Efficacy and Safety of 1064‐nm Nanosecond Laser Modalities (Q‐NDY and MDF Handpieces) for Treating Hand Skin Aging: A Prospective Randomized Controlled Trial

Background and Objectives: Hand aging is complex, and while laser treatments effectively address pigmentation, their precise impact on skin thickness and wrinkles remains unclear. This study evaluates the effects of two 1064‐nm nanosecond laser modalities (Q‐switched Nd:YAG laser (Q‐NDY) and multidepth fractional laser (MDF)) on hand skin rejuvenation and safety. Materials and Methods: A randomized controlled trial involving 20 patients with hand aging signs was conducted. Participants were randomized to the Q‐NDY or MDF group, receiving three treatments at four‐week intervals, followed by a three‐month follow‐up. Outcomes were evaluated by two independent plastic surgeons using an observer‐reported scale. Skin physiology (thickness, melanin, and erythema indices) was measured, and patient satisfaction was assessed using the patient satisfaction scale (PSS). Results: Both modalities improved pigmentation and reduced wrinkles. The MDF group showed significantly greater improvement in fine wrinkles ( p = 0.0086) and skin texture ( p = 0.0209) and a significant increase in skin thickness ( p < 0.01), whereas the Q‐NDY group did not. Melanin and erythema indices decreased significantly by week 20, with a greater reduction in erythema in the MDF group ( p = 0.021). Overall satisfaction was 75% for Q‐NDY and 90% for MDF. Conclusion: Both 1064‐nm nanosecond laser modalities rejuvenate hand skin. The MDF mode showed superior outcomes in wrinkle reduction, skin texture, and thickness, offering a safe and effective treatment option for hand rejuvenation. Trial Registration: Chinese Registry of Clinical Trials: MR‐31‐23‐013044