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The 1,444 nm wavelength is also well absorbed in water making it a possible setting for treatment of cystic lesions such as eccrine hydrocystomas and syringomas.The authors aimed to investigate the efficacy of an externally used 1,444 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of periorbital syringomas.Nineteen patients with periorbital syringomas were treated twice with the externally used 1,444 nm Nd:YAG laser at 2-month intervals. Laser fluences were delivered to each papule with pulse energy of 160 mJ, 1.6 W of power, and at a 10 Hz pulse rate. Clinical improvement and patient satisfaction were assessed at 2 and 6 months after each treatment. Side effects were also examined.Clinical improvement of >50% was observed in 68.4% of individuals at 2 months after first treatment (2FT) and in all patients at 6 months after second treatment (6ST). Patient satisfaction of no less than “satisfied” was recorded for 63.2% of patients at 2FT, and in 89.5% of patients at 6ST. Erythema was observed in 63.2% of patients but only at 2FT.Externally used 1,444 nm Nd:YAG laser treatment may represent an effective and safe approach for the treatment of periorbital syringomas, resulting in good satisfaction and minimal side effects.