Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet (1,064 nm) Laser for the Treatment of Facial Melasma in Asians

Wattanakrai, Penpun; Mornchan, Ratchathorn; Eimpunth, Sasima

doi:10.1111/j.1524-4725.2009.01383.x

Cited by 209 publications

(248 citation statements)

References 39 publications

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“…In their study all patients had recurrence. 15 Recent reviews on the treatment of melasma with lasers in pigmented skin suggest that it should not be used as a first line treatment but only considered when other treatments have failed. 16 Chemical peels remain popular for the treatment of pigmentation and aesthetic improvement.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of 70% glycolic acid versus Q Switched Nd:YAG laser in the treatment of melasma: acomparative study

et al. 2017

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Background: Melasma is an acquired hypermelanosis characterized by light-to-deep brown pigmentation over cheeks, forehead, upper lip, and nose. Treatment of this condition is difficult and associated with high recurrence rates. Among newer therapies, there is interest in the use of glycolic acid peels and Q-switched Nd:YAG laser (QSNYL). The aim of the present study was to compare the therapeutic efficacy and in melasma. Methods: 60 patients of melasma were included. They were randomly divided in two groups (Group A = 30 patients treated with glycolic acid and Group B = 30 patients treated with QSNYL). Out of the 60 patients included, 26 patients in Group A, 24 patients in Group B completed the study. Response to treatment was assessed using MASI scores. Results: The peak incidence of melasma was seen in the age group 31-40 years. Female preponderance was seen in the study (F: M-6.6:1). Sunlight was the common aggravating factor in both the groups (30%). Malar type was the most common (51.7%) observed in both the groups. MASI scores improved from 7.14 to 4.99 with glycolic acid peel and from 6.17 to 4.67 in the laser group at the end of the study. The common adverse effect observed in the study was erythema in both the groups. Postinflammatory hyperpigmentation was frequent in laser treated patients.Conclusion: 70% Glycolic peels were better than Q switched Nd:YAG laser for the treatment of melasma. Among patients treated with laser postinflammatory hyperpigmentation was a significant side effect especially in darker skin types.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of 70% glycolic acid versus Q Switched Nd:YAG laser in the treatment of melasma: acomparative study

et al. 2017

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“…They concluded that such a laser therapy would induce temporary improvement with undesirable adverse effects. 11 Kroon et al compared 8-week treatment with fractionated nonablative 1550-nm erbium glass laser (held every other week) with 8-week treatment with TTC. Although they found no difference between groups in GPA, selfsatisfaction was significantly higher in those treated with laser.…”

Section: Discussionmentioning

confidence: 99%

Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial

et al. 2017

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Introduction: Ablative and nonablative lasers have been used to treat melasma. We aimed to assess and compare the combining Q-switched Nd:YAG laser (QSNYL) and fractional erbium:YAG laser (FEYL) with QSNYL alone in treatment of melasma. Methods: This randomized controlled clinical trial was performed in our Research Center during 2013-2014. Women with melasma and without a history of keloid formation, hypersensitivity to hydroquinone, or pigmentary changes due to laser therapy were randomly allocated to receive four sessions of either QSNYL-FEYL combination or QSNYL alone. All patients received topical treatment with Kligman's formula. Before laser therapy and 4 weeks after the last treatment session, patients' skin was assessed for changes in skin color, melanin content, and erythema intensity of melasma lesions quantitatively. ; P < 0.001). After adjustment for baseline values, the post treatment intensity of erythema was significantly lower in QSNYL-FEYL group (P < 0.001). The patients reported no adverse events. Conclusion: QSNYL-FEYL was significantly more effective in decreasing melanin content of lesions than QSNYL and led to a lighter skin.

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“…Several studies reported good improvement of melasma [68][69][70][71], especially when patients were pretreated with TCC [72] or when combined with glycolic acid peels [73], IPL [74] or dermabrasion [75]. However, reports of patients developing spotty hypopigmentation, depigmentation, leukotrichia, rebound hyperpigmentation and recurrence of melasma are noteworthy especially with too frequent (weekly) and too many sessions (>6-10) [71,76,77].…”

Section: Other Botanicals As Potential Bleaching Agentsmentioning

confidence: 99%

Melasma, Novel Treatment Modalities

Abdallah¹

2014

Pigmentary Disorders

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Treatment of melasma remains challenging due to frequent relapses and the occurrence of post-inflammatory hyperpigmentation (PIH) following many interventions. Treatment goals are inhibition of melanin synthesis and transfer by sunscreens, sun avoidance and the use of bleaching agents on one hand and removal of already present pigment by peeling, lasers and light on the other hand. Triple combination creams (TCC) (also known as Kligman's formula utilizing hydroquinone and modifications of Kligman's formula) remain the mainstay of treatment. Newer bleaching agents derived from plants and synthetic compounds have been introduced and many of them are promising safe substitutes for hydroquinone.Peeling agents especially superficial and medium depth peels are effective treatment modalities for melasma. Newer peeling agents are less irritating and may thus lead to fewer side effects. Q-switched lasers, which target melanin, have led to PIH until the innovation of "laser toning" and fractional Qswitched ruby, which have better outcomes. Fractional non-ablative and ablative lasers are useful at lower fluencies. Pulsed dye laser, which targets the vascular component in melasma, is promising with less melasma rebound.Combinations of the above-mentioned modalities usually have a better treatment outcome than either alone. This review will focus on the more recently introduced therapies.

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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

Abstract: 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.

Cited by 209 publications

References 39 publications

Efficacy and safety of 70% glycolic acid versus Q Switched Nd:YAG laser in the treatment of melasma: acomparative study

Efficacy and safety of 70% glycolic acid versus Q Switched Nd:YAG laser in the treatment of melasma: acomparative study

Combination of Q-Switched Nd:YAG and Fractional Erbium:YAG Lasers in Treatment of Melasma: A Randomized Controlled Clinical Trial

Melasma, Novel Treatment Modalities

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