Melasma treatment with a 1064 nm, picosecond‐domain laser with a fractionated multibeam lens array

Abstract

Background and ObjectivesPicosecond‐domain lasers have been fitted with fractionated optics for dermal remodeling. This study evaluates the safety and efficacy of a multiwavelength picosecond‐domain laser, using a 1064 nm multibeam lens array, for improving the appearance of melasma.Study Design/Materials and MethodsTwenty adults with a clinical diagnosis of melasma were enrolled and received 4 monthly 1064‐nm, 450 ps laser treatments delivered with a 10 × 10 fractional array of 150 µm microbeams. Cosmetic units with melasma were treated with fluences ranging from 1.7 to 2.9 mJ/microbeam with a repetition rate of 6 Hz. Treatment effect was evaluation of digital images by dermatologists blinded as to the treatment conditions, comparing baseline and 3‐ and 8‐month post‐treatment images. Modified melasma area and severity index (mMASI) scores were determined by the study investigator based on clinical photography. Subject self‐assessment of treatment effects was also recorded.ResultsBlinded reviewers correctly identified the post‐treatment image in 16 of the 20 image sets (80%). Ratings demonstrated statistically significant (p < 0.001) improvement on an 11‐point scale at both the 3‐ and 8‐month timepoints for a mean improvement of 3.7 point (range −8 to 10) or 37% improvement at the 3‐month follow‐up, and 2.7 (range −8 to 9) or 27% at the 8‐month follow‐up for all subjects. The average mMASI score showed highly significant reduction at both the 3‐ and 8‐month follow‐ups compared to baseline (p < 0.01). Most subjects (90%) were satisfied with the treatment outcome in melasma at both follow‐ups, which is consistent with the treatment outcome and mMASI scores.ConclusionThe fractionated, picosecond‐domain, 1064 nm laser is safe and effective for improving melasma and should be considered as an adjunct to topical treatment regimens and sun‐protection for management of melasma.

Comments on “Melasma treatment with a 1064 nm, picosecond‐domain laser with a fractionated multibeam lens array”

“…The authors declare no conflict of interest. Manoj Pawar MD 1 Assel Satvaldinova MD 1 Mehak Singh MD…”

“…We read with great interest the nicely written article by Bernstein E et al 1 on-picosecond laser in melasma. We have been also practicing with the same laser i.e.…”

Combining large‐spot low‐fluence 1064‐nm and fractional 1064‐nm picosecond lasers for promoting protective melanosome autophagy via the PI3K/Akt/mTOR signalling pathway for the treatment of melasma

“…The picosecond laser also has a 1064-nm wavelength and a large spot of >6 mm; therefore, we found that adopting a combination of large-spot lowfluence 1064-nm and fractional 1064-nm picosecond lasers to treat melasma is relatively safe and effective, which has been reported in many studies. 13,14 Picosecond lasers mainly produce photoacoustic effects, and the 'subcellular selective photothermal effect' has not been demonstrated in the treatment of melasma; therefore, we aimed to determine the mechanism by which picosecond lasers promote melanin metabolism for treating melasma.…”