Introduction: Pigmentary changes can be bothersome and affect one’s well-being. Laser therapy has been shown to effectively treat such skin discolouration. We aimed to assess the utility of a 755 nm alexandrite laser in pigmented lesions removal. Materials and methods: A total of 109 patients aged 44.17 ± 8.2 years were enrolled and underwent laser treatment of facial skin hyperpigmentation. The efficacy was analysed on the basis of photographic diagnosis using the VISIA Complexion Analysis System. The following measures were assessed: (1) score; (2) feature count; (3) comparison figure. Results: A single laser treatment significantly improved the size and area of the lesion and decreased the number of lesion features. Parallelly, the overall skin condition significantly improved (p < 0.05). We found a statistical tendency of a higher feature count baseline, thus its change in men (p = 0.05 and 0.07, respectively), but failed to find any statistically significant associations (p > 0.05) between tested measures and skin phototypes and hyperpigmentation types. Age was also not correlated with the laser efficacy (p > 0.05). Conclusions: The use of the 755 nm laser is effective in reducing pigmented lesions.

Objectives: The increasing demand for aesthetic medical treatments has led to advancements in laser therapies, particularly for pigmented and vascular facial lesions. This study compares the efficacy of 532 nm and 755 nm lasers for treating facial pigmented and vascular lesions. Methods: Data extraction was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Primary outcomes included the (i) improvement and (ii) pain sensation. Secondary outcomes included the occurrence of adverse events. A random-effects meta-analysis was conducted for outcomes where two or more studies provided data. Continuous outcomes were analyzed using pooled standardized mean differences, while nominal outcomes were assessed using pooled risk ratios in endpoints, using observed cases only. Results: A total of 16 studies involving 509 participants were included. No significant difference in overall improvement between the 532 nm and 755 nm lasers was found. Subgroup analysis showed a slight advantage in the 755 nm group for lesion improvement (RR = 1.512, 95% CI [1.070, 2.136], p = 0.019). Adverse event occurrence was minimal, with no significant differences between the laser types, however the pain score was higher for the 532 nm laser (SMD = −1.336, SE = 0.636, 95% CI [−2.582, −0.09], p = 0.036). No publication bias with respect to any evaluated intervention was detected. Conclusions: This meta-analysis concludes that both 532 nm and 755 nm lasers are effective in treating facial pigmented and vascular lesions, with the 755 nm laser showing a slight advantage and the 532 nm one producing more painful experiences but fewer adverse events in the case of vascular lesions.