The 755-nm picosecond alexandrite laser with a diffractive lens array effectively treats photoaging in Asian patients but may cause transient adverse effects due to temporary disruption of the skin barrier. This study evaluated the efficacy and safety of a topical integrated skincare regimen containing CE Ferulic serum, Discoloration Defense (3% tranexamic acid), and Triple Lipid Restore 2:4:2 (CE/DD/242) following treatment with a 755-nm picosecond alexandrite laser with a diffractive lens array (DLA) in an Asian population. This single-center, randomized, evaluator-blinded, split-face controlled study enrolled 35 patients aged 25-63 years with facial photoaging. Each patient underwent three laser treatment sessions at four-week intervals. Patients applied Phyto Corrective serum and sunscreen to one cheek (control side) and adjunctive CE/DD/242 to the other cheek (treatment side). Clinical efficacy was evaluated using the VISIA® Complexion Analysis System, the FocuSkin® Skin Analyzer, and a participant satisfaction questionnaire. Self-reported redness or swelling was recorded by telephone follow-up. Laser treatment significantly improved pores (p=0.0011), brown spots (p=0.0003), and skin moisture (p=0.0001). Adjunctive integrated skincare further enhanced wrinkle reduction (adjusted difference - 2.33, p=0.018) and texture improvement (adjusted difference - 0.63, p=0.027). Females over 46 years demonstrated greater wrinkle reduction (p=0.0437), while males showed greater elasticity improvement (p=0.0003). Temporary erythema occurred in 13 of 35 patients, while 18 reported no adverse effects. Patient satisfaction scores were higher on the CE/DD/242 treatment side. The 755-nm picosecond alexandrite laser with a diffractive lens array improves photoaging and overall skin quality. Adjunctive integrated skincare (CE/DD/242) provides synergistic clinical benefits with minimal adverse effects, resulting in greater improvements in wrinkles and skin texture. Evidence obtained from at least one properly designed randomized controlled trial. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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