Depends on the size of your tank. I mean most nanos don't require either but if your tank is bigger then while they aren't ABSOLUTELY necessary they will lessen the nutrients quite dramatically. Refugiums and skimmers work at end and beginning of the nitrogen cycle respectively. The skimmer will remove DOCs (dissolved organic compounds) that will later become nitrates however your tank will have nitrates and phosphates added to it via food and the skimmer has no impact on any of these. This is where the refugium comes in with macroalgae as these absorb phosphates and nitrates from the water column in order to grow thereby lowering levels. Macroalgae in a refugium is not going to reduce DOCs though, in actual fact they really dislike DOCs and other particulates building up on their surface. I think skimmers and refugium with macros are complementary techniques to maintain 'ideal' water parameters, whether you have both, either-or is really up to you.
Hope this helps
Regards