Journal of Clinical & Experimental Dermatology Research
Open Access

Abstract

Pilot Trial of a New Laser Protocol for Melisma Using Q-Switched Nd: YAG Laser

Dong Yiyun, Zhou Guoyu, Shen Lingyue, Li Pingping and Xu Qing

Background: Low-fluence 1064 nm Q-switched Nd:YAG laser has recently been popular in the treatment of melasma but with dissatisfaction of a high recurrence and adverse effects in our practice. The optimal regime of 1,064- nm QS-Nd:YAG laser in the treatment of melasma is not established. It raises a question as to whether we can explore the possibility of a new treatment model.

Objectives: To establish a new laser regime of treatment using 1064 nm Q-switched Nd:YAG laser of melasma in Chinese patients, which on the hypothesis to decrease the melanosome without destroying the normal balance of production and transportation of melanin.

Materials and Methods: 35 Chinese with melasma were treated with the 1064 nm Q-switched Nd:YAG laser (4-mm spot size, 4.5 J/cm² fluence, one pass) at 4-week interval for an average of 24 months to the entire lesion. Two independent investigators evaluated the results by Modified Melanin Area and Severity Index (mMASI), Derma- Spectrometer of melanin index (MI) and erythema index (EI) at baseline, each session and 8,16 weeks after the completion of the treatment. Patients were asked to rate satisfaction at last visit. All possible side effects were recorded.

Results: The effective rate of patients at 8, 16 weeks follow up was 85.71% (30/35), 88.57% (31/35) compared with the baseline (P<0.01). The mean mMASI score decreased from 17.56 ± 10.74 at baseline to 3.11 ± 2.73 at the last visit. Correspondingly, the mean MI data lowered from (49.04 ± 10.32)% to (34.82 ± 7.70)% at 16-week follow up and showed a statistically decrease (P<0.01). There was no liner correlation between MI and EI. No severe adverse events were observed.

Conclusions: The new approach of 1064 nm Q-switched Nd:YAG laser (4.5 J/cm2, 4.0 mm, one pass) can be effectively and safely used in the treatment of melasma and achieved a marked curative effect. It can supply a good alternative option compared with low fluence laser therapy.