Hybrid fractional laser facial resurfacing: A comparison between a single treatment at high settings versus multiple treatments at low to moderate settings

Objectives: Fractional laser treatments for facial skin rejuvenation is an evolving field with the increase of innovative technologies. Typically, better results are achieved by using more aggressive approaches although this is accompanied by an increased risk. The demand for a modality that combines efficacy with minimal downtime and risk of adverse events led to the development of a hybrid laser, which delivers a fractional treatment of ablative CO₂ and nonablative 1570 nm lasers, simultaneously. This study compares the clinical results, side effects, and downtime profile of the hybrid laser in multiple low-to-moderate-setting treatments versus a single high-setting treatment in the facial area. Materials and Methods: This retrospective single-center study included 44 patients who underwent 1–3 treatments with the hybrid laser for facial rejuvenation between the years 2020–2022. The patients were divided into two groups based on the number of treatments they had received (Group A; single high-setting treatment, Group B; 2–3 low-to-moderate setting treatments). Three independent nontreating physicians evaluated the objective improvement by assessing the patients' standardized clinical photographs before and after the treatments, using three different scales. Treatment data, adverse events, and patients' satisfaction in each group were also reviewed. Results: A superiority to 2–3 low-to-moderate setting treatments (Group B) was found in most of the evaluated scales. Patients' satisfaction was significantly higher in Group B, and the average downtime was significantly lower: 4.3 ± 1.6 days versus 7.3 ± 2.3 days in Group A. The expected treatment effects were significantly milder in severity in Group B as graded by the patients, and no adverse events were reported in this group. An average overall improvement of 51%–75% according to Global Esthetic Improvement Scale (GAIS) was found in both groups. Conclusions: The new hybrid laser generates remarkable clinical outcomes in facial rejuvenation. Performing several treatments at mild to moderate settings can lead to a safer and more favorable procedure while maintaining high efficacy and achieving higher patients' satisfaction.