5). Conclusion: NAFL treatment was effective long term in both SR and SA patients.     

Treatment of striae distensae using an ablative Erbium: YAG fractional laser versus a 585-nm pulsed-dye laser

Abstract

Striae distensae (SD) represent a common disfiguring cutaneous condition characterized by linear reddish smooth bands of atrophic-appearing skin. Most often SD develop in areas of dermal damage produced by stretching. Numerous treatment modalities have been applied with varying success. Novel approaches include treatments with various types of lasers with the flashlamp-pumped pulsed dye laser (PDL; 585 nm) being the most commonly reported. Very recently, fractional photothermolysis has been suggested as an effective method for the treatment of SD. Here, we report on the effect of an ablative Erbium:YAG fractional laser in two cases of axillary SD in comparison with a 585-nm PDL.     

Efficacy and safety of 1565-nm nonablative fractional laser combined with mucopolysaccharide polysulfate cream for erythematous acne scars

Purpose

To evaluate the efficacy and safety of 1565-nm nonablative fractional laser (NAFL) combined with mucopolysaccharide polysulfate (MPS) cream in the treatment of erythematous acne scars.

Methods

A total of 28 subjects with erythematous acne scars from June 2021 to April 2022 were enrolled. One side of each subject's face was randomly assigned to be treated with 1565-nm NAFL (at 2 sessions with four-week intervals) combined with MPS cream (twice daily) for 8 weeks, and the other side with 1565-nm NAFL combined with placebo cream. CBS® images and parameters, dermoscopic images and the quantitative data processed by ImageJ software, and quantitative global scarring grading system (GSS) score were obtained at baseline and after treatment. Subjects' satisfaction assessment was performed after treatment. Adverse events were recorded during treatment.

Results

In CBS® parameters, the red area, red area concentration, and smoothness were improved more significantly on the 1565-nm NAFL combined with MPS cream side than on the 1565-nm NAFL combined with placebo cream side after treatment (p = 0.015, p = 0.013, and p = 0.021). For dermoscopy, both scar area and scar redness achieved a significantly greater percentage of improvement on the side of 1565-nm NAFL combined with MPS cream than the side of 1565-nm NAFL combined with placebo cream after treatment (p = 0.005 and p = 0.041). The reduction of quantitative GSS score and Subjects' satisfaction assessment were similarly superior on the 1565-nm NAFL combined with MPS cream side. Temporary erythema was experienced by all subjects after each 1565-nm NAFL treatment. No subject reported intolerance or allergy to the cream during follow-up.

Conclusions

The combined application of 1565-nm NAFL and MPS cream could be an effective and safe treatment for erythematous acne scars. ImageJ software enables quantitative evaluation of dermoscopic images of acne scars.     

Treatment of port-wine stains with the 595-nm pulsed dye laser: a pilot study in Chinese patients

The 595-nm pulsed dye laser (PDL) is one of the newest developments in the treatment for port-wine stains (PWS). The aim of this study was to investigate the effectiveness of the treatment of PWS in Chinese patients using the 595-nm PDL. In total, 184 patients with PWS over the face, neck and trunk or limbs were enrolled in the study. All the patients were treated with the 595-nm PDL 3-6 times, with a 4-week interval between each treatment. Treatment parameters varied for each patient according to the colour and location of the PWS. The efficacy of treatments and any side-effects were evaluated. Results were graded as percentage resolution (0-25%, 25-50%, 50-75% and 75-100%). Of the 184 patients who completed the study, 115 (62.5%) achieved excellent improvement, 38 (20.7%) achieved good results, and 31 (16.8%) had an unsatisfactory outcome (moderate and poor response). We found > 75% improvement for 76% of facial PWS (95/125), 43% of neck PWS and 20.8% of trunk or limb PWS. Pain and topical erythema were commonly reported immediately after the laser treatments. Prominent hyperpigmentation occurred in only 11 cases (6.0%) with poor improvement, and resolved within 6 months. The 595-nm PDL appears to be safe, effective and well tolerated in the treatment of PWS in Chinese patients.     

Evaluation of the clinical and immunohistological efficacy of the 585-nm pulsed dye laser in the treatment of psoriasis

Background  The 585-nm pulsed dye laser (PDL) therapy is useful for the patients with psoriasis. PDL treatment is based on selective photothermolysis of the dermal vasculature.
Objective  The objectives of this study were to evaluate the clinical and immunohistological effects of PDL on psoriasis and to examine the association between psoriatic dermal vasculature and the clinical effects.
Methods  Eleven patients with recalcitrant psoriasis were treated with 585-nm PDL. Biopsy specimens obtained before and after treatment were stained with CD31. All microvessels to the depth of 400 µm from the rete ridge were counted and the internal diameters were measured.
Results  The mean percent reduction of plaque severity score was 42. The mean microvessel count decreased significantly from 63 to 35.6 ( P  < 0.001). There was a strong positive correlation between the plaque severity score and microvessel number ( P  < 0.001) and a strong negative correlation between the microvessel count of an untreated area and degree of the change in the microvessel count after treatment ( P  = 0.005).
Conclusions  The findings of this study suggest that PDL treatment improves psoriasis. Moreover, PDL treatment decreased the number of dermal papillary microvessels. Dermal papillary microvessels are important pathogenetic targets of psoriasis, and PDL therapy, which selectively targets superficial vessels, is therefore a valid therapeutic approach.

Conflicts of interest

None declared     

Genital angiokeratomas of Fordyce 595-nm variable-pulse pulsed dye laser treatment

Background: Angiokeratoma of Fordyce (AF) represents dark red or blue-black papules with a scaly surface located on scrotum, labia majora, and penis. Though usually asymptomatic, bleeding after mechanical trauma and sexual intercourse may occur. AF should be differentiated from malignant melanoma, angiosarcoma, and other pigmented lesions. The treatment, usually asked from patients as the result of anxiety and social embarrassment, should be performed in a non-aggressive manner. Objectives: To determine the safety and effectiveness of 595-nm variable-pulse pulsed dye laser (VPPDL) with a Dynamic Cooling Device (DCD) in the treatment of AF. Methods: Twenty-four patients (22 men and two women) aged 40.88 ± 12.48 years with AF were included in the retrospective study. Lesions located on scrotum, labia majora, and penis were treated with 595-nm VPPDL in the intervals of one to three months. Variable spot, fluence, and pulse-width parameters were used with and/or without DCD skin cooling. Results: AF were successfully removed in all patients in one to seven (mean ± SD = 3.38 ± 2.16) treatment sessions with no permanent side effects or complications such as dyspigmentations or scarring. Recidives were observed in four patients after 0.5–1 year intervals. Conclusions: 595-nm VPPDL with DCD represents an efficient and safe method for the removal of multiple lesions of AF in genital localization.     

Combined Treatment with Botulinum Toxin and 595-nm Pulsed Dye Laser for Traumatic Scarring

Traumatic scars on skin covering areas of high movement, especially areas on the face, can be stressful for patients. We report two cases of traumatic scars that occurred on the chin, and that were successfully treated with a combined therapy of 595-nm pulsed dye laser (PDL) and intramuscular injection of botulinum toxin. After the treatment, good cosmetic results were achieved in both patients. The only adverse effect during and after the treatments was mild pain, which resolved within several days without any additional treatment. In conclusion, the combination of 595-nm PDL and intramuscular botulinum toxin injection was shown to be a safe and effective treatment for traumatic scars on the mobile chin area in Korean patients.     

Combined pulsed dye laser and fiberoptic Nd-YAG laser for the treatment of hypertrophic port wine stain

The hypertrophic Port Wine Stain (PWS) is only partially and superficially treated with the Pulsed dye laser (PDL) because of its limited depth of penetration. We used combined PDL and fiberoptic 1444-nm Nd-YAG laser to treat a case with hypertrophic PWS. Method: After tumescent anesthesia, few holes were made by a 16-gauge needle on different sides of the lesion. The fiberoptic tip of 1444-nm Nd-YAG laser was inserted within the holes and was pushed forward while triggering. In a fan pattern and by a back and forth movement, the subcutaneous and deep dermal areas were coagulated. The skin and outer mucosal surfaces were then treated by PDL. The fiberoptic system used was Accusculpt 1444-nm Nd-YAG laser (Lutronic lasers, South Korea), and the PDL used was 585 nm Nlite system (Chromogenex UK). The parameters used for PDL were fluence = 9 Joules/cm² and the spot size was 5 mm. The parameters used for fiberoptic 1444-nm Nd-YAG laser were: Pulse rate = 30 Hz, pulse energy = 300 mJ, power = 6 W, and the total energy = 4000 J for the whole face and mucosa. Result: Little sign of regression and moderate purpura were detected immediately after combined fiberoptic Nd-YAG and PDL therapy. The lesion gradually regressed within 4 months with satisfactory color and volume change. Conclusion: Combined fiberoptic Nd-YAG laser and PDL can be used for the treatment of deeper and superficial layers of hypertrophic PWS.     

Resolution of retracted scar after 585-nm pulse dye laser surgery

BACKGROUND: Laser scar revision has been an effective method for improving several aspects of scarring through ablative and non-ablative sources. The 585-nm pulsed dye laser (PDL) is an important non-ablative instrument for reducing scar bulk and symptoms. OBJECTIVE: To describe the use of a 585-nm PDL for the treatment of a retracted and atrophic facial scar. METHODS: We report the case of a 26-year-old patient who presented with a retracted facial scar following surgical excision of an aggressive benign tumor. Treatment was carried out using the 585-nm PDL. RESULTS: Treatment of the scar using two low-level PDL therapies significantly altered the appearance of the scar and augmentation of the retracted defect was avoided. CONCLUSION: Treatment of this retracted and atrophic facial scar with the 585-nm PDL was very effective and safe.     

Treatment of angiokeratoma of Mibelli alone or in combination with pulsed dye laser and long‐pulsed Nd: YAG laser

Treatment of angiokeratoma of Mibelli is usually challenging because of the location, the pathogenetic condition and the cosmetic requirements. We present our characteristic treatment with the application of pulsed dye laser PDL and lpNd:YAG laser. All of these lesions were treated by topical anesthesia with Emla. Combined dual PDL‐lpNd:YAG (PDL: 595 nm, 5 mm/7 mm, 0.5 ms, 8–10 J/cm²; lpNd:YAG: 3 mm/5 mm, 15 ms, 90–120 J/cm²) treatment was used to treat lesions which with moderate to severe hyperkeratosis and hyperplasia. To the maculopapule ones, the energy density of lpNd:YAG might upgrade to 150 J/cm². Singular PDL (595 nm, 5 mm/7 mm, 0.5 ms, 9–12 J/cm²) treatment was used to treat lesions which with slight hyperkeratosis and hyperplasia. Continuous airflow cooling was always applied during the laser treatment. The treatment interval was 6–12 weeks. Of the 5 patients, 3 of them were cured and 2 of them were improved. All of them were satisfied with the cosmetic results. We recommended the combined dual PDL‐lpNd:YAG laser in treating severe hyperkeratotic and hyperplastic angiokeratoma of Mibelli. It can aid in achieving a desirable outcome whilst also reducing the required treatment sessions. However, most patients felt painful during the operation and experienced a severe long term recovery time after operation.     

Treatment of early-stage erythematotelangiectatic rosacea with a Q-switched 595-nm Nd:YAG laser

Erythematotelangiectatic rosacea presents as persistent erythema and telangiectasia with frequent flushing and blushing on the facial and extrafacial skin. Additionally, papulopustular rosacea shows acneiform papules, pustules, and nodules with persistent plaque-form edema. Despite garnering only grade-C or -D level recommendations, a 585-nm or 595-nm flashlamp-pumped pulsed-dye laser can be considered as an effective therapeutic modality for the treatment of rosacea in patients who are refractory to topical and/or systemic treatments. In this report, treatment with a Q-switched 595-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with low non-purpuragenic fluence proved to be safe and effective in treating early-stage erythematotelangiectatic rosacea in two female Korean patients. Laser treatment for rosacea was delivered with the settings of pulse energy of 0.4–0.5 J/cm², pulse duration of 5–10 ns, 5-mm spot size, 5 Hz, and 500 shots. Additionally, we found that remarkable therapeutic effects were achieved for both rosacea and melasma by combining Q-switched quick pulse-to-pulse 1,064-nm Nd:YAG and Q-switched 595-nm Nd:YAG laser treatments, which required only the changing of handpieces equipped with solid dye. In conclusion, we suggest that treatment with a Q-switched 595-nm Nd:YAG laser with low fluence may provide an additional therapeutic option for treating early-stage erythematotelangiectatic rosacea.     

Comparison of the 308-nm excimer laser and a 308-nm excimer lamp with 311-nm narrowband ultraviolet B in the treatment of psoriasis

BACKGROUND: Psoriasis is a chronic, genetically determined inflammatory disease, characterized by an immunomediated pathogenesis, which affects approximately 1-3% of the population. Various modalities have been used for psoriasis treatment, including ultraviolet (UV) radiation. Narrowband UVB (311 nm) phototherapy is a well-established, widely used and highly efficient treatment for psoriasis, but a big disadvantage is that large areas of unaffected skin are irradiated along with the psoriatic lesions. OBJECTIVES: This investigation evaluates a 308-nm excimer laser and a 308-nm excimer lamp in comparison with 311-nm narrowband UVB in the treatment of patch psoriasis by using two different dose-increase schemes. MATERIALS AND METHODS: Fifteen patients with plaque psoriasis were enrolled in the study (first regime). Three different psoriatic lesions were treated with the 308-nm excimer laser, the 308-nm excimer lamp or 311-nm narrowband UVB three times per week. UVB doses were increased slowly and stepwise (1, 1, 2, 2, 3, 3, ...multiple MEDs). Sixteen patients were enrolled in the second regime. Two plaques were treated with the 308-nm excimer laser or with the 308-nm lamp with an accelerated scheme (2, 2, 4, 4, 6, 6, ...multiple MEDs) three times per week. We increased the UVB doses every second treatment (first and second regime) during the whole treatment. If blistering occurred, the blistered plaque was not treated on the next scheduled treatment. At every third visit and 1, 2 and 4 months after the last treatment a Psoriasis Severity Index (PSI) score was assigned in both regimes. RESULTS: Using Friedman analysis, the PSI scores did not show a statistically significant difference (P > 0.05) comparing 308-nm laser therapy, 308-nm lamp therapy and 311-nm narrowband therapy after 10 weeks in the first regime. The mean number of treatments to achieve clearance was 24. With the accelerated scheme, clearance could be achieved with fewer treatments and with half the cumulative dose of the first regime. Nevertheless, the side-effects such as blistering and crusting were also increased. CONCLUSIONS: Both 308-nm light sources can clear patch psoriasis in a similar manner to standard phototherapy, with the advantage of the ability to treat exclusively the affected skin and with a reduced cumulative dose, thus perhaps reducing the long-term risk of carcinogenicity.     

Treatment of pulsed dye laser-resistant port wine stain birthmarks

The concept of selective photothermolysis with the 577-/585-nm pulsed dye laser (PDL) revolutionized treatment of relatively common port wine stain (PWS) birthmarks. The majority of PWS can be significantly lightened with the PDL. However, few PWS are lightened completely with PDL and up to 20% hardly lighten at all. PDL-resistant PWS exist in any large cutaneous laser practice and constitute a difficult management problem. This article discusses the proposed cause, and currently available and emerging options for PDL-resistant PWS. These include higher power, longer wavelength, variable pulse width lasers with selective epidermal cooling such as 595-nm PDL, 755-nm alexandrite, 810-nm diode, 1064-nm neodymium:yttrium-aluminum-garnet, and intense pulse light systems. Other promising modalities include topical and systemic photodynamic therapy, electrical optical synergy technology, pulse stacking of similar or differing wavelengths, use of optical clearing agents in conjunction with laser, and erbium laser epidermal stripping before laser treatment.     

强脉冲光及595nm染料激光治疗面部痤疮后红斑自身对比研究

目的 评价及对比强脉冲光和595 nm染料激光治疗痤疮后红斑的临床疗效及安全性.方法 采用随机自身左右面部对照临床试验研究方法,选取20例患有痤疮后红斑的患者,每例患者的两侧面颊随机分配接受强脉冲光或595 nm染料激光治疗3次,每次间隔4周.分别在每次治疗前以及最后1次治疗1个月后使用VISIA拍照,测量红斑值;通过四分红斑严重程度表评价治疗前后双侧面部红斑严重程度.每次治疗后均填写疼痛评分表、不良反应记录表,最后1次随访通过问卷形式对患者进行满意度调查.结果 强脉冲光侧平均红斑值治疗前472.25±86.02,治疗后357.15±82.71;595 nm染料激光侧治疗前476.40±74.25,治疗后360.05±64.83,经重复测量资料方差分析,可以认为随治疗时间延长,患者红斑值有所降低(F=197.666,P＜0.001);强脉冲光侧治疗效果优于595 nm染料激光侧(F=1 173.909,P＜0.001).强脉冲光侧治疗前后四分红斑值差异有统计学意义(Z=28.735,P＜ 0.001),595 nm染料激光侧差异亦有统计学意义(Z=31.450,P＜0.001).激光术后VAS视觉评分发现,595 nm染料激光治疗侧疼痛度低于强脉冲光,两者差异有统计学意义(t=2.468,P＜0.05).评价满意和非常满意的患者595 nm染料激光17例,强脉冲光15例,两组差异无统计学意义(Z=2.696,P＞0.05).强脉冲光不良反应包括红斑、灼烧感、紧绷感、水疱、色素沉着,595 nm染料激光不良反应包括红斑、紫癜反应,均在数小时至数天消失.结论 应用强脉冲光及595 nm染料激光治疗痤疮后红斑均安全有效,适合临床推广应用,强脉冲光相较于595 nm染料激光疗效更优,但疼痛度更高.     

Comparison of pulsed dye laser versus combined pulsed dye laser and Nd:YAG laser in the treatment of inflammatory acne vulgaris

Background: Both pulsed dye laser and combined 585/1064-nm (sequential dual-wavelength PDL and Nd:YAG) laser improves inflammatory skin disorders including acne vulgaris. Objective: To compare the efficacy of 585-nm pulsed dye laser versus sequential dual-wavelength PDL and Nd:YAG in treatment of acne vulgaris. Patients and method: Thirty patients with acne vulgaris were treated by PDL alone on half of the face while contra lateral half was treated by combined 585/1064 nm laser. Results: The study showed that inflammatory acne lesions count was significantly reduced by 82.5% (p 0.0001) on PDL sides and by 83.5% (p 0.00001) on combined 585/1064-nm side after 8 weeks, while reduction of non-inflammatory acne lesions was observed at 8 weeks by 58.4% and 71.5% respectively. However, difference between the two modalities was not statistically significant. Conclusion: PDL and combined PDL/Nd:YAG laser treatment were found to be an effective, safe and well-tolerated treatment option for inflammatory and non-inflammatory acne vulgaris.