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Low-fluence Q-switched neodymium-doped yttrium aluminum garnet (1,064 nm) laser for the treatment of facial melasma in Asians.

AbstractBACKGROUND:
Pigment lasers have been used in melasma with unsatisfactory results.
OBJECTIVE:
To determine the effectiveness and safety of 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS-Nd:YAG) laser treatment of melasma in Asians.
MATERIALS AND METHODS:
Split-face randomized study comparing combination QS-Nd:YAG laser and 2% hydroquinone with topical treatment in dermal or mixed-type melasma. Twenty-two patients were treated with 1,064-nm QS-Nd:YAG laser, 6-mm spot size, 3.0- to 3.8-J/cm(2) fluence for five sessions at 1-week intervals. Pigmentation was objectively recorded using a colorimeter (lightness index score), and subjective assessments were evaluated using the modified Melasma Area and Severity Index (mMASI) score.
RESULTS:
After five laser treatments, statistically significant improvement of melasma from baseline was observed in colorimeter (p<.001) and mMASI score (p<.001) on the laser side. The laser side achieved an average 92.5% improvement in relative lightness index and 75.9% improvement in mMASI, compared with 19.7% and 24%, respectively, on the control side (p<.001). Mottled hypopigmentation developed in three patients. During follow-up, four of 22 patients developed rebound hyperpigmentation, and all patients had recurrence of melasma.
CONCLUSION:
QS-Nd:YAG laser treatment for melasma in Asians produced only temporary improvement and had side effects. Common complications were hypopigmentation, melasma recurrence, and rebound hyperpigmentation.
AuthorsPenpun Wattanakrai, Ratchathorn Mornchan, Sasima Eimpunth
JournalDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 36 Issue 1 Pg. 76-87 ( 2010) ISSN: 1524-4725 [Electronic] United States
PMID20298254 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Dermatologic Agents
  • Hydroquinones
  • hydroquinone
Topics
  • Administration, Topical
  • Adult
  • Asian People
  • Combined Modality Therapy
  • Dermatologic Agents (administration & dosage)
  • Female
  • Humans
  • Hydroquinones (administration & dosage)
  • Lasers, Solid-State
  • Low-Level Light Therapy
  • Male
  • Melanosis (therapy)
  • Middle Aged
  • Skin (drug effects, radiation effects)
  • Skin Pigmentation (drug effects, radiation effects)
  • Treatment Outcome

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