Preliminary experience of the Q‐switched 1064‐nm neodymium:yttrium aluminum garnet laser in the treatment of Café‐au‐lait macules

Yuan, Lin; Liu, H.X.; Shi, Wenhao; Wang, H.X.; Geng, Jianhui; Guo, Xiaojie; Wang, J.L.; Zhang, F.R.

doi:10.1111/jdv.15364

Cited by 3 publications

(4 citation statements)

References 9 publications

(10 reference statements)

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“…17 Several studies have reported the use of the LFQS 1064-nm laser in the treatment of CALMs with good results and low side effects (Supporting Information: Table 2). [8][9][10][11][12] This prospective, self-controlled study confirmed that the overall effectiveness of LFQS 1064-nm laser and conventional HFQS 755-nm laser in the treatment of CALMs within 3 months were not significantly different. But 11 lesions treated with LFQS 1064-nm laser and 7 treated with HFQS 755-nm laser were included in the Tertile 3 group (3.67 ≤ VAS ≤ 4), suggesting that within 3 months, the LFQS 1064-nm laser may help more patients achieve the top-third of efficacy.…”

Section: Discussionsupporting

confidence: 65%

“…They used low fluence 1064‐nm Q‐switched Nd: YAG laser multiple times to improve photoaging skin 17 . Several studies have reported the use of the LFQS 1064‐nm laser in the treatment of CALMs with good results and low side effects (Supporting Information: Table ) 8–12 …”

Section: Discussionmentioning

confidence: 99%

“…In 2009, Kim first used LFQS 1064‐nm laser to successfully treat a patient with CALM that could not be effectively removed by previous laser, grinding, and bleaching treatments 7 . Since then, several studies have reported the good effect and low recurrence rate (0%−24.1%) of the LFQS 1064‐nm laser in the treatment of CALMs 8–13 . However, the most popular lasers used currently are the QS 755‐nm laser and QS 532‐nm laser.…”

Section: Introductionmentioning

confidence: 99%

“…7 Since then, several studies have reported the good effect and low recurrence rate (0%−24.1%) of the LFQS 1064-nm laser in the treatment of CALMs. [8][9][10][11][12][13] However, the most popular lasers used currently are the QS 755-nm laser and QS 532-nm laser. Our study confirmed these had similar efficacy.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the safety and efficacy of low fluence Q‐switched 1064‐nm and conventional Q‐Switched 755‐nm lasers in the treatment of café‐au‐lait macules: A prospective self‐controlled trial

et al. 2022

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Background Conventional high fluence Q‐switched (HFQS) Alexandrite 755‐nm are widely used in clinical café‐au‐lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q‐switched (LFQS) Nd: YAG 1064‐nm lasers. Objective To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs. Methods Within 3 months, 20 patients underwent prospective self‐controlled split‐lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow‐up visit. Patient and physician preferences for laser selection were also recorded. Results The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82−2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment. Conclusions The efficacy difference between the LFQS 1064‐nm laser and HFQS 755‐nm laser in treating CALMs in a 3‐month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of the safety and efficacy of low fluence Q‐switched 1064‐nm and conventional Q‐Switched 755‐nm lasers in the treatment of café‐au‐lait macules: A prospective self‐controlled trial

et al. 2022

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Comparison of the efficacy and safety between a low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser and a conventional Q-switched 532-nm laser for the treatment of cafe-au-lait macules in 40 Chinese children: a prospective, randomized, parallel-controlled, evaluator-blinded trial

et al. 2021

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Laser treatment for Cafe-au-lait Macules: a systematic review and meta-analysis

Guo

Wang

et al. 2023

Eur J Med Res

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Nowadays, laser is the mainstay treatment for cafe-au-lait macules (CALMs), but no systematic review has been published to demonstrate the overall efficacy and it’s still controversial which type of laser is optimal. Thus, we conduct the meta-analysis to evaluate the effectiveness and side effects of various types of lasers in treating CALMs. Original articles reporting the efficacy and side effects for CALMs in laser treatment were identified in PubMed, EMBASE, and Web of Science from 1983 to April 11, 2023. Using R software and the ‘meta’ package, meta-analysis was conducted for clearance and recurrence for evaluation of efficacy. And the occurrence of hypopigmentation and hyperpigmentation rate was pooled for safety evaluation. We used RoB2 and ROBINS-I tools to assess the risks of bias in RCT studies and non-RCT studies, respectively. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the quality of the evidence. Nineteen studies involving 991 patients were included, which had a very low to moderate quality of evidence. The pooled 75% clearance rate was 43.3% (95% CI 31.8–54.7%, I2 = 96%), 50% clearance rate was 75% (95% CI 62.2–85.9%, I2 = 89%) and the recurrence rate was 13% (95% CI 3.2–26.5%, I2 = 88%). The pooled hypopigmentation and hyperpigmentation rates were 1.2% (95% CI 0.3–2.1%, I2 = 0%) and 1.2% (95% CI 0.3–2%, I2 = 0%), respectively. Subgroup analysis revealed that QS-1064-nm Nd:YAG laser treatment not only achieved more than 75% clearance rate in 50.9% of patients (95% CI 26.9–74.4%, I2 = 90%) but also resulted in the lowest hypopigmentation and hyperpigmentation rate of 0.5% (95% CI 0.0–2.5%, I2 = 26%) and 0.4% (95% CI 0.0–2.5%, I2 = 0%). To draw a conclusion, the laser treatment could reach an overall clearance rate of 50% for 75% of the patients with CALMs, for 43.3% of the patients, the clearance rate could reach 75%. When looking at different wavelength subgroups, QS-1064-nm Nd:YAG laser exhibited the best treatment capability. Laser of all the wavelength subgroups presented acceptable safety regarding of the low occurrence of side effects, namely, hypopigmentation and hyperpigmentation.

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Preliminary experience of the Q‐switched 1064‐nm neodymium:yttrium aluminum garnet laser in the treatment of Café‐au‐lait macules

Abstract: Figure 1 (a) A 7-year-old male before the treatment with the Q-switched 1064 nm Nd : YAG laser (b) after 2 treatments (c) A 1-year-old male before treatment and (d) after 4 treatments.

Cited by 3 publications

References 9 publications

Comparison of the safety and efficacy of low fluence Q‐switched 1064‐nm and conventional Q‐Switched 755‐nm lasers in the treatment of café‐au‐lait macules: A prospective self‐controlled trial

Comparison of the safety and efficacy of low fluence Q‐switched 1064‐nm and conventional Q‐Switched 755‐nm lasers in the treatment of café‐au‐lait macules: A prospective self‐controlled trial

Laser treatment for Cafe-au-lait Macules: a systematic review and meta-analysis

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