Ablative fractional CO₂ laser is an established tool for dermatologic and aesthetic indications. Non-ablative wavelengths, such as 1540 and 1570 nm, are increasingly being combined with CO₂ laser to optimise the results while reducing the recovery time. A narrative review of the literature was conducted, including ex vivo, in vivo, and in vitro studies, as well as human clinical trials that evaluated the efficacy, safety, and histological impact of dual-laser systems. Preclinical studies have shown that sequential application of fractional CO₂ followed by 1540/1570 nm expands the thermal coagulation zone without increasing the ablation depth. At the histological level, the dual protocol promotes collagen remodelling with greater thermal precision. On a clinical level, a combined treatment has shown efficacy in improving scars, striae distensae, skin laxity, and wrinkles, with reduced recovery times compared to CO₂ monotherapy. Preliminary data also suggest potential benefits in inflammatory conditions such as hidradenitis suppurativa. The sequential CO₂ + 1540/1570 nm combination represents an effective and well-tolerated approach in regenerative dermatology. Current evidence supports its use as a versatile, safe, and reproducible technique for skin rejuvenation and scar modulation; however, further comparative studies are needed to standardise protocols.

Cosmetic dermatology increasingly utilizes laser technologies to address various aesthetic concerns. This study evaluates the efficacy of the flash-lamp pulsed-dye laser (FPDL) in treating vascular and scar-related conditions. A cohort of 71 patients with diverse vascular lesions, including facial telangiectasia, port-wine stains (PWSs), striae rubrae, erythematous acne scars, facial traumatic scars, and keloids, was treated using the FPDL (Synchro Vas-Q, Deka MELA). Treatment protocols varied based on lesion type, with sessions ranging from one to eight at intervals of four to eight weeks. Clinical outcomes were assessed using a four-point grading scale and patient satisfaction surveys. Results indicated that 70.4% of patients achieved excellent clearance of lesions, while 16.9% and 9.9% showed moderate-good and slight clearance, respectively. Minimal or no improvement was observed in 2.8% of cases. High patient satisfaction was reported, correlating with effective lesion reduction and manageable side effects, primarily post-operative purpura. The study underscores FPDL’s selective efficacy for hemoglobin-rich lesions and its safety profile, advocating for its continued use in cosmetic dermatological practices. These findings contribute to the growing evidence supporting laser therapy as a pivotal tool in aesthetic medicine, emphasizing the importance of tailored treatment protocols and patient education for optimal outcomes.

Laser-assisted exosome delivery (LAED) combines ablative fractional lasers with immediate topical application of exosomes. Here, we introduce the LAED concept and report two uncontrolled feasibility observations: a 62-year-old man with atrophic acne scars and a 68-year-old woman with diffuse dyschromia underwent fractional CO₂ laser treatment followed by topical exosomes. Both cases showed early, encouraging signals of clinical improvement and shorter downtime, with good tolerability. An exploratory day-7 patient self-evaluation using a 5-point Likert scale for speed/comfort of recovery yielded 5/5 in both cases. Given the two-case, non-comparative design, causality cannot be inferred, and efficacy remains hypothesis-generating. These preliminary findings motivate controlled trials with standardized objective and patient-reported measures and longer follow-up to determine whether LAED truly enhances the cosmetic benefits of fractional laser treatment.

Skin scars represent a complex therapeutic challenge, with significant functional, aesthetic, and psychological implications. Despite advances in laser therapy, monotherapy has significant limitations, particularly for patients with complex scars with atrophic, hypertrophic, vascular, and pigmentary components. The combined use of multiple laser sources, in sequential or simultaneous mode, allows for the selective targeting of specific tissue components and improves clinical efficacy while maintaining a good safety profile. This narrative review critically analyses the available evidence on combination therapies for atrophic, hypertrophic, keloid, and post-surgical and burn scars. Protocols combining ablative lasers (CO₂, Er:YAG), non-ablative lasers (1540–1550 nm), vascular lasers (PDL, Nd:YAG) and intense pulsed light (IPL) are reported. Possible integrations with adjuvant techniques, such as radiofrequency, platelet-rich plasma (PRP), and laser-assisted drug delivery, are also mentioned as areas for future development. The available data suggest a promising role for multimodal strategies, but the literature remains limited by small cohorts, heterogeneous protocols, and short follow-up periods. Although adverse events are generally mild and transient, typically involving erythema, oedema, or temporary dyschromia, an awareness of safety considerations remains essential, particularly in higher phototypes and when using ablative modalities. Further prospective and multicentre studies are needed to define standardised protocols and consolidate the role of combination therapies in the management of scars.

Background/Objectives: Rhinophyma, an advanced form of rosacea, is characterized by significant nasal tissue enlargement and deformation, leading to aesthetic and psychosocial challenges. Traditional treatments are often invasive with variable outcomes, emphasizing the need for improved therapeutic approaches. This study evaluates the efficacy of a dual-laser therapy (CO₂ and dye lasers) in treating rhinophyma. An innovative diagnostic algorithm using multispectral imaging guided treatment decisions, while Optical Coherence Tomography (OCT) was utilized to analyze post-treatment vascular and collagen changes. Methods: A prospective study was conducted involving 20 patients with rhinophyma. Multispectral imaging was used to guide the tailored application of CO₂ laser, dye laser, or both, depending on the predominant vascular or glandular components in the nasal tissue. Post-treatment analysis employed OCT to assess changes in vascular and collagen density, providing insights into the tissue modifications induced by laser therapy. Results: The treatment significantly reduced vascular density from 35,526.75 to 26,577.55 at 300 microns and from 46,916.25 to 35,509.25 at 500 microns. Collagen density decreased from 81.35 to 66.34. All reductions were statistically significant, with highly significant p-values. These findings highlight the dual-laser therapy’s effectiveness in addressing the pathological features of rhinophyma. Conclusions: Dual-laser therapy guided by multispectral imaging provides a targeted and effective treatment for rhinophyma, addressing its vascular and glandular components. The use of OCT enhances understanding of laser-induced tissue changes and confirms significant reductions in vascular and collagen density. This approach represents a significant advancement in the management of rhinophyma, offering improved precision and therapeutic outcomes.

Background: Acne vulgaris is a multifactorial disease with significant clinical and psychosocial impacts. Methods: The purpose of this study was to evaluate the efficacy of a combination therapy including oral isotretinoin and a non-ablative 675 nm red-light laser compared with laser monotherapy. Thirteen young patients with active facial acne of varying severity were enrolled and divided into two groups: Seven subjects received laser monotherapy treatment (RT group), while six underwent combined laser and isotretinoin therapy (RTI group). The laser protocol consisted of six weekly sessions, with a 5-point pain scale used to monitor tolerability. Standardized photographs were obtained at baseline and at a 3-month follow-up after the last treatment. Each patient completed the Acne Radar Questionnaire, and lesion severity was assessed using the Global Evaluation Acne (GEA) scale. Results: All patients completed the study without adverse events. Scores from the Acne Radar Questionnaire improved in both groups, while the GEA scale demonstrated a significant reduction in lesion severity, confirmed by photographic comparison. Pain was reported as mild in most cases, and no discontinuations occurred. Conclusions: These findings indicate that the 675 nm laser is a safe and effective therapeutic option for acne vulgaris, with isotretinoin addition resulting in more rapid and pronounced clinical improvement.